24 pages. "This report sets forth by HIOS ID and state market risk pool the applicable adjustments to 2021 benefit year risk adjustment state transfers based on the 2021 benefit year HHS-RADV results.... These HHS-RADV adjustment amounts will be collected ... in the fall of 2023[.]" [Also available: Appendix A: Issuer-Specific 2021 HHS-RADV Adjustments to 2021 Risk Adjustment State Transfer for Non-Merged Market States (XLSX); Appendix B: Issuer-Specific 2021 HHS-RADV Adjustments to 2021 Risk Adjustment State Transfers for Merged Market States (XLSX); Appendix C: HHS-Operated Risk Adjustment Program State-Specific Data (XLSX)]  MORE >>

"If finalized, the changes may require many employers to modify certain plan designs and administrative processes. In particular, employers could no longer offer a preventive services plan and a group hospital fixed-indemnity plan to the same group of employees."  MORE >>

"The guidance proposes [1] changes to what qualifies as short-term, limited-duration insurance, [2] amendments to the requirements for independent, non-coordinated coverage, and fixed indemnity insurance to be considered an 'excepted benefit', and [3] clarifications of the tax treatment of fixed amount benefit payments under employment-based accident and health plans.... By clarifying the limitations of these types of coverage and the corresponding tax treatment, the agencies hope to make it harder to market these types of policies as comprehensive healthcare coverage or as a valid tax-avoidance arrangement."  MORE >>

"A recent string of lawsuits, regulatory guidance, and market trends have dramatically impacted the types of services that enjoy first dollar coverage under high deductible health plan (HDHP) and health savings account (HSA) offerings. Plan sponsors, third party administrators, and plan service providers should pay special attention to plan designs moving forward to ensure recent events do not ruin HDHP members' ability to make or receive pre-tax contributions into their HSAs."  MORE >>

"The [Civil Monetary Penalty (CMP)] Final Rule authorizes the OIG to impose CMPs against Developers and HIN/HIEs who commit information blocking, with penalties of up to $1 million per violation.... In the preamble to the CMP Final Rule, the OIG notes that information blocking 'poses a threat to patient safety and undermines efforts by providers, payers, and others to make the health system more efficient and effective' and 'may also constitute an element of a fraud scheme, such as by forcing unnecessary tests or conditioning information exchange on referrals.' "  MORE >>

"The program covers up to 12 weeks of paid family leave and 12 weeks of paid medical leave, with a total of no more than 16 weeks of leave allowed in a 12-month period beginning on the first day an employee files for leave. Leave can be taken incrementally in periods of no less than 8 hours."  MORE >>

"Some common, but often not considered, business associates include legal counsel, auditors, billing companies and accountants, copier/printer/scanner vendors, IT contractors, answering services, external benefit call centers, shredding service providers, offsite storage providers, cloud storage services, email encryption services, and web hosts.... [It] is important to review your processes, policies and procedures periodically and consider if you have accounted for all your business associates."  MORE >>

"[Q]questions you may ask about a plan include: [1] Does it require a contract for a specified amount of time? [2] Does the plan have providers as part of its own network? Does it offer psychiatry sessions at an additional cost? [3] Can the plan be purchased as a stand-alone? Or can it be included as a service to augment a more traditional EAP with a wider range of services? [4] Do you need a vendor with a national network?"  MORE >>

"Basic (non-Medicare) plans will increase 10.95% overall. Members enrolled in CalPERS' Basic Health Maintenance Organization (HMO) plans will have an average premium increase of 10.50%. Preferred Provider Organization (PPO) Basic plans will have an overall increase of 12.17%. Medicare plan premiums will rise 9.55% overall."  MORE >>