"This Form 1095-A provides information you need to complete Form 8962, Premium Tax Credit (PTC)."   MORE >>

"With the proposed rules and technical release, the departments aim to promote changes in network composition and plans' and issuers' medical management techniques to make mental health and substance use disorder provider networks more accessible and create parity in treatment limitations, such as network composition standards and prior authorizations, for people seeking mental health and substance use disorder treatment."  MORE >>

"The [DOL] is encouraging plan sponsors to amend their group health plans to extend the period for special enrollment, as many employees will soon lose eligibility for Medicaid and other government health coverage.... According to the DOL, some employees may not even realize that they lost Medicaid or CHIP coverage until they try to access care, since they may have missed notices from their state agency and therefore missed the opportunity to enroll in other coverage."  MORE >>

"Course-corrective measures that companies would be expected to take if they are found to be inadequate include having them add more mental health professionals to their networks and reducing the amount of red tape to get care. The proposed rules will also include specifications on what health plans can and cannot do, explicitly stating companies cannot use 'more restrictive prior authorization, other medical management techniques, or narrower networks' in order to limit mental healthcare access."  MORE >>

"A great deal is riding on whether facilities and providers are participating or nonparticipating for NSA purposes, and whether providers are in or out of network for ACA purposes. If it is possible for a nonparticipating facility to have a participating provider, then there would seem to be a gap in the NSA's protections. In the government's view, this is not possible, so there is no gap."  MORE >>

"Today's proposed rule reinforces MHPAEA's fundamental goal of ensuring that families have the same access to mental health and substance use benefits as they do physical health benefits.... ... Specifically, the proposed rule would: Require health plans to make changes when they are providing inadequate access to mental health care ... Make it clear what health plans can and cannot do.... Close existing loopholes."  MORE >>

"With health care costs rising for the foreseeable future, savvy employers are implementing strategies to ensure their benefits plans are sustainable and valuable to employees. By understanding medical trend and its impact on health plan renewal rates, employers can implement effective strategies to ... manage health care costs. This article explains medical trend and its impact on employers' renewal rates."  MORE >>

"Preliminary estimate based on the 'Description of the Chairman's Mark' posted on July 24, 2023. Subject to revision based on review of legislative language."  MORE >>

"[B]efore plaintiff law firms can translate their success in excessive fee lawsuits from retirement to health plans, they should tap the [brakes] on their expectations with [a recent district court decision], which involved the threshold issue of standing to sue over health plan fees. The New Jersey court's decision ... is a reminder that plan participants do not have standing to sue plan sponsors for purported excessive plan fees when their benefits are not impaired in defined benefit health plans." [Knudsen v. MetLife Group, No. 23-0426 (D.N.J. July 18, 2023);  MORE >>