"HHS and NIST issued new guidance to provide information and serve as a resource for HIPAA-regulated entities to improve cybersecurity and compliance with the HIPAA Security Rule. The guidance comes after HHS announced a new carrots-and-sticks strategy to improve cybersecurity in the healthcare industry with additional resources and a proposal to increase civil penalties for data breaches to incentivize security measures."  MORE >>

"Disclosure to CMS involves certifying that your plan's prescription drug coverage is at least as good, actuarially speaking, as the standard coverage offered by Medicare. While this may seem difficult to quantify (and it is!), CMS provides a general basis against which you can measure your plan's coverage to determine whether it is creditable."  MORE >>

"For erroneous elections, the IRS only allows an employer and employee to correct a mistaken election if there is 'clear and convincing evidence' that a mistake has occurred.... Examples may be wrong salary reductions, benefit elections entered into the HRIS/payroll system, or a delay in changing a salary reduction when a change in status occurs."  MORE >>

"[A diagram provides] a visual overview of how the RxDC reporting fits into the larger scheme of health care transparency legislation.... Chief among [the] necessary compliance steps is communicating with carriers and TPAs about how they will assist with detailed reporting requirements, as most, if not all, group health plans will not possess the requisite information on their own."  MORE >>

"While the information contained in an SBC is only a summary and can change, the standardized format makes it easier for people to compare health plans. This resource provides an overview of the layout and key terms used in the Summary of Benefits and Coverage."  MORE >>

"Beginning in the 2023 coverage year, HealthCare.gov reintroduced standardized plan design options, which are labeled 'easy pricing'. These plans are intended to simplify and streamline plan comparison within each metal level ... Every health insurance company offering plans on HealthCare.gov must provide a standardized plan for each metal level, plan type, and service area where they offer non-standardized plans."  MORE >>

"San Francisco contractors and lessees (and their subcontractors and subtenants) may have to provide covered employees health coverage meeting minimum standards or make an alternative payment under the Health Care Accountability Ordinance (HCAO). The Department of Public Health (DPH) has clarified how these standards apply to covered employers. Minimum standards and alternative payments also apply for covered employees at the San Francisco International Airport (SFO) under the Healthy Airport Ordinance (HAO) ... Finally, covered service contractors and airport tenants are subject to minimum compensation rates and time-off requirements under the city’s Minimum Compensation Ordinance (MCO)."  MORE >>

"[T]he Court found that by a simple calendar count, [the claims administrator's] extension request was not timely.  ... The fact that [the administrator] waited 29 days before requesting the independent physician review, and then claimed the need to provide Plaintiff with time to rebut the review were unpersuasive reasons when [the administrator's] own actions caused the need for additional time." [Witt v. Intel Corporation Long-Term Disability Plan, No. 23-01087 (D. Ore. Feb. 16, 2024)]  MORE >>

"[L]evel-funded health plans are steadily gaining ground as a viable middle approach between fully insured health plan and self-funded health plans ... Their growing popularity, however, is now catching the attention of both lawmakers and regulators who are concerned about the lack of regulation that exists between fully insured and self-insured plans, particularly regarding the use of stop-loss insurance."  MORE >>

"The CAP also requires the provider to develop (or update) its HIPAA policies and procedures. As revised, the policies and procedures must address -- at a minimum -- a lengthy set of issues under HIPAA's Privacy and Security Rules[.]"  MORE >>

"On its incident page, Optum listed more than 100 Change Healthcare services that were affected. Among various other core functions being impacted are benefits verification, claims submission and status updates, remittance information transmittal and prior authorization. As of Feb. 25, Optum had not offered new information about the attack nor a timeline for when Change Healthcare's systems will be up and running."  MORE >>

"Setting up a step-by-step method for measuring employee engagement with benefits communication helps you keep track of your progress and quickly bring other team members into the process as your team grows or changes. [1] Evaluate past performance ... [2] Benchmark key metrics ... [3] Identify opportunities for improvement ... [4] Act on key insights."  MORE >>