"The notice must feature the limitations of the coverage to ensure consumers are not mistakenly purchasing fixed-indemnity coverage as an alternative to more comprehensive coverage. The notice must be provided to participants in any marketing, enrollment or reenrollment materials at or prior to enrollment and re-enrollment. The notice must be in at least 14-point font."  MORE >>

"[T]he final rules add a required consumer protection notice be provided to employees in relation to group fixed indemnity excepted benefits coverage, applicable to plan years beginning on or after January 1, 2025. The notice is designed to highlight the differences between fixed indemnity excepted benefits and comprehensive major medical coverage ... Insurers can satisfy this new notice requirement on behalf of the plan sponsor."  MORE >>

"This article examines provisions related to the individual and small group market risk adjustment programs. The final rule continues existing risk adjustment policies for the 2025 benefit year with narrow exceptions, mirroring HHS' original proposals."  MORE >>

20 pages. "The PBM regulatory landscape continues to evolve rapidly at both federal and state levels ... This Winter 2024 update builds on prior issues and highlights federal and state activity from October, November, and December 2023."  MORE >>

"You will find in each section fact sheets, printable resources, checklists, drop-in articles, and more to help meet your needs. In this toolkit, you will learn how to: [1] Cultivate supportive people managers; [2] Develop an employee-driven mental health strategy; [3] Build an impactful mental health employee resource group; [4] Provide and educate employees about benefits and resources; and [5] Find creative ways to think beyond the norms of basic benefits."  MORE >>

"Only 53% of employers offer health coverage, ... and of those that do, just 24% offer HSA-capable coverage.... HSA contributions have remained stagnant, with a mere half of eligibles seeding their HSA, which is unchanged since 2017. Average annual individual contributions actually declined to $1,880 in 2021.... As many as 88% of accounts remained in capital preservation (money market) funds in 2021."  MORE >>

"Federal lawmakers face a year-end deadline to solidify or scuttle an array of covid-era payment changes for telehealth services ... Most of the proposals focus on how Medicare covers telehealth services.... [T]ypically private insurers and some government programs follow Medicare's example. Without congressional action, virtual health care services like audio-only calls or meeting online with specialty doctors -- such as an occupational therapist -- could end."  MORE >>

18 pages. "Amid economic and political uncertainty, many employers are hesitant to put money toward a problem that is only destined to grow worse -- and for many companies, it's becoming harder to avoid passing increased costs on to employees.... [The] highlights of this study ... point to how benefit leaders and employees are confronting the state of healthcare today, revealing where employers can up their game and what cost drivers they can actually control."  MORE >>

"The New York Times investigation found that '[l]arge health insurers are working with a little-known data company to boost their profits, often at the expense of patients and doctors.'... The AHA urges the [DOL] to immediately open an investigation into these practices and hold companies like MultiPlan and its corporate commercial insurer partners to account for these unconscionable practices, distorted incentives, potential violations of ERISA, and ultimately, harms to American patients and employees."  MORE >>