CMS Archives - Employee Benefits I AP Benefit Advisors

CMS FAQs on Essential Health Benefits and COVID-19

The Centers for Medicare & Medicaid Services (CMS) released a list of frequently asked questions (FAQs) on Essential Health Benefit (EHB) coverage and the Coronavirus (COVID-19). Under the Affordable Care Act (ACA), EHB reflects the scope of benefits covered by a typical employer and covers at least 10 specified categories of items and services. CMS’ FAQs: 1.Does […]

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Rx Plans May Exclude Value of Drug Manufacturers’ Coupons Until Further Notice

The DOL, HHS, and IRS have jointly issued an FAQ addressing whether health plans must count drug manufacturers’ coupons toward the annual cost-sharing limits under the Affordable Care Act (ACA). (Note:  these limits apply to non-grandfathered group health plans, including self-insured and insured small and large group market health plans.) Regulations that announced the 2020 […]

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Upcoming Filing Deadlines: Annual Prescription Drug Notice, HIPAA Breach Report & ACA Reporting

As we head into the last couple days of February, we want to take this opportunity to remind employers about the following upcoming filing deadlines: Annual Prescription Drug Notice Group health plans must notify the Centers of Medicare and Medicaid Services (CMS) each year regarding whether the group health plan’s prescription drug coverage offered to […]

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Annual Filing Reminders

As we head into the last few weeks of February, we want to take this opportunity to remind employers about the following upcoming annual filing deadlines: Annual Prescription Drug Notice Group health plans must notify the Centers for Medicare and Medicaid Services (CMS) each year regarding whether the group health plan’s prescription drug coverage offered […]

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Year End Compliance Requirements & Deadlines

Key benefit requirements and deadlines for 2016. September Summary Annual Report (SAR) – A narrative summary of your Form 5500, including a statement of the right to receive the annual report, must be distributed to plan participants by the last day of the ninth month following the end of the plan year, by September 30th […]

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Women’s Preventive Services Coverage and Non-Profit Religious Organizations

The US Department of Labor, EBSA (Employee Benefits Security Administration) has posted some new information. Most health plans are required to cover certain recommended preventive services, including certain women’s preventive health services, without charging cost sharing, like a co-pay, co-insurance, or deductible. The independent Institute of Medicine (IOM) provided recommendations to the Department of Health […]

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Exchanges Gear Up for 2015

by Allison Bell, LifeHealthPro.com The U.S. Department of Health and Human Services and state agencies are already starting to issue regulations and guidelines for the 2015 public exchange program. Many states have had trouble getting 2014 exchange enrollment systems to work properly. Oregon, for example, has not yet completed work on its enrollment site, and […]

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HHS Issues New Sample HIPAA Privacy Notices

HHS’ Office for Civil Rights (OCR) and Office of the National Coordinator (ONC) for Health Information Technology have collaborated to develop model Notices of Privacy Practices (NPPs) for health care providers and health plans to use to communicate with their patients and plan members. The HIPAA Privacy Rule gives individuals a fundamental right to be […]

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