Articles, News and Information

Second Rx Report Due June 1, 2023

Health plan and health insurance issues must submit their second prescription drug data report by June 1, 2023, as part of the annual reporting requirements. Employers and insurance carriers will generally submit these reports on an annual basis no later than June 1st of each year, reporting information for the prior calendar year.   RxDc…

COVID-19 National and Public Health Emergencies Will Terminate May 11, 2023

While California’s COVID-19 state of emergency ended on February 28, 2023, the national COVID-19 Public Health Emergency is still active and will terminate on May 11, 2023. Consumers impacted by the COVID-19 Public Health Emergency may qualify for Special Enrollment using the “Public Health Emergency” Qualifying Life Event to enroll and make changes to their…

2024 ACA Pay or Play Increasing Penalties

On March 9, 2023, the IRS revised the penalty amounts for the employer shared responsibility (pay or play) rules under the Affordable Care Act (ACA) for 2024. For the calendar year 2024, the adjusted $2,000 penalty amount is $2,970, and the revised $3,000 penalty amount is $4,460.   Pay Or Play Penalty An applicable large…

Benefits of a Grandfathered Plan

Grandfathered Plan Overview The grandfathered plan was created on March 23, 2010, with few changes implemented since then. Plans with grandfathered status are exempt from some Affordable Care Act (ACA) regulations, but if that status is lost, the plan must adhere to more ACA criteria. An attempt by employers to scale back the benefits of…

CA Bereavement Leave as of January 2023

Starting Jan 1, 2023, employers with five or more employees must abide by new bereavement leave provisions. This is due to an amendment that was made to California Family Rights Act (CFRA) on September 29, 2022. This modification included the implementation of Assembly Bill No. 1949 (AB-1949). Under this bill, eligible employees may take up…

The Basics Employers Need to Know About CAA Prescription Drug Reporting

Rx reporting is a federal mandate that requires insurance companies and group health plans to provide a report of prescription drug data to the government. Logistics regarding the act can be found under Section 204 (of Title II, Division BB) of the Consolidated Appropriations Act, 2021 (CAA).   CAA Submission Requirements The following list includes…