Group health plans and health insurance issuers must annually submit detailed information on prescription drug and health care spending to the federal government. This reporting is referred to as the “prescription drug data collection” (or “RxDC report”). This is an annual reporting requirement—pla…Continued
Since the Consolidated Appropriation Act of 2021 was passed, increased scrutiny of medical and pharmacy carrier practices has led to lawsuits by health plans suing carriers and TPAs for suppression of data, improper out-of-network charges and hidden fees. More recently, health plan members and reti…Continued
What HappenedOn January 5, 2025, the Social Security Fairness Act became law. The Act abolishes two long-standing provisions of the Social Security benefits structure:WEP – Windfall Elimination ProvisionGPO – Government Pension OffsetThe new rules apply to all payments payable for January 2024 and …Continued
Employers should be aware of the top compliance issues that may impact their health plan coverage for 2025. Some of these compliance issues are established requirements for employers, such as the new simplified reporting under the Affordable Care Act (ACA). Other compliance issues are anticipated d…Continued
In 2024, employers of all sizes and industries faced several trends affecting the employee benefits market. Rising health care costs, a competitive labor market and regulatory concerns all shaped how employers navigated operational challenges. A number of these concerns, such as health care costs a…Continued
By Zack Fritz, Sage Policy GroupSupply constraints were a—and perhaps the—defining dynamic of the post-pandemic economy. Shutdown orders frustrated supply chains and reduced shipping capacity, while a barrage of early retirements devastated the labor supply. The latter was exacerbated by the increa…Continued
