IRS Releases New PCOR Fee for Policy or Plan Years Ending On or After October 1, 2024 and Before October 1, 2025

This update was originally published by Larry Grudzien. The IRS recently announced in Notice 2024-83 that the adjusted applicable amount for the Patient-Centered Outcomes Research (PCOR) Fees is $3.47 for policy (more…)

Anthem SOCA MEWA and Ohio Farm Bureau MEWA to File 1094/1095 Data Electronically

Based on popular broker request, Anthem will prepare the 1094B and 1095B forms for the 2024 tax filing year and post to Employer Access. Additionally, the SOCA Benefit Plan and (more…)

Gag Clause Attestations are Due December 31! Here is Your How-To Guide

The annual Gag Clause Prohibition Compliance Attestation (GCPCA) is a new requirement from the Consolidated Appropriations Act (CAA) that prohibits group health plans and health insurance issuers offering group health (more…)

Anthem KY’s Small Group and Individual MLR Rebates Update

Anthem pays annual rebates to fully insured groups when their medical loss ratio (MLR) is less than 80 percent for small groups and individuals. For 2023, the KY small group (more…)

Pay-or-Play Affordability Percentage Will Increase for 2025

On September 6, 2024, the IRS released Revenue Procedure 2024-35 to index the contribution percentage in 2025 for determining the affordability of an employer’s plan under the Affordable Care Act (more…)

Employer Action Required: Distribute Medicare Part D Notices by October 15, 2024

This post is continually updated with the latest carrier information. Please be sure to check back for any additions. Group health plan sponsors must provide Medicare Part D “creditable coverage” (more…)

CMS and DE/EDE System Access Requirements

This post was originally published by CMS.gov As a reminder, section IV.c. of the Agent and Broker General Agreement documents proper uses of CMS systems, including Direct Enrollment (DE) systems, (more…)

PCORI Fees Due to IRS No Later Than July 31, 2024

Fees to fund the Patient-Centered Outcomes Research Institute (PCORI) are due to the IRS no later than July 31, 2024, from employers who sponsor certain self-insured health plans, such as (more…)

IRS Releases HSA Limits for 2025

This update was originally published by Larry Grudzien. Recently, the IRS issued Revenue Procedure 2024-25, which provides the 2025 cost-of-living contribution and coverage adjustments for HSAs, as required under Code (more…)

Important: Updates to Short-Term Health Insurance Plans Coming Soon

The Departments of Health and Human Services, Labor, and the Treasury recently announced a change to the federal definition of Short-Term, Limited-Duration Insurance (STLDI) that imposes nationwide plan duration limits (more…)

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