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PCORI Fees

The Affordable Care Act (ACA) created a nonprofit corporation, the Patient-Centered Outcomes Research Institute (PCORI) to support clinical effectiveness research. It is funded in part by fees paid by health insurers and sponsors of self-funded health plans (PCORI fees), which are reported on paid annually using Form 720.

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Washington Paid Family and Medical Leave: Is it time to consider opting out?

For the last two years, the Washington Paid Family and Medical Leave program has been in place and paying benefits. With the state increasing premiums this year, now is a good time for your organization to consider whether opting out would be beneficial.

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Congress Temporarily Reinstates Telemedicine/HSA Eligibility Relief

The recently signed Consolidated Appropriations Act, 2022 (Act) includes another twist on telemedicine (sometimes referred to as telehealth) coverage and eligibility for a health savings account (HSA). The Act provides that telemedicine coverage will again be temporarily disregarded for purposes of HSA eligibility from April 1, 2022 through December 31, 2022.

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Keeping Up With Clinical Risk Management:
Employee Notaries in Healthcare

Some healthcare facilities may also utilize their employee notaries for documents related to business operations, such as real estate documents, legal contracts, etc. Although notaries can assist with certifying important documents, they can also be held liable if the laws and guidelines that govern their position are not followed.

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UPDATE – Additional Guidance Released for Health Plan Coverage of Over-The-Counter COVID-19 Tests

The Department of Labor (DOL), Secretary of Health and Human Services (HHS), and Department of the Treasury (Treasury) [collectively, “the Departments”] have issued additional guidance, in a new set of FAQs, that clarify certain aspects of the requirement that health plans cover the cost of over-the-counter COVID test with no cost sharing.

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2022 State Individual Mandates and Reporting Requirements

In the last two years, some jurisdictions have enacted their own individual mandate, similar to the repealed federal individual mandate that requires residents to have minimum essential coverage. These mandates also include various reporting requirements for employers to help the state reconcile which individuals were covered.

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Washington Long-Term Care Services and Supports Act – Payroll Tax for Washington Workers Delayed Until July 2023

Background Washington state passed the Long-Term Care (LTC) Services and Supports Act in 2019. This bill quickly became known as the “LTC payroll tax law” as it requires Washington workers to pay a tax of 0.58% on W-2 payroll amounts to fund the state’s LTC program. Employers do not pay the tax; it is funded Read More »

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Strategic Business Perpetuation – A Look at ESOPs from the Surety’s Perspective

Inevitably, every business owner will have to address the question of, “What’s next?” This can be a complicated and difficult question to answer when it comes to perpetuating a business. Business owners these days have enough on their plates as they navigate an ever-changing and demanding business landscape.

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Supreme Court Blocks OSHA’s Emergency Temporary Standard For Employers

The Supreme Court (SCOTUS) has issued a stay that effectively blocks the Occupational Safety and Health Administration’s (OSHA) Emergency Temporary Standard (ETS) which would have required employers with 100 or more employees to implement a workplace vaccine or testing requirement. At the same time, the court allowed the Centers for Medicare & Medicaid Services’ (CMS) vaccination mandate for certain health care workers to move forward.

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What is Fiduciary Liability, and Does My Organization Need It?

When I talk to clients about fiduciary liability, many assume that I am referring to their ERISA bond, which is actually crime coverage protecting a plan from fraudulent activities and theft of assets, and a requirement of ERISA plans. A fiduciary liability policy provides much different coverage than an ERISA bond without any overlap in coverage.

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Guidance Released for Health Plan Coverage of Over-The-Counter COVID-19 Tests

On January 10, 2022, the Departments of Labor (DOL), Health and Human Services (HHS), and Treasury (“The Departments”) released Frequently Asked Questions (FAQ) Part 51, in response to the Biden Administration’s directive to issue guidance requiring group health care plans and insurers to provide coverage of over-the-counter (OTC) in-home COVID-19 diagnostic tests.

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IRS Releases Updated PCORI Fees

In Notice 2022-4, the IRS provided the adjusted PCORI fees for plan years ending in October 2021 through September 2022. Employers who sponsored self-funded medical plans that ended sometime during 2021 are required to report and pay the ACA Patient-Centered Outcomes Research Institute (PCORI) fees no later than July 31, 2022.

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