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New Reg Reduces Medicare Coverage Gaps
Starting in 2023, benefits to kick in sooner
A new federal regulation will keep 65-year-olds from having to wait for their Medicare coverage to kick in regardless of when they apply during official enrollment periods. The rule, finalized on October 28, also provides several new special enrollment windows, including for people who, through no fault of their own, didn’t sign up when they were supposed to.
The new regulation implements Medicare enrollment changes included in the sweeping appropriations law Congress passed in late 2020 and will take effect Jan. 1.
Starting next year, as long as you apply for Medicare during any part of your seven-month initial enrollment period or during the general enrollment period, your coverage would take effect beginning the following month. Learn more at AARP.
The Inflation Reduction Act of 2022 will transform Medicare’s prescription drug coverage through provisions that for the first time will allow the program to negotiate prices of some medications with drugmakers, cap out-of-pocket costs for beneficiaries and make vital vaccines free to enrollees.
As with many new pieces of legislation, these changes will roll out over time. Here’s a year-by-year look at how and when the landmark legislation will affect Medicare beneficiaries. The benefits of the law will apply both to people enrolled in original Medicare and those who belong to Medicare Advantage plans. Learn more at AARP.
Sponsored by Word & Brown
CAA’S Prescription Drug Data Collection (RXDC) Requirements for Health Plans
The Consolidated Appropriations Act (CAA) of 2021 created a myriad of new compliance requirements for health plans, insurance issuers, insurance agents, and providers – all aimed to promote transparency. While the law was signed on December 27, 2020, many of its requirements and deadlines are approaching now. Full article here.
The IRS has released the 2023 cost-of-living adjustments (COLAs) for a wide variety of tax-related limits, including limits relating to health FSAs, qualified transportation fringe benefits, qualified small employer health reimbursement arrangements (QSEHRAs), adoption assistance, DCAPs, the small business health care tax credit, the premium tax credit, and Archer MSAs. From isolved: read full article here.
Beginning Jan. 1, 2023, the California state minimum wage will be $15.50 per hour for all employers, regardless of size. This state minimum wage rate is also used to determine the salary threshold for the administrative, executive and professional exemptions — the threshold is two times the statewide minimum wage. This means, for 2023, business owners will need to ensure all exempt employees earn at least $64,480 per year.
In jurisdictions without a local minimum wage ordinance or with a local wage rate that is lower than the California state minimum wage, the state minimum wage rate will apply.
2023 Local Minimum Wage Rate Increases List: click here.
The IRS, after cautioning last year not to expect future extensions to the Jan. 31 deadline for furnishing Affordable Care Act (ACA) reporting forms to employees, has changed its mind.
In new proposed regulations, the IRS would permanently extend by 30 days the deadline for employers to distribute individual statements to full-time employees that indicate whether their employer-sponsored health insurance met ACA requirements for minimum essential coverage. The new deadline for furnishing Forms 1095-B or 1095-C would be March Read more here.
This Is Why The U.S. Can’t Have A Government-Run Healthcare System
The U.S. spends more than twice the amount per person on healthcare as other developed nations, yet our outcomes aren’t much different. So why don’t we do what other countries do, which is to have a government-run or heavily government-dominated system that forces prices down?
This segment of Steve Forbes What’s Ahead podcast provides the stunning answer: We can’t.
Watch on YouTube.
In a groundbreaking piece in the Washington Post, David Goldhill, CEO of SesameCare.com, explains the stunning truth of how the sky-high prices we in the U.S. pay subsidize the rest of the world’s healthcare.
The U.S. is an extraordinary — and utterly underappreciated — font of constant innovations, big and small. The question now is: How can we continue these breakthroughs and improvements while achieving the kinds of cost-reducing productivity gains we experience in high tech and elsewhere?
Read Forbes Article
Sponsored by White Wing Insurance Solutions
Health benefit cost rose 3.2% in 2022, but employers see bigger increases ahead, says Mercer survey
U.S. employers expect a sharper increase of 5.4% in 2023 — and faster cost growth in the years ahead seems likely. For now, most employers are prioritizing enhancing benefits to attract and retain workers over cost-cutting; enhancements range from adding perks to improving healthcare affordability. Mental health remains a top concern of employers and employees – and virtual mental healthcare is proving key to improving access to services.
The average per-employee cost of employer-sponsored health insurance rose by 3.2% in 2022, according to Mercer’s 2022 National Survey of Employer-Sponsored Health Plans. Last year saw a spike in cost growth (to 6.3%) as individuals caught up on healthcare needs delayed as a result of the pandemic. While this year’s increase may seem like a return to normal trend, it is far below general inflation, which is averaging about 8% for 2022.
Typically, health benefit cost growth runs higher than general inflation. According to Sunit Patel, Chief Health Actuary at Mercer, 2022 is an anomaly because employer health plan sponsors haven’t felt the full impact of inflation yet. Read Article
If you reevaluate what you consider employee benefits — thinking beyond insurance and 401(k)s — plenty of non-monetary benefits can enrich employees’ lives. How can you add value to the lives of your employees in ways not dependent on economic conditions? Read Forbes Article
A majority of the youngest U.S. kids haven’t received a flu or COVID vaccine, according to federal health data — this as hospitals struggle to handle a deluge of patients with respiratory viruses. Nearly 58% of children 6 months through 17 years old haven’t received the flu vaccine this year, according to the U.S. Centers for Disease Control and Prevention, citing a telephone survey. Learn more here.
Protect Our Planet and Your Health This Holiday
Five tips for more sustainable giving and gathering.
From Blue Shield of California
With the holiday season upon us, it’s time for giving and gathering – and frankly, a lot more waste. On average, Americans throw away 25% more trash from Thanksgiving to New Year’s. That’s about one million extra tons of trash per year, according to the Environmental Protection Agency. Dig in here.
Multiple studies show a strong association between higher levels of optimism and healthy aging. We ask some dedicated optimists what might explain the connection. Explore here.
2023 INDUSTRY EVENTS
- Jan. 10, OCAHU Legislative Updates from Shore to Shore, East Anaheim Community Center. More info.
- Jan. 18, 10:30A – 11:30 am PST, CAHIP Annual Legislative Update Online Webinar. Register.
- Jan. 24, 10:00 AM to 1:00 pm PST, NAHU Live Virtual Corporate Wellness Certification. Register
- Feb 5-8, You Powered Symposium hosted by E-Powered Companies, Miami, Florida. Register. One of the speakers is our own trailblazing contributor Dawn McFarland!
- Feb. 9, 8:00 am PST, OCAHU Annual Sales Symposium, Spring Field Banquet Center – Fullerton. More info.
- Feb. 23, 11:30 am – 1:30 pm PST by Zoom, 70th Annual Will G. Farrell Award & Leadership Recognition Event, sponsored by NAIFA-LA and FSP. Info: firstname.lastname@example.org
- Mar. 4, 9:00 am to 1:30 pm PST, by zoom: WIFS-LA Women’s Forum “Embrace Empowerment” Info: email@example.com
- March 13-15, Ellevate Women’s Leadership 2023 Summit, JW Marriott just outside Las Vegas. Register here.
- March 29-31, Self-Insurance Institute of America (SIIA) Spring Forum, JW Marriott Grande Lakes • Orlando, FL Register now
- April 11-14, Virtual Fourth National Medicare Advantage Summit by Global Health Care, Heritage Value-based Care Conference Series, Virtual/Online Live Video; Media Partners: Harvard Health Policy Review, Health Affairs and Inside Health Policy. Phone: (800) 503-0078. Registration@hcconferences.com, www.medicareadvantagesummit.com
- May 8-10, CAHIP Capitol Summit, Sacramento. Info.
December Print Magazine features
NAHU Shifts to Embrace the Generations– Part 1. By Dawn McFarland. Look for Part 2 in January.
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