Health Plan Disclosure Requirements for Prescription Drugs

Category: Events

Health Plan Disclosure Requirements for Prescription Drugs

Posted On: September 29, 2022 | Categorized as: Events

health plan disclosure requirements

Under the Affordable Care Act (ACA) transparency-in-coverage (TiC) rules and provisions of the Consolidated Appropriations Act, 2021 (CAA), group health plan sponsors must both disclose and report detailed information regarding a plan’s prescription drug coverage and costs. There is significant overlap under the two sets of disclosure rules, which has led to confusion regarding compliance. The confusion is even greater since the rules impose two required components for prescription drug cost disclosure – an annual report (Report) to the Centers for Medicare & Medicaid Services (CMS) and a mandatory machine-readable file (MRF). The Report deadline was originally set for last year, but the Departments that enforce the rules delayed the deadline until December 27, 2022. Also, because there is significant overlap in the rules regarding prescription drug costs, the Departments delayed the prescription drug MRF requirement indefinitely pending further regulation and guidance. Recent CMS guidance provided some technical clarifications to…


Departments Issue No Surprises Act FAQ and Clarify Independent Dispute Resolution Process

Posted On: September 29, 2022 | Categorized as: Events

no surprises act FAQ

The U.S. Departments of Health and Human Services, Labor, and the Treasury (the “Departments”) recently released final rules regarding the No Surprises Act. The rules specifically address required independent dispute resolution (IDR) of certain claims and expenses and finalize prior interim final rules relating to information that group health plans must disclose.Federal IDR ProcessThe No Surprises Act required regulators to develop an IDR process to resolve conflicts between payers and providers regarding out-of-network expense amounts. Any disputes unresolved after 30 days of negotiating can be referred by either side to binding arbitration from a certified IDR entity. The IDR entity will consider the qualified payment amount (QPA) – the insurance plan's median contracted rate for the same or similar service in an area – and other relevant submitted information, and then select one side’s suggested payment amount.Under interim final rules issued in October 2021, certified IDR entities were to select…


New Jersey Division on Civil Rights Enacts New Workplace Poster Requirements

Posted On: September 14, 2022 | Categorized as: Events

On August 1, 2022, the New Jersey Division on Civil Rights (DCR) adopted new and amended regulations around the “Display of Official Posters of the Division on Civil Rights.” New Jersey employers, housing providers and places of public accommodation are required to display posters to inform individuals and covered entities of their rights and obligations under the New Jersey Law Against Discrimination (LAD) and New Jersey Family Leave Act (NJFLA). The DCR has now released the revised posters that will need to be utilized to satisfy the requirements under the LAD. Additionally, employers with 30 or more employees who are covered by the NJFLA, will also need to replace their current NJFLA poster with the revised version. The revised posters must be prominently displayed in places easily visible to those who would be impacted by violations under the laws. Covered employers will also need to distribute the posters annually to…


With Inflation on the Rise, How Can You Ensure Your Employer Health Benefit Costs Are Under Control?

Posted On: June 29, 2022 | Categorized as: Events

Innovative is thrilled to announce the first August event of the month: With Inflation on the Rise, How Can You Ensure Your Employer Health Benefit Costs are Under Control? Health insurance is a billion-dollar business with many inefficiencies and hidden revenue streams within it. In many ways, your employer sponsored health plan is funding it, which is impacting your costs. What we find is most employers have no idea how much waste and hidden revenue there is, causing you high costs and a broken plan.During this seminar, you will learn the components causing the waste and how to uncover it within your plan. We will review several strategies and solutions available to middle market employers that you can begin to deploy to disrupt the system and begin to put money back in your pocket and your employees’ pockets.Learning objectives include:Understand what is happening in the health insurance system and whyUncover…


Mental Health: What a Stigma-Free Workplace Looks Like Breakfast-N-Learn

Posted On: May 26, 2022 | Categorized as: Events

Innovative is excited to host our Breakfast-N-Learn, Mental Health: What a Stigma Free Workplace Looks Like. Mental health is top of mind everywhere these days as about 20% of adult Americans report symptoms of mental illness according to the Centers for Disease Control. Workplace mental health concerns such as anxiety, stress, burnout, and depression had already been growing, and then the COVID-19 pandemic and remote work situations just intensified these matters. It’s no secret that work-related factors, especially during the pandemic, are impacting employee’s mental health. It’s no longer a bonus to discuss mental health in the workplace, employers have a responsibility to support employees. During this presentation, we will dive into:Learning objectives include:Benefits of addressing mental health in the workplace Understanding the physical health connection and potential health risks How to build a culture of mental health and break the stigma in the workplaceCreating management and leadership trainingWorkplace Wellness initiatives to encourage…


Innovative Launches Exclusive Client Lunch-n-Learn

Posted On: March 3, 2022 | Categorized as: Events

Innovative is proud to launch our new exclusive client lunch-n-learn, Noontime Knowledge for 2022. This biannual event will take place at our Moorestown office’s Learning Exchange each June and October. During this one-hour lunch, clients can come together to learn and lean on each other. Learn the latest trends and products to optimize your health plan offerings, as well as review current and upcoming compliance changes and obligations.  Lean on our community of like-minded professionals to share best practices. Learning Outcomes Include: Compliance updates and upcoming deadlines Tips to optimize your benefit offering Trends in HR, Employee Benefits, and Retirement Plans Workplace wellness tips based on the relevant season and observances Community Roundtable: Do you have a burning topic or issue you have been dealing with? Let’s lean on our community of like-minded professionals! At the end of each lunch, we will conduct a roundtable discussion to collaborate and share…


How New DOL Cybersecurity Guidelines Affect Plan Sponsors

Posted On: November 19, 2021 | Categorized as: Events

The Department of Labor recently issued its first cybersecurity guidelines for plan sponsors, plan fiduciaries, record keepers, plan participants, and beneficiaries. According to the DOL, trillions of dollars in assets in more than 140 million retirement plans across the country could be vulnerable to cybersecurity threats. The department says that the Employee Retirement Income Security Act of 1974 (ERISA) requires plan fiduciaries to take appropriate precautions to minimize the risk of cyberattacks. These guidelines outline the department’s minimum expectations on cybersecurity for ERISA-covered plans.Which Organizations Are Affected?Companies and organizations of any size that provide ERISA-covered plans with retirement or health & welfare benefits are expected to follow the guidelines. Plan sponsors and fiduciaries must strive to protect plan asset data and participants’ personally identifiable information (PII). Not all security threats can be prevented and eliminated, but the DOL does expect companies to take reasonable steps to mitigate those risks.Why Are…


WEBINAR: Employer Vaccination Strategies & Requirements

Posted On: October 11, 2021 | Categorized as: Events

Employer Vaccination Strategies & Requirements Innovative Benefit Planning is happy to provide you with critical updates on President Biden’s recently announced new vaccination requirements, employer vaccination strategies, and best practices for handling the mandate and benefit surcharge issues. We invite you to join us on October 21st at 10:00am EDT where our partner and expert Rhonda Hollier of HR Service will join us live to provide an informative legal update, discuss how this impacts employers, as well as answer the frequently asked questions we get from employers. Discussion includes: • New Biden Vaccination Requirements • COVID Vaccinations – making them mandatory or not? • EEOC Guidance on Vaccine Incentive • FAQ about Biden's Vaccination Requirements • Live Q&A When: October 21, 2021 at 10:00am Duration: 60 Minutes (includes live Q&A) Register Now


July 2021 Compliance Recap

Posted On: August 9, 2021 | Categorized as: Events

July 2021 Compliance Recap July 2021 was a quiet month in the benefits industry, largely due to the summer vacation season and the July 4th Independence Day holiday. Importantly, however, the U.S. Departments of Health and Human Services, Labor, and Treasury, along with the Office of Personnel Management (collectively, the “Departments”), issued an interim final rule (IFR) to explain provisions of the No Surprises Act (the Act) that passed as part of sweeping COVID-19 relief legislation signed in December 2020. Additionally, the Internal Revenue Service (IRS) released Notice 2021-46 (Notice) to clarify lingering questions employer plan sponsors and other interested parties have been asking since the American Rescue Plan Act of 2021 (ARPA) became law in March 2020. No Surprises Act Interim Final Rule Under the Act, group health plans, or health insurance issuers offering group or individual health insurance coverage, that provide or cover any benefits for services in…


Innovative’s 2nd Annual Well-Being @ Work Summit

Posted On: September 21, 2020 | Categorized as: Events, Workplace Wellness

Innovative's 2nd Annual Well-Being @ Work Summit On September 15th, 2020, Innovative Benefit Planning hosted the 2nd Annual Well-Being @ Work Summit, which is dedicated to making workplaces healthier (but with a twist)! Due to the COVID-19 pandemic, the team had decided to create a virtual event in order to ensure the health and safety of everyone involved.  However, going virtual this year ended up opening up many doors, including the opportunity to welcome a total of 8 speakers! Attendees even received a “registration box” which included a shirt for the day of the summit, promotional items from sponsors such as cups, mints, tooth brushes, and hand sanitizer, as well as a drink kit and Innovative face mask.  The event had a wonderful turnout, including HR professionals, C-Suite decision-makers, health and well-being professionals and top well-being vendors in the industry. The morning started out on the right foot with a…


Creating a Financial Wellness Program

Posted On: April 28, 2020 | Categorized as: Events

The case for financial wellness from an employee and employer perspective Many employers incorporate a health wellness program into their organization, but financial wellness is just as important. Studies show that 47% of all employees are stressed about finances and 54% of those employees say they will likely use their retirement funds for expenses other than retirement.1 Employees who are stressed about money or debt often bring that stress into the workplace, causing lower productivity, higher absentee rates and neglect or postponing of personal healthcare. In addition, employees that cannot retire may have a negative impact on employer profitability (higher healthcare/workman’s compensation costs) and impede the development of the next generation of leaders. 5 Steps for Creating a Financial Wellness Program Discovery Understand your organizational goals and objectives. Review current demographic and participation information of existing benefit programs. Survey employees to determine their financial literacy level and pain points. Analyze…


What To Do When Your Retirement Vendor Is Sold

Posted On: January 28, 2020 | Categorized as: Events

What To Do When Your Retirement Vendor Is Sold January 28th, 2020 The retirement plan industry is undergoing a wave of consolidation, with many 401(k) vendors merging with competitors or being acquired. Their pending merger may be in the best interest of the companies combining, but you must determine if it is also in your best interest. As a plan sponsor, when your record keeper changes, you have a fiduciary obligation to research what is happening and how it affects both your organization and your participants. While this may be a good move for your plan, accepting an automatic conversion remains a fiduciary decision. Plan sponsors should initiate a process to determine whether the change is best for plan participants and beneficiaries, or if an alternative solution would be better. A plan sponsor also needs to document that decision. Your documentation should include a thorough review of the cost and…


30 Pledges to Giveback Halfway Recap

Posted On: June 18, 2019 | Categorized as: Company News, Events

30 Giveback

We’re almost halfway through the year and our 30 year givebacks campaign is in full swing! To celebrate our 30 year anniversary and pay thanks to our amazing community and countless partners, Innovative had pledged back in January to give back in 30 different ways this year, and make our community a key part of our business in 2019. As we hit the halfway point, we are half way to 30!   The givebacks we've done so far: #30. The Innovative team came together to support the United Way Impact Fund Campaign for their 2019 Annual Campaign. #29. Innovative sponsored and supported “For Pete’s Sake-Take a Break from Cancer” Annual Gala. #28. We sponsored Samaritan Healthcare & Hospice's annual "Celebration of Life Gala". #27. The Innovative team collected coats for our Winter Coat "Share the Warmth" Drive, which benefited the local nonprofit "Code Blue Collaborative". #26. A team from Innovative cooked…


Innovative Benefit Planning Celebrates 30 Years of Business

Posted On: January 10, 2019 | Categorized as: Company News, Employee Benefits, Events, HR Consulting, Retirement Plans, Workplace Wellness

As we enter 2019, Innovative Benefit Planning celebrates 30 years of success as a national, employee benefit, and financial services company.  Founded in 1989 by Terriann Procida and Mark Sulpizio in Mt. Laurel, NJ, the firm’s vision was to provide unique employee benefit consulting and financial planning services to businesses and their executives in the Philadelphia/Southern New Jersey region.  Terriann and Mark started the company with one simple objective, to always put people first, and it’s this exact mission that has led the company to triple in size, expand practice areas and grow from a regional service area to a national company with an admirable reputation for work ethic, integrity, credibility and experience. Over the course of 30 years, Innovative’s history of outstanding service, pioneering turn-key, cost-saving plans, and technical expertise in the areas of employee benefits, financial planning, population health management and HR consulting have resulted in substantial growth…


The Innovative Learning Exchange Hosts YMCA Board Training

Posted On: February 16, 2017 | Categorized as: Company News, Events

Last Wednesday, February 8th, the Learning Exchange at Innovative hosted YMCA Board Training  for the Board of Directors of the YMCA of Burlington and Camden Counties administered by Laura Solomon of Laura Solomon & Associates. The detailed training session focused on best practices in board governance.  Thank you to Laura for the wonderful session and a special thank you to Melanie Grant of Escalatus, LLC for coordinating!


Innovative Presents “Update from the Hill” at the 30th Annual Tri-State HRMA Conference

Posted On: May 10, 2016 | Categorized as: Company News, Compliance, Employee Benefits, Events

Last Thursday, May 5th, Innovative's Employee Benefits Consultants, Dan Foley and Ryan Kastner, had the honor of speaking at the 30th Annual Tri-State HRMA Conference.  The two presented a curtailed version of their popular "Update from the Hill" seminar which summarizes key takeaways from this year's NAHU Capitol Conference and explains what employers can do to prepare for upcoming legislative changes, and policies they can implement to reduce risk. Dan and Ryan  have presented "Update from the Hill" twice this year prior to the Tri-State Conference  at well-attended Lunch N' Learns in both Philadelphia and Moorestown, NJ.  For those who attended the Tri-State session (and those who missed it) who would like the chance to see the presentation in its entirety, we are holding an "Update from the Hill" Breakfast N' Learn session next Friday, May 20th. Interested parties can register for the event here.


Need a custom plan designed for your team?

Schedule a Consultation

Contact Us Now To Get Your Business Covered