In this episode, Patrick Myers and Suzanne Spradley review recent litigation and administrative action brought under the Mental Health Parity and Addiction Equity Act (MHPAEA). Suzanne begins the discussion by providing background on the requirements imposed on plans by MHPAEA, with a particular focus on non-quantitative treatment limitations (NQTLs). Suzanne then discusses the report submitted to Congress by the DOL, HHS and the IRS that highlighted several deficiencies they found when examining plan sponsors and insurance providers for MHPAEA compliance. She follows up by discussing a large civil case involving a behavioral health provider. And the episode closes with a discussion on two large settlements between the DOL and administrative service providers as part of the agency’s efforts to enforce MHPAEA compliance.

In this episode, Chase Cannon and Suzanne Spradley outline a few explanations on recently-asked benefits compliance questions. First, Chase describes the challenges relating to the requirement to provide a Medicare Part D creditable disclosure to CMS and individuals. Chase and Suzanne then dig into HSA eligibility where an employee has a spouse or dependent who is enrolled in Medicare, including the HSA contribution maximum and distributions from the HSA. The two close with a discussion about tricky scenarios on the COBRA Initial Notice, including the requirement to distribute the notice to newly enrolled spouses.

In this episode, Suzanne Spradley and Chase Cannon discuss the ACA provider nondiscrimination rules — the idea that individuals have the right to access health services from the full range of providers licensed and certified in their state. Suzanne leads off with a background on why Congress felt it necessary to include the provider nondiscrimination rules as part of the ACA. Next, Suzanne and Chase discuss prior state law and litigation in the courts and how the ACA rules attempt to address the related issues. The two go deeper into the rules themselves, the process, and then back and forth between the agencies (DOL, Treasury, etc.) and the Senate on the intent and purpose of the law. Suzanne closes by outlining a recent agency “listening session,” wherein providers and group health plans gave feedback on questions that future guidance should address.

In this episode, Chase Cannon and Suzanne Spradley break down the recent Supreme Court decision relating to the vaccine mandates for large employers and healthcare workers. Chase starts by outlining the large employer vaccine mandate, including the OSHA emergency temporary standard, or ETS rule, that was challenged in the courts. Next, Chase and Suzanne discuss the Supreme Court’s decision to halt enforcement of the OSHA ETS — what the ruling means from a legal and practical viewpoint and how state law could come into play. While the decision appears to be the end of the road for the OSHA ETS, Chase closes things out by discussing the CMS healthcare worker vaccine mandate (held valid by the Supreme Court) and the vaccine mandate for government contractors (held up in federal courts).

Join Mark Reider, NFP's own Head of Innovation, as he discusses the future of the ever-changing insurance marketplace with Denise Garth, Chief Strategy Officer at Majesco on their "The Future of Insurance: Industry Leaders" podcast.

Discussion points include:

• How employers can utilize innovative thinking to boost employee retention

• What emerging tools and systems employers can offer to benefit their employees and how these technologies are shaping the future

• How we try to look at insurance from the buyer's perspective today and how that will change tomorrow

Thanks for coming on this journey with us.

In this episode, Chase Cannon and Suzanne Spradley break down the recent OSHA guidance (emergency temporary standard, or ETS) relating to the employer COVID-19 vaccine and testing mandate. Chase outlines the general requirement for employers with 100 or more employees to ensure employees are vaccinated or tested regularly. Suzanne and Chase discuss legal challenges to the ETS guidance at the federal and state level. The two outline the ETS requirements relating to counting employees, vaccination policies, proof of vaccination status, alternative testing, employee notification and penalties. The two close by discussing some practical planning tips, and the importance of engaging outside counsel to assist with mandate compliance.

In this episode, Suzanne Spradley and Patrick Myers discuss the growing trend of HIPAA breaches, particularly those that involve ransomware attacks and employee errors. Suzanne points out how the pandemic and the increased use of telehealth encouraged a growing reliance on electronic transmission and data. Suzanne and Patrick discuss HIPAA privacy law, recent updates to the law, its notification requirements, and the Health Risk Assessment requirement. Finally, the two close by discussing enforcement actions, penalties, and common violations that result in fines imposed by the federal government.

In this episode, Kim Bell, EVP, Head of Health and Benefits and Dale Sagen, VP and Leader of Group Captive Solutions focus on NFP’s newest launch, our Medical Stop Loss Captive, sharing an overview of our captive practice, and the benefits of leveraging this type of program.

In this episode, Chase Cannon and Patrick Myers provide an update on vaccine mandates and surcharges, including some helpful governmental guidance on HIPAA wellness program rule application to vaccine surcharges. Chase then digs in on some end-of-year and open enrollment considerations for pandemic-related compliance obligations. Chase and Patrick discuss the mandatory and optional plan design changes and what employers should consider communicating to employees during open enrollment. The two close by addressing the temporary telehealth exception relating to HSA eligibility, currently set to expire at the end of the 2021 plan year, and whether we can expect any Congressional extension.

In this episode, Chase Cannon and Suzanne Spradley discuss the history of, and legal challenges to, OSHA's Emergency Temporary Standards (ETS), the format for the Biden administration’s recently announced vaccine mandate and COVID-19 testing alternative for employers. Suzanne begins with an overview of the likely legal challenges to the use of the ETS process, the historical use of OSHA's ETS instead of the standard rule-making process and prior court rulings that generally did not support the use of the ETS. Suzanne and Chase review the questions that will likely be raised considering the prior COVID-19-related ETS limited to healthcare workers and evidence that may be used to support a more expansive ETS.