New versions of the Summary of Benefits and Coverage (SBC) template, instructions, uniform glossary, and related documents are required for use on or after April 1, 2017. Under the Affordable Care Act, group health plans and health insurance issuers are generally required to provide a written SBC to plan participants and beneficiaries at specified times during the enrollment process and upon request.
Changes to SBC Template
The new SBC template includes an additional coverage example as well as language and terms to improve individuals' understanding of their health coverage. Specifically, the new template includes more information about cost sharing, such as enhanced language to explain deductibles, and requires plans to address individual and overall out-of-pocket limits. Changes have also been made to the SBC to improve readability.
Implementation Date for Using New Template and Related Documents
The implementation date for using the new SBC template and associated materials will be as follows:
President Trump has issued a memorandum directing the Secretary of Labor to examine the U.S. Department of Labor's (DOL) Fiduciary Duty Rule to determine whether the rule may adversely affect individuals' abilities to gain access to retirement information and financial advice. In response to the memorandum, the DOL has stated that the agency will now consider delaying the applicability date of the rule.
On April 8, 2016, the DOL released a final rule ("Fiduciary Duty Rule") expanding the number of persons that are subject to fiduciary standards when they provide retirement investment advice, including exemptions that would allow advisers to continue to receive payments that could create conflicts of interest if certain conditions are met.
Review of Fiduciary Duty Rule
The memorandum directs the Secretary of Labor ("Secretary") to prepare an updated economic and legal analysis concerning the impact of the Fiduciary Duty Rule. Such analysis is expected to address the following topics:
In response to the memorandum, the DOL has stated that the agency "will now consider its legal options to delay the applicability date as we comply with the President's memorandum." Until further guidance is issued, however, the rule is set to become applicable on April 10, 2017.
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As a reminder, employers should note that U.S. Citizenship and Immigration Services (USCIS) has released a new version of Form I-9, Employment Eligibility Verification. As of January 22, 2017, employers must use the updated form.
Federal law requires employers to hire only individuals who may legally work in the United States--either U.S. citizens or foreign citizens who have the necessary authorization. To comply with the law, employers must verify the identity and employment authorization of each person they hire by completing and retaining Form I-9.
New Form I-9 and Dates
As of January 22, 2017, employers must use the "11/14/2016 N" version of Form I-9 to verify the identity and work eligibility of every new employee, or for the reverification of expiring employment authorization of current employees (if applicable). This date is found on the lower left hand corner of the form.
Prior versions of the form will no longer be valid for use. Employers who fail to use Form I-9 "11/14/2016 N" on or after January 22, 2017 may be subject to any and all applicable penalties under the Immigration and Nationality Act. Employers should continue to follow existing storage and retention rules for each previously completed Form I-9.
Note: The instructions for completing Form I-9 are now separate from the form.
Prescription drugs remain a hot topic as drug costs continue to rise nearing $500 billion dollars (2015 data) in the United States. When it comes to specialty drug spend, around 1.5% of members using specialty drugs account for around 42% of drug costs.
Connecticare and ESI continue to roll out innovative, behind the scene programs, impacting members leading to better adherence to high cost medication, decreasing waste and improving health conditions when a member is using a high cost specialty medication. Please take a moment and review the attached document which outlines the ScreenRx program; ESI/ Connecticare’s proprietary screening solution which combines early detection with tailored interventions to increase patient adherence and healthcare savings.
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Source: HR 360, Inc.
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