Who’s the Boss?
You’re an employer. You are the buyer. You hold the cards in deciding which medical and prescription drug plan vendors you work with, and the price you’re going to pay. You are the boss, right? (more…)
3 Things to Watch in Rx Plan Design
The prescription drug space is making headlines everyday with stories ranging from novel drug approvals to political and legislative proposals that have PBMs and drug manufacturers on edge. Here are three current issues that should be on every plan sponsor’s radar. (more…)
Final Notice of Benefit and Payment Parameters for 2020
The Department of Health and Human Services (HHS) released its final Notice of Benefit and Payment Parameters for 2020. This rule describes benefit and payment parameters under the Affordable Care Act (ACA) that apply for the 2020 benefit year. Standards included in the rule relate to:
- Annual limitations on cost sharing;
- The individual mandate’s affordability exemption;
- Direct enrollment in the Exchanges; and
- Special enrollment periods in the Exchanges.
HHS also sought comments on issues to address in the future, such as the practice of “silver loading,” the automatic re-enrollment process through the Exchanges and any additional measures that would reduce eligibility errors and potential government misspending. Although the final rule does not finalize any policies related to these issues, HHS noted that it intends to take the comments received in response to the proposed rule into consideration in future rulemaking. (more…)