IRS Finalizes Change to Family Coverage Affordability Rules

The IRS released a final rule that changes the eligibility rules for the premium tax credit (PTC). The PTC is available to eligible individuals who purchase health insurance coverage through the Exchange. Individuals are not eligible for the PTC if they have access to employer-sponsored health coverage that is affordable and provides minimum value. The rule provides that affordability of employer sponsored coverage for family members is determined based on the cost of family coverage. Read more…

 

 

 

 

Health Plans Must Provide Price Comparison Tool for 2023

Beginning in 2023, group health plans and health insurance issuers must make an internet-based price comparison tool available to participants, beneficiaries and enrollees. The purpose of this tool is to provide consumers with real-time estimates of their cost-sharing liability from different providers for covered items and services, including prescription drugs, so they can shop and compare prices before receiving care. Read more…

 

 

 

 

Revised Surprise Billing Model Notice

The Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) jointly released FAQs implementing provisions of the No Surprises Act, including the requirement that plans and issuers disclose certain balance billing protections to participants. Previously, the Departments released a model notice that could be used to satisfy these disclosure requirements. Based on public comments, the Departments revised this model notice and included it in the appendix of the latest FAQs. Read more…