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Employers Curtail Health Cost-Shifting to Workers

by Inoventive Solutions
December 30, 2021

One of the health insurance trends that went largely unnoticed in 2021 was that employers halted cost-shifting to their employees by reducing or holding steady workers’ deductibles and other cost-sharing.

That’s according to a new study by consulting firm Mercer, which points out that concerns about health care affordability for lower-wage workers, coupled with a difficult hiring environment and the need to attract and retain talent, has prompted many firms to not pass on cost-sharing in the form of higher deductibles and out-of-pocket maximums.

Additionally, despite average group health premiums growing 6.3% in 2021, employers did not increase employee’s share of premiums significantly.

The trend is the result of the ongoing COVID-19 pandemic and a hot labor market, in which most companies are struggling to find staff as well as keep current employees from seeking out new opportunities. Companies are also adding extra benefits for workers and focusing on the overall health of their staff, who are demanding improved access to mental health and substance abuse benefits, and more.

Mercer found that:

  • Among small employers (50-499 employees), the median deductible for individual coverage in a preferred provider organization dropped to $900 in 2021 from $1,000 the year prior.
  • Among large employers (500 or more workers), the median PPO deductible for individual coverage remained steady at $750.
  • Among large employers, the median individual deductible in high-deductible health plans dropped to $1,850 in 2021 from $2,000 in 2020.
  • Among small employers, the median individual deductible in HDHPs stayed steady at $2,800.
  • The average employee share of premiums for employees enrolled in an individual PPO plan rose just $7 to $167 in 2021, and $12 for family coverage ($590 to $602).

While PPOs are still the most popular type of group health plan in the country, the percentage of workers enrolled in HDHPs continues to grow, hitting 40% in 2021, up from 38% in 2020.

The other shoe

The pandemic forced a great deal of suffering on a large swath of Americans, creating a number of personal challenges to their mental and emotional health as well as help in dealing with substance abuse problems that also increased during the pandemic.

As a result, employers have been increasing access to mental health and substance abuse services, with 74% of large businesses rating improved access as important or very important in the Mercer survey. The number is even higher for employers with 20,000 or more workers, with 86% of them rating access to these services as the most important benefits issue for them.

“In today’s extremely tight labor market, generous health benefits can help tip the scales in attracting and retaining staff,” says Tracy Watts, national leader for U.S. Health Policy at Mercer. “Beyond that, in the wake of the pandemic many employers committed to help end health disparities, and ensuring care is affordable for their full workforce is an important part of that.”

Managing costs with no cost-shifting

Instead of cost-shifting, many employers are absorbing the higher premiums, which have averaged 6.3% in 2021, according to the study. Mercer found that 60% of employers aren’t making plan changes of any type in order to reduce cost increases.

Employers are instead looking at ways to optimize their health benefits with quality initiatives, increased use of virtual care and personalizing benefits.

Firms are also tapping into ways to control drug costs for their employees. This includes more closely evaluating their spending on expensive specialty drugs, such as biologics that are injected or infused. Employers are encouraging the use of biosimilars as lower-cost, clinically effective options.

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Uncategorized

Pandemic Fallout: Employers Boost Mental Health, Substance Abuse Benefits

by Inoventive Solutions
December 21, 2021

The COVID-19 pandemic has had profound effects on health insurance in the U.S., with many employers improving mental health and other benefits to help their workers during this trying period, according to a new report by the Kaiser Family Foundation.

Despite the disruptions caused by the pandemic, the proportion of employers that offer their staff health coverage has remained steady, while health insurance premiums and out-of-pocket expense increases have remained moderate, according to KFF’s “2021 Employer Health Benefits Survey.”

With the stress of the pandemic weighing on workers in all industries, as well as the effects on their families and society from lockdowns and other changes brought on by COVID-19, many Americans have been struggling with mental health as well as substance abuse.

Provisional data from the Centers for Disease Control’s National Center for Health Statistics indicate that there were an estimated 100,306 drug overdose deaths in the United States during the 12-month period ending in April 2021, an increase of 28.5% from the 78,056 deaths during the same period the year before.

Besides drugs, alcohol abuse has also skyrocketed during the pandemic, according to the CDC.

Another report by the CDC found that 40% of U.S. adults had reported struggling with mental health or substance abuse:

  • 31% reported symptoms of anxiety and/or depression.
  • 26% reported symptoms of trauma/stressor-related disorder.
  • 13% started or increased substance abuse.
  • 11% reported seriously considering suicide.

It’s no surprise then that since the pandemic started, 39% of employers surveyed said they’d boosted their benefits covering these issues.

Of those that made changes:

  • 31% increased the ways employees can access mental health services, such as telemedicine.
  • 58% of employers with 200 or more employees and 38% of those with 50 to 199 employees expanded online counseling services.
  • 16% started offering employee assistance programs or other new resources for mental health.
  • 6% expanded access to in-network mental health providers.
  • 4% reduced cost-sharing for such visits.
  • 3% increased coverage for out-of-network services.

How did employers act? For example, after the pandemic hit, Rhode Island-based Thundermist Health Center’s employee health plan reduced the copayments for behavioral health visits to zero from $30.

As to employees, they responded by taking advantage of the new and expanded services:

  • 38% of large companies (1,000 or more workers) said their workers had used more mental health services in 2021 than the year before.
  • 12% of companies with at least 50 employees said their workers had increased their use of mental health services.

What you can do

With so many people suffering from mental health and substance abuse issues that may have been exacerbated by or are a direct result of the pandemic, it’s certain that most employers have staff who are struggling.

Talk to us about what your current plan choices offer in terms of substance abuse and mental health counseling benefits. Many insurers, in response to rising demand, have been increasing access to these treatments.

If you do not have one, you may also consider an employee assistance program, which will provide a set amount of counseling appointments as well as substance abuse treatment to complement your health plan.

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Hospital Indemnity Insurance a Key Voluntary Benefit

by Inoventive Solutions
December 14, 2021

Most employers offer major medical coverage to their full-time employees. But that still leaves workers and their families with significant exposure to financial hardship in the event of a serious medical emergency.

For example, even with insurance, treating a broken leg or undergoing emergency appendicitis surgery can mean thousands of dollars in out-of-pocket medical costs.

Meanwhile, most households can’t afford to cover a $1,000 emergency. Fortunately, employers can help by offering their workers voluntary hospital indemnity insurance that can provide peace of mind in case they have a serious medical episode.

Hospital indemnity insurance

This coverage offers a cash payment directly to the insured worker in the event of the hospitalization of themselves or a covered family member.

The worker can use this cash benefit for any purpose, including:

  • Deductibles
  • Copays
  • Coinsurance
  • Drugs
  • Transportation
  • Medical equipment, such as wheelchairs or walkers
  • Offset lost wages
  • Hiring home care assistance.

How coverage works

One of your employees calls in and says she had to take her daughter to the hospital the previous night with severe stomach pain.

The doctor diagnoses the girl with appendicitis, and schedules her for immediate surgery. She spends two days in the hospital. She’ll be fine. But your employee now has some significant medical bills.

The average cost of appendix-removal surgery is over $30,000. Your group medical plan will pay for most of it. But if you have an 80-20 plan, your worker is still responsible for her deductible (averaging over $1,600), plus 20% of that cost, or over $6,000.

That leaves your worker exposed to a total out-of-pocket cost of over $7,600.

If she takes a few days off work to care for her daughter at home while she recovers, the net cost is even greater.

Few people can cover that. When faced with medical bills like that, many of them go into debt, or skip needed medical care, which can lead to still greater costs down the road.

In fact, medical bills are a major contributing factor to personal bankruptcy ― even for people with health insurance.

Little or no cost to the employer

Hospital indemnity coverage is generally offered as part of a voluntary benefits package, and often at little or no cost to the employer.

Employees pay part or all of the premiums via payroll deduction. Coverage specifics vary, but plans are designed to be affordable for all kinds of workers.

Coordination with group health insurance

Many employers use hospital indemnity coverage to help close the gap between the worker’s needs and what an existing group medical plan will cover.

In many cases, the availability of a direct cash benefit in the event of a qualifying hospitalization or emergency room visit can coax employees to opt for a lower-cost high-deductible health plan reducing overall costs for the business, while giving the worker peace of mind that they can foot the bill in case of emergency.

We can help you customize your voluntary benefits package and coordinate it with your existing group medical offering.

Note: Hospital indemnity insurance is a supplemental insurance product. It does not constitute comprehensive health insurance and is not intended to replace a qualifying major medical insurance plan.

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2022 Health Insurance Outlook, Changes

by Inoventive Solutions
December 1, 2021

As we enter 2022, there are a number of changes on the horizon that plan sponsors need to be aware of as they will affect group health plans as well as employees enrolled in those plans.

Some of the changes concern temporary rules that were implemented during the COVID-19 pandemic. In addition, new rulemaking is likely to be introduced in 2022 that will affect health plans, including non-discrimination rules for wellness plans and new rules governing what must be included on insurance plan ID cards.

Here’s a list of what to expect in 2022.

HDHP telehealth services — The CARES Act, signed into law in 2020 after the pandemic started, temporarily allowed high-deductible health plans to pay for telehealth services before an enrollee had met their deductible.

That comes to an end Dec. 31, 2021, and for plan years that start on or after Jan. 1, 2022, HDHPs must charge enrollees for telehealth services if they have not yet met their deductible.

Mid-year election changes — The Consolidated Appropriations Act of 2021 (CAA) and ensuing guidance from the IRS relaxed a number of rules that will come to an end for plans incepting on or after Jan. 1, 2022. These rules were all not mandatory and employers could choose whether to relax them or not.

Here are the rules that will sunset at the end of 2021:

  • Allowing employees who had declined group health insurance for the 2021 plan year to sign up for coverage.
  • Allowing employees who had enrolled in one health plan option under their group health plan to change to another plan (such as switching insurance carriers or opting for a silver plan instead of a bronze plan).
  • For health flexible spending accounts (FSAs), allowing participants to enroll mid-year, increase or decrease their annual contribution amount, or pull out of the plan altogether and stop contributing.
  • For plan years ending in 2020 and 2021, permitting employers to modify their FSAs to include a grace period of up to 12 months to spend unused funds from the prior policy year.
  • Allowing for a higher FSA carryover amount than the typical $500.

Any plans that allowed these changes would have to have been amended to reflect that, and for 2022 they’ll have to be amended to reflect reverting to the old rules that forbid such changes.

Affordability level falls — Under the Affordable Care Act, employers with 50 or more full-time or full-time equivalent workers are required to provide health coverage to at least 95% of their full-time employees. The ACA requires that the coverage is “affordable” for the worker, which is set as a percentage of their household income.

For 2022, the affordability level will be 9.61% of their household income, down from 9.83% in 2021.

Electronic filing threshold drops — Starting in 2022, employers with 100 or more workers will be required file their 2021 ACA-related tax forms with the IRS electronically, as a result of changes brough on by the Taxpayer First Act. That’s a change from the prior threshold of 250. This applies to forms 1094-C, 1095-C, 1094-B and 1094-B.

While the IRS has yet to release guidance for this change, it’s expected it will do so by the end of 2021.

More guidance coming

The CAA created a number of new requirements that affect health insurance and coverage. Look for various government agencies, chiefly the Centers for Medicare and Medicaid Services, to provide new guidance on:

Insurance plan identification cards — Part of the CAA requires health plans and issuers to include information about deductibles, out-of-pocket maximum limitations and contact information for assistance on any ID cards issued to enrollees on or after Jan. 1, 2022.

Continuity of care requirements — The CAA also requires insurers to offer anyone who is a “continuing care patient” of a provider or facility the option to elect to continue to receive care for up to 90 days from the provider or facility, even when there’s a change in that provider’s contract status with a health plan that could normally result in a loss of covered benefits.

If certain conditions apply, this transitional care would be provided as if the contractual relationship with the provider had not changed.

Wellness program incentives — The Equal Employment Opportunity Commission is expected to issue new regulations on what kind of incentives are permissible for employer-sponsored wellness programs. The main focus is on incentives and if they are discriminatory to some workers.

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Uncategorized

Helping Your Employees Find the Right Plan for Them

by Inoventive Solutions
November 16, 2021

Studies have found that nine out of 10 employees opt for the same benefits every year and that around a third of workers don’t fully understand the group health plan benefits they are enrolled for.

Staying in the same plan after year can be a waste of money if someone is in the wrong plan for them. And not understanding benefits can lead to wasted money as well, as workers often skip necessary appointments, check-ups and treatment regimens for chronic conditions, which in turn puts their health at risk.

As coverage has grown in complexity over the past decade, it’s important that you provide the resources for your employees to choose the health plan that is best for them. Here are three tips that will help them get the most out of their benefits.

Don’t skimp on explaining

While some employees’ eyes are bound to gloss over while someone is explaining the various plan options, their networks, their copays, deductibles and more, it pays to take the time to explain them step by step.

That means breaking the benefits down to the basics in language anyone can understand. Avoid getting bogged down in health insurance jargon and keep it simple. The simpler the better.

Don’t think of it as talking down to your employees, because there’s a good chance some of them are not familiar with how health coverage works. Encourage questions, by telling them there are no stupid questions. Invite employees to speak one-on-one with your benefits point person if they have questions they’d rather ask privately.

Make benefits communications all year long

When the new year starts and open enrollment is in the mirror, most employers don’t reach out to staff until a few weeks before the next year’s enrollment period starts.

Plan now for regular benefits communications throughout next year. Send them e-mails and materials during the course of the year that remind them to consider how their current coverage is measuring up to their needs.

This is especially important if someone’s health situation changes. They may be looking to make a change during the next open enrollment, and feeding them periodic memos about their coverage can help them educate themselves and prepare.

Communications could include explainers about cafeteria plans, health savings accounts, how to use their health benefits wisely, and more.

Know your crew

After open enrollment, run a report looking at what plans your employees are signed up for and see if they are concentrated in certain plans. Many employees when choosing health plans ask their co-workers, which often leads to them choosing a plan that is not optimum for them since there are many factors that may vary, including:

  • Their age.
  • Whether or not they are married.
  • Whether or not they have children.
  • Their health situation.

That’s why it’s important to run some analytics on your employees’ health plan choices. We can work with you to make sure that they are in the right plans and identify what might be a better alternative for them.

For example, in many cases, the younger and healthier someone is, the best choice may be a high-deductible health plan with lower premiums, tied to an HSA. Older employees and those with health conditions — those who are more likely to use medical services and be on medication — may need a plan with a lower deductible.

The takeaway

It benefits both your employees and you if your employees are in the appropriate plan for their life and health situation.

Fortunately, you can ensure that they understand their benefits by understanding their needs and helping them learn about their benefits throughout the year.

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Uncategorized

Draft Would Help Policyholders Meet Drug Deductibles, Copays

by Inoventive Solutions
November 9, 2021

A model measure would require health plans to include financial assistance that policyholders receive, as well as drug rebates, towards their pharmaceutical deductibles, copays and coinsurance.

Most health plans do not allow rebates and outside financial assistance to count towards a policyholder’s drug deductible, which critics assert penalizes enrollees.

The model measure introduced by the National Council of Insurance Legislators (NCOIL), a bi-partisan organization of state elected officials who specialize in insurance law, would require them to count those outlays towards coinsurance and deductibles.

It’s expected that some NCOIL members will introduce similar legislation in their home states in 2022 or in subsequent years.

If successful, such laws could be a boon for some patients who receive help from drug companies or whose drugs are eligible for rebates

This is a significant move as pharmaceuticals become more expensive and lawmakers and policymakers wrestle with how to make them more affordable and stem steep annual cost increases.

The problem

Health plans’ and PBMs’ drug formularies have different cost-sharing amounts for different tiers of drugs. The lowest amount of cost-sharing is mostly for generic drugs, some of which are even available with no copays.

There are typically at least three tiers of drugs, with the higher reserved for brand-name drugs for which there are not always generic versions available. The top tier is usually reserved for the most expensive, specialty medications.

For expensive pharmaceuticals, some drug makers will sometimes work with patient advocacy groups to fund programs that offer financial support towards out-of-pocket expenses for patients that purchase their drugs.

Drug companies will also provide rebates. But often, pharmacy benefit managers and health insurers will receive those rebates and there have been questions as to how much of them they share. And they don’t count those rebates towards the patient’s out-of-pocket maximum.

The model legislation

The model legislation is just that: a model. NCOIL has put the proposed measure on its agenda for its Nov. 18 meeting.

It’s expected that some NCOIL members — Republican and Democratic lawmakers from all 50 states — will write and help pass similar measures in their home states.

The preamble to the language in the measure states that it aims to address programs that keep cost-sharing assistance payments from counting towards a patient’s annual out-of-pocket spending limit.

That draft’s model language states: “When calculating an enrollee’s overall contribution to any out-of-pocket maximum or any cost-sharing requirement under a health plan, a carrier/insurer/issuer or pharmacy benefit manager shall include any amounts paid by the enrollee or paid on behalf of the enrollee by another person.”

Insurance companies and PBMs say that the measure would be improved if it would limit its scope to only include drugs with no lower-cost or generic alternative. That way, it would keep pharmaceutical companies from steering patients to their more expensive drugs when there are lower-cost alternatives.

Right now, there is no pending legislation at the state level, but this could be the starting point to bring some financial relief to drug plan enrollees that are either high users of prescription drugs or have been prescribed expensive medications.

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COVID-19 Home Test Kits Reimbursable under FSAs, HSAs

by Inoventive Solutions
November 3, 2021

Under new guidance issued by the IRS, at-home COVID-19 testing kits will be considered a reimbursable medical expense under the three main health care savings vehicles offered to employees.

This new guidance adds to the list of personal COVID-19-related expenses for which employees can seek reimbursement under:

  • Health savings accounts
  • Health reimbursement arrangements, and
  • Flexible spending accounts.

This is good news as these home tests become more common during this stretch of the pandemic.

The IRS earlier announced that personal protective equipment for use in preventing infection and spread of COVID-19 is also reimbursable by HSAs, FSAs and HRAs. That includes:

  • Masks,
  • Sanitary wipes, and
  • Hand sanitizers.

What to do

If you offer one of the above savings vehicles, you may need to amend your group health plan’s language, unless the plan is drafted to reimburse all IRS-permitted expenses. In that case, you can leave it as is.

If, however, the plan lists all permitted expenses, you’ll need to amend it. If you plan to set the effective date for 2021, say Sept. 15, you should make the amendment no later than Dec. 31, 2021 for it to be effective.

Regardless of whether you have to change the plan or not, you should notify all participating staff of the change so they can take advantage of their plan if they need to.

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Uncategorized

Pandemic Spurs Supplemental Benefits Uptake Among Workers

by Inoventive Solutions
October 26, 2021

A new study has found that in response to the COVID-19 pandemic nearly half of U.S. workers added one new supplemental health-related benefit on top of their group health coverage.

The 2021 “Aflac WorkForces Report” found that 44% of employees bought one additional benefit, with life insurance policies seeing the biggest uptake. The fact that so many workers decided to boost their supplemental health benefits reflects the profound effect the pandemic has had on people and how it has opened their eyes to the fragility of life.

“Anxieties over the past year brought questions about health coverage ― especially about whether current coverage is enough for workers and their families,” Aflac wrote in its report. “The survey found that employees sought ways to help offset the financial burdens they experienced, including through supplemental insurance.”

Interestingly, the largest uptake of these benefits was among millennial workers.

With the pandemic still not over and more people having seen the effects on friends, family and acquaintances, the report predicts that the trend will continue.

The most popular additional benefits

The percentages of workers who have purchased a voluntary benefit since the pandemic started:

  • Life insurance: 22% overall and 34% of millennial workers.
  • Critical illness insurance: 16% overall and 23% of millennial workers.
  • Mental health resources: 14% overall and 21% of millennial workers.
  • Hospital insurance: 14% overall and 21% of millennial workers.
  • Accident insurance: 12% overall and 19% of millennial workers.
  • Disability insurance: 10% overall and 16% of millennial workers.
  • Cancer insurance: 4% overall and 6% of millennial workers.

Overall views of supplemental benefits have also improved since the pandemic started. The survey found that:

  • One-third of employees say supplemental insurance is more important now due to the pandemic.
  • 51% of all American workers view supplemental benefits as a core component of a comprehensive benefits program.
  • 90% of employees believe the need for supplemental insurance is increasing.
  • 48% employees (and 63% of millennials) are highly interested in purchasing supplemental insurance to help cover the financial costs related to COVID-19 or other pandemics.

The takeaway

In light of these findings, it’s more important than ever that employers offer more than group health coverage and provide their workers with a slate of voluntary benefit offerings, many of which do not cost the employer much extra.

In fact, the study found that 70% of employers believe supplemental insurance helps them recruit employees and 75% say it helps with retention.

But keep in mind that may employees believe they already have enough coverage to meet their needs. Open enrollment is a prime time to educate them about the health-related expenses that group health insurance doesn’t cover, such as death benefits and long-term care.

One way you can put together a slate of offerings that your workforce needs and is interested in, is to conduct a study of your staff to see which options they would most prefer.  

And finally: Introduce your benefits consultant (in person or virtually) prior to or at the start of open enrollment. That way, employees become familiar with them and can be more comfortable asking questions about the various coverages they can choose from.

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Uncategorized

Large Employers Must File ACA Forms, Not the Insurers

by Inoventive Solutions
October 19, 2021

One mistake more and more employers are making is failing to file the required Affordable Care Act tax-related forms with the IRS.

If you are what’s considered an “applicable large employer” (ALE) under the ACA, you are required to file with the IRS forms 1094 and 1095, often separately and before your annual tax returns are due.

Under the ACA, employers with 50 or more full-time and “full-time equivalent” workers are considered an ALE and are required to provide affordable health insurance to their staff that also covers 10 essential benefits as prescribed by the law. This is what’s known as “the employer mandate.”

Filing these documents is not the responsibility of your health insurer as it’s you that’s arranging the employer-sponsored health insurance for your staff. Be aware that you can face penalties if you:

  • Don’t file the forms in a timely manner,
  • Make mistakes when filing the forms, or
  • Fail to file the forms altogether.

The IRS requires these forms to ensure that ALEs are providing health coverage to their employees and that the employer is complying with the employer mandate portion of the ACA.

The forms

  • Form 1095-C — This is basically the W-2 reporting form for health insurance. The form tells the IRS which employers are providing coverage and which employees are getting coverage through their employers.
  • Form 1094-C — This form provides information about health insurance coverage that the employer provides.

Here are the deadlines you need to be aware of:

  • Jan. 31, 2022 — Individual statements (Form 1094 C) for 2021 must be furnished to employees by this date.
  • Feb. 28, 2022 — If filing paper returns, Forms 1094 C and 1095 C must be filed by this date.
  • March 31, 2022 — If filing electronically, Forms 1094 C and 1095 C must be filed by this date.

Penalties

The general potential late/incorrect ACA reporting penalties are $280 for the late/incorrect Forms 1095-C furnished to employees, and $280 for the late/incorrect Forms 1094-C and copies of the Forms 1095-C filed with the IRS.

That comes to a total potential general ACA reporting penalty of $560 per employee when factoring in both the late/incorrect Form 1095-C furnished to the employee and the late/incorrect copy of that Form 1095-C filed with the IRS.

The maximum penalty for a calendar year will not exceed $3,392,000 for late/incorrect furnishing or filing.

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New Issues for 2022 Group Plan Open Enrollment

by Inoventive Solutions
October 13, 2021

Employers are entering the second year of open enrollment taking place during the COVID-19 pandemic, which is still having an outsized impact on the process and which has changed the face of health insurance.

There are a number of issues that will have an effect on health plans, including regulations and laws affecting coverage that were born out of the pandemic. Mercer LLC recently published a list of compliance-related priorities that health plan administrators and sponsors have to consider, including:

Legal and regulatory changes

Health plan transparency in coverage rules takes effect on Jan. 1, 2022. Newly introduced regulations require hospitals to publish their standard prices, and for negotiated rates between health plans and providers to be made transparent too.

Employers will need to communicate these changes to their employees, particularly rules that require health plans to provide enrollees with out-of-pocket estimates for upcoming procedures.

Also, the No Surprises Act, which will prohibit surprise bills for certain out-of-network services, takes effect at the start of 2022 for providers and group health plans. Employers need to meet with their plan administrator to make sure that their plans are in compliance with these new regulations.

COVID-19 issues

The pandemic will continue casting its shadow over health insurance and open enrollment.

Legislation passed last year requires health plans to cover additional services such as mental health and telehealth until the end of this year. Whether your plan offerings will keep providing those enhanced benefits or not, you’ll need to communicate that to plan participants and include it in your plan documents.

You should also confirm that your group plans comply with COVID-19 testing and vaccine coverage requirements in the Family First Coronavirus Response Act, the CARES Act and any state laws.

Gender and family planning issues

Employers should review their benefit eligibility rules after the Supreme Court in 2020 ruled that Title VII of the 1965 Civil Rights Act protects LEGBTW employees from discrimination in benefits.

You should ensure that benefits offered to opposite-sex spouses are the same as are offered to same-sex spouses.

Mental health parity

All health plans have to prepare a comparative analysis of their medical and surgical benefits and mental health and substance abuse treatment benefits to demonstrate that treatment limitations are applied comparably. This job does not fall on the employer, but you should make sure your plan has prepared the analysis or is working on it.

This is part of new laws that require health plans to offer similar benefit coverage for mental health and substance abuse treatment as they do for other medical and surgical procedures and services.

HSA, HRA and FSA revisions

The CARES Act temporarily authorized employers to allow employees with health savings accounts, health reimbursement arrangements and flexible spending accounts to make mid-year changes to how much they deposit in those accounts.

It also authorized them to permit employees to roll over unused amounts in their health and dependent-care flexible spending arrangements from 2020 to 2021 and from 2021 to 2022.

Employers that opted to allow their employees to make these changes and roll over funds, have to communicate to their employees that these changes come to an end on Dec. 31 this year.

There were also some permanent changes made by the CARES Act, including reinstating over-the-counter medical products as eligible expenses for HSAs, certain HRAs and FSAs without a prescription.

These accounts may now allow certain menstrual care products, such as tampons, pads, liners and cups, as eligible medical expenses. These are retroactive benefits to Jan. 1, 2020.

Make sure to notify your staff of these changes. You can tell them that if they have receipts for eligible expenses that date back to then, they can submit them for reimbursement.

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