Resources

2022 The Patient-Centered Outcomes Research Institute (PCORI) Fee

The Patient-Centered Outcomes Research Institute (PCORI) fee, which is also referred to as the  Comparative Effectiveness Fee, initially applied from 2012 to 2019. However, in December 2019, the Further Consolidated Appropriations Act, 2020 extended the fee to 2029. The fee is due based on ...

Compliance Recap | May 2022

The month of May again brought relatively little major employee benefit compliance guidance from federal agencies. However, there was plenty of activity in the courts to provide useful insight into steps employer plan sponsors can take to safeguard against benefits. Department of Labor Provides ...

Advocacy in Action | Preventative vs. Diagnostic Claims

A member contacted her Patient Advocate to find out why she was being billed $753.00 for her routine preventative colonoscopy. This was the first time she had ever had a colonoscopy and her doctor told her it was a preventative test. She told her Patient Advocate she had just lost her mother ...

Dear HR Manager from Under a Microscope

Dear HR Manager, I have a new supervisor, and he is a grade “A” micromanager. He proofs every single one of my client emails, tracks my arrival and departure times, and doesn’t let me make even minor decisions on my projects. As a result, I am starting to second-guess whether this is the right ...

Getting Clarity on Transparency: What Health Plan Sponsors Need to Know about Publishing Machine-Readable Files

As of July 1, 2022, group health plans must clear one of the first major compliance hurdles required by the Affordable Care Act’s (ACA) Transparency in Coverage (TiC) Final Rules. By that date, plans and insurance carriers must have prepared and posted two machine-readable files (MRFs) to a ...

Workplace Culture | The Business Case for Pet Insurance

Gym reimbursements, hotel discounts, mental health resources, and more options in today’s competitive benefits packages offer more than yesteryear’s standard health insurance package. Cutting-edge companies understand that their employees are unique and that they need to provide ...

Diversity, Equity & Inclusion | Pay Transparency: More than Dollars and Cents for Women and People of Color

Pay transparency is a hot topic in the employment world. WorldAtWork describes pay transparency as the “degree to which employers are open about what, why, how and how much employees are compensated — and to what degree they allow employees to share that information with others.” This topic is ...

Advocacy in Action | Health Reimbursement Arrangement (HRA) Education

A member contacted Purple Card upset about a large amount of out-of-pocket money he owed the service provider for his emergency room visit. His Patient Advocate listened to the member and then reviewed the member’s emergency room claims and his coverage. She saw the member had selected a high ...

Compliance Recap | April 2022

After several very quiet months this year, April saw renewed compliance activity. The IRS provided guidance on transportation fringe benefits unused due to COVID-19 workplace changes and announced inflation-adjusted amounts for HSAs and HRAs. The Centers for Medicare & Medicaid Services ...

Dear HR Manager from In the Doghouse

Dear HR Manager, The cat’s out of the bag…I don’t like my colleague’s dog. A dog-friendly office sounded like a great perk when I joined the company until my co-worker’s puppy made a habit of gnawing on my leg during Zoom calls. I am also taking inconvenient breaks to walk Fido as my colleague ...

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