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Friday, 05/27/22

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Walt Podgurski, Editor

Millions risk losing US healthcare when Covid emergency declaration expires
An estimated 5.3 million to 14.2 million could lose Medicaid coverage when the public health emergency ends in July
Guardian / / Read Article

When the US federal government’s pandemic health emergency declaration expires, millions of Americans are at risk of losing healthcare coverage through Medicaid with potentially devastating consequences.

According to an analysis by the Kaiser Family Foundation, an estimated 5.3 million to 14.2 million could lose their Medicaid coverage when the Covid-19 public health emergency ends on 15 July if it is not extended.

The analysts cited the wide range due to uncertainty on how states will respond to the end of continuous enrollment and how many people will lose coverage as a result. Medicaid enrollment is estimated to reach 110.2 million people by the end of fiscal year 2022, with enrollment expected to decline significantly when continuous enrollment ends.

Employer Savings Eyed in Plan to Ease Family Obamacare Subsidies
Bloomberg Law / / Read Article

An IRS proposal that would make it easier for families to get subsidies for health insurance in the Obamacare exchanges would help businesses that would no longer need to pay some of those costs, health insurance brokers say.

The proposal (RIN 1545–BQ16) published in the Federal Register on April 7 would change current regulations to allow family members that qualified to get subsides in the Affordable Care Act exchanges. Currently, family members are excluded from ACA subsidies if anyone in a household has access to an employer-sponsored plan that meets ACA requirements for affordability and coverage, which has been dubbed the “family glitch.”

ACA supporters have long advocated for allowing family members to get the subsidies, arguing that many families can’t afford coverage even if they have someone in their household who has employer coverage. But the proposal is costly, estimated at more than $45 billion from 2020 to 2030, and White House estimates show it would lead to only 200,000 uninsured people gaining coverage.

The rule, if finalized, could also be subject to legal challenges.


See who is already confirmed to present at:
"ADVANTAGE 2002 / Voluntary Week"


Noyo Closes $45 Million For Accelerating Delivery Of Frictionless Employee Benefits
By Annie Baker / Pulse 2.0 / / Read Article

Noyo – a leading API platform powering frictionless benefits – recently announced that it has closed $45 million in Series B financing. Norwest Venture Partners led the round, joined by Workday Ventures, Gusto, Cap Table Coalition, and existing investors Costanoa Ventures, Spark Capital, Homebrew, Operator Collective, Fika Ventures, Precursor Ventures, Garuda Ventures, Core Innovation Capital, and Webb Investment Network. As part of the funding Ed Yip, a partner at Norwest Venture Partners, will join Noyo’s Board of Directors.

This funding round represents resounding validation of Noyo’s technology and mission to unite key players in the group benefits ecosystem around the need to deliver modern, frictionless benefits experiences. And the COVID-19 pandemic and the rise of a remote workforce have increased complexities for how companies offer employee benefits across multiple states, at the same time these benefits have become critical to attracting and retaining talent in a tight labor market.

Founded to bring group benefits into the modern age, Noyo’s technology streamlines the digital transformation of the benefits industry, enabling fast, accurate, and secure data exchange through API-powered data infrastructure. And the company’s suite of APIs allows critical insurance and benefits data to flow from point to point or exist embedded in the applications consumers use every day, unlocking industry-wide connectivity with powerful network effects.

In Rockstars Rocking Podcast by Eric Silverman / / Watch Video

Episode Highlights:

Being recognized as a Top 5 Finalist for Benefits Broker of the Year by BenefitsPRO Magazine
What stops employers from making a change?
Making benefits innovation as easy as the status quo
Is our national healthcare system broken?
The usefulness of medical tourism
Having the right tools in your toolbox
Give employers a roadmap forward, so they understand where they are going
Looking ahead, starting his own COHP – Community Owned Health Plan

The Benefits Cooldown:
Eric Silverman, Voluntary Disruption & Edwige Ligonde , Executive Vice President @ Nielsen Benefits Group / / Read Article / / Watch Video

How do we make benefits fun for employees? Join Eric and Ed for a discussion about how to drive engagement. They posit that making the process fun for employees is the key to driving education and participation, with Ed detailing some of the ways he’s had success via “gamifying” benefits education.

Companies Face Increased Litigation Over COBRA Notices
Employers often have difficulty with COBRA’s technical requirements
Charles F. Seemann III & Kyle R. Bevan © Jackson Lewis / SHRM / / Read Article

Companies around the U.S. have recently seen a barrage of cases alleging that notices required under the Consolidated Omnibus Budget Reconciliation Act (COBRA) fail to provide all information required by COBRA. Class action cases filed against high-visibility defendants in Georgia, Michigan, Florida, and elsewhere allege the companies violated federal law when they sent purportedly inaccurate, threatening, or confusing notices of former employees' rights to elect to continue medical-insurance coverage after their employment ended.
Under COBRA, election notices must contain information including a mailing address for payments, the identity of the plan administrator, an explanation of how to enroll, and a physical form to elect coverage. The U.S. Department of Labor (DOL) provides a model COBRA notice template, updated in 2020, which contains these items. Yet few companies use DOL's model COBRA notice, for several reasons:

Most companies contract with third-party vendors, who design and provide their own notices to covered persons experiencing a qualifying event, such as job separation.

These vendors often omit the plan administrator's name to avoid confusion, because the payments must be mailed to the third-party vendor.

Many items specified in the DOL model notice are often unknown (and therefore omitted) at the time notice is given. The resulting litigation is directed at the employer or plan sponsor as the defendant, but not the vendor whose election notice is challenged.

LifeWorks Partners with Nayya to Improve Benefits Enrollment Experience for Employees Throughout the U.S.
Nayya Health, Inc., LifeWorks / PRNewswire / / Read Article

LifeWorks, a leading provider of benefits administration solutions and comprehensive mental health, digital, and in-person total wellbeing solutions, today announced a partnership to integrate Nayya's leading benefits experience and healthcare management solution into its benefits administration platform. This partnership demonstrates the companies' shared commitment and desire to transform the benefits experience for Americans. Through the partnership, LifeWorks will offer Nayya's Choose & Use product suites on its leading benefits administration platform, transforming the benefits experience for millions of employees throughout the U.S, with personalized navigation of their benefits programs and step-by-step decision support.

The American employee is at a crossroads: In the wake of the pandemic, rising inflation, skyrocketing healthcare costs, and soaring medical and personal debt, employees are struggling to maintain their day-to-day finances while providing for themselves and their families. The complexity associated with choosing the proper benefits or healthcare plan confuses even the most engaged consumer. This new partnership simplifies the process every employee faces when choosing benefits, bringing much needed context and clarity to empower better decisions. Never has benefits selection been more important: The LifeWorks and Nayya integration will lower costs for consumers while improving their mental, physical, social, and financial wellbeing.

Surprise: Long Term Care Providers Are Not Exempt from The No Surprises Act’s Good Faith Estimate Requirement for Uninsured and Self-Pay Patients
JD Supra / / Read Article

The federal No Surprises Act and interim final rules implementing the Act went into effect on January 1, 2022. Part I is aimed at reducing “surprise bills” to patients in the context of services provided at hospitals and ambulatory surgical centers. A “surprise bill” is one that a patient receives for services from a provider who the patient was not aware was out-of-network with the patient’s insurer and often follows an emergency service or procedure.

Part II requires that “providers” give uninsured and self-pay patients a good faith estimate of charges before certain procedures and services are provided. The definition of “provider” in Part II is very broad and includes “health care facilities.” A health care facility is further defined to include any facility required to be licensed under state law. Skilled nursing and other long term care facilities are not specifically mentioned as examples in Part II, so many thought that long term care providers were not included. However, a CMS FAQ states that “No specific specialties, facility types, or sites of service are exempt from this requirement.”

Five things to know: Republicans file Medicaid expansion bill for North Carolina
By Charles Duncan North Carolina / SPECTRUM NEWS1 / / Read Article

Republicans in the North Carolina Senate have reversed course on Medicaid expansion, moving Wednesday to expand health care coverage to hundreds of thousands more people.

The GOP in the General Assembly have opposed expanding Medicaid in North Carolina since it became possible during the Obama administration with the Affordable Care Act.

“We must do something to improve health care, especially expand access and lower costs,” Senate Pro Tem Phil Berger said Wednesday. “We need coverage in North Carolina for the working poor.”

The Affordable Care Act, also known as Obamacare, gave federal funding for states that chose to expand Medicaid coverage for more people.

The law faced numerous legislative and legal challenges, but most provisions in the law have survived in the dozen years since it was enacted.

Berger said he has been one of the most vocal opponents of Medicaid expansion in North Carolina over the past decade. But things have changed.

“Medicaid expansion has evolved to a point where it is now good fiscal policy,” he said in a news conference Wednesday, flanked by Republican colleagues at the General Assembly.

The Medicaid expansion proposal comes as an amendment to what originally was a bill to expand telehealth services.

State Health Insurance Exchange Abandons $2.8M Fee Hike
cbia - The Connecticut Business & Industry Association  / / Read Article

The state health insurance exchange has abandoned a controversial proposal hiking the assessment rate on fully-insured health insurance plans from 1.65% to 1.80%.

The Access Health CT board delayed an April 20 vote on the assessment change—essentially a tax increase—after CBIA submitted comments opposing the plan.

The proposed $2.8 million assessment hike would have raised premium costs for small businesses and their employees.

The Access Health CT board voted last week to remove the assessment from its fiscal 2023-2024 budget.

Echoing CBIA's comments, several board members voiced concerns about the proposal given Connecticut's workforce and economic challenges, as well as the uncertainty about the future of federal pandemic funding.

The exchange will now draw from its reserves to cover the $2.8 million budget deficit.

Tuesday, 05/24/22 - Gen Re Releases U.S. Individual Disability Market Survey Results

Wednesday, 05/25/22 -  72% of U.S. Employees Are Stressed About Their Finances, According to the BrightPlan 2022 Wellness Barometer Survey

Thursday, 05/26/22 - Open Enrollment Report 2021-22: Industry Benchmarks, Best Practices, and Tips for Better Results

Friday, 05/20/22 - Health Insurance Market will be Valued at $2,259,670.09 Million by 2029 | Market Key Players: Aetna, Cigna, Allianz Care, AXA