Group health plans that are subject to the Form 5500 filing and have extended the deadline via a Form 5558 If an extension of time to file Form 5500 is obtained, the plan administrator must furnish the SAR within two months after the close of the extension period. Employers must provide the SAR to participants […]

All group medical plans Plans and carriers may not enter into an agreement with a provider, network, TPA or other service provider offering access to a network of providers that restricts the plan from; providing provider-specific cost or quality of care data, electronically access de-identified claim and encounter data for each participant or beneficiary and […]

Employers with Self-funded/Level-Funded health plans This rule prohibits group health plans from discriminating in favor of highly compensated individuals with respect to both eligibility and benefits offered under the plan. Employers should review their plans and ensure plans are still within compliance and not discriminating against non-Highly Compensated Individuals (HCIs). HCIs must include the excess […]

Employers with Self-funded/Level-Funded health plans Plan is ultimately responsible for updating three machine readable files (MRFs) disclosing: in-network rates, OON allowed amounts, billed charges, negotiated rates and historical net prices for Rx drugs. Employers should collaborate with a third-party administrator to ensure the plan is administered in accordance with the TiC rules at each renewal. […]