Proposed Rule Impacts Employer Sponsored Health Plans

proposed rule published on November 27th by the IRS, U.S. DOL, and HHS would place new requirements on group health plans and health insurance providers. The rule would require providers to disclose cost-sharing information to participants, beneficiaries, and other covered individuals which would outline their liability to pay certain cost-sharing amounts and out-of-pocket expenses. This rule is part of a Trump Administration effort to foster competition among insurers and healthcare providers in the marketplace. An article published by the Society for Human Resources Management (SHRM) outlines the concerns many employers have regarding the costs associated with implementing the requirements of the proposed rule. These requirements include providing plan enrollees with an online self-service portal where they can see these cost-sharing amounts, as well as require greater collaboration between third party plan administrators, pharmacy benefit managers, and other specialty providers to ensure the accurate disclosure of enrollee financial obligations. Comments on the proposed rule are due by January 14, 2020.

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2020, Department of Health and Human Services (HHS), Department of Labor (DOL), Human Resources (HR), Internal Revenue Service (IRS)


Scott Moore

Scott A. Moore, Esq. has been in the emergency medical services field for over 26 years. Scott has held various executive positions at several ambulance services in Massachusetts. Scott is a licensed attorney, specializing in Human Resource, employment and labor law, employee benefits, and corporate compliance matters. Scott has a certification as a Professional in Human Resources (PHR) and was the Co-Chair of the Education Committee for the American Ambulance Association (AAA) for several years. In addition, Scott is a Site Reviewer for the Commission on the Accreditation of Ambulance Services (CAAS). Scott earned his Bachelor’s Degree in Psychology from Salem State College and his Juris Doctor from Suffolk University Law School. Scott maintains his EMT and still works actively in the field as a call-firefighter/EMT in his hometown. Scott is a member of the American Bar Association, the Massachusetts Bar Association, the Society for Human Resource Management, and the Northeast Human Resource Association.

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