May 23, 2023
Up to 18 million people may no longer be eligible for Medicaid coverage now that states are required to resume annual Medicaid renewals, following a “break” and relaxed social service benefits rules during the pandemic. Because The Families First Coronavirus Response Act (FFCRA) declared a public health emergency, states were prohibited from disenrolling Medicaid recipients.
This is no longer the case — and those impacted by disenrollment will likely look toward employer-sponsored plans for coverage.
A provision of the federal Consolidated Appropriates Act of 2023 separates the public health emergency from the Medicaid enrollment process. This means states can return to their previous Medicaid redetermination processes.
As employers, you play an important role in advocating for health care coverage and can serve as a valuable resource for team members who may lose their state benefit. First, work with your benefits consultant to understand the potential impact of Medicaid recipients joining your plan. How will this impact claims, cost and coverage. A proactive communication and support strategy will help you maintain compliance while delivering important information to employees during a stressful time.
Help employees understand their options. Here are some ways you can prepare for potential changes and serve as an advocate for your people.
How can we help? Contact your TFG Employee Benefits consultant today.
Additional information can be found here.
January 9, 2024
Sponsors of self-funded ERISA plans have fiduciary obligations to plan participants, which includes the obligation to provide a full and fair review of claims and effectively and meaningfully communicate or engage with plan participants regarding claims denials. One district court recently clarified that this obligation may include the need for the plan administrator, which is […]
December 4, 2023
On July 25, 2023, the agencies released an extensive proposed rule related to the Mental Health Parity and Addiction Equity Act (the “Proposed Rule”) as well as a Technical Release requesting comments on certain proposed data requirements for nonquantitative treatment limitations (“NQTLs”) and the potential for an enforcement safe harbor if certain data requirements are […]