March 12, 2020
The IRS has released Notice 2020-15 which provides clarification as to how testing and treatment of COVID-19 will affect those enrolled in a High Deductible Health Plan (HDHP) that is coupled with a Health Savings Account (HSA). There has been confusion as to whether claims associated with COVID-19 would be subject to deductibles. Because of the current public health crisis, the IRS is allowing HDHP plans to cover these services so that they are NOT subject to any deductible.
These guidelines will remain in place until further notice from the IRS. Self funded plans can choose to “opt out” from this guidance but we recommend against this course of action.
The following link provides the complete notice.
“Due to the unprecedented public health emergency posed by COVID-19, and the need to eliminate potential administrative and financial barriers to testing for and treatment of COVID-19, a health plan that otherwise satisfies the requirements to be an HDHP under section 223(c)(2)(A) will not fail to be an HDHP merely because the health plan provides medical care services and items purchased related to testing for and treatment of COVID-19 prior to the satisfaction of the applicable minimum deductible. As a result, the individuals covered by such a plan will not fail to be eligible individuals under section 223(c)(1) merely because of the provision of those health benefits for testing and treatment of COVID-19.”
As is widely reported in the media, testing availability continues to be limited. In addition, federal and state governments are concerned about overwhelming health care facilities. With events rapidly unfolding, The Fedeli Group is working with the various insurers it represents to better understand their approaches to member communication and coordination with health care facilities. We will be reporting to our clients globally and on a case by case basis.
Stilll have questions or concerns? Let’s talk.
September 8, 2023
Tenth Circuit Court of Appeals Hands Down a Big Win for ERISA Preemption After several failed attempts by pharmacy benefit managers (“PBM”) to challenge state laws regulating PBMs, the 10th Circuit Court of Appeals (in Pharmaceutical Care Management Association v. Mulready) handed down a big win for PBMs and, by extension, self-funded ERISA plans, when […]
August 28, 2023
IRS Issues Affordability Percentage Adjustment for 2024 The Internal Revenue Service (IRS) has released Rev. Proc. 2023-29, which contains the inflation adjusted amounts for 2024 used to determine whether employer-sponsored coverage is “affordable” for purposes of the Affordable Care Act’s (ACA) employer shared responsibility provisions and premium tax credit program. As shown in the table […]