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Supreme Court's Roe v. Wade Decision: Carrier Responses

The Supreme Court released its decision regarding abortion rights on June 24, essentially reversing the previous Roe v. Wade and Planned Parenthood v. Casey decisions. While this decision does not dir...

New Guidance and Delayed Enforcement for Prescription Drug Data Collection (RxDC)

On the eve of the requirement for employer-sponsored health plans and health insurance carriers to submit prescription drug cost reporting data (RxDC), the Departments of Labor, Health and Human Servi...

Health Net Announces Small Group Q2 2023 Updates

Health Net invites you to join their leadership team to hear the latest updates for Q2 2023 Small Group Business! They have good news to share designed to help boost Health Net sales. Join Health N...

Kaiser Permanente's® COVID-19 Vaccine Update for Children Under 5

The Centers for Disease Control and Prevention has approved the use of updated COVID-19 vaccines for children 6 months to 5 years. Kaiser Permanente® expects to offer updated vaccines to this age grou...

Sharp Health Plan Rate Update, April 2023

Sharp Health Plan has issued a rate update for Q2 2023. Plans will increase 1.6% compared to Q1 rates, and 4.3% as an annual change. There are no plan or underwriting changes and quoting will be ava...

Blue Shield of California Choice Medical Group Successful Contract Negotiation

Choice Medical Group Successful Contract Negotiation Blue Shield of California has agreed to a multiyear provider contract negotiation with Choice Medical Group Apple Valley and Choice Medical Grou...

Small Employers Can Save Big with Aetna Funding Advantage™

Now small employers can take advantage of lower monthly payments and a claims surplus opportunity at annual renewal. They also get fixed monthly payments and monthly reporting with Aetna Funding Advan...

Accessing Care is Easier with Kaiser Permanente's® New Travel Card for Members

When employees receive in-person urgent or emergency care from providers in non-Kaiser Permanente states, they will soon have the option of showing their digital ID card in the Kaiser Permanente mobil...

Kaiser Permanente® Adds New Enhancements to Group Bills

Following Kaiser Permanente's® recent feedback, employer groups will begin seeing new enhancements to commercial group invoices on their December or January bills (depending on billing cycles). Lea...

Sutter Health Plus and Prescription Drug Data Collection Reporting (RxDC) Requirements

The Consolidated Appropriations Act of 2021 (Section 204) requires insurance companies and employer-based health plans to submit information to the federal government about: Spending on prescrip...

Blue Shield of California and Prescription Drug Data Collection Reporting (RxDC) Requirements

Blue Shield of California is preparing to submit data files as required by the Consolidated Appropriations Act, Section 204 – Pharmacy Drug Cost Reporting for reports due December 27, 2022. This feder...

CCSB Introduces Family Glitch Toolkit

In October 2022, the U.S. Department of the Treasury's bureau of Internal Revenue Service (IRS) released a final rule to address the “family glitch” issue. The family glitch deemed that employer-spons...

Sutter Health Plus Rate and Benefit Pass 2nd Quarter 2023

Sutter Health Plus has announced a rate pass for Q2 2023. Quoting will be available soon! There are no network or benefit changes. Remember that available January 1, 2023 Sutter Health Plus adde...

Compliance Considerations When Moving from Fully-Insured to Self-Funded

Employers may choose self-funded group health plan coverage to obtain more flexibility with plan design and hopefully save some money. However, in doing so, there are additional responsibilities and c...

UnitedHealthcare Consumer Price Transparency Tool Available on January 1, 2023

UnitedHealthcare will provide members with a new tool to estimate and compare select health service costs based on CAA requirements. Beginning Jan. 1, 2023, price comparison information for a speci...

Cigna Vision Reminder: Enhancements Coming In 2023

Cigna is enhancing the Cigna Vision Plan experience and the benefits are clear to see! In alignment with Cigna's mission to provide whole health solutions that are simple and affordable, they are ...

Blue Shield of California: Choice Medical Group Network Termination

Blue Shield of California has yet to reach an agreement on rates and terms of contracts with Choice Medical Group Apple Valley and Choice Medical Group Barstow, and the current agreement will end on J...

Health Net Offers Flu Shots at No Charge Through Network Pharmacies

Many of you asked that flu shots be made available in a pharmacy setting for HMO members. Health Net heard you and they are happy to share that they’ve increased access so that members can obtain a...

Transparency in Coverage: Prescription Drug Data Collection Reporting (RxDC) Requirements, December 2022

The RxDC reporting provision of the Consolidated Appropriations Act (CAA) requires reports on drug utilization and spending trends to be submitted to U.S. Department of Health and Human Services begin...

New PCORI Fee Announced

At the time we originally distributed the announcement for the IRS and ACA limits for 2023, the new PCORI Fee amount was projected to be $2.93 for Plan Years ending on or after October 1, 2022 and bef...