This is an example of one Ohio company adjusting how they administer coupons people use at the pharmacy. The program helps make sure members’ out-of-pocket cost for prescription drugs are properly applied to deductibles and maximum out-of-pocket amounts.
The benefit of the coupon is easy to grasp. Someone on an expensive brand medication can obtain it at low or no cost.
The problem can be that the carrier processes it as a paid claim and the member never pays what the plan requires. There are reasons both employers and carriers want real out of pocket to be met by the member.
The carriers now are adjusting and working on ensuring that the member is not given credit or given a reimbursement for something they never paid for personally. Members can use the coupons, but the carrier will credit only what the member actually paid.
This seems like a reasonable solution. It will likely become a normal way coupons are processed.
The ACA imposes a maximum dollar limit on employee contributions to health flexible spending accounts (FSAs). Although the ACA set this limit at $2,500, the limit is indexed for cost-of-living adjustments each year. On Oct. 19, 2017, the IRS announced that, for taxable years beginning in 2018, the dollar limit on employees’ salary reduction contributions to a health FSA will increase to $2,650.
Employers may continue to impose their own dollar limits on employee contributions to health FSAs, as long as the employer’s limit does not exceed the ACA’s maximum limit in effect for the plan year. For example, an employer may decide to continue limiting employee health FSA contributions for the 2018 plan year to $2,500.
Go here for more information.
Health FSA Limit Will Increase for 2018 10-19-17
Employers with over 50 employees must pay attention to FMLA. With some employers, we are finding that concerns about abuse are growing.
While FMLA is designed to help employees that are in a tough spot, the prepared employer can head off abuses by having good processes in place and have access to the right information. In some cases, we have found the employees abusing FMLA are actually the experts!
Here is some FMLA info you may find useful – FMLA Rights for Nontraditional Families.
If you need assistance on FMLA resources, we can help.
Perhaps this is early but you can file it.
IRS Announces HSA-HDHP Limits for 2018
Who knows where the federal healthcare regulations are going, but if the Republicans (and the President) pass anything it will likely affect the group market by:
- Removing the cost share regulations
- Reduce the reporting requirements
- Allow carriers to create more types of plans
We will report on those types of things when/if the Senate releases their proposed version of a new healthcare bill .