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Anthem News: Drug list name will change for some Small Groups in Virginia

If your company offers an Anthem medical plan that complies with health care reform law, you may notice that the name of the plan's drug list (also called a formulary) has changed. The new name is the Traditional Open Drug List. The medications included on the drug list have not changed. The goal of the list is to provide access to drugs and therapies with clinical evidence to improve the health of Anthem members, while keeping health care affordable. As a reminder, Anthem's Drug Search Tool lets members see results specific to their plan's drug list, after they've logged into their...

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House Republicans Release Proposed ACA ‘Repeal and Replace’ Bill

UPDATE 3/27/17: Despite days of intense negotiations and last-minute concessions to win over wavering GOP conservatives and moderates, House Republican leaders Friday failed to secure enough support to pass their plan to repeal and replace the Affordable Care Act. House Speaker Paul Ryan pulled the bill from consideration after he rushed to the White House to tell President Donald Trump that there weren’t the 216 votes necessary for passage." (Kaiser Health News, March 24, 2017)   Republican leaders in the U.S. House of Representatives have released the American Health Care Act, a bill which seeks to "repeal and replace" the Affordable Care Act...

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Anthem’s Customized Credit Freeze Program Following 2015 Cyber Attack

Earlier Anthem announced that they have agreed to provide a customized credit freeze program for minors who were under the age of 18 on January 27, 2015, when they first discovered indications of the 2015 cyber attack. Anthem announced that, as part of the Minor Credit Protection program, they will: Cover the one-time costs to set and remove a freeze at all three major credit bureaus (Equifax, Experian, and TransUnion), if a parent chooses to set a minor credit freeze for his or her minor child. Reimburse the costs incurred for an existing minor credit freeze with the three credit bureaus, if...

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New SBC Template Required For Use On or After April 1

New versions of the Summary of Benefits and Coverage (SBC) template, instructions, uniform glossary, and related documents are required for use on or after April 1, 2017. Under the Affordable Care Act, group health plans and health insurance issuers are generally required to provide a written SBC to plan participants and beneficiaries at specified times during the enrollment process and upon request. Changes to SBC Template The new SBC template includes an additional coverage example as well as language and terms to improve individuals' understanding of their health coverage. Specifically, the new template includes more information about cost sharing, such as...

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Revised Model CHIP Notice Now Available

A revised model notice is now available for all employers that provide group health coverage in states with premium assistance through the Children's Health Insurance Program (CHIP), or Medicaid, to inform employees of potential opportunities for assistance in obtaining coverage. The employer CHIP notice must be furnished to all employees annually before the start of each plan year. An employer may provide the notice applicable to the state in which an employee resides concurrent with the furnishing of: Materials notifying the employee of health plan eligibility; Materials provided to the employee in connection with an...

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SIMA at the ALA

SIMA was delighted to share information and good times with the members of the Association of Legal Administrators at their annual retreat this past month in Williamsburg, Virginia. Consultant Chris Nagle and Marketing Coordinator Kerri White discussed ways in which administrators in legal offices can work smarter, not harder, to alleviate many of the burdens associated with accounting, payroll, benefits, retirement plans, and ever-increasing compliance concerns. For our clients in the legal space, we extend an invitation to join us next year for exceptional networking and educational opportunities. This year we benefitted from sessions regarding the EEOC...

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An EAP can keep your top players on the floor

A good basketball team is at its best when its top players are on the floor. Similarly, a company is the most productive, efficient and innovative when its best employees are in the right positions, doing great work. Unfortunately, it’s not uncommon for good employees to battle personal problems, such as substance dependence, financial and legal woes, or mental health issues. These struggles can negatively affect their productivity and the working environment around them. One way employers can help is by offering a benefit called an employee assistance program (EAP). A benefit with benefits An EAP helps identify at-risk employees and assist them...

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Medicare Part D Online Disclosure to CMS Due Mar. 1

The Medicare Modernization Act requires employers that provide prescription drug coverage to Medicare-eligible individuals to complete the Online Disclosure Form to the U.S. Centers for Medicare & Medicaid Services (CMS) to report whether such coverage is creditable prescription drug coverage (“creditable coverage”). Creditable coverage is coverage that is expected to pay, on average, as much as the standard Medicare prescription drug coverage. This disclosure is required annually, no later than 60 days from the beginning of a plan year—typically March 1st for calendar year plans—and at certain other times. Visit our section on Medicare for more information about how the law...

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Executive Order Calls for Minimizing Economic Burden of ACA

President Trump has signed an executive order calling upon federal administrative agencies to minimize the economic burden of the Affordable Care Act (ACA), pending repeal of the law. Until further guidance is issued or legislation is signed, however, all ACA requirements remain in effect, including penalties for noncompliance. In addition to making clear that the Trump administration seeks the prompt repeal of the ACA, the executive order specifically calls upon agencies to exercise authority and discretion to: Waive, defer, grant exemptions from, or delay the implementation of any ACA provision or requirement that would impose a fiscal...

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New Executive Order Calls for Minimizing Fiscal Burdens of ACA

President Trump has signed an executive order calling upon federal administrative agencies to minimize the economic burden of the Affordable Care Act (ACA), pending repeal of the law. Until further guidance is issued or legislation is signed, however, all ACA requirements remain in effect, including penalties for noncompliance. In addition to making it clear that the Trump administration seeks the prompt repeal of the ACA, the executive order specifically calls upon agencies to exercise authority and discretion to: Waive, defer, grant exemptions from, or delay the implementation of any ACA provision or requirement that would impose a...

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