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2024 Open Enrollment Checklist

2024 Open Enrollment Checklist

2024 Open Enrollment Checklist

To download this entire document as a PDF, click here: Open Enrollment eBook

This Compliance Overview is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice.  Readers should contact legal counsel for legal advice. 

In preparation for open enrollment, Employers should review their plan documents in light of changes for the plan year beginning Jan 1, 2024. Below is an Employer 2024 Open Enrollment Checklist including some administrative items to prepare for in 2024.

Change has been constant for employer plans in the last few years. Unfortunately, 2023 was no exception. As they prepare for 2024 open enrollment, employers must incorporate new requirements affecting the design and administration of their health plans for plan years beginning on or after Jan. 1, 2024. Those changes include items that are adjusted for cost of living changes each year, – e.g., the cost-sharing limits for high deductible health plans (HDHPs), contribution limits to health savings accounts (HSAs), as well as new requirements due to legislative and regulatory updates, such as the expiration of COVID-19 mandates, to name a few.

Employers should ensure their health plan is updated and communicate benefit changes to participants through an updated summary plan description (SPD) or a summary of material modifications (SMM) for the 2024 plan year.

As a general best practice, employers should confirm that their open enrollment materials contain certain required participant notices and consider including some periodic notices, such as the Medicare Part D creditable/non-creditable coverage notice, in their open enrollment materials.

PLAN DESIGN CHANGES

ACA Mandates 

Affordability Requirements 

Under the ACA’s employer shared responsibility rules (the “pay or play” rules), applicable large employers (ALEs) (those with 50 or more full-time employees or the equivalent) are required to offer affordable, minimum value health coverage to their full-time employees (and dependent children) or risk paying a penalty. 

Under the ACA, an ALE’s health coverage is considered affordable if the employee’s required contribution to the plan does not exceed 9.5% of the employee’s household income for the taxable year (as adjusted each year). The adjusted percentage is 9.12% for 2023.

The affordability percentage for plan years that begin on or after Jan. 1, 2024, will be 8.39%.  That is another reduction demonstrating the need for ALEs to monitor the affordability percentage each year so they can confirm that at least one of the health plans offered to full-time employees satisfies the ACA’s affordability standard (typically by the use of one of the optional safe harbors – federal poverty level, W-2 or rate of pay).

Out-of-pocket Maximum

Under the ACA, non-grandfathered health plans (which apply to almost all employer plans) are subject to limits on cost sharing for essential health benefits. Confirm that out-of-pocket maximum limits for your health plan comply with the ACA’s limits for the 2024 plan year. 

Plan years beginning on or after Jan. 1, 2024:

  • $9,450 for self-only coverage
  • $18,900 for family coverage

Note, the out-of-pocket maximum limits for HDHPs compatible with HSAs must be lower than the ACA’s limits. For the 2024 plan year, the out-of-pocket maximum limits for HDHPs are $8,050 for self-only coverage and $16,100 for family coverage. 

Preventive Care Benefits 

doctor examining a baby being held by mother

The ACA requires non-grandfathered health plans to cover certain preventive health services without imposing cost-sharing requirements (e.g., deductibles, copayments, or coinsurance) when in-network healthcare providers supply the services. The preventive care services covered by the requirements are based on the following:

  • Evidence-based items or services that have a rating of A or B in the current recommendations of the United States Preventive Services Task Force (USPSTF).
  • Immunizations for routine use in children, adolescents, and adults that are currently recommended by the Centers for Disease Control and Prevention.
  • Evidence-informed preventive care and screenings are included in the Health Resources and Services Administration (HRSA) guidelines for infants, children, and adolescents.
  • Evidence-informed preventive care and screenings are included in HRSA-supported guidelines for women.

There needs to be some clarity. An ongoing court case has raised some uncertainty about using the USPSTF recommendations. However, guidance from federal agencies will permit employers to use those factors without the risk of penalties for the time being. Therefore, employers should monitor future developments regarding the ACA’s preventive care mandate, which is expected by the end of 2023.

Coverage For COVID-19 Vaccines, Testing And Treatment

Because the COVID-19 public health emergency has ended (see Alert here), health plans are no longer required to cover COVID-19 diagnostic tests and related services without cost sharing or other medical management requirements. Health plans are still required to cover recommended preventive services (under the ACA requirements), including COVID-19 immunizations, without cost sharing, but this coverage requirement can now be limited to in-network providers.

 

patient getting temperature taken by doctor

For plan years ending after Dec. 31, 2024, an HSA-compatible HDHP is no longer permitted to provide COVID-19 testing and treatment benefits without a deductible (or with a deductible below the minimum deductible for an HDHP). Therefore, employers should

  • Determine whether health plans will impose cost-sharing requirements, prior authorization, or other medical management requirements on COVID-19 testing for the upcoming plan year.
  • Determine whether health plans will continue covering COVID-19 immunizations without cost sharing from all healthcare providers or whether this first-dollar coverage will be limited to in-network providers.
  • Confirm that HDHPs that do not have a calendar year as the plan year will not pay benefits for COVID-19 testing and treatment before the annual minimum deductible has been met for plan years ending after Dec. 31, 2024.
  • Notify plan participants of any changes for the 2024 plan year regarding COVID-19 testing and vaccines through an updated SPD or SMM.

Health FSA Contributions

The IRS issued a memorandum on claims substantiation (see Article here) for health FSAs. The memorandum clarifies that health FSA expenses are not considered properly substantiated if employees self-certify expenses, if the plan uses sampling, if only amounts over a certain level are substantiated, or if charges from favored providers are not substantiated. Employers should, therefore, review the health FSA substantiation procedures to make sure they comply with IRS rules. 

HDHP and HSA Limits for 2024

2024 Health Savings Account Limits announced

If you offer an HDHP to your employees that is compatible with an HSA, you should confirm that the HDHP’s minimum deductible and out-of-pocket maximum comply with the 2020 limits. The IRS limits for HSA contributions and HDHP cost-sharing increase for 2024. The HSA contribution limits will increase effective Jan. 1, 2024, while the HDHP limits will increase effective for plan years beginning on or after Jan. 1, 2024.

  • Check whether your HDHP’s cost-sharing limits need to be adjusted for the 2024 limits.
  • If you communicate the HSA contribution limits to employees as part of the enrollment process, these enrollment materials should be updated to reflect the increased limits that apply for 2024.

The following table contains the HDHP and HSA limits for 2024 as compared to 2023. It also includes the catch-up contribution limit that applies to HSA-eligible individuals who are age 55 or older, which is not adjusted for inflation and stays the same from year to year.

Type of Limit 2024 2023 Change
HSA Contribution Limit Self-only $4,150 $3,850 Up $300
Family $8,300 $7,750 Up $550
HSA Catch-up Contributions (not subject to adjustment for inflation) Age 55 or older $1,000 $1,000 No change
HDHP Minimum Deductible Self-only $1,600 $1,500 Up $100
Family $3,200 $3,000 Up $200
HDHP Maximum Out-of-pocket Expense Limit (deductibles, copayments and other amounts, but not premiums) Self-only $8,050 $7,500 Up $550
Family $16,100 $15,000 Up $1,100

HDHP Design Option – Telehealth  

At the beginning of the COVID-19 pandemic, Congress temporarily relaxed the rules for HDHPs to allow them to provide benefits for telehealth or other remote care services before plan deductibles were met without jeopardizing HSA eligibility.  That relaxed rule currently applies for plan years beginning before Jan. 1, 2025. 

  • Determine whether HDHPs will waive the deductible for telehealth services for the plan year beginning in 2024
  • Communicate plan changes for the upcoming year to participants through an updated SPD or SMM

Mental Health Parity – Required Comparative Analysis For NQTLs  

The Mental Health Parity and Addiction Equity Act (MHPAEA) requires parity between a group health plan’s medical/surgical benefits and its mental health or substance use disorder (MH/SUD) benefits. These parity requirements apply to financial requirements and treatment limits for MH/SUD benefits. In addition, any nonquantitative treatment limitations (NQTLs) placed on MH/SUD benefits must comply with MHPAEA’s parity requirements. For example, NQTLs include prior authorization, step therapy protocols, network adequacy, and medical necessity criteria. 

MHPAEA requires health plans and issuers to conduct comparative analyses of the NQTLs used for medical/surgical benefits compared to MH/SUD benefits. This analysis must contain a detailed, written, and reasoned explanation of the specific plan terms and practices and include the basis for the plan or issuer’s conclusion that the NQTLs comply with MHPAEA. Plans and issuers must make their comparative analyses available to specific federal agencies or applicable state authorities upon request. 

  • Employers should request that health plan issuers (or third-party administrators) confirm that comparative analyses of NQTLs will be updated, if necessary, for the plan year beginning in 2024 and make the analysis available to the employee.

Open Enrollment Notices

Employers who sponsor group health plans should provide certain benefits notices in connection with their open enrollment periods. Some of these notices must be provided at open enrollment time, such as the Summary of Benefit and Coverage (SBC). Other notices, such as the WHCRA notice, must be distributed annually. Although these annual notices may be provided at different times throughout the year, employers often include them in their open enrollment materials for administrative convenience. 

In addition, employers should review their open enrollment materials to confirm that they accurately reflect the terms and cost of coverage. In general, any plan design changes for 2024 should be communicated to plan participants through an updated SPD or an SMM. 

Summary Of Benefits And Coverage


The ACA requires health plans and health insurance issuers to provide an SBC to applicants and enrollees each year at open enrollment or renewal. Federal agencies have provided a template for the SBC, which health plans must use. 

  • Note that for self-funded plans, the plan administrator is responsible for providing the SBC. For insured plans, the issuer usually prepares the SBC. If the issuer prepares the SBC, an employer is not required to also prepare an SBC for the health plan, although the employer may need to distribute the SBC prepared by the issuer. 

Medicare Part D Notices

Group health plan sponsors must provide a notice of creditable or non-creditable prescription drug coverage to Medicare Part D-eligible individuals covered by, or who apply for, prescription drug coverage under the health plan. The notice alerts the individuals about whether their prescription drug coverage is at least as good as Medicare Part D coverage. The notice generally must be provided at various times that cannot always be anticipated, including when an individual enrolls in the plan and each year before Oct. 15 (when the Medicare annual open enrollment period begins). Therefore, the best practice is to provide it annually at open enrollment, as that will ensure timely compliance. Model notices are available on the Centers for Medicare and Medicaid Services’ website

Annual CHIP Notices 

Group health plans covering residents in a state that provides a premium subsidy to low-income children and their families to help pay for employer-sponsored coverage must send an annual Children’s Health Insurance Program (CHIP) notice about the available assistance to all employees in that state. The U.S. Department of Labor (DOL) has provided a model notice.

Initial COBRA Notices 

 COBRA applies to employers with 20 or more employees who sponsor group health plans. Group health plan administrators must provide an initial COBRA notice to new participants and certain dependents within 90 days after plan coverage begins. The initial COBRA notice may be incorporated into the plan’s SPD. Because the COBRA election-period will not start until this notice is provided, it is helpful to many employers to include a copy in the open enrollment materials as a backup. 

woman holding a small cartoon heart over her chest

Notices Of Patient Protections 

Under the ACA, group health plans and issuers that require the designation of a participating primary care provider must permit each participant, beneficiary, and enrollee to designate any available participating primary care provider (including a pediatrician for children). Additionally, plans and issuers that provide obstetrical/gynecological care and require a designation of a participating primary care provider may not require preauthorization or referral for such care. If a health plan requires participants to designate a participating primary care provider, the plan or issuer must provide a notice of these patient protections whenever the SPD or similar description of benefits is provided to a participant. If an employer’s plan is subject to this notice requirement, they should confirm that it is included in the plan’s open enrollment materials. This notice may be included in the plan’s SPD. Model language is available from the DOL. 

Grandfathered Plan Notices 

If an employer has a grandfathered plan, they should include information about its grandfathered status in plan materials describing the coverage under the plan, such as SPDs and open enrollment materials. Model language is available from the DOL. 

Notices Of HIPAA Special Enrollment Rights 

At or before enrollment, an employer’s group health plan must provide each eligible employee with a notice of their special enrollment rights under HIPAA. This notice may be included in the plan’s SPD.

HIPAA Privacy Notices  

The HIPAA Privacy Rule requires covered entities (including group health plans and issuers) to provide a Notice of Privacy Practices (or Privacy Notice) to everyone who is the subject of protected health information (PHI). Health plans are required to send the Privacy Notice at certain times, including to new enrollees at the time of enrollment. Also, at least once every three years, health plans must either redistribute the Privacy Notice or notify participants that the Privacy Notice is available and explain how to obtain a copy. Self-insured health plans are required to maintain and provide their own Privacy Notices. However, special rules apply for fully insured plans, where the health insurance issuer, not the plan itself, is primarily responsible for the Privacy Notice.

woman holding a piece of paper with "HIPPA" on it

Special Rules for Fully Insured Plans 

The plan sponsor of a fully insured health plan has limited responsibilities with respect to the Privacy Notice, including the following:

  • If the sponsor of a fully insured plan has access to PHI for plan administrative functions, they are required to maintain a Privacy Notice and to provide the notice upon request.
  • If the sponsor of a fully insured plan does not have access to PHI for plan administrative functions, they are not required to maintain or provide a Privacy Notice.
  • A plan sponsor’s access to enrollment information, summary health information, and PHI that is released pursuant to a HIPAA authorization does not qualify as having access to PHI for plan administration purposes.

Model Privacy Notices are available through the Department of Health and Human Services.

WHCRA Notices 

Plans and issuers must provide notice of participants’ rights to mastectomy-related benefits under the WHCRA at the time of enrollment and annually. The DOL’s compliance assistance guide includes model language for this disclosure.

SARs 

Plan administrators required to file  Form 5500 must provide participants with a narrative summary of the information in Form 5500, called a summary annual report (SAR). A model notice is available from the DOL. 

Group health plans that are unfunded (that is, benefits are payable from the employer’s general assets and not through an insurance policy or trust) are not subject to the SAR requirement. The plan administrator generally must provide the SAR within nine months of the close of the plan year. If an extension of time to file Form 5500 is obtained, the plan administrator must furnish the SAR within two months after the close of the extension period. 

Wellness Program Notices 

Group health plans that include wellness programs may be required to provide certain notices regarding the program’s design. As a general rule, these notices should be provided when the wellness program is communicated to employees and before employees provide any health-related information or undergo medical examinations. These notices are required in the following situations:

  • HIPAA Wellness Program Notice—HIPAA imposes a notice requirement on health-contingent wellness programs offered under group health plans. Health-contingent wellness plans require individuals to satisfy standards related to health factors (e.g., not smoking) to obtain rewards. The notice must disclose the availability of a reasonable alternative standard to qualify for the reward (and, if applicable, the possibility of waiver of the otherwise applicable standard) in all plan materials describing the terms of a health-contingent wellness program. The DOL’s compliance assistance guide includes a model notice that can be used to satisfy this requirement.
  • ADA Wellness Program Notice—Employers with 15 or more employees are subject to the Americans with Disabilities Act (ADA). Wellness programs that include health-related questions or medical exams must comply with the ADA’s requirements, including an employee notice requirement. Employers must give participating employees a notice that tells them what information will be collected as part of the wellness program, with whom it will be shared, and for what purpose, as well as the limits on disclosure and the way information will be kept confidential. The U.S. Equal Employment Opportunity Commission (EEOC) has provided a sample notice to help employers comply with this ADA requirement.

ICHRA Notices 

Employers may use individual coverage HRAs (ICHRAs) to reimburse their eligible employees for insurance policies purchased in the individual market or Medicare premiums. Employers with ICHRAs must notify eligible participants about the ICHRA and its interaction with the ACA’s premium tax credit. In general, this notice must be provided at least 90 days before the start of each plan year. Employers may provide this notice at open enrollment time if it is at least 90 days before the beginning of the plan year. A model notice is available for employers to use to satisfy this notice requirement.

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Enhance Your Employee Benefits Package.  A competitive benefits package is key to keeping and attracting top talent.  Assess your current benefits package and consider making necessary adjustments to include options, such as expanded mental health support, for example. 

GENERAL HR  

Review Employee Records.  The fourth quarter is a good time to review your employee records and check record retention guidelines. Don’t forget to dispose of outdated termination and outdated job applications properly. With W2s around the corner, make sure all addresses and information are updated.

Develop and Distribute Your 2024 Calendar.  Create and distribute a calendar outlining important dates, vacation time, pay dates, and company-observed holidays for 2024. 

Review and Update Employee Handbook. Review your employee handbook to make sure it is up-to-date and addresses areas, such as employment law mandates, new COVID-related policies, guidelines for remote working, privacy policies, compensation and performance reviews, social media policies, attendance, and time-off, break periods, benefits, and procedures for termination, discipline, workplace safety, and emergency procedures.

PLEASE NOTE: This Checklist is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel for legal advice. This information is for general reference purposes only. Because laws, regulations, and filing deadlines are likely to change, please check with the appropriate organizations or government agencies for the latest information and consult your employment attorney and/or benefits advisor regarding your responsibilities. In addition, your business may be exempt from certain requirements and/or be subject to different requirements under the laws of your state. (Updated Sept 3, 2023)

Contact us at (855) 667-4621 or email us at info@medicalsolutionscorp.com

 

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NYS DFS 2024 Rates Approved

NYS DFS 2024 Rates Approved

Earlier today, the long-awaited NYS Dept of Financial Services approved 2024 health insurance rate requests. And it was worth it with small groups stabilized.  Small group rates increased by 7.4% and  12.4% for individuals.

As per NY State Law, Health Insurers are required to send out early notices of rate request filings to groups and subscribers. Despite only 3 months of mature claims data experience for 2023  health insurers’ original requests were noticeably above the average of 22%/individuals and 15.3% for small groups.

State Department of Financial Services officials asserted the rising cost of medical care — including in-patient hospital stays and rapid increases in drug prices — continued to be the main driver of health insurance premium increases. The final approved rates for 2024 would keep health insurers’ profit provisions at 1%, state officials added, noting they sought to limit those returns in light of ongoing inflationary pressures harming consumers. That said, in anticipation of spikes in claims submissions + overall inflation, a larger-than-average increase is needed. This is in addition to increases in pricing by hospitals, consolidated IPA groups, and pharmaceuticals.

Rate Factors

The state noted that the premiums increase main drivers are medications.  “Rising medical costs and inflation continue to put upward pressure on premiums,” said Superintendent Harris. “With our rate actions announced today, we continue to prioritize the financial well-being of consumers while ensuring that New Yorkers have access to a robust, stable health insurance market.”  Also, DFS, recognizing the continued uncertainty of the pandemic’s effect on consumers’ healthcare costs and the economy, held insurers’ profit provisions to a low 1%. 

Health Insurers

Oxford/Unitedhealthcare, notably, got only a 4.7% rate increase approval for next year. This is a sharp reduction from the original 15.5% request in part to disagreed anticipated costs, held reserves, overall market pricing, and reinsurance gained from ACA’s Risk Corridor.  See more info here, https://medicalsolutionscorp.com/risk-adjustment-reinsurance-and-risk-corridors/.

Small Group Market   

Almost 800,000 New Yorkers are enrolled in small group plans, which cover employers with up to 100 employees. Insurers requested an average rate increase of 15.3% in the small group market, which DFS cut by 52% to 7.4% for 2024, saving small businesses $607 million. A number of small businesses also will be eligible for tax credits that may lower those premium costs even further, such as the Small Business Health Care Tax Credit.

DFS SMALL GROUP MARKET RATE ACTIONS   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Indicates the Company will offer products on the NY State of Health Marketplace in 2024.

PEO Alternatives to Small Group

Before you consider renewing automatically, you should first find out what is a PEO so that you can know exactly what to expect from it. PEOs are large-group markets underwritten.  With the right PEO, you will be able to manage your business’s demand for growth and your employees as well.

Clients on average save 15-40% off the small group market. If you are looking for a complete insurance solution for your business, go to our website and check out our business insurance solutions. Contact us for more information today.

Learn how a PEO can make a difference for your group. For more information on how Employer-Sponsored Insurance and a PEO can make a difference for your small business please contact us at info@medicalsolutionscorp.com or 855-667-4621.

 

 

 

 

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For more information on PEOs or a custiomized quote please submit your contact. We will be in touch ASAP. 

Webinar: Employee Benefits Communications Into Advantage

Webinar: Employee Benefits Communications Into Advantage

Join Us for the Sept 26, 2023 Webinar!

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Don’t Get Caught Out of Timre. Be Proactive Before Your Plan Renews.

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Engaging your workforce and captivating them: How do you achieve this? During this session we discuss how to deploy engaging tactics with the right balance of frequency and educational impacts across a multi-generational workforce to engage your employees when it matters most..

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Bradford Sherry

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Dawn Wilkins

Director of Employee Communications

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Webinar:  How To Decipher Your Medical Insurance Renewal

Webinar: How To Decipher Your Medical Insurance Renewal

Join Us for the August 22, 2023 Webinar!

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How To Decipher Your Medical Insurance Renewal So You Don’t Get Duped?

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Employers have become accustomed to just accepting carrier data, ludicrous assumptions, and flawed methodology in the underwriting process. This is understandable since the fully insured renewal proposal can be hard to decipher. We will help you decode what seems undecodable and give you the tools and knowledge to understand your renewal — sharing an actual case study. This will help put you in the driver’s seat to ask the right questions, challenge carrier assumptions that do not align with your plan analytics and give you more leverage for negotiating your renewal to save money.

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Best Hospitals – Newsweek 2023

Best Hospitals – Newsweek 2023

Recently, Newsweek released their annual top hospitals rankings.

“This year’s rankings represent an expanded universe, with three new countries on the list—Colombia, Saudi Arabia, and the United Arab Emirates—bringing the total to over 2,300 hospitals in 28 countries. And the results show a remarkable cross-section of excellence across the world: Twenty-one countries are represented in the global top 150. The U.S. leads with 29 hospitals, followed by Germany with 16; Italy and France with 10 each; and South Korea with eight. Overall, there were 13 new hospitals in this year’s top 100. Among the biggest movers from last year’s rankings were  No. 8 Northwestern Memorial Hospital (28 in 2022); No. 40 Seoul’s Samsung Medical Center (73) and No. 11 New York’s NYU Langone Hospitals (59).”

Top 10 Internationally:

1 Mayo Clinic Rochester-   United States
2 Cleveland Clinic-    United States
3 Massachusetts General Hospital-    United States
4 The Johns Hopkins Hospital-   United States
5 Toronto General – University Health Network-   Canada
6 Karolinska Universitetssjukhuset-   Sweden
7 Charité – Universitätsmedizin-    Berlin Germany
8 AP-HP – Hôpital Universitaire Pitié Salpêtrière-    France
9 Singapore General Hospital-     Singapore
10 UCLA Health – Ronald Reagan Medical Center-    United States

 

Top 20 Nationally:

1 Mayo Clinic – Rochester
2 Cleveland Clinic
3 Massachusetts General Hospital
4 The Johns Hopkins Hospital
5 UCLA Health – Ronald Reagan Medical Center
6  Stanford Health Care – Stanford Hospital
7 Brigham And Women’s Hospital
8 Northwestern Memorial Hospital
9 The Mount Sinai Hospital
10 New York-Presbyterian Hospital-Columbia and Cornell                                                                                                         

11. University of Michigan Hospitals – Michigan Medicine
12  Cedars-Sinai Medical Center
13.  UCSF Medical Center
14. Duke  University Hospital
15. Hospital of the University of Pennsylvania – Penn Presbyterian
16. NYU Langone Hospitals
17. Mayo Clinic – Jacksonville
18. Russh University Medical Center
19. Mayo Clinic – Phoenix
20. Houston Methodist Hospital

Top 10 NY/NJ Metro Hospitals:

9 The Mount Sinai Hospital 83.98% New York NY
10 New York-Presbyterian Hospital-Columbia and Cornell 83.94% New York NY
16 NYU Langone Hospitals 81.23% New York NY
46 Morristown Medical Center 70.66% Morristown NJ
57 Hackensack University Medical Center 69.52% Hackensack NJ
117 Strong Memorial Hospital – University of Rochester 65.36% Rochester NY
121 Valley Hospital 65.30% Ridgewood NJ
130 North Shore University Hospital 65.21% Manhasset NY
148 Saratoga Hospital 64.71% Saratoga Springs NY
167 Overlook Medical Center 64.42% Summit NJ

 

Top 3 CT Hospitals:

35    Yale New Haven Hospital
158    St. Francis Hospital & Medical Center
201    Griffin Hospital

Top 10 PA Hospitals:

15 Hospital of the University of Pennsylvania – Penn Presbyterian Philadelphia PA
54 Jefferson Health – Thomas Jefferson University Hospitals Philadelphia PA
58 UPMC Presbyterian & Shadyside Pittsburgh PA
64 Penn State Health – Milton S. Hershey Medical Center Hershey PA
76 Penn Medicine Chester County Hospital West Chester PA
103 Reading Hospital Reading PA
116 St. Luke’s Hospital Bethlehem Bethlehem PA
122 Doylestown Hospital Doylestown PA
153 Lancaster General Hospital Lancaster PA
168 Main Line Health – Lankenau Medical Center Wynnewood PA

Top 10 FL Hospitals:

17 Mayo Clinic – Jacksonville Jacksonville FL
45 Cleveland Clinic – Florida Weston FL
84 Tampa General Hospital Tampa FL
146 Sarasota Memorial Hospital Sarasota FL
149 St. Joseph’s Hospital – BayCare Tampa FL
172 Baptist Health Baptist Hospital Miami FL
176 Morton Plant Hospital Clearwater FL
179 Baptist Medical Center – Beaches Jacksonville Beach FL
183 Adventhealth Orlando Orlando FL
215 Cape Canaveral Hospital Cocoa Beach FL

NOTE: For patients and their physicians, these rankings and ratings should be seen as just a starting point. While this is helpful information to have, benefit plan participants should also research quality hospitals using transparency tools if these services are available through the health plan or benefits package. For a customized review of your commercial sponsored plan using latest tools and third part-tools please contact us today.

For information about transparency providers and new tech tools contact us at info@medicalsolutionscorp.com or (855)667-4621.

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WEBINAR: Cutting Costs or Improving Health Benefits?

WEBINAR: Cutting Costs or Improving Health Benefits?

Join Us for the July 25, 2023 Webinar!

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Cutting Costs or Improving Health Benefits?
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About this Session:
The healthcare landscape continues to change quickly and significantly. Why, then, are many of the health plans being offered today designed years ago? Changes made to plans are often limited to cost-shifting, which can help control costs, but do not provide solutions to improving health outcomes and can put an undue burden on your employees. In this session, we will go over some of the new and innovative options and demonstrate a different approach to designing a health plan. We will introduce care and value initiatives that can reduce cost and improve overall population health and provide 10 tips to take back control of your health plan.

Meet our Speaker

Bradford Sherry

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Lindsay Fuhrman

Director of Population Health Management

Underwriting and Actuarial

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VP, Director of Analytics and Actuarial Services

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WEBINAR: Current State of the Benefit Marketplace

WEBINAR: Current State of the Benefit Marketplace

June 27, 2023 Webinar!

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Discover the latest employee benefit marketplace trends, explore their impact on costs and member experience, and delve into healthcare utilization patterns, medical inflation drivers, and the response from the medical insurer marketplace.

Each month our team covers hot topics to help simplify them and educate you on the latest trends, issues, and innovations

Learn

BE INFORMED TO BE EMPOWERED WEBINARS  World Insurance Associates PEO

 

About this Session:
Employee benefit marketplace trends can positively or negatively impact costs and member experience. We’ll take a deep dive into current healthcare utilization patterns, medical inflation drivers, and the medical insurer marketplace’s response. With a thorough understanding of the current state of the market, you will be able to see how the benefits program of the future can provide opportunities along with challenges — and help you plan now.

During this session, we will also introduce some of the disrupters making waves in mainstream benefits strategies from the “Insuretech” marketplace and the health outcomes and the financial impacts of those programs.

Accreditation: By attending this webinar, you will receive 1 hour (General) recertification credit hour through the HR Certification Institute® (HRCI) and 1 hour credit through SHRM.

Meet our Speaker

Mike Barton 

Chief Growth Officer

 

Meet our Speaker

Josh Simerman

Head of Carrier Relations and Placement

Blog

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Get In Touch

Please join us for next week’s webinar. Submit suggestions for future webinar topics interesting to you. Avanti!

Join Us!

Register

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Contact Us

info@medicalsolutionscorp.com

Charting the Employee Benefit Landscape in 2023 & Beyond

Charting the Employee Benefit Landscape in 2023 & Beyond

Join Us for the June 14, 2023 Seminar! 

Frost Science Museum Miami, FL

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Employers be prepared for whats coming in healthcare and employee benefits.

What Can You Do and What Are the Best Practices?

Learn

BE INFORMED TO BE EMPOWERED

SEMINAR SERIESWorld Insurance Associates PEO

 

About this Session:

We have developed a seminar to help business owners and executives be prepared for what is to come:

  • What is the outlook for the healthcare landscape for 2023 and beyond?
  • Are you aware of the potential compliance traps and the financial repercussions?
  • What financial exposure can this cause to employer healthcare plans?
  • Can a modern health plan put you in a good position for what is to come?
  • What are the best practices to ensure your plans are in compliance?

HRCI & SHRM Accreditations

Education and information to help keep you up-to-date and informed

Each month our Employee Benefits team covers trending, topofmind topics relevant to the world of benefits. These subject matter experts leverage their extensive experience, data, and research, and then simplify and summarize these topics to educate and help leaders drive their businesses forward.

Don’t Let Employee Leaves Keep You Guessing. What Can You Do and What are the Best Practices?

We know business owners and executives are challenged with controlling costs while meeting the company’s changing physical, emotional, and financial needs. The employee benefits landscape also continues to change, and so do compliance rules and regulations. How do you stay on top of it?

Meet our Speaker

Jay Kirschbaum, Director of Employee Benefits Compliance

Meet our Speaker

Mike Barton. Chief Growth Officer Employee Benefits

Mike has more than 30 years of insurance industry experience, with a proven-track record in business development and multi-channel distribution. He oversees all aspects of sales and plays a pivotal role in the development of new business, market cultivation, and product development, as well as our long-term growth goals. (Click Home icon to view full bio).

Underwriting and Actuarial

Meet our Speaker

David Stoddard. Director of Analytics and Actuarial Services

David has over 10 years of experience in the health care industry as a lead health benefits actuary performing high impact actuarial consulting for large multi-state employers in a variety of industries. He creates new, scalable, data-driven solutions for clients including financial and contractual analysis, claims utilization and modeling, renewal projection, and premium rate analysis and modeling. (Click Home icon to view full bio).

Blog

Follow Along

Get In Touch

Please join us for next week’s webinar. Submit suggestions for future webinar topics interesting to you. Avanti!

Join Us!

Register

Get Your Tickets!

Contact Us

info@medicalsolutionscorp.com

Current State Of The Benefit Marketplace

Current State Of The Benefit Marketplace

June 27, 2023 Webinar!

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Did you know that as your business grows, you can use your company’s size and data to your advantage? 

Employee benefit marketplace trends can positively or negatively impact costs and member experience.

Learn

BE INFORMED TO BE EMPOWERED WEBINARS  World Insurance Associates PEO

 

About this Session:

Employee benefit marketplace trends can positively or negatively impact costs and member experience. We’ll take a deep dive into current healthcare utilization patterns, medical inflation drivers, and the medical insurer marketplace’s response. With a thorough understanding of the current state of the market, you will be able to see how the benefits program of the future can provide opportunities along with challenges —and help you plan now.

During this session, we will also introduce some of the disrupters making waves in mainstream benefits strategies from the “Insuretech” marketplace and the health outcomes and the financial impacts of those programs.

Accreditation: By attending this webinar, you will receive 1 hour (General) recertification credit hour through the HR Certification Institute® (HRCI) and 1 hour credit through SHRM.

Meet our Speaker

Mike Barton

Chief Growth Officer Employee Benefits

 

Meet our Speaker

Josh Simerman

Head of Carrier Relations and Placement

Blog

Follow Along

Get In Touch

Please join us for next week’s webinar. Submit suggestions for future webinar topics interesting to you. Avanti!

Join Us!

Register

Get Your Tickets!

Contact Us

info@medicalsolutionscorp.com

New Florida E-Verify Law July 2023

New Florida E-Verify Law July 2023

Effective July 1, 2023, private employers operating in Florida with 25 or more employees must use E-Verify during their onboarding process. Previously, the E-Verify requirement only applied to public employers, contractors, and subcontractors, while private employers were required to either comply with Form I-9 requirements or use E-Verify.

What is E-Verify?

E-Verify is a digital employment eligibility tool that verifies if the newly hired employee is authorized to work in the United States.

To Whom Does This Law Apply?

This requirement applies to Florida private employers with 25 or more employees. Employers with less than 25 employees are encouraged to use E-Verify but are not required to do so. Employers are not required to utilize E-Verify on independent contractors since they are not considered employees.

Moving Forward: What Are Employers Required to Do? 

Florida private employers should update their onboarding process, if necessary, to incorporate the new E-Verify requirement in conjunction with Form I-9 in anticipation of the July 1, 2023, deadline. Employers must verify employment eligibility within three business days of the new hire’s start date.
Record-Keeping Requirements and Certification
Employers must maintain a copy of the documentation provided for Form I-9 and E-Verify and any official verification for three years after the employee’s start date.

Penalties

Beginning July 1, 2024, if the Florida Department of Economic Opportunity (DEO) finds that an employer has knowingly hired someone who is not authorized and did not verify the employee’s employment eligibility, the DEO can impose civil penalties on the employer, including the repayment of any economic development incentive and the DEO will put the employer on probation for one year, requiring the employer to demonstrate compliance every quarter. In addition, if another violation occurs within 24 months, the DEO is authorized to suspend or revoke all Florida-issued licenses.
Additionally, if the DEO finds that an employer failed to use the E-Verify system, it will notify the employer and give them 30 days to rectify the non-compliance. If the DEO finds that the employer has not used the E-Verify system 3 times within a 24-month period, the DEO can fine the employer $1,000 per day until the employer provides proof that it has rectified the non-compliance.

Interested in learning more? World Payroll or our PEO Partners can assist with the E-Verify process. Please email info@medialsolutionscorp.com or call us at 855-667-4621. 

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Please Note: While the information within this alert may concern certain employment laws and regulations to be aware of, it is provided solely as general guidance so that you maintain compliance. It is not the equivalent of legal advice, nor does it serve as a  substitute for the advice of an attorney, if applicable.