TAILORED BUSINESS

10/26/2021

The Consolidated Appropriations Act, 2021 (CAA), including the “No Surprises Act,” require medical insurance carriers to make changes to the way certain benefits are administered. Changes may be implemented as soon as Jan. 1, 2022 or at policy renewal.

These changes include protections for insured against balance billing from out-of-network providers in three specific situations:

• Emergency services received at an out-of-network (OON) emergency department of a hospital or an independent freestanding emergency department
• Non-emergency services received from an OON provider at an in-network facility except, with regard to non-ancillary providers, when the member receives notice of, and provides consent to, treatment by the provider and balance billing
• OON air ambulance if the services would have been covered if provided by an in-network air ambulance provider

03/23/2021

The American Rescue Plan Act (ARPA) signed into law 03/11/2021 has far reaching impacts designed to offer relief from hardships created by the COVID-19 pandemic. One of the most publicized entitlements is the direct payment, called "recovery rebates," of $1400 available to many Americans. If you are still wondering about the status of your payment you can check with the IRS here: https://sa.www4.irs.gov/irfof-wmsp/notice

12/12/2020

BlueCross BlueShield of TN notification regarding FDA approval of COVID-19 Vaccine for emergency use.

BlueCross has created a list of frequently asked questions and answers to help employer sponsored group participants understand how the vaccine will be paid for and administered, how the FDA determines vaccines are safe for use and more. You can find these FAQs by going to the following BlueCross https://bcbstupdates.com/employer-qa-specific-to-covid-19-vaccines/.

BlueCross has also created a list of vaccine FAQs https://bcbstupdates.com/vaccine/ which addresses several specific questions regarding the vaccine itself and plans for distribution. This page will be updated as new details develop.

Employer Q&A Specific to COVID-19 Vaccines Last Updated on December 7, 2020 We’re here for you and your employees during this unusual time. It doesn’t feel good, but together we’ll get through this. We’ve compiled answers to your most asked ... Read more

10/14/2020

Starting Jan. 1, 2021, the maximum earnings subject to the Social Security payroll tax will rise by $5,100 to $142,800, the Social Security Administration announced on 10/13/2020. By the start of the new year, employers should adjust their payroll systems to account for the higher taxable wage base.

10/09/2020

Employers that received PPP loans of $50,000 or less can now use a simplified application (Form 3508S) released this week by the SBA and the Treasury Department.
When a borrower submits Form 3508S the lender must:

Confirm receipt of the borrower’s certifications included with the form.
Confirm receipt of payroll and nonpayroll cost documentation.

09/25/2020

“If you want something you've never had, You must be willing to do something you've never done.” -Thomas Jefferson

08/12/2020

On Saturday, August 8, the President signed The Memorandum on Deferring Payroll Tax Obligations in Light of the Ongoing COVID-19 Disaster. This executive order directs the Secretary of the Treasury to “defer the withholding, deposit, and payment” of employee OASDI tax liability from September 1, 2020 through December 31, 2020. This deferral applies to employees whose wages are generally $4,000 or less during any biweekly pay period. The order also directs the Secretary to issue guidance to effectuate this directive as well as pursue mechanisms to forgive any deferral.
Challenges:
The brevity of the order and the context of its origins have created uncertainty as to how it will be implemented and if it will be superseded by subsequent legislation, guidance, and/or executive orders. Some fundamental concepts requiring definition include:
• How to interpret and apply the “$4,000” qualifier
• Whether employers must defer for all employees or must offer deferral to each employee
• Employer payment obligations, responsibilities, and potential liabilities
• 941 and W-2 reporting requirements, and any associated retroactive implications

04/15/2020

Show me the money!

The first round of Economic Stimulus Payments have been released. For those that have received yours, Fantastic News!

However, if for whatever reason you have not received your payment from the IRS, you can go to the website below to check the status of your payment and update bank information if needed. This will be the case if your did not get a refund on the latest filed tax return.

https://www.irs.gov/coronavirus/economic-impact-payments

You will need the following pieces of information from your 2018 or 2019 tax return:
1. Adjusted Gross Income
a. Line 8b from 2019 return
b. Line 7 from your 2018 return
2. Amount you owed OR your refund

We’re committed to helping you get your economic impact, or stimulus, payment as soon as possible. See if you are eligible for an Economic Impact Payment.

03/30/2020

The following is an online resource detailing several facets impacting compliance, HR and employees related to recent COVID-19 legislation:

Use these resources, created by Zywave’s team of in-house experts, to help your brokerage and your clients navigate the COVID-19 pandemic.

03/24/2020

How has your medical insurance carrier reacted to COVID-19?

The insurance industry is making several special appropriations to better serve their insured clientele.
In response to Families First Coronavirus Response Act, ALL credible carriers will provide no cost share testing to cover the detection of SARS–CoV–2 or the diagnosis of the virus that causes COVID–19.

In addition to the federal mandate, several carriers are providing unique and additional coverages.
The following are just a sample of two of the largest insurers in Tennessee.

BlueCross BlueShield of TN

• In addition to FDA-approved testing, BlueCross will also cover test which are experimental.
• Prescriptions can be filled early and in greater amounts
• $0 cost share for telehealth visits through PhysicianNow Powered by MDLive. Members may use PhysicianNow for any service typically offered under their telehealth benefit, not just for COVID-19 concerns. This enhanced benefit is available now through April 30, 2020.

United Healthcare

• Enacting a special enrollment opportunity for fully insured small groups and employees who previously waived coverage for themselves, spouse or children. The enrollment opportunity will extend from March 23 to April 3, 2020.
• Virtual Visits through designated telehealth providers

These are just a few examples. Be sure to know your benefits, log in to your coverage website, ask your group administrator, agent, or health insurance account manager to understand your benefits.

03/18/2020

The U.S. Senate approved the Families First Coronavirus Response Act in a 90-8 vote on March 18.

For now, the Families First Coronavirus Response Act (H.R. 6201) would provide:
Free coronavirus testing.
Paid emergency leave.
Enhanced unemployment insurance.
Additional funding for nutritional programs.
Protections for health care workers and employees responsible for cleaning at-risk places.
Additional federal funds for Medicaid.