Tag Archives: Regs and guidance

Considerations for product governance risk management

A key focus of the insurance regulatory authorities around the world has been the protection of policyholder interest. This has resulted in more emphasis on product governance and product life-cycle management. The insurance directive launched under the European Union insurance law has issued guidelines for insurers to embed product oversight and governance into their risk management frameworks.

A robust product governance process can help reduce mis-selling and complaints, and increase policyholder confidence in the market. It can also ensure internal and regulatory compliance for the products offered by the insurer.

The core components of a robust product governance process are:

• Product governance policy
• Product development
• Pricing and value
• Distribution and sales
• Legal, compliance and risk management
• Ongoing assessment of the product

To read more about building a strong product governance policy, read Neha Taneja’s article here.

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

2018 Social Security and Medicare trustees’ reports released
The Social Security and Medicare Boards of Trustees issued their annual financial review of the programs. The projections indicate that income is sufficient to pay full scheduled benefits until 2026 for Medicare’s Hospital Insurance program, 2032 for Social Security’s Disability Insurance program, and until 2034 for Social Security’s Old Age and Survivors Insurance program. The Supplementary Medical Insurance (SMI) Trust Fund remains adequately financed throughout the projection period, but only because SMI has unlimited access to general revenues.

For more information, click here.

The CMS’ RDS Center changes its location for retiree and cost report files
The Centers for Medicare and Medicaid Services’ (CMS) Retiree Drug Subsidy (RDS) Center is changing the location where retiree and cost report files are sent via Connect:Direct. By the end of 2018, all files that are currently sent to the RDS Center via Connect:Direct must be sent to the new location. This change only impacts vendors that submit data to the RDS Center via Connect:Direct and does not affect vendors that submit data using the RDS secure website.

For more information, click here.

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

IRS inflation adjusted amounts for HSAs in 2019
The Internal Revenue Service (IRS) released Revenue Procedure 2018-30, which provides the inflation-adjusted amounts for health savings accounts (HSAs) for calendar year 2019. The updated limits specify the maximum annual contributions to HSAs that may be tax-deductible, as well as the minimum deductibles and the maximum out-of-pocket expenses allowed under qualifying high-deductible health plans (HDHPs).

For more information, click here.

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

Small employers receive relief for small business healthcare tax credit
The Internal Revenue Service (IRS) issued guidance that provides relief for certain small employers that wish to claim the “Small Business Health Care Tax Credit” for 2017 and later years.

The tax credit can benefit certain small employers that provide health coverage to their employees. Generally, small employers must provide employees with a qualified health plan from a Small Business Health Options Program (SHOP) marketplace to qualify for the credit. Small employers may only claim the credit for two consecutive years.

Notice 2018-27 gives guidance about calculating the credit under these circumstances. The notice does not affect previous transition relief for the credit that was separately provided for 2014, 2015, and 2016.

For information on whether a county had or has coverage available through a SHOP marketplace, click here.

Relief granted for taxpayers affected by reduction of maximum deductible health savings account contributions
The IRS announced relief for taxpayers with family coverage under a high-deductible health plan (HDHP) who contribute to a health savings account (HSA). For 2018, taxpayers with family coverage under an HDHP may treat $6,900 as the maximum deductible HSA contribution.

To learn more, click here.

FAQ: Prescription drug pricing and policy
A published Congressional Research Service (CRS) report addresses frequently asked questions (FAQs) about government and private-sector policies that affect drug prices and availability. Among the prescription drug topics covered are federally funded research and development, regulation of direct-to-consumer advertising, legal restrictions on re-importation, and federal price negotiation. The report provides a broad overview of the issues as well as references to more in-depth CRS products.

To download the report, click here.

Implications of proposed changes to short-term medical plans

In February 2018, the Departments of Health and Human Services (HHS), Labor, and the Treasury released a proposed rule that would change the maximum duration of short-term, limited-duration insurance (STLDI) policies. Under the proposed rule, STLDI plans, or “short-term medical” plans, may emerge as an alternative form of individual health insurance. In this article, Milliman actuaries Jason Karcher and Nick Ortner discuss the proposed changes and the potential effect they might have on the individual health insurance market.

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

2019 Medicare Part D benefit parameters published
The Centers for Medicare and Medicaid Services (CMS) released the Medicare Part D standard benefit parameters and the cost thresholds and limits for qualified retiree prescription drug plans for 2019.

For more information, click here.

CMS’s RDS Center now accepting Medicare Beneficiary Identifier (MBI) in retirees files
Effective as of April 1, 2018, CMS’s Retiree Drug Subsidy (RDS) Center is accepting Medicare Beneficiary Identifier (MBI) in retiree files. Plan sponsors and vendors should note that the use of MBI is not mandatory within the RDS program and that RDS will continue to accept Social Security number (SSN) and/or health insurance claim number (HICN) or Railroad Retirement Board (RRB) indefinitely. For information on the use of MBI in RDS retiree file formats please reference the following pages in the RDS User Guide:

• Retiree File Layouts
• Retiree Response File Layouts
• Weekly Notification File Layouts
• Covered Retiree List File Layout and Format
• RDS Reason Codes

For more information, contact CMS’s RDS Center.