Top 5 Compliance Priorities for 2022
August 26, 2021
In our current environment of the ongoing pandemic, a flurry of new laws and regulations, and social change, employers face unique challenges in health and wellness benefits management. As COVID variants emerge, the debate over vaccinations continues, and renewed focus on diversity and inclusion surfaces, employers have new opportunities but also new standards, many of which take effect beginning in 2022.
A couple of major proposals that would impact healthcare reforms and expand existing rules created with the Affordable Care Act (ACA) include permanent marketplace subsidies, a public health option, and changes to Medicare. The passage of any changes is uncertain, and we continue to monitor congressional developments and will keep you informed.
Regardless of what happens, we have recently issued guidance on surprise medical billing and transparency in coverage regulations scheduled to take effect on January 1, 2022. Employers will be expected to show good-faith compliance, and therefore should consider these top five compliance-related priorities for planning 2022 health, leave, and fringe benefits:
1. COVID-19 impacts: With the public health emergency, national emergency, and related agency guidance still in place, COVID-19 considerations for group health plans will likely continue into 2022. Employers should review the continuing coverage mandates, various COVID-19 relief regulations, and 2021 communications to plan participants about pandemic-related covered benefits and deadline extensions. Whether continuing certain benefit enhancements or returning to pre-pandemic terms, communications with plan participants and plan documentation are essential.
2. Safe and healthy workplace: While COVID-19 variant outbreaks continue, employers must consider the risk and expectations of employees returning to an on-site workplace. Employers will need to decide whether to let workers continue working remotely full time or provide some hybrid transition back to pre-pandemic work schedules. Developing contingency operating plans for 2022 that value flexible work and reflect conditions while prioritizing employee safety, health, diversity, and inclusion will be key.
3. Surprise billing: A federal law prohibiting surprise bills for certain services takes effect for providers, group health plans, and individual/group health insurance policies beginning on or after Jan. 1, 2022. The No Surprises Act, adopted as part of the 2021 Consolidated Appropriations Act (CAA), builds on parts of the ACA by creating comprehensive patient protections against surprise medical bills. Employers should review the new law and rules and confer with third-party administrators (TPAs) and carriers to prepare plans for compliance. Plan administrators will need to adapt claims administration processes to comply with tight time frames, apply new cost-sharing and provider-payment procedures, and provide new disclosures in plan documents and explanations of benefits (EOBs), among other requirements.
4. HSA, FSA, and HRA developments: For 2022, employers must prepare to discontinue changes made by temporary COVID-19 relief, unless future legislation extends or makes the relief permanent. Employers will need to:
- Continue (or adopt) the permanent enhancements to account-based plans made by the Coronavirus Aid, Relief and Economic Stimulus (CARES) Act and IRS guidance.
- Adopt Section 125 plan amendments for changes reflecting COVID-19 relief; the first amendments are due by December 31, 2021.
- Update High Deductible Health Plans (HDHPs) and account-based plans for indexed dollar limits.
- Identify pre- or no-deductible health benefits, programs or point solutions that could jeopardize an individual’s eligibility to make or receive health savings account (HSA) contributions and confirm strategy.
- Consider whether pending IRS regulations on individual-coverage health reimbursement arrangements (ICHRAs) or direct primary care arrangements (DPCAs) will affect benefit strategies and compliance efforts.
- Review future IRS guidance on medical expenses or the definition of tax dependents for any impact on account-based plans.
5. Ongoing ACA concerns: Employers must continue to calculate and pay the Patient-Centered Outcomes Research Institute (PCORI) fee for self-funded health plans. Monitoring ongoing litigation challenging various ACA provisions, including the obligation for non-grandfathered group health plans to cover ACA-required in-network preventive services without participant cost sharing, will be important.
As your partners in the administration of employee health benefits, Chard Snyder is here to assist you in reviewing your employee benefits to ensure these changes have not triggered any adverse consequences for your company or your employees. Feel free to send questions to health.compliance@ascensus.com.