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Alera Group Webinar: Machine-Readable Files and Pharmacy Reporting

Business owners and human-resource managers, July 1 is fast approaching. Are you prepared to post machine-readable files? 

Alera Group invites you to join us on Thursday, May 19, from 2-3 p.m. EDT for the second webinar in our quarterly series on employee benefits compliance. Our primary focus will be on two topics: 

  • Publicly-accessible, machine-readable files containing price comparisons for employee group health plans. In accordance with the federal Transparency in Coverage Rule, health insurers and employer self-insured plans are required to post the files by July 1. 
  • Pharmacy reporting. Another piece of federal legislation, the Consolidated Appropriations Act (CAA), 2021 requires group health plans and health insurance issuers to submit information regarding prescription drug and other healthcare spending to three U.S. departments: Health and Human Services, Labor and Treasury. The reporting deadline for calendar years 2020 and 2021 is this December 27. Reporting for subsequent years, including 2022, will be due annually on June 1. 

If your business provides healthcare benefits, this applies to you. 

As Alera Group reported in an August 2021 legal alert, the CAA reporting requirement “applies to group health plans of any size (except for church plans). This means it will apply to any group health plan that is fully insured, self-funded, or sponsored by a government or municipality. There is no exclusion for ‘small plans’ or groups of fewer than 100.”  

A more recent legal alert, issued in March, details various aspects of the Transparency in Coverage Rule, including content of the machine-readable files for both in-network rates and out-of-network allowed amounts.  

While both releases are informative and comprehensive, the topics they address are complex. During our May 19 webinar, co-presenter Stacy Barrow and I will review key elements in clear, straightforward terms and answer questions from our audience. You’ll come away with a strengthened understanding of the requirements and any missing pieces you’ll need to secure to meet the upcoming deadlines.   

To register for the webinar, click on the link below. 

REGISTER 
 


About the Author 

Danielle Capilla 
Vice President of Compliance, Employee Benefits 
Alera Group  

Danielle Capilla is focused on enhancing Alera Group’s existing compliance capabilities and building new, world-class compliance solutions for our employee benefits clients. Her areas of expertise include healthcare and employee benefit compliance, with an emphasis on the Patient Protection and Affordable Care Act. Additionally, she regularly works with issues regarding Section 125 plans, COBRA, ERISA, Medicare, HIPAA and consumer-driven healthcare plans. Danielle earned her JD in Health Law from DePaul University College of Law. Her background in law enables her to simplify complex topics, helping Alera Group clients navigate the intertwined landscape of healthcare regulation and their benefit plans. 

Contact information:  

The information contained herein should be understood to be general insurance brokerage information only and does not constitute advice for any particular situation or fact pattern and cannot be relied upon as such. Statements concerning financial, regulatory or legal matters are based on general observations as an insurance broker and may not be relied upon as financial, regulatory or legal advice. This document is owned by Alera Group, Inc., and its contents may not be reproduced, in whole or in part, without the written permission of Alera Group, Inc. 

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