Gemellaro Systems Integration, Inc.

Table of Content

  1. Header
  2. Agenda
  3. Who is NFP
    1. Size, offerings
    2. The NFP Team
    3. Compensation Consulting
  4. Compliance
    1. Updates
    2. NFP Compliance Support
  5. 2023 Renewal Overview
    1. Renewal Summary
  6. Medical
    1. Current vs Renewal
    2. Marketing Results
    3. Option 1 | Plan Design Consideration
    4. Option 2 | Plan Design Consideration
    5. Blues News
    6. Benchmarking
  7. Non-Medical
    1. Dental
    2. Vision
    3. Life & Disability
    4. Benchmarking
  8. Planning Ahead
    1. Employee Communications
    2. Timeline
    3. Q&A
  9. Footer

Who is NFP


The NFP Team

Compliance

2023 HSA Increase: HSA maximums increased to $3,850 (single) & $7,750 (family)


2023 Affordability Test: 9.12% -This is a non-issue for GSI, the single employee contribution for all plans is well within affordability requirements.


ACA “Family Glitch”: On October 11, 2022, the IRS finalized its proposed rule to fix the “family glitch” in eligibility rules for the ACA premium tax credit (PTC). The new final rule will be effective starting in the 2023 tax year. the new rule applies a separate PTC affordability standard for family members based on the full cost-share contribution for family coverage. Under the rule, an eligible employer-sponsored plan will be treated as affordable for family members (i.e., the spouse if filing jointly and tax dependents) if the portion of the annual premium the employee must pay for family coverage, that is, the employee's required contribution, does not exceed 9.12% of household income (indexed annually). As a result, an employee’s family may qualify for a PTC even if the employee does not. The new rule does not impact the employee affordability test and does not increase exposure to employer shared responsibility (employer mandate) penalties.


2023 ACA Reporting: Our records indicate that GSI had 50+ full time employees during 2021, this requires GSI to complete ACA reporting requirements. How will GSI be handling ACA reporting for the 2022 plan year? 1095-C forms due to employees on 1/31/2023 and due to the IRS by 2/28/2023 if filing by paper – or – by 3/31/2023 if filing electronically.


Massachusetts Health Insurance Responsibility Disclosure: The Health Insurance Responsibility Disclosure (HIRD) form, launched in 2018, is a state reporting requirement in Massachusetts that applies to in-state and out-of-state employers with employees in Massachusetts. Employers with six or more employees who worked in Massachusetts must submit a HIRD form annually. The most recent census reflects you have 1 employee in MA.


Payer Transparency: Health insurers are required to publicly display certain health care price information via machine-readable files on their websites as part of Transparency in Coverage. These machine-readable files will include negotiated rates with in-network providers and allowed amounts for out-of-network providers. The Departments of Health and Human Services (HHS), Labor and Treasury have issued guidance indicating they will enforce compliance of the machine-readable file requirements beginning July 1, 2022. This does not require any steps from GSI.

ACA Employer Mandate Reporting

NFP Whitepaper

ACA Employer Mandate Reporting

NFP Whitepaper

Payer Transparency

BCBSM/BCN Action Plan

Payer Transparency

BCBSM/BCN Action Plan

NFP Compliance Support

2023 Renewal Overview

BCBSM/BCN Medical/Rx: +6% overall increase (PPO +5%, POS & HMO +9%)


All other lines are renewing with no change for 2023!


Executive Summary for Renewal costs assumes no plan design changes and maintains the current employee contribution percentages.