Not All Surprises Are Good – Phase I of the Surprise Billing Rules

Matthew P. Chiarello • August 16, 2021

On July 1, 2021, the Office of Personnel Management, Department of the Treasury, Department of Health and Human Services, and Department of Labor issued the interim final rule “ Requirements Related to Surprise Billing; Part I ” (the “IFR”), which is the first phase of regulations implementing the No Surprises Act. The No Surprises Act provides certain protections against surprise medical bills and was signed into law on December 27, 2020 as part of the Consolidated Appropriations Act, 2021.

The No Surprises Act and the IFR do not completely eliminate surprise billing, but they provide relief from some of the more common scenarios when an individual may experience high and unexpected medical costs. Those scenarios include surprise medical bills from:

  1. emergency services;
  2. non-emergency services performed by nonparticipating providers at participating health care facilities; and
  3. air ambulance services.

For more information about the No Surprises Act and its impact on employer-sponsored group health plans, see our SW Benefits Update, “ Not All Surprises Are Good – Phase I of the Surprise Billing Rules.”

Employee burnout: what it is and how to prevent it

By Mardy Gould • May 24, 2024
Employee burnout has become an epidemic in today’s modern workplace. So much so that the World Health Organization (WHO) officially recognizes it as an “occupational phenomenon.”1 While many used to consider mounting workplace stress an individual employee problem, these days, it’s become an employer’s responsibility to prevent burnout before it hurts productivity and business performance—not to mention your employees’ physical and mental health. Luckily, you can prevent burnout from affecting your workforce in several ways. This article will explore the causes and signs of employee burnout and the steps you can take to create a positive work environment where employees feel safe from toxic stress levels.

Form 720 and PCORI fee FAQs

By Mardy Gould • May 23, 2024
If you're a small business owner, you may have heard of the acronym PCORI and the fees that come with it. But what is PCORI, and how does it apply to your organization? Under the Affordable Care Act (ACA), sponsors of self-insured health plans must pay a fee to fund the federal Patient-Centered Outcomes Research Institute (PCORI). PCORI is an independent organization the ACA created to conduct research to help healthcare consumers make better decisions for their specific needs and outcomes. It also performs research related to clinical effectiveness. Employers offering a self-insured medical reimbursement health plan, such as a health reimbursement arrangement (HRA), must pay this fee by July 31 each year via Form 7201. This fee was initially set to expire in 2019, but Congress extended it through September 30, 20292, due to the Further Consolidated Appropriations Act of 20203.
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