America's Benefit Specialist March 2023

NABIP’s LEGISLATIVE PRIORITIES

for Congress to pass the Commonsense Reporting Act to en sure that only those individuals who do not have an “afford able” offer of coverage from an employer receive a tax credit. Currently, HHS, IRS and DOL rely on employer data reported after the plan year to reconcile whether an individual appro priately received a subsidy. The IRS then seeks to recoup any excess in subsidy that was distributed through an increase in taxes to the individual. This is a long, burdensome and con fusing process for consumers and could be avoided with the Commonsense Reporting Act if employers were to report at the beginning of the plan year what they are offering to em ployees, their spouses and dependents so that the IRS would know before distributing a subsidy whether the individual has an affordable offer of coverage from an employer. This would be a huge benefit to consumers in both the individual and employer market while streamlining the system for the federal government to ensure compliance with the employer mandate and confirming eligibility for individual subsidies in the marketplace. Reforming the reporting requirements with the Com monsense Reporting Act would provide a more consum er-friendly process for individuals and a less burdensome and costly compliance process for employers, the federally facilitated and state-based exchange systems, and the IRS. PROMOTE INNOVATION AND DIVERSITY OF PLAN DESIGNS AND OFFERINGS FOR EMPLOYEES Employers have led the way in benefit design and innova tion for decades and will continue to do so for many years to come. There is no one-size-fits-all employer health plan, nor should the federal government enact or implement laws to undercut ERISA and stifle an employer’s ability to develop benefit offerings that meet the specific workforce’s needs, regardless of where that workforce is located. A recent example is the onset of the pandemic, which presented immense challenges to the workforce. During that time, many employers expanded the ways through which en rollees could get mental-health or substance-abuse services, and others developed new resources, such as employee- assistance programs.. All levels of government should work constructively with private-sector employers to ensure that they have the tools and flexibility to foster benefits design and innovations that provide employees with benefits that are crucial to their wellbeing. We urge Congress to remove barriers for employers to participate in innovative payment initiatives, such as direct contracting, centers of excellence and high- performance networks. NABIP appreciates the policies adopted during the pan demic to help employees and employers, including expand ing telemedicine availability to employees, enabling employ ees to roll over unused Flexible Spending Account funds,

• lowering the employer affordability calculation to 8.5%, which would have increased the cost of employer-sponsored coverage • civil monetary penalties on employers for noncompliance with network adequacy for mental health parity 4 NABIP worked hand in hand with Senator Mike Rounds (R-SD) to introduce legislation that would explicitly ex clude independent agents and brokers from the current Medicare recording requirement. The bill is expected to be introduced in the 118th Congress. 4 NABIP supported provisions in the 2022 Omnibus Bill: • allowing individuals to be able to pay up to $2,500 each year for long-term care insurance with their 401(k)s, 403(b)s and IRAs without a 10% early- withdrawal penalty tax. • extending HSA telehealth flexibilities through January 1, 2025. 4 NABIP fought tirelessly to exclude from any large legislative packages provisions that would limit the use of Medicare as a secondary payer for end stage renal disease and instead shift the cost to employers. Regulatory 4 Following the 116th Congress’s passage of the No Sur prises Act, NABIP successfully impacted regulations for the implementation of the Act to use the qualified payment amount (QPA) during the independent dispute resolution process, which NABIP believes will drive down the costs negotiated for these surprise bills. 4 The No Surprises Act also included provisions requiring agents and brokers earning over $1,000 in commissions in the individual and employer markets to disclose their earnings to clients prior to enrollment. The language of the Act left many unanswered questions about im plementation, and upon request from NABIP, the DOL released a set of FAQs and a good-faith standard of enforcement for the employer market. 4 Days after being sworn in, President Biden released an executive order allowing for a special enrollment period during the national health emergency for the federal marketplace. NABIP had been advocating for this since the pandemic began in 2020. 4 After opposing the previous administration’s drug-re bating rule because of unintended consequences that could lead to higher costs in the prescription drug market, the Biden Administration rescinded the final rule.

10 ABS | benefitspecialistmagazine.com

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