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  • On August 8th, 2022, the Senate approved bill H.R. 5376, the Inflation Reduction Act of 2022. This bill will make a historic down payment on deficit reduction to fight inflation, invest in domestic energy production and manufacturing, and reduce carbon emissions by 40 percent by 2030. In addition, the bill will allow Medicare to negotiate prescription drug prices and extend the expanded Affordable Care Act Program (ACA) for three years.

    While Democrats and supporters of the legislation believe it would lower health care costs, prescription drugs, and energy costs, and make the U.S. tax code fairer, others disagree. Individuals argue that the new spending would further aggravate inflation and stifle growth. While the bill must still pass in the House of Representatives and be signed by President Joe Biden, it’s more than likely to become a law.

    What This Means For Small Business Owners

    To stay compliant, small business owners must keep up with changing laws and regulations. Following the passing of the Inflation Reduction Act, it’s important to understand the following provisions:

    • 15% minimum tax on corporations with over $1 billion in revenue 
    • 1% excise tax on corporate share buybacks
    • $80 billion more in IRS enforcement

    The following are health care provisions: 

    • Extend the ACA subsidies through 2025
    • Allow Medicare to negotiate drug prices, starting with 10 drugs in 2026
    • Cap Medicare recipients’ drug expenditures at $2,000 per year

    Uncertainties Relieved Through GMS 

    Despite the uncertainty surrounding the new Senate bill, GMS experts are ready to help your small business. We provide you with resources and guidance to get you through unprecedented times. Our benefits services allow your business to offer competitive, cost-effective benefits such as health insurance while you focus on what you do best. Get back to focusing on what’s important, your business. Contact us today.

  • If Congress allows the expansion of the health care subsidies included in the American Rescue Plan Act (ARPA) to expire, thousands of South Carolinians could see their 2023 premiums skyrocket. This is specifically related to individuals who get their health insurance through the Affordable Care Act’s (ACA) individual marketplace.

    There are currently about 365,000 individuals who have ACA plans. Amongst those individuals, 60,000 would lose health coverage and become uninsured if these subsidies don’t get extended. In addition, 225,000 South Carolinians would lose all or a portion of the financial assistance they currently receive.

    Benefits Of Temporary Subsidies 

    The ACA has provided subsidized health insurance on HealthCare.gov and state-run Marketplaces since 2014. There are approximately nine million individuals who purchase coverage with federal premium assistance. However, there are still millions who remain uninsured.

    The March 2021 COVID-19 relief legislation, also known as the ARPA, extends eligibility for ACA health insurance subsidies to individuals who buy their own health coverage on the Marketplace who have incomes over 400% of poverty. This law increases the amount of financial assistance for those on lower incomes who were already eligible under the ACA. It is shown that 21.8 million individuals are eligible for a subsidy to purchase Marketplace coverage with the passage of the ARPA. Also, 63% of uninsured individuals are now eligible for financial assistance through the Marketplaces, Medicaid, or basic health plans.

    Since the temporary subsidies in 2021, there has been an increase in financial assistance. In addition, these subsidies expanded aid to many middle-income individuals who had previously been ineligible for assistance.

    What This Means For Other States

    Outside of South Carolinians who are expected to see health premiums rise, the federal government has warned millions of individuals across the U.S. that they could lose health insurance. It is estimated that approximately three million individuals would lose health insurance should these subsidies stop. In addition, 10.4 million individuals with an ACA plan would pay a significantly higher dollar amount for coverage to stay insured.

    How GMS Comes Into Play

    Access to quality, affordable health care is essential for individuals to remain healthy. While questions are still looming, it’s concerning to individuals in South Carolina and across the U.S. who have been utilizing these subsidies. Let GMS take the stress off your shoulders. We now offer individuals voluntary benefits, providing you with access to health care, life insurance, pet insurance, and so much more. Contact us today.

  • In Pennsylvania, health insurers are proposing an average of 7.1% increase in monthly health premiums beginning January 2023. The state Insurance Department announced that 375,000 individuals who are covered through the online state marketplace could be affected by this increase.

    “Increased choices and plan options will provide Pennsylvanians with the opportunity to shop for the best coverage options for themselves and their families,” Insurance Commissioner Michael Humphreys said in a prepared statement. “As we navigate through the aftermath of the COVID-19 pandemic, Pennsylvania continues to have a strong and competitive insurance market.”

    A U.S Senate vote is expected this week on a bill called the Inflation Reduction Act of 2022, which would extend premium subsidies for three years. Rate increases were attributed to rising health care costs, deferred claims resulting from the pandemic, and the end of enhanced premium tax subsidies.

    Additional Results Of Health Premium Increase 

    • Pennsylvania’s uninsured rate fell to 5.4%, the lowest rate due to the higher subsidies in 2022. 
    • Federal American Rescue Plan funding cut out-of-pocket premium costs by an average of 9% in 2022. The funding expires at the end of the year. 
    • It’s predicted that there will be an average increase of 5.2% for small groups. The department has the authority to modify the rate requests and continues to review the rates sought by insurers. 

    Help Lower Your Healthcare Premiums 

    Whether your organization lacks an HR department or needs a resource to make more informed decisions regarding benefits management, GMS can help. We offer you the opportunity to enter a relationship that encompasses all your administrative functions, allowing you to focus on what you do best. Contact us today to learn how you can lower your healthcare premiums.

  • President Joe Biden announced that the uninsured rate reached 8%, the lowest rate in U.S. history. Over 5.2 million individuals have gained health coverage since 2020. This news came shortly after the Democratic party released an extensive deal focusing on climate change, health care, and tax. This deal extended generous federal subsidies for people who buy private health insurance, which is credited with driving down the uninsured rates.

    In addition, Democrats have also proposed spending $64 billion to extend these price breaks for three more years. Originally set to expire this year, Senator Joe Manchin III of West Virginia agreed to extend the high subsidies until 2025. If Democrats can pass the package on a party-line vote in the Senate, this deal will be extended.

    The initial fall in uninsured Americans began in 2021 when Congress and President Biden signed off on a $1.9 trillion coronavirus relief bill. This bill ultimately lowered premiums and out-of-pocket costs for new or returning customers purchasing plans through the Affordable Care Act’s (ACA) private health insurance markets.

    Additional Actions

    After the ACA was enacted in 2010, the number of uninsured Americans began decreasing. The ACA expanded Medicaid and provided health insurance to individuals who lacked job-based coverage through a mix of subsidized private plans. It also produced improved health outcomes, better access to care, and improved financial security for families.

    Additional actions that are being taken to decrease the uninsured rate include expanding Medicaid under Obamacare in all states. Officials are also providing a path to legal status for unlawful migrants living in the U.S., so they can qualify for insurance programs.

    Furthermore, President Biden lobbied Congress to pass signature legislation to protect Obamacare gains. This legislation would lower healthcare costs and make health insurance coverage more accessible for families across the country.

    How GMS Plays A Part

    Although there is a lower uninsured rate, roughly 26.4 million individuals remain uninsured. If you’re an individual who is trying to find insurance, you’ve come to the right place. GMS now offers individuals voluntary benefits at a lower monthly rate. If you don’t receive benefits from your employer, GMS has you covered. Contact us today to learn more.

  • Since the beginning of COVID-19, small business owners have continued to face ongoing hardships. While some problems stem from pandemic fallout, such as staffing issues or low retention rates, others were unforeseen. To combat these challenges, local government officials have made it a priority to help small businesses within their communities.

    What Is ARPA?

    The American Rescue Plan Act of 2021 (ARPA) was signed into law as a relief package. The main goal of the act was to support business owners and community members by providing:

    • State and local aid
    • Education
    • Rental assistance
    • Transit
    • Stimulus payments

    Fund Eligibility 

    Not only was the ARPA implemented for the state but also for local governments. ARPA authorizes additional funding totaling $350 billion to be distributed amongst all 50 states. These funds are only eligible to be used for:

    • Revenue replacement due to the COVID-19 public health emergency
    • COVID-19 expenditures or negative economic impacts which include assistance to small businesses, households, and hard-hit industries and economic recovery
    • Premium pay for essential workers
    • Investments in water, sewer, and broadband infrastructure

    Fund Restrictions 

    Since the money is split between state and local aid, there are different requirements that were established. The influx of funds is beneficial to the state and local finances. However, it also supports aiding recovery from budgetary, economic, and financial impacts of the pandemic. Funds are available until December 31st, 2024. Each county within the state can make its own use of the funds, along with providing them with specific monetary amounts, and who can apply for them. All states, however, have the following restrictions:

    • Funds may not be deposited into any pension fund
    • Funding is to be spent by the end of the 2024 calendar year
    • Allocation to states cannot be used to directly or indirectly offset tax reductions or delay tax, or tax increase

    Why GMS

    At GMS, our mission is to see small businesses succeed. When it comes to changing legislation, GMS is the first to ensure that your business will remain compliant. Stay up to date on all the opportunities to support your business’s recovery following COVID-19. Contact GMS today to learn more.

  • A survey conducted by AKASKA, a leading developer in Artificial Intelligence for healthcare operations, released findings demonstrating how individuals research healthcare. The survey indicated that Americans often turn to health insurers for pricing rather than other sources. In addition, the findings of this survey showcase the need for both payers and providers to be proactive on price transparency measures.

    Survey Findings

    Among the 2,000 adults who participated in the survey, only 36% indicated that they researched prices for healthcare services. In addition:

    • 60% look to their insurance provider for pricing information
    • 44% look on the websites of health insurers for information
    • 29% would call their health insurance company for information 

    In addition to the statistics above, respondents said: 

    • 44% say their health insurance company does not provide pricing information for local healthcare providers
    • 34% are uncertain if this information is available

    On July 1st, 2022, the Centers for Medicaid and Medicare Services began requiring health plans to comply with several initiatives related to price transparency. The goal is to provide consumers with the necessary information to make knowledgeable health care decisions. Along with price transparency, health plans must provide machine-readable files (MRF) with information on in-network and out-of-network insurance rates. However, some question how valuable the MRF format is because it’s not user-friendly and difficult to interpret.

    Stop Questioning Your Health Plans

    Medical coverage isn’t just a benefit for employees; it’s a necessity. At GMS, we provide our clients with various tools and resources to find a coverage solution tailored to their needs. Not only do we provide clients with the buying power of a large corporation, but we’re able to offer financial security, flexible benefit options, and an unprecedented customer service experience. Along with your dedicated benefits specialist, you gain access to a team of experts who train your employees on how your plan works and answer coverage questions. Health insurance is complicated, allow GMS to support you. Contact us today.

  • Governor Ron DeSantis signed an executive order on Friday, July 8th at Cape Coral High School to increase transparency for prescription drug prices in Florida. The order would help make pharmacy benefit managers and third-party administrators of prescription drug programs, accountable when managing prescription drug benefits for insurance companies.

    Gov. DeSantis’s goal in signing this order is to create lower costs for prescription drugs in Florida. DeSantis says, “With food and gas costs on the rise, addressing the pharmaceutical costs is one area I can make a difference in.” He continues to state, “This executive order requires accountability and transparency for pharmaceutical middlemen when doing business within the state, thereby reducing the upward pressure on prescription drug costs.”

    The order directs all executive agencies to include the following in future contracts:  

    • Prohibit spread pricing 
    • Prohibit reimbursement callbacks 
    • Include data transparency and reporting requirements 
    • Review all rebates, payments, and relationships between pharmacies, insurers, and manufacturers 
    • Amend all current contracts they can with the same provisions 

    Additional Programs In Progress

    During the Drug Transparency Order signing, Gov. DeSantis’ administration is working on the Canadian Prescription Drug Importation Program. This will allow prescriptions from Canada to be imported when their prices are significantly lower than those in the United States. The Food and Drug Administration (FDA) has been reviewing this for the past 600 days. 

    By developing new programs after the Drug Transparency executive order, Gov. DeSantis’ administration can find effective ways for Florida residents to save money.

    Navigating Prescription Drug Transparency

    By partnering with GMS, you gain access to a handful of resources beneficial for your business. At GMS, we have a designated Rx specialist who works with your employees to find them the most cost-effective options. Our promise is to make your business operations simpler, safer, and stronger. Learn more by contacting us today. 

  • The Healthcare Literacy Takes One Step Forward, and Two Steps Back consumer report created by Optavise has revealed data showing that consumers are still struggling with healthcare literacy. The organization surveyed 1,055 employees with employer-sponsored health insurance in the United States. Survey results show that 65 percent of respondents stated that they do not usually compare prices before getting healthcare. As a result, they may be overpaying. Only 10 percent of respondents stated they check whether a medical provider or facility is in-network whenever their health plan changes (down from 25% in 2021).

    By partnering with health benefits educators and digitizing education, more employers can help employees improve their financial well-being and healthcare literacy.  

    Additional Key Findings: 

    • Avoid surprise medical bills (39%)
    • Understand how their deductible, copay/coinsurance, and out-of-pocket maximum (OOPM) impact their wallet (33%)
    • Review an explanation of benefits (EOB) and medical bill for errors (30%)
    • Research healthcare costs and why they matter (29%)
    • Choose a plan and where to get care (22%)

    How GMS Can Benefit Your Business

    Here at GMS, we understand that it is important for you and your employees to have a better understanding of healthcare costs. We provide our clients with various tools and resources to find a coverage solution tailored to your needs. Furthermore, partnering with GMS will provide you with access to a team of experts who will be there to answer any questions you may have. Contact us today to learn more.

  • Research conducted by the Colorado Department of Insurance (DOI) shows groups could potentially see a significant spike in premium costs for 2023. Those affected by higher prices include small businesses and individuals who receive health insurance outside of their employer’s health plan.

    After reviewing insurance company filings, they show:

    • An 11% increase for individuals
    • A 9% increase for businesses with fewer than 100 employees

    New Option For Coloradans In 2023

    With the expected increases in health insurance for 2023, there will be an additional option for Coloradans. The new option will offer plans at a lower cost than the market average. The deadline for individuals to weigh in on this is August 1, 2022.

    The DOI will examine the reasoning behind these increases after August 1st. Depending on the findings, the DOI will decide if health insurance increases are reasonable or if prices should be adjusted.

    As part of the new lower-cost Colorado option, the DOI has created a Standard Plan to allow consumers and businesses to easily compare plans and choose the best fit. In addition to free primary care and mental health visits, this new plan aims to reduce racial health disparities. However, this will only be available for Coloradans who buy their health insurance on the individual market and for small employers with two to 100 employees. For more information, click here.

    Lower Your Healthcare Premiums With GMS

    While Colorado is creating additional options to lower the cost of health insurance for individuals, GMS also provides health insurance to small businesses. Small businesses have access to the buying power of large corporations by partnering with GMS, which leads to a greater selection of affordable health insurance options. Through our buying power, we’re able to offer financial security, flexible benefit options, and an unprecedented customer service experience. Contact us about small company health insurance today.

  • President Joe Biden’s administration has requested state TennCare officials to make major revisions to the Medicaid block grant program. This program currently provides healthcare to 1.6 million Tennessee residents.

    Under the block grant program, Tennessee would receive a set amount of funding but have more flexibility in how they spend it. This will enable the state to retain savings for health care and health-supporting initiatives.

    State and Federal officials have been discussing these revisions for quite some time. The state has the option of approving or rejecting the changes, as this is a request from the federal government. Furthermore, Tennessee has until August 30th to decide if revisions will be made to the TennCare program. The benefits of 2021 will be preserved in the meantime.

    How Revisions Can Affect Tennessee Residents

    Some experts from Tennessee say that the revisions to the waiver grant program would be beneficial and is good news for Tennesseans. Organizations like the American Heart Association, the American Cancer Society, and many others opposed the granted waiver because of the harm it would do to 1.6 million Tennessee adults and children who rely on TennCare. Michele Johnson, Executive Director of the Tennessee Justice Center says, “all the groups warned it would damage the health care system on which we all depend and would worsen the rural health crisis across Tennessee.”

    On the other hand, by requesting the waiver in 2019, Tennessee Gov. Bill Lee’s administration hoped to save money by directing those funds into health care initiatives and programs. This was followed by a year of criticism from GOP lawmakers who did not want to expand the Medicaid program under the previous Affordable Care Act. By the beginning of 2021, the waiver grant program had finally been approved.

    Under Medicaid, the federal government pays two-thirds of TennCare’s costs. There are no spending caps on state Medicaid expenditures which means Tennessee could boost or even expand the existing TennCare programs if it wishes. Depending on how much more of its own money the state was willing to put into it.

    The Center for Medicare and Medicaid Services is recommending these other provisions:

    • The Center for Medicare and Medicaid Services’ letter states it supports Tennessee’s policy goals to expand coverage and benefits. But the letter says center officials propose that “instead of the current framework for savings and investment,” the federal agency will “work with the state on necessary expenditure authorities to meet common goals.”
    • Modify the waiver’s specific terms and conditions section to “more explicitly state” Tennessee cannot cut benefits or coverage in effect from Dec. 31, 2021, without a procedural amendment subject to an additional public comment period and Center for Medicare and Medicaid Services approval.

    How GMS Can Help

    GMS does more than offer coverage like a traditional medical insurance company. To help our clients find the right coverage solution, we offer a variety of tools and resources including:

    • Education- In addition to a dedicated benefits specialist, you gain access to a team of experts who can train employees on how your plan works and answer questions.
    • Guidance – Health insurance is complicated. Our experts provide guidance on how to best utilize your plans, maintain compliance, and stay on top of Affordable Care Act regulations.
    • Control – GMS gives you more control of your business. Partnering with a PEO for group health insurance lets you focus on growing your business while making your benefits administration more efficient.

    To learn more, contact us today!