Question
If a self-funded or level funded group health plan filed the Gag Clause Prohibition Compliance Attestation (GCPCA) with CMS in 2023, do they have to file it again in 2024?
Yes, they do!
Submitting of the Attestation must be done annually. The Attestation reports the group health plan to be in compliance with the prohibition against ‘gag clauses’ in any agreements with service providers working with the plan to provide benefits to employees.
Definition of ‘gag clause’ = any contractual term directly or indirectly restricting the plan or insurer from disclosing specified data and information, such as cost or quality of care data.
The Attestation must be submitted to CMS (through the HIOS system) by December 31 of each calendar year. Ultimately, the plan sponsor of a self-funded or level funded group health plan is responsible for the attestation. If a carrier is administering the self-funded or level funded group health plan, the plan sponsor should be communicating with the carrier to see what they may be doing to assist with the process. Or, if a third party administrator is administering the group health plan, the plan sponsor should be working with the TPA to understand what they may be doing to assist with the process.
Other Resources
Medicare Part D Non-Creditable Plan List
The Medicare Part D prescription drug coverage will
expand in 2025 as required under the Inflation Reduction Act (IRA), which could impact whether an employer’s group health plan provides creditable prescription drug coverage.
Yes, HRAs and HSAs Can Be Compatible
Employers offering a high deductible health plan (HDHP) may want to offer HDHP participants a health reimbursement arrangement (HRA) to buy down the deductible. The HRA design will determine whether HDHP participants can also maintain eligibility to contribute to a health savings account (HSA).
ACA Employer Reporting Summary
Certain employers, plan sponsors, and insurers are required to report health plan information and participant coverage data to the IRS each year. The IRS uses this information to administer and regulate various aspects of the Affordable Care Act (ACA), including an individual’s eligibility for a premium tax credit when purchasing health insurance through a public Marketplace and the §4980H employer shared responsibility rules.
Extension of Employee Benefit Timelines Announced by DOL and IRS – Hurricane Relief
The Department of Labor (DOL) and the Department of Treasury (IRS) issued several notices
extending time frames generally applicable under HIPAA, COBRA, and ERISA to provide relief to plan participants, beneficiaries, qualified beneficiaries, and claimants as well as plan sponsors that may have been impacted by
Hurricane Helene, Tropical Storm Helene, or Hurricane Milton. In addition, the Department of Health and Human Services (HHS) encourages plan sponsors of non-federal governmental plans to follow the guidance.
