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The Families First Coronavirus Response Act (FFCRA)

April 8, 2020

The Families First Coronavirus Response Act (FFCRA) requires certain employers to provide employees with expanded family and medical leave for specified reasons related to COVID-19. The attached HR Compliance Bulletin includes guidance issued by the DOL regarding employee expanded family and medical leave rights under the law.

Also, attached is a HR Compliance Bulletin that contains questions and answers issued by the DOL to provide compliance assistance to employers and employees on their responsibilities and rights under the FFCRA.

Under the FFCRA, covered employers must post a notice of the FFCRA requirements in a visible place on its premises. The attached HR Compliance Bulletin includes FAQs issued by the DOL on this notice requirement. The required notice poster is, also, attached for your use.

If you have any questions, please contact us at customerservice@consociate.com.

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The CARES Act and Health Plan Coverage

April 3, 2020

On March 27, 2020 President Trump signed the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) into law to provide $2.2 trillion in federal funding to address the coronavirus crisis.  The new law also includes several provisions affecting health plan coverage. The attached Compliance Bulletin summarizes the CARES Act’s changes for health plans.

The attached Know Your Benefits article explains how the CARES Act repeals the Medicine Cabinet Tax provision of the Affordable Care Act, expanding the list of qualifying expenses that can be purchased with Flexible Spending Accounts (FSAs), Health Reimbursement Arrangements (HRAs) and Health Savings Accounts (HSAs).

FSA/HRA/HSA Plan Changes to allow Tax-Free Coverage for OTC Drugs and Menstrual Products

Effective Jan. 1, 2020, the CARES Act provides that OTC medicines are qualifying medical expenses that may be paid for (or reimbursed) on a tax-free basis by a health FSA, HRA or HSA. This change eliminates an ACA provision that required individuals to have a prescription for an OTC medication (except insulin) to pay for it on a tax-free basis with their health FSA, HRA or HSA.

In addition, effective Jan. 1, 2020, menstrual care products are qualifying medical expenses that can be paid for (or reimbursed) on a tax-free basis by a health FSA, HRA or HSA. Menstrual care products include tampons, pads, liners, cups, sponges or similar products used by individuals with respect to menstruation.

These changes are discretionary for employers that sponsor health FSAs and HRAs. However, because HSAs are individual accounts, and not employer plans, employers do not control how HSA funds are used.

What if Consociate Health Administers my FSA/HRA/HSA Benefits?

Consociate Health is ready to process any manual claims submitted (when a Debit Card is not used) for reimbursement on these products. We are also setup behind the scenes with our Debit Card Vendor to make sure your consumers can begin to utilize their benefits debit card for the purchase of these products as soon as possible.

Please Note:  Your members can not yet purchase OTC or menstrual care items using their benefits debit card. Consociate Health is ready, but several steps must be taken by merchants before the members will be able to use their benefits debit card at the Mass merchandiser and Pharmacy locations.

The below steps will need to occur before the benefits debit card will be able to be used for the newly eligible items.

  • IIAS Standards (SIGIS) board must first adopt these new standards and publish the revised Eligible Product List.
  • Merchants (i.e. Walmart, Walgreens, CVS and smaller drug and grocery stores) must update their systems with the new Eligible Product List.

We expect merchants to start adopting changes for the OTC items around April 15th. However, merchants may take anywhere from 4-6 weeks to complete the changes that will allow consumers to purchase these items with a card swipe. All of this will undoubtedly result in inconsistencies in shopping experiences for the consumer (i.e. OTCs may be allowable at one merchant, but not another) as the industry makes this important transition. We expect any issues like this to be temporary and resolved in a fairly short timeframe.

If consumers try to purchase these items with their benefits card before the systems have been updated and the transaction is denied, they can submit a claim for reimbursement.

If you have any questions, please contact us at customerservice@consociate.com.

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Making Sense of Your Prescription Drug Plan

Your employer offers a prescription drug plan, but do you know how to use it? Do you understand the benefits the plan provides, and how the prescription drug choices you and your doctor make can affect you, your family and your employer?
Understanding your drug plan and prescriptions can help you save money, stay healthier and receive greater satisfaction from your health plan.

Prescription Drugs and Your Employer

Employees who understand their benefit plans make more informed choices about the medical services they receive, and can reduce the amounts they are required to pay out their own pockets by choosing less expensive alternatives. Making cost-effective choices also helps keep employer costs down.

Prescription drugs are one of the most costly elements of employer-sponsored health plans. Helping reduce costs for your employer can lead to lower premium increases in the future and the continued availability of your health and prescription drug plans.

Generic vs. Brand Name Drugs

Choosing generic drugs over the brand name is generally less expensive. However, many people question whether generic drugs are as good, effective or safe as their brand name counterparts. The perception is that since many generic items found in grocery stores tend to be of lesser quality, the same must be true for medications.

Fortunately, in the case of prescription and over-the-counter (OTC) medications, generic substitutes are the equivalent of brand name drugs. The U.S. Food and Drug Administration (FDA) regulates the chemical equivalency of generic drugs to ensure they are just as safe and effective as the brand name drugs they mimic.

Not all medications have generic equivalents, particularly newer drugs with patent protection. After the patent expires on a brand name drug, other pharmaceutical companies can manufacture that drug under a generic name. Generic drugs are usually less expensive than the brand name versions, due to lower development and marketing costs. Consistently choosing generics over brand name drugs, when available, is one of the best strategies for saving money on your prescription drugs.

Follow Directions Completely

Nearly half of all dispensed prescriptions are taken inappropriately. These “non-compliant” patients are doing one or more of the following:

  • Taking medications at the wrong time of day
  • Under-dosing or stopping too soon
  • Sharing prescriptions with others
  • Mixing medicines with alcohol, tobacco, certain foods or other drugs
  • Failing to fill or refill prescriptions altogether

Is Your Drug Plan Hard to Swallow?

Not taking your prescription in accordance with your doctor’s orders can result in serious health complications. Taking the incorrect dosage, or not completing a full course of antibiotics, for example, can worsen your condition. Poor patient compliance has historically cost billions of dollars in medical bills, resulted in lower quality patient health and even caused unnecessary deaths.

Talk to Your Doctor

The best way to ensure that you know all you can about a drug you have been prescribed, and its generic equivalents, is to talk openly with your doctor. Below are some suggested questions that you may want to ask.

  • Is there a generic substitute for this drug available?
  • Are there any drug interactions that I should be aware of?
  • Does this medication cause any side effects?
  • If I forget to take a dose, what should I do?

Also, make sure your doctor knows about any previous reactions you have had to medications. In addition, be sure to call your doctor immediately if you have any problems or adverse side effects from a new prescription.

Choosing generic drugs when available, following your doctor’s and pharmacist’s instructions fully, and talking openly with your doctor will help you make the most of our prescription drug plan. These strategies can help you not only save money on the prescription itself, but also avoid future health problems that could be costly.

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HHS Increases Civil Penalties for HIPAA Violations

March 31, 2020

The Department of Health and Human Services (HHS) recently published a final rule increasing the civil monetary penalties for violations of laws enforced by HHS, including the HIPAA privacy and security rules. HHS is required to adjust these penalties for inflation each year to improve their effectiveness and maintain their deterrent effect. The new penalty amounts are effective for penalties assessed on or after Jan. 17, 2020.

2020 HIPAA Civil Penalties

HHS may assess civil penalties when it discovers a HIPAA violation. The penalty amount depends on the facts involved.

  • For violations where the covered entity does not know about the violation (and by exercising reasonable diligence, would not have known about the violation), the penalty amount is between $119 and $59,522 for each violation.
  • If the violation is due to reasonable cause, the penalty amount is between $1,191 and $59,522 for each violation.
  • For corrected violations that are caused by willful neglect, the penalty amount is between $11,904 and $59,522 for each violation.
  • For violations caused by willful neglect that are not corrected, the penalty amount is $59,522 per violation, with an annual cap of $1,785,651 for all violations of an identical requirement.

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