Employee Benefit Guidance & Compliance Solutions


Medicare Eligibility: Who pays first?

Posted by on December 2, 2020 in Human Resources, Notices

Message to Employers with employees for whom Medicare is the primary payer PF Compass wants you to know some important rules for your Medicare-eligible employees. Eligible members are encouraged to enroll in Medicare in order to maximize their health plan benefits and minimize expenses. If your employer has an employee headcount of twenty or more employees, a commercial health plan is the primary payer. If your employer has an employee headcount of under twenty employees, Medicare is the primary payer. It’s important for eligible members to enroll in Medicare Once a member is eligible for Medicare as their primary payor, and if they are not enrolled in Medicare, health plans will coordinate benefits with their group coverage and pay benefits as though they were enrolled in Medicare Part B. This means that benefits will be paid by subtracting the amount that Medicare would have paid (usually 80 percent of...

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Guidance on the COVID-19 Vaccination

Posted by on November 13, 2020 in Human Resources, Notices

Important notice concerning guidance on the COVID-19 vaccination has been released by the Departments of Labor (DOL).  This is extremely important to your business, as new advances are being made on the vaccination daily. PF Compass will continue to update on any new information found to keep you and your business updated and informed! The Scoop   On Nov. 6, 2020, the Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (Departments) published an interim final rule requiring Medicare, Medicaid, and private insurers to cover a COVID-19 vaccine without any cost-sharing, once the Food and Drug Administration (FDA) authorizes and approves a vaccine. COVID-19 Vaccine Coverage for Private Health Plans.  The interim final rule implements the requirement in the Coronavirus Aid, Relief and Economic Security (CARES) Act that non-grandfathered group health plans and health insurance issuers offering non-grandfathered group or individual health insurance coverage provide coverage,...

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