News

Blue Shield has successfully submitted 2025 Prescription Drug Cost data reports to the Centers for Medicare and Medicaid Services (CMS). Groups who did not submit D1 Premium Information to Blue Shield, or groups with prescription drug (pharmacy) benefits with another carrier, should have submitted required information directly to CMS. This submission included: • D1 Premium Contribution information submitted to Blue Shield via the Prescription Drug and Healthcare Spending survey • D2 data available under the medical benefit for all employer groups • D3-D8 for employer groups with a prescription drug (pharmacy) benefit plan with Blue Shield For More Information or Help Quoting Blue Shield, Please Contact Your Dickerson Sales Representative.

Health Net News Now is a monthly newsletter crafted to keep you informed and empowered with the latest news articles and company updates that directly impact your profession and the services you provide to your clients. Aetna understands the fast-paced nature of the insurance industry and the importance of staying ahead of the curve. With Health Net News Now, you can expect a curated selection of articles covering a wide variety of topics, including industry trends and updates, but also, company announcements and information, ensuring that you are always in the loop regarding any changes or enhancements to our products and services. Health Net News Now is designed to be concise, informative, and easily digestible, ensuring that you can quickly get up to speed on the most relevant and impactful news without being overwhelmed by unnecessary information. For More Information or Help Quoting Health Net, Please Contact Your Dickerson Sales Representative.

Unum’s Group Long Term Disability Insurance provides a solid base of income protection and valuable resources for employees. Plus, Unum offers additional options and services that help support your workforce and business. Unum plans offer: • Choice of employer paid, shared contributions or employee paid • Own-occupation, residual and partial definitions of disability • Own-occupation period of 12 to 60 months, or the benefit duration • Benefit duration to age 65, 67 or to the Social Security Normal Retirement Age • Up to 66 2/3% income replacement • And more Click Here for Details For More Information or Help Quoting Unum, Please Contact Your Dickerson Sales Representative.

Sharp Health is introducing their broker bonus program coverage effective Apr. 1, 2025 - Sept. 1,2025. Offering some of the lowest small group rates in the market, making it easy to get the high-quality care and service. Earn more now on new small group sales. Enroll new business and earn When you enroll new small group business with effective dates of April 1, 2025 to Sept. 1, 2025, you’ll earn big with our tiered bonus program! Click Here for Details Total # of EEs Enrolled from 4/1 to 9/1 Bonus for Each EE Enrolled 10-19 $50 20-29 $75 30-39 $100 40-49 $125 50-74 $150 75+ $200 For More Information or Help Quoting Sharp, Please Contact Your Dickerson Sales Representative.

Beginning on January 1, 2026, Aetna CVS Health individual and family plans will no longer be available. Aetna CVS Health plans were designed to offer the best value to its members, and they remain committed to helping members make the most of their benefits in 2025. You can count on the same plan benefits and service you have today for the rest of 2025. The last day of your Aetna CVS Health coverage is December 31, 2025. There is nothing you need to do at this time. By July 1, 2025, you will receive a letter from Aetna with more information and next steps. During the fall Open Enrollment season, you will need to choose a new health insurance plan with a different company to be covered in 2026. Open Enrollment begins on November 1, 2025, in most states. You can visit HealthCare.gov to get started. There you can view available health insurance plans or find a link to your state’s marketplace. Compare plans to save money and find a plan that best meets your needs and budget. You can call Aetna at the toll-free number on the back of your Aetna ID card if you have questions. You can also chat through your Aetna member website. For help choosing a new plan during open enrollment, please contact your Dickerson Sales Rep .

Protect ACA Subsidies: There is a potential reduction in ACA subsidies on the horizon. NABIP has organized an advocacy campaign, and they need agents to participate. Congress is considering the Healthcare Affordability Act (H.R. 247 / S. 46) , which would permanently extend the enhanced ACA premium tax credits , which expire at the end of 2025. If this legislation is not passed, the impact will be swift and severe for your clients, your business, and the broader health insurance marketplace. If these credits vanish, millions of Americans will see their premiums spike or lose coverage altogether. Clients you've helped enroll in affordable plans could be priced out overnight, seriously undermining your ability to serve and support them. The Healthcare Affordability Act would protect and improve affordability by: • Setting a 0% premium contribution for households earning up to 150% of the federal poverty level • Maintaining the existing income-based sliding scale for households between 150% and 400% • Eliminating the subsidy cliff by extending credits to those earning over 400%, capped at 8.5% of income These provisions have already helped more than 20 million Americans access affordable coverage since 2021. Without action, that progress is at risk. The result? Higher uninsured rates, disrupted care, and a destabilized individual market affect every professional in our field. As trusted experts in health benefits, you understand these stakes better than anyone. Now, Congress needs to hear from you. To Read More Click Here

Employers that sponsor self-insured group health plans, including health reimbursement arrangements (HRAs) should keep in mind the upcoming July 31, 2025 deadline for paying fees that fund the Patient-Centered Outcomes Research Institute (PCORI) via Form 720, which was recently updated and released by the IRS. As background, the PCORI was established as part of the Affordable Care Act (ACA) to conduct research to evaluate the effectiveness of medical treatments, procedures and strategies that treat, manage, diagnose or prevent illness or injury. Under the ACA, most employer sponsors and insurers are required to pay PCORI fees until 2029, as it only applies to plan years ending on or before September 30, 2029 (unless extended). The amount of PCORI fees due by employer sponsors and insurers is based upon the number of covered lives under each “applicable self-insured health plan” and “specified health insurance policy” (as defined by regulations) and the plan or policy year end date. This year, employers will pay the fee for plan years ending in 2024. The fee is due by July 31, 2025 and varies based on the applicable plan year as follows: • For plan years that ended between January 1, 2024 and September 30, 2024, the fee is $3.22 per covered life. • For plan years that ended between October 1, 2024 and December 31, 2024, the fee is $3.47 per covered life. For example, for a plan year that ran from July 1, 2023 through June 30, 2024 the fee is $3.22 per covered life. The fee for calendar year 2024 plans is $3.47 per covered life. The insurance carrier is responsible for paying the PCORI fee on behalf of a fully insured plan. The employer is responsible for paying the fee on behalf of a self-insured plan, including an HRA. In general, health FSAs are not subject to the PCORI fee. Employers that sponsor self-insured group health plans must report and pay PCORI fees using the newly released (Rev. June 2025) IRS Form 720, Quarterly Federal Excise Tax Return. Employers indicate on Form 720 and Form 720-V (the payment voucher) that the form and payment are for the 2nd quarter of 2025. If this is an employer’s last PCORI payment and they do not expect to owe excise taxes that are reportable on Form 720 in future quarters (e.g., because the plan is terminating), they may check the “final return” box above Part I of Form 720. Also note that because the PCORI fee is assessed on the plan sponsor of a self-insured plan, it generally should not be included in the premium equivalent rate that is developed for self-insured plans if the plan includes employee contributions. However, an employer’s payment of PCORI fees is tax deductible as an ordinary and necessary business expense. To Read The Full Alert Click Here