We understand how complex the Affordable Care Act (ACA) can be and how it is ever changing. We are here to help you meet ACA guidelines with Hours Tracking, IRS Reporting, and Minimum Essential Coverage (MEC) Plans.
BRMS Response to No Surprises Act
As an administrator for over 40 years and as a plan sponsor ourselves, BRMS spends countless hours studying and implementing all new governmental processes and procedures to ensure you remain compliant. In the case of the No Surprises Act and NQTL, we have elected not to inundate you with each and every new change this new legislation brings. Rest-assured that we are compliant with these new requirements and are engaged in an ongoing process of implementing and partnering with our vendors. Together, we will keep you at the forefront of each and every change ahead of us.
Machine Readable Files (MRFs)
Effective 7/1/2022, under the federal regulations, an in-network and out-of-network MRF are required to be publicly available for certain health plans or issuers. A machine-readable file is a digital representation of data or information in a file that can be imported or read by a computer system for further processing without human intervention. These files are not meant for a consumer-friendly search of rates, benefits, or cost sharing.
By following the link below, BRMS is providing public access to machine readable files for the employer self-insured healthcare plans they administer.
Providers and balance Billing
BRMS will work with the health plans interested in modifying their benefit plans since employees will no longer be impacted by balance bills for the situations covered under the No Surprises Act. BRMS will provide end-to-end process for negotiating surprise medical bills with providers and administering the IDR process for health plans consistent with the No Surprises Act (NSA).
These services include:
- Intake of dispute and determination if dispute is eligible for IDR based on applicable law.
- Engage provider in formal negotiation process. Monitor and administer the negotiation process in accordance with required timelines.
If negotiations fail and provider invokes formal arbitration in required timeframe, then BRMS will:
- Prepare and submit IDR the final offer and any additional information to the IDR entity.
- Engage as needed to defend QPA/par median methodology.
- Monitors and administers required timelines and compliance with IDR rules/guidelines.
- If provider offer is accepted by IDR entity, BRMS will handle payment of arbitration fee, and claim payment adjustment through customer’s claim funding account.
To learn more, please download:
Minimum Essential Coverage (MEC) Plans
The Benefit & Risk Management Services Minimum Essential Coverage (MEC) plans offer integrated solutions that help employers avoid costly penalties and are affordable for employees. Minimum essential coverage plans offer the minimum amount of essential coverage required by individuals to avoid the shared responsibility payment.
It’s a simple way to resolve issues faced by employers such as rising cost of health care, unaffordable health plans, complicated administration.
- Affordable pricing
- Provides 100% of the minimum essential benefits required by Patient Protection and Affordable Care Act (PPACA)
- Single administrative platform
- Flexible plan designs to meet benefit levels and price
Monthly Hours Tracking
Tracking your employees’ time worked and calculating both full-time employees and full-time equivalents is integral to your employer status, which will determine your responsibility as an employer to provide affordable healthcare coverage.
Improve your company’s timekeeping process by transitioning from a manual method to an automated solution that will help you meet ACA guidelines.
Benefit & Risk Management Services provides support and assistance with ongoing analysis and data tracking. The ACA support provided by Benefit & Risk Management Services includes:
- Hours tracking support for employers
- Configure measurement, stability and administrative periods
- Ability to set weekly and monthly thresholds in the system and provide historical snapshots
- ACA status notification of employee’s pending eligibility
- Continuous updated to reflect the ongoing ACA rules and regulations
- Movement of employee’s in MyHealthBenefits to new benefit/non-benefit eligible benefit groups
1095 Reporting
The Affordable Care Act (ACA) created new reporting requirements based on the health care coverage provided to employees. Employers with 50 or more full-time equivalent employees are required to complete an employee form (1095-B or 1095-C) for each full-time employee.
As experts in employee benefits and everything Affordable Care Act related, we are uniquely prepared to assist employers in the completing of all of their IRC 6055 & IRC 6056 obligations. Employers recognize that ACA compliance is critical to their success as a business: IRS Filing and Create 1095 Employee Form.
Find out how BRMS can help you streamline your ACA reporting!