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Making Exceptions Can Cost More Than You Think Employers often want to support their employees by making special exceptions to their group health plans—especially in challenging situations. While these actions may seem compassionate and employee-friendly, they can create significant compliance risks and financial liabilities. Why Exceptions Can Be Problematic Health plans—especially fully insured and self-funded […]

Compliance News Update – Week Ending May 30, 2025 Stay informed with the latest developments in health benefits compliance. This week’s highlights include updates on transparency regulations, preventive care coverage, and the impending expiration of telehealth relief for Health Savings Account (HSA) eligibility. Transparency Regulations: New Guidance Issued Federal agencies have released updated guidance on

Sutter Health Plus Finalizes 2025 Payer Agreements As of September 16, 2024, Sutter Health Plus has successfully completed renewal agreements with several key health plan providers for the 2025 plan year. These finalized agreements ensure that members across Northern California will continue to have access to a broad network of healthcare services. Aetna – Agreement

The California Department of Managed Health Care (DMHC) has recently announced significant developments aimed at enhancing consumer protections and expanding health care coverage across the state. Anthem Blue Cross Penalized for Misleading Denial Letters On May 12, 2025, the DMHC imposed a $750,000 fine on Anthem Blue Cross for issuing thousands of denial letters to

California has once again taken a progressive step in healthcare policy with the passage of Senate Bill 729 (SB 729), which mandates significant changes in how health insurance providers handle fertility care. Signed into law on September 29, 2023, the bill goes into effect on July 1, 2025, and introduces mandatory coverage for infertility diagnosis

A significant shift is coming to California’s health insurance market: starting July 1, 2025, infertility services—including in vitro fertilization (IVF)—will become a standard feature in fully insured Large Group health plans. Senate Bill 729 (SB 729), signed by Governor Gavin Newsom in 2024, mandates that health plans issued, amended, or renewed on or after this

​As of January 1, 2025, Doc’s Surgical Hospital is no longer part of the Anthem Blue Cross network. This change affects all Anthem health plans, including employer-sponsored, individual, and Medicare Advantage plans.​ What This Means for Anthem Members Anthem members who previously received care at Doc’s Surgical Hospital will now need to seek services at

​Health Net is set to launch a new Maternity and Family Planning webpage in April 2025, aiming to provide members with comprehensive information on pre- and postpartum care programs. This initiative is part of Health Net’s commitment to supporting maternal and infant health.​Amwins Connect+2Amwins Connect+2Amwins Connect+2Amwins Connect Key Features of the New Webpage The upcoming

📂 Why Record Retention Matters Employee benefit records are more than just paperwork — they provide a trail of documentation that supports compliance with federal, state, and even internal requirements. These records may include things like: Plan documents and amendments Enrollment and claims forms Communication with employees about benefits Payroll records and contribution logs Proper

The third quarter of 2025 brings exciting updates for MediExcel, a leading provider of innovative healthcare solutions. From enhanced features to expanded offerings, here’s what you need to know. 1. New Product Enhancements MediExcel continues to refine its offerings with upgrades designed to improve efficiency and user experience. Key updates include: Streamlined Claims Processing – Faster, more