Compliance News

Released each time a rule or law may affect your plan, Update provides quick, simple summaries of the change and what you need to do to stay on top.

2019

  • May 24, 2019

    Medicare Part D Drug Benefit Program Changes for 2020

    The Medicare Part D standard benefit design parameters will be higher in 2020, the Centers for Medicare & Medicaid Services (CMS) recently announced.

    While the deductible will increase by less than 5 percent, the out-of-pocket threshold will increase dramatically: 24 percent.

    The reason for the jump in the out-of-pocket threshold, sometimes known as the TrOOP, is the expiration of a provision of the Affordable Care Act (ACA) that slowed the growth of the TrOOP between 2014 and 2019.

    In 2020 and beyond, the TrOOP will be determined using a pre-ACA calculation. Plan sponsors that contract with a Medicare Part D Prescription Drug Plan or Medicare Advantage-Prescription Drug Plan (also known as EGWPs) will likely receive lower payments from CMS as a result of this change, meaning that these plans will be more expensive.

    CMS also announced that the Retiree Drug Subsidy (RDS) amounts it pays to sponsors of group health plans that provide prescription drug coverage to Medicare-eligible retirees will be higher in 2020. 

    This Update features charts comparing the 2020 numbers to the 2019 numbers.


    Medicare Part D Drug Benefit Program Changes for 2020

    The Medicare Part D standard benefit design parameters will be higher in 2020, the Centers for Medicare & Medicaid Services (CMS) recently announced.

    While the deductible will increase by less than 5 percent, the out-of-pocket threshold will increase dramatically: 24 percent.

    The reason for the jump in the out-of-pocket threshold, sometimes known as the TrOOP, is the expiration of a provision of the Affordable Care Act (ACA) that slowed the growth of the TrOOP between 2014 and 2019.

    In 2020 and beyond, the TrOOP will be determined using a pre-ACA calculation. Plan sponsors that contract with a Medicare Part D Prescription Drug Plan or Medicare Advantage-Prescription Drug Plan (also known as EGWPs) will likely receive lower payments from CMS as a result of this change, meaning that these plans will be more expensive.

    CMS also announced that the Retiree Drug Subsidy (RDS) amounts it pays to sponsors of group health plans that provide prescription drug coverage to Medicare-eligible retirees will be higher in 2020. 

    This Update features charts comparing the 2020 numbers to the 2019 numbers.


  • March 19, 2019

    401(k)-Based Student Loan Repayment Program: A New IRS Private Letter Ruling Released

  • March 12, 2019

    First Mortality Tables for Public Sector Retirement Plans Published

2018

2017

2016

2015

Older Archived Compliance Publications

For older compliance publications, please visit our full publications archive.

Older Archived Compliance Publications

For older compliance publications, please visit our full publications archive.

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