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Webinar Replay: A “Dope” Response to Pharmacy Transparency
Watch a replay of the third webinar in Humaculture, Inc.’s Hidden Opportunities, Strategic Compliance Series, which focuses on why the new pharmacy transparency law will not increase transparency; will increase costs, administration, and litigation risk; and how to effectively respond.
Presenters
- Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
- Wes Rogers, Humaculturist® and strategy consultant
- Jack Towarnicky, LLM, JD, MBA, CEBS, attorney, strategy and compliance consultant
- Scott McKibbin, strategy and pharmacy consultant
Objective
Beyond basic compliance, this series addresses how to strategically leverage the No Surprises Act to create a competitive financial advantage for both the plan sponsor and plan participants. This session focuses on leveraging Acquisition Cost Based Pharmacy Pricing as well as Behavioral Design and Messaging as an example of a strategic action organizations can take to optimize this compliance opportunity.
Pharmacy Transparency Key Takeaways
During this session, participants will learn:
- Transparency is a misnomer – New rules don’t provide transparency
- Pharmacy is likely to continue to be rather “opaque”
- The conundrum – mere compliance will likely increase costs, administration, and litigation risk
- How to use Acquisition Cost Based Pharmacy Pricing as well as Behavioral Design and Messaging as examples of strategic actions to:
- Avoid what can be avoided
- Provide true transparency with pharmacy benefits
- Empower consumers to make better, more clinically appropriate decisions
- Communicate all negatives as the result of compliance
- Inform/educate consumers (before they become patients)
Available Support
We are available to support you in your strategy, design, compliance, financial, and monitoring needs. To that end, our team of consultants, including actuaries, clinicians, behavioral health, pharmacy, and legal resources are available to guide you through the compliance process. Please contact us: [email protected].
Watch
Watch the Hidden Opportunities: Preserving the Harvest…Leveraging HSAs Webinar Replay below, or via Rumble or YouTube.
Hidden Opportunities, A Strategic Compliance Series: A “Dope” Response to Pharmacy Transparency
You can now access a replay of this webinar here.
Join us on Thursday, March 17 from 12:00 to 12:30 CST for the third webinar in Humaculture, Inc.’s Hidden Opportunities, Strategic Compliance Series, to learn why the new pharmacy transparency law will not increase transparency; will increase costs, administration, and litigation risk; and how to effectively respond.
Presenters
- Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
- Wes Rogers, Humaculturist® and strategy consultant
- Jack Towarnicky, LLM, JD, MBA, CEBS, attorney, strategy and compliance consultant
- Scott McKibbin, strategy and pharmacy consultant
Objective
Beyond basic compliance, this series addresses how to strategically leverage the No Surprises Act and Transparency in Coverage to create a competitive advantage for both the employer and employees. In this session we will include a focus on leveraging Acquisition Cost Based Pharmacy Pricing as well as Behavioral Design and Messaging as an example of a strategic action organizations can take to optimize this compliance opportunity.
Pharmacy Transparency Key Takeaways
During this session, participants will learn:
- Transparency is a misnomer – New rules don’t provide transparency
- Pharmacy is likely to continue to be rather “opaque”
- The conundrum – mere compliance will likely increase costs, administration, and litigation risk
- How to use Acquisition Cost Based Pharmacy Pricing as well as Behavioral Design and Messaging as examples of strategic actions to:
- Avoid what can be avoided
- Provide true transparency with pharmacy benefits
- Empower consumers to make better, more clinically appropriate decisions
- Communicate all negatives as the result of compliance
- Inform/educate consumers (before they become patients)
Webinar Replay: Preserving the Harvest…Leveraging HSAs
Watch a replay of the second webinar in Humaculture, Inc.’s Hidden Opportunities, Strategic Compliance Series, which focuses on Surpassing Mere Compliance and includes an example of leveraging Health Savings Accounts (HSAs) to use tax preferences to finance what can’t/shouldn’t be avoided, promote financial well-being, and make benefits more distinctive in talent attraction and retention.
Presenters
- Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
- Wes Rogers, Humaculturist® and strategy consultant
- Jack Towarnicky, LLM, JD, MBA, CEBS, attorney, strategy and compliance consultant
- Kelley C. Long, CPA/PFS, CFP®, accountant, financial well-being planner, coach, and consultant
Objectives
Beyond basic compliance, this series addresses how to strategically leverage the No Surprises Act to create a competitive financial advantage for both the plan sponsor and plan participants. This session focuses on Surpassing Mere Compliance and includes Reference Based Pricing as an example of a strategic response to use tax preferences to “preserve the harvest” by financing tax effectively what can’t/shouldn’t be avoided with the No Surprises Act.
Leveraging HSAs Key Takeaways
During this session, participants will learn:
- Why the No Surprises Act is likely to be inflationary – increasing employer and employee costs
- How employees are financially fragile and aren’t prepared for out-of-pocket expenses
- Why Transparency Rules present opportunities to help employees become better consumers
- How to communicate all negatives as necessary due to compliance
- How HSA-eligible coverage with an HSA is one strategic action you can take to:
- Use tax preferences to finance what can’t/shouldn’t be avoided
- Use design levers to reduce plan and participant cost
- Create a distinctive design to attract and retain talent (self-selection)
Available Support
We are available to support you in your strategy, design, compliance, financial, and monitoring needs. To that end, our team of consultants, including actuaries, clinicians, behavioral health, pharmacy, and legal resources are available to guide you through the compliance process. Please contact us: [email protected].
Watch
Watch the Hidden Opportunities: Preserving the Harvest… Leveraging HSAs Webinar Replay below, or via Rumble or YouTube.
Compliance Toolkit First Quarterly Update Released
The Compliance Toolkit first quarterly update was released on January 31, 2022 for changes since it was released on November 11, 2021. The Consolidated Appropriations Act (CAA), No Surprises Act, and Transparency in Coverage Final Rule Compliance toolkit will next be updated on or around April 30, 2022 if there are any updates required.
Compliance Toolkit First Quarterly Update
The Compliance Toolkit first quarterly update addresses:
- The Independent Dispute Resolution section was updated to include a section for the Revenue Procedure 2022-11 which published the percentage adjustment for median contracted rates.
- The Pharmacy Benefit and Drug Cost Reporting section was updated to include a section reflecting the guidance contained in the November 23, 2021 Prescription Drug and Health Care Spending Interim Final Rules, implementing Section 204, Title II, another phase of the transparency provisions of the Consolidated Appropriations Act (CAA) of 2021.
- The Direct and Indirect Compensation section was updated to reflect clarifying language and a section was added to address guidance contained in the Field Assistance Bulletin No. 2021-03 released by the Department of Labor (“DOL”) on December 30, 2021.
- Attachment 1: Compliance Tool – CAA and Transparency Financial Impact Analysis Tool was updated to reflect additional calculations.
- Attachment 9: Compliance Tool – MHPAEA Comparative and Fee Analysis Tool was updated to improve some of the functionality.
Compliance Toolkit Contents
To address the compliance needs of the industry, Humaculture, Inc. partnered with Attorneys Howard Lapin and Larry Grudzien to create a Compliance Toolkit to address all of the requirements in the new law and regulations. It contains over forty documents, including:
- A detailed explanation of the law and regulations;
- A compliance tool that highlights all of the required changes and what steps needed to be taken to comply;
- Sample provisions for plan documents, Summary Plan Descriptions, and administrative services agreements;
- All of the model notices that have to be provided to covered individuals;
- Sample notices that have to be provided to participants; and
- Sample disclosures and reports that have to be made to the governmental agencies.
There are over two hundred and eighty-five (285) pages of documents in this Compliance Toolkit. It has been specially designed for use by employers, insurers, brokers, and third-party administrator to help them effectively to comply with all of the requirements.
Webinar Reviewing the Compliance Toolkit
On December 14, 2021, we conducted a free webinar to review the Compliance Toolkit. We reviewed its contents and explained how it can be used to comply with the requirements. You can view the webinar here.
Hidden Opportunities, A Strategic Compliance Series
Humaculture, Inc. is conducting a strategic compliance webinar series on the third Thursday of the month over the first five months of 2022 focusing on harnessing the Hidden Opportunities in the No Surprises Act and Transparency in Coverage Final Rule. Our goal is to help organizations create a competitive advantage. Does it make sense to expend limited resources to merely comply with the law and regulations, or is there a way to strategically “design the compliance away” while strategically differentiating the employee value proposition?
Ordering
You can purchase the Compliance Toolkit for only $450 by responding to this email and we will invoice you for the purchase price. Contact us to order your own copy or to ask any questions.
Available Support
We are available to support you in your compliance and financial needs. This Compliance Toolkit, including Financial Analysis Tools will help facilitate self compliance. Our team of consultants, including actuaries, clinicians, behavioral health, pharmacy, and legal resources are also available to guide you through the compliance process, or we can take the lead. We would be happy to have a conversation regarding your needs and can customize a proposal for the level and type of support you may need. Please contact us.
Hidden Opportunities, A Strategic Compliance Series: Preserving the Harvest…Leveraging HSAs
This webinar can now be accessed from Here.
Join us on Thursday, February 17 from 12:00 to 12:30 CST for the second webinar in Humaculture, Inc.’s Hidden Opportunities, Strategic Compliance Series, which will focus on Surpassing Mere Compliance and include an example of leveraging Health Savings Accounts (HSAs) to use tax preferences to finance what can’t/shouldn’t be avoided, promote financial well-being, and make benefits more distinctive in talent attraction and retention.
Presenters
- Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
- Wes Rogers, Humaculturist® and strategy consultant
- Jack Towarnicky, LLM, JD, MBA, CEBS, attorney, strategy and compliance consultant
- Kelley C. Long, CPA/PFS, CFP®, accountant, financial well-being planner, coach, and consultant
Objective
Beyond basic compliance, this series addresses how to strategically leverage the No Surprises Act and Transparency in Coverage to create a competitive advantage for both the employer and employees. In this session we will include a focus on leveraging HSAs as an example of a strategic response to use tax preferences to finance what can’t/shouldn’t be avoided with the No Surprises Act.
Leveraging HSAs Key Takeaways
During this session, participants will learn:
- Why the No Surprises Act is likely to be inflationary – increasing employer and employee costs
- How employees are financially fragile and aren’t prepared for out-of-pocket expenses
- Why Transparency Rules present opportunities to help employees become better consumers
- How to communicate all negatives as necessary due to compliance
- How HSA-eligible coverage with an HSA is one strategic action you can take to:
- Use tax preferences to finance what can’t/shouldn’t be avoided
- Use design levers to reduce plan and participant cost
- Create a distinctive design to attract and retain talent (self-selection)
Webinar Replay: Surpassing Mere Compliance – Including Reference Based Pricing
Watch a replay of the first webinar in Humaculture, Inc.’s Hidden Opportunities, Strategic Compliance Series, which focuses on Surpassing Mere Compliance and includes an example of using Reference Based Pricing.
Presenters
- Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
- Wes Rogers, Humaculturist® and strategy consultant
- Jack Towarnicky, LLM, JD, MBA, CEBS, strategy and compliance consultant
Objectives
Beyond basic compliance, this series addresses how to strategically leverage the No Surprises Act to create a competitive financial advantage for both the plan sponsor and plan participants. This session focuses on Surpassing Mere Compliance and includes Reference Based Pricing as an example of a strategic response to avoid compliance with many aspects of the No Surprises Act.
Surpassing Mere Compliance Takeaways
During this session, participants will learn:
- The No Surprises Act doesn’t eliminate all “surprises”
- The No Surprises Act is likely to be inflationary
- Mere compliance won’t reign in costs, will increase administration, and may increase litigation risk
- Using Reference Based Pricing as one example of strategic actions you can take to:
- Avoid what can be avoided
- Use tax preferences to finance what can’t/shouldn’t be avoided
- Communicate all negatives as the result of compliance
- Inform/educate consumers (before they become patients)
Available Support
We are available to support you in your strategy, design, compliance, financial, and monitoring needs. To that end, our team of consultants, including actuaries, clinicians, behavioral health, pharmacy, and legal resources are available to guide you through the compliance process. Please Contact us.
Watch
Watch the Hidden Opportunities: Surpassing Mere Compliance – Including Reference Based Pricing Webinar Replay below, or via Rumble or YouTube.
Hidden Opportunities, A Strategic Compliance Series: Surpassing Mere Compliance – Including Reference Based Pricing
This webinar can now be accessed from Here.
Join us on Thursday, January 20 from 12:00 to 12:30 CST for the first webinar in Humaculture, Inc.’s Hidden Opportunities, Strategic Compliance Series, which will focus on Surpassing Mere Compliance and include an example of using Reference Based Pricing.
Presenters
- Steve Cyboran, ASA, MAAA, FCA, CEBS, actuary and strategy consultant
- Wes Rogers, Humaculturist® and strategy consultant
- Jack Towarnicky, LLM, JD, MBA, CEBS, strategy and compliance consultant
Objective
Beyond basic compliance, this series will address how to strategically leverage the No Surprises Act to create a competitive financial advantage for both the plan sponsor and plan participants. In this session we will include a focus on Surpassing Mere Compliance and include Reference Based Pricing as an example of a strategic response to avoid compliance with many aspects of the No Surprises Act.
Surpassing Mere Compliance Takeaways
During this session, participants will learn:
- The No Surprises Act doesn’t eliminate all “surprises”
- The No Surprises Act is likely to be inflationary
- Mere compliance won’t reign in costs, will increase administration, and may increase litigation risk
- Using Reference Based Pricing as one example of strategic actions you can take to:
- Avoid what can be avoided
- Use tax preferences to finance what can’t/shouldn’t be avoided
- Communicate all negatives as the result of compliance
- Inform/educate consumers (before they become patients)
Compliance Toolkit Overview Webinar Replay: Learn About Humaculture’s CAA and Transparency Compliance Toolkit
This Compliance Toolkit Overview Webinar Replay will help you understand the Toolkit contents and how to use each aspect effectively to help meet the compliance requirements. The video addresses questions from the participants in the original webinar.
On November 11, Humaculture, Inc. released its Compliance Toolkit. Humaculture, Inc. designed the Toolkit to help you comply with Requirements Under the Consolidated Appropriations Act (“CAA”) and the New “Transparency in Coverage” Regulations. The Toolkit includes over one hundred and seventy-five (175) pages and contains over fifty-five (55) Exhibits and Attachments.
On December 14, 2021, Actuary Steve Cyboran, Wes Rogers, and Attorney Howard Lapin reviewed the contents of the Humaculture, Inc. Compliance Toolkit and explain how to use it to comply with the new requirements under the CAA and the “Transparency in Coverage” regulations.
This Webinar focuses on how to use the Compliance Toolkit, not the compliance requirements. To better understand the compliance requirements or download the presentation slides, please access our prior Blog Post.
Ordering
When you order the Compliance Toolkit, it will be provided to you in a Word file and can be easily branded for use with your clients.
How do I order? Contact us.
You can purchase the Compliance Toolkit for only $450 by responding to this email and we will invoice you for the purchase price.
The price includes quarterly updates through September 30, 2022 at no extra charge.
As soon as we receive your payment, we will send you a copy of the Compliance Toolkit.
If you would like to see a sample, please contact us and we will schedule time to review the Toolkit with you.
Questions? If you have any questions before or after ordering the Compliance Toolkit, please contact us.
Available Support
We are available to support you in your compliance and financial needs. This Compliance Toolkit, including Financial Analysis Tools will help facilitate self compliance. Our team of consultants, including actuaries, clinicians, behavioral health, pharmacy, and legal resources are also available to guide you through the compliance process, or we can take the lead. We would be happy to have a conversation regarding your needs and can customize a proposal for the level and type of support you may need.
Watch
Watch the Compliance Toolkit Webinar Replay below, or via Rumble.
Hidden Opportunities, A Strategic Compliance Series
Please join us on the third Thursday of the month over the next five months for our upcoming strategic compliance series. This series will focus on harnessing Hidden Opportunities in the No Surprises Act and Transparency in Coverage regulations.
In this webinar series we explore ways organizations can go beyond basic compliance and improve their “organizational soil” through a strategic response to the No Surprises Act and the Transparency in Coverage regulations. Our goal is to help organizations create a competitive advantage. Does it make sense to expend limited resources to merely comply with the law and regulations, or is there a way to strategically “design the compliance away” while strategically differentiating the employee value proposition?
For example, a knowledgeable horticulturist may use the high temperatures of the summer season, which are a normal part of the environment just as law and regulation are a normal part of the business environment, to solarize the soil. This is a low cost and simple process of spreading a plastic sheet over an area of soil to trap and intensify the sun’s energy. It is a process that works well to destroy weed seeds and pathogens. Similarly, a knowledgeable Humaculturist® can employ techniques to leverage laws and regulations to strategically improve the organization. This webinar series seeks to identify some of these techniques.
The topics for the upcoming series will include:
| Hidden Opportunities: No Surprises Act | |
| January 20, 2022 12:00-12:30 CST | Surpassing Mere Compliance – Including Reference Based Pricing |
| February 17, 2022 12:00-12:30 CST | Preserving the Harvest…Leveraging HSAs |
| Hidden Opportunities: Transparency | |
| March 17, 2022 12:00-12:30 CST | A “Dope” Response to Pharmacy Transparency |
| April 21, 2022 12:00-12:30 CST | Mental Health Parity…A Lucid Approach |
| May 19, 2022 12:00-12:30 CST | Pest Management, Minimizing Plan Losses through Fee Disclosure |
To view a video on the Humaculture, Inc. Compliance Toolkit that can help support your basic compliance efforts, click here.
Available Support
We are available to support you in your strategy, design, compliance, financial, and monitoring needs. To that end, our team of consultants, including actuaries, clinicians, behavioral health, pharmacy, and legal resources are available to guide you through the compliance process. Please contact us.
