Adam V. Russo | September 29, 2010
By Robert Weisman of The Boston Globe, www.boston.com
Harvard Pilgrim Health Care has notified customers that it will drop its Medicare Advantage health insurance program at the end of the year, forcing 22,000 senior citizens in Massachusetts, New Hampshire, and Maine to seek alternative supplemental coverage. (more…)
Adam V. Russo | September 29, 2010
Economy helps fuel largest cost increase since 2005: Study
By Jerry Geisel of Business Insurance Magazine, www.businessinsurance.com
Group health care plan costs are expected to increase an average of 8.8% in 2011, the largest percentage gain since 2005, new research shows.
The average group health plan cost per employee is projected to rise to $9,821 next year, according to an analysis released by Lincolnshire, Ill.-based Hewitt Associates Inc. this week. Costs include employer and employee premium contributions, but not employee out-of-pocket costs, such as copayments and coinsurance. (more…)
Adam V. Russo | September 29, 2010
By Jerry Geisel of Business Insurance Magazine, www.businessinsurance.com
WASHINGTON—The latest health care reform law regulatory guidance gives employers more time to comply with certain provisions, clears up uncertainty on other requirements and suggests that some rules will be relaxed.
The most significant changes in last week’s Labor Department guidance involve Patient Protection and Affordable Care Act provisions affecting coverage decisions and review procedures. For example, the law requires that health plan enrollees be notified of an urgent care coverage decision within 24 hours of a request. A decade-old Labor Department rule had required that such decisions be made within 72 hours. (more…)
Adam V. Russo | September 27, 2010
Employer’s Guide to Self-Insuring Health Benefits
The health care reform law makes significant changes to group health plan administration.
Self-funded plans are under increasing scrutiny, with the federal government taking a close look at the role that self-funded plans play in the health plan market.
The Employer’s Guide to Self-Insuring Health Benefits, with its new contributing editor Adam Russo, Esq., analyzes the best ways you can run self-funded plans in light of rising health care costs and, more importantly, how you can now manage your new compliance obligations due to the health care reform law.
Price: $449 plus $29.50 shipping and handling, 10% off of the regular price of $499
The New Health Care Reform Law: What Employers Need to Know (A Q&A Guide)
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Receive 20% off when you purchase both books (price is $638, a savings of $160 off the regular price of $798). We’ll even waive the shipping and handling when you bundle!
Register for this Thursday’s webinar “Health Care Reform Clarifications” at www.phiagroup.com. Ordering information will be available at the time of the webinar.
Adam V. Russo | September 23, 2010
Today marks a new beginning for many plans as they enter their new plan years. September 23, 2010 has been engrained in the mind of plans and TPAs alike as coverage that starts today (or any day after which plan coverage renews) will have to comply with the new healthcare reform changes. (more…)
Adam V. Russo | September 22, 2010
By Carla K Johnson of Yahoo News, www.yahoo.com
CHICAGO – The nation’s new health care law turns 6 months old Thursday and starts delivering protections and dollars-and-cents benefits that Americans can grasp. But it won’t affect all consumers the same way, which may cause confusion. (more…)
Adam V. Russo | September 21, 2010
By Michelle Andrews of National Public Radio, www.npr.org
With health insurance costs climbing and open enrollment season almost upon us, you might expect that the boss will do everything to wriggle out of new requirements coming down with the federal health overhaul.
But that may not be the case. And in a way you might not expect, those decisions could put you on the hook for higher deductibles, copayments and out-of-pocket costs. (more…)
Adam V. Russo | September 21, 2010
By Jeffrey Clayton of Pension and Benefits Blog, www.pblog.bna.com
The provision of the PPACA is deceptively simple: “A group health plan (other than a self insured plan) shall satisfy the requirements of section 105(h)(2) of the Internal Revenue Code of 1986 (relating to prohibition on discrimination in favor of highly compensated individuals).” *** “Rules similar [my emphasis] to the rules contained in paragraphs (3),(4) and (8) of section 105(h) of such Code shall apply.” (more…)
Adam V. Russo | September 21, 2010
By Dave Lenckus of Business Insurance, www.businessinsurance.com
Some critics of the landmark Patient Protection and Affordable Care Act doubt that opponents of the health care reform law will prevail in court.
Pointing to legal precedents on congressional powers, several legal experts critical of the law expect it to go into full effect in 2014, unless Republicans regain control of Congress and repeal the law. (more…)
Adam V. Russo | September 21, 2010
Future revisions expected to clarify several issues
By Jerry Geisel of Business Insurance, www.businessinsurance.com
WASHINGTON—Regulations to implement sweeping health care reform legislation that Congress passed and the president signed into law in March have been issued at a torrid pace.
“Regulators have really worked at warp speed to get rules out prior to the effective date of provisions. Even regulators would probably admit that the speed has been unusual,” said Michael Thompson, a principal at PricewaterhouseCoopers L.L.P. in New York. (more…)
Adam V. Russo | September 21, 2010
MyHealthGuide, www.myhealthguide.com
MyHealthGuide Source: AEGIS Risk, www.aegisrisk.com
This year’s Survey was completed in the wake of health care reform and its removal of individual lifetime maximums — which significantly alters the underlying risk covered by medical stop loss.
Although stop loss is not mandated to offer unlimited coverage, the risk is created, and according to this year’s Survey,
79% of respondents intend to review its coverage.
44% of those stating its requirement. In comparison.
8% reported an unlimited stop loss maximum in pre-reform 2009. (more…)
Adam V. Russo | September 21, 2010
Business Week, www.businessweek.com
Health-care overhaul won’t get most young companies to offer employee coverage, says Scott Shane, so government programs and state exchanges must serve
By Scott Shane
Through the debate on reforming health insurance for small businesses, an important piece of information was missing: Policymakers had little data on why only some young companies offer their employees health insurance. Common sense and much research indicate that cost plays a big role in business owners’ health insurance decisions. Why do some entrepreneurs choose to incur this cost while others do not? (more…)
Adam V. Russo | September 21, 2010
PLANSPONSOR, www.plansponsor.com
September 7, 2010 (PLANSPONSOR.com) – Last week, we wrote about new requirements for health plans conducting internal claims and appeals under the Patient Protection and Affordable Care Act (PPACA).
However, the Departments of Treasury, Labor, and Health and Human Services also have issued regulations on a new external review process. 75 Fed. Reg. 43,330 (July 23, 2010). These new requirements apply to both individual and group health plans (insured and self-funded), but do not apply to grandfathered plans. (more…)
Adam V. Russo | September 16, 2010
NASP, www.subrogation.org
NASP was invited to speak to the Ohio State Bar Association (OSBA) Subrogation Committee Meeting on September 14, 2010. NASP President Elect, Ken Levine, was in attendance and NASP Amicus Committee Chair, Daran Kiefer, represented NASP at this meeting, presenting written testimony that you can read on the NASP website at www.subrogation.org. (more…)
Adam V. Russo | September 9, 2010
SIIA, www.siia.org
As reported by SIIA’s Government Relations Staff, Federal agencies will be continually issuing regulations and notices of guidance pertaining to how provisions of the newly enacted Patient Protection and Affordable Care Act will be implemented. SIIA staff will develop summaries of these and distribute along with the full documents as soon as they are released. (more…)
