cmonfils | October 27, 2011
In a strongly-worded letter addressed today to New Jersey Insurance Commissioner Thomas Considine, the Self-Insurance Institute of America, Inc. (SIIA) requested that Insurance Department Bulletin No. 11-20 (Selected Marketing of Stop-Loss Insurance) be rescinded immediately.
cmonfils | October 26, 2011
Washington, D.C. — The ERISA Industry Committee (ERIC) today submitted comments on proposed regulations regarding implementation of the uniform summary of benefits and coverage (SBC) provisions under the Patient Protection and Affordable Care Act (ACA). The Departments of Health and Human Services, Labor, and Treasury published the proposed regulations in the Federal Register on August 22, 2011.
cmonfils | October 26, 2011
Third party administrators (TPAs) are struggling to determine if and how the new service provider fee disclosure regulations will affect their practices. Many TPAs have determined that they are not subject to the disclosure requirements because they receive their compensation directly from the employer or from the plan. TPAs that have made such determinations may, nevertheless, have concerns because they may receive unanticipated indirect payments from financial institutions to which they refer business. In this technical update, we will discuss how a TPA deals with unanticipated indirect compensation.
cmonfils | October 26, 2011
from Spencer’s Benefits Reports: In 2012, Medicare beneficiaries enrolled in Part D stand-alone prescription drug plans (PDPs), on average, will experience a 4% increase in monthly premiums, according to a recent study from the Kaiser Family Foundation (KFF) Program on Medicare Policy. More than 29 million beneficiaries are enrolled in Part D plans, about two-thirds of whom are in PDPs. The KFF Medicare Part D Data Spotlight, Medicare Part D: A First Look at Part D Plan Offerings in 2012, provides an overview of the 2012 stand-alone PDP options and key changes from prior years. The study was prepared by researchers from Georgetown University, KFF, and the National Opinion Research Center at the University of Chicago.
cmonfils | October 26, 2011
Growing numbers of companies are offering money and merchandise to get workers to exercise, lose weight or meet other health goals to cut costs.
cmonfils | October 26, 2011
Signing up for health insurance during your company’s annual enrollment period, which for many plans is right now, may feel like taking a nasty dose of medicine: You know it’s good for you, but it sure doesn’t go down easy.
cmonfils | October 26, 2011
We ain’t seen nothin’ yet.
The key provisions of the federal health overhaul take effect in 2014, including a requirement for most people to have health insurance; a ban on insurance companies considering individuals’ health status when they sell plans; and the creation of new health-coverage marketplaces called “exchanges.”
cmonfils | October 26, 2011
October 21, 2011 (PLANSPONSOR.com) – Employers experiencing higher medical costs due to unnecessary emergency room utilization by employees may be able to reduce those costs by better educating employees about their choices.
cmonfils | October 26, 2011
Background and Effective Date
Under health care reform, employers are required to report to employees the cost of their employer-sponsored group health plan coverage. This reporting is for informational purposes only and is intended to inform employees of the cost of their health care coverage. The Internal Revenue Service (IRS) continues to stress that this new reporting requirement does not cause excludable employer-provided health care coverage to become taxable.
cmonfils | October 26, 2011
After trying to mollify its critics in recent years by offering better health care benefits to its employees, Wal-Mart is substantially rolling back coverage for part-time workers and significantly raising premiums for many full-time staff.
cmonfils | October 26, 2011
The Obama administration on Thursday bowed to health industry concerns about its plans for Medicare accountable care organizations, making it easier for doctors and hospitals to participate in the program designed to lower medical costs.
cmonfils | October 26, 2011
from Spencer’s Benefits Reports: For the last few years, states have been leading the way toward more comprehensive health care coverage to ensure that more people have or can obtain health insurance. With the passage of federal health care reform, states will have increasing responsibilities in regard to employer-provided health insurance benefits. Spencer’s Benefits Reports continues to provide regular updates about state health care reform.
cmonfils | October 26, 2011
The health care reforms introduced in 2010 take effect in stages. The IRS, DOL and HHS delayed the enforcement of some market reforms that took effect for group health plans in plan years beginning on or after September 23, 2010. Others require regular review to ensure continued adherence. In addition, it is not yet clear whether compliance with notification provisions intended to take effect in 2012 will be postponed. Some deadlines for plans with a calendar year plan year to keep in mind for 2012 are listed below.
cmonfils | October 26, 2011
The Institute of Medicine (IOM) recently issued its long-awaited report on defining the essential health benefits under the Affordable Care Act (ACA). As expected, the committee preparing the IOM report did not recommend which specific services should be covered, but rather discussed what the process should be for defining the essential benefits, which all insurers selling coverage to individuals and small businesses will have to provide beginning in 2014. Somewhat unexpected was their recommendation to set a dollar target – reflecting the current average cost of a small business health insurance plan – as the benchmark for decisions about what to include and not include in the essential health benefits package.
cmonfils | October 26, 2011
Over the last two decades, paying health insurance premiums and other health care bills has become increasingly hard for American families. As premiums have gone up each year and the cost of health care has escalated, more and more costs have been shifted to consumers through increases in deductibles and copayments and decreases in covered services. Middle-class and low-income families need relief from escalating health care costs. The Affordable Care Act, when fully implemented, will provide tangible and measurable relief to American families.
