cmonfils | December 16, 2011
The Self-Insurer November 2011 Issue & Volume 37
By: John Hickman, Esq., Alston & Bird, LLP
New Fees for Group Health Plans Loom on the Horizon
The Affordable Care Act (ACA or the “Act”) imposes two new temporary fees with respect to group health plans that go into effect in the near future:
- A Fee to fund comparative effectiveness research that, in the case of calendar year plan years, it is first due for plan years starting on or after January 1, 2012, and
- Starting in 2014, a “contribution” in an amount to be determined by the Department of Health and Human Services (HHS) and collected at the state level that is part of the temporary reinsurance program established under ACA to help ensure the financial stability of the individual insurance market as further reforms go into effect (including the guaranteed issue requirement) and the Affordable Insurance Exchanges (“Exchanges”0 become operational. (more…)
Category: Health Care Legislation, Health Insurance, HHS, HIPAA, PPACA, Third Party Administrators |
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cmonfils | December 16, 2011
2011 was the year in which employers began to amend their plans to comply with the health care reform law.
The initial changes were modest and relatively simple to put into place. For example, few employers had difficulty amending their plans to extend coverage—as the law requires—to employees’ adult children up to age 26; previously, employers typically ended coverage at age 18 or 19, or 23 or 24 in the case of full-time college students.
Category: Health Care Legislation, HHS, PPACA |
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cmonfils | December 16, 2011
The best and the worst development of 2011 concerning health care reform, two benefit experts say, involved the same issue: a reform law requirement that employers provide to employees a summary of their benefits and coverage.
http://www.businessinsurance.com/article/20111211/NEWS03/312119992?tags=%7C307%7C278#
Category: Health Care Legislation |
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cmonfils | December 16, 2011
San Francisco’s Health Care Security Ordinance has been amended to require more of certain employers with workers in the City and County of San Francisco. The amendments will take effect January 1, 2012.
The Ordinance requires many employers to spend a specified minimum amount toward certain health care expenses for their employees working in the City and County of San Francisco. (For more information on the Ordinance, see our article, San Francisco Health Care Law Survives ERISA Preemption.)
Category: California, Health Care Legislation |
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cmonfils | December 16, 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.
Category: California, Health Care Legislation, Indiana, Louisiana, Minnesota, New York |
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cmonfils | December 16, 2011
Federal officials hope to crack down more effectively on operators of “multiple employer” health plans that have defrauded small businesses and their workers of hundreds of millions of dollars, often leaving them stuck with unpaid medical bills, according to new rules proposed Monday by the Obama administration under the health care legislation.
Category: DOL, Health Care Legislation |
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cmonfils | December 16, 2011
Two new requirements imposed by the health care reform act (ACA) make the issue of self-funding and the need for stop loss insurance more compelling for plan sponsors.
First, ACA adds new federal taxes on health insurer providers beginning in 2014. These new taxes will add to state insurance premium taxes and make the savings from self-funding more compelling for many fully insured medical plans. Second, the ACA requirement to remove annual and lifetime limits beginning in 2014 will increase interest in stop loss coverage for self-funded groups without stop loss coverage in force. Medical stop loss insurance is a layer of coverage designed to protect self-funded plan sponsors from the risk of unpredictable, high-cost claim activity.
Category: Health Care Legislation, Stop Loss |
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cmonfils | December 16, 2011
As 2011 comes to a close, questions about President Obama’s highly publicized Patient Protection and Affordable Care Act linger for many small businesses still reeling from the nation’s worst economic crisis in decades. Companies large and small are struggling to turn red balance sheets to black and recoup losses sustained over the last three years. Some employers fear that federally mandated health care reform may only add to their fiscal burden without alleviating any of the current financial strain.
Category: Health Care Legislation, PPACA |
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cmonfils | December 15, 2011
The CMS said in a proposed rule that it recommends delaying data collection (PDF) in a reform law provision intended to expose financial relationships between drug and device manufacturers, GPOs and providers.
The agency said in the proposed rule that manufacturers and GPOs should not be required to start collecting information about their financial relationships with physicians and teaching hospitals on Jan. 1.
http://www.modernhealthcare.com/article/20111214/NEWS/312149973?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMZmFWdndGRWxiNUtpQzMyWmFwNW5nWUpidWk
Category: CMS, Health Care Legislation, Medicaid, Medicare |
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cmonfils | December 14, 2011
For the seventh straight year, most top-quality health plans are nonprofit, according to the latest rankings by the National Committee for Quality Assurance.
The rankings are rekindling calls for federal regulators to require that plans sold on the healthcare reform law’s state-based insurance exchanges make transparent to consumers whether they’re for-profit or nonprofit. The Alliance for Advancing Nonprofit Health Care spearheaded that request in recent comments to the Department of Health and Human Services.
Category: Health Care Legislation, Health Insurance, HHS |
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cmonfils | December 14, 2011
As part of the changes made by health care reform, Section 6051(a)(14) of the Internal Revenue Code requires employers to report on Form W-2 the aggregate cost of employer-sponsored health coverage provided to employees. Though the reporting requirement doesn’t apply until employers furnish W-2s for calendar year 2012, employers need to make sure that they have procedures in place now so that they can capture the relevant information during 2012.
Category: Health Care Legislation, Health Insurance |
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cmonfils | December 14, 2011
After so much ink spilled and heartache over health reform, plan sponsors might think the dust has settled and say: “The coast is clear. We can come out of hiding.” But if you thought that all this effort has totally clarified health reform (and if you think you know just what to do to comply), you’d be mistaken, sadly mistaken.
http://smarthr.blogs.thompson.com/2011/12/09/6-health-reform-issues-loom-over-plan-sponsors-in-2012/
Category: Health Care Legislation, Plan Sponsor |
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cmonfils | December 13, 2011
WASHINGTON (AP) — In a surprise move with election-year implications, the Obama administration’s top health official overruled her own drug regulators and stopped the Plan B morning-after pill from moving onto drugstore shelves next to the condoms.
The decision by Health and Human Services Secretary Kathleen Sebelius means the Plan B One-Step emergency contraceptive will remain behind pharmacy counters, as it is sold today — available without a prescription only to those 17 and older who can prove their age.
http://www.benefitspro.com/2011/12/07/sebelius-says-no-to-over-the-counter-morning-after?utm_source=BenefitsProNewsAlert&utm_medium=eNL&utm_campaign=BenefitsPro_eNLs
Category: Health Care Legislation, HHS |
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cmonfils | December 12, 2011
The insurance industry is terrified that the Supreme Court will strike down the individual mandate to buy insurance next year while leaving the rest of the healthcare reform law intact.
For insurers, the death of the mandate alone — one of many plausible outcomes in the blockbuster case — is the nightmare scenario, one Republican healthcare lobbyist told The Hill.
Category: Health Care Legislation, Supreme Court |
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cmonfils | December 12, 2011
During World War II, the U.S. government put wage controls on businesses so workers on the home front wouldn’t earn more than their military counterparts on tightly controlled salaries. But with so much of the workforce overseas, the competition for talent became fierce. So companies beefed up their compensation packages with benefits like health insurance, which weren’t subject to wage controls. And the rest, as they say, is history.
Category: Health Care Legislation |
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