cmonfils | May 10, 2012
| This is part of our series of alerts intended to help guide employers and plan sponsors through their new obligations under the health care reform laws and related guidance.
On April 12, 2012, the IRS released proposed regulations regarding the implementation of the comparative effectiveness fee that is to be imposed on health insurance companies issuing accident or health insurance policies and plan sponsors of self-insured group health plans providing accident or health coverage. If you sponsor an insured group health plan, your insurer (not you) will be responsible for paying this fee. The fee will be used to fund the Patient-Centered Outcomes Research Trust Fund, a private, non-profit corporation that will collect, analyze and report on comparative clinical effectiveness research findings. |
Category: Health Care Legislation, IRS, Plan Sponsor |
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cmonfils | May 1, 2012
www.siia.org
April 30, 2012 – SIIA has just received a request for comments from the Department of Treasury on minimum values group health plans must maintain as well as comments on reporting of participants in such plans. (more…)
Category: IRS, Plan Sponsor, PPACA, Self-Funding |
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cmonfils | April 24, 2012
CONCORD, N.H.—Legislation previously approved by the New Hampshire House of Representatives to allow insurers to exclude prescription contraceptive coverage from group plans if plan sponsors have “religious objections” to the coverage faces an uncertain future after a Senate committee vote to further study the bill.
http://www.businessinsurance.com/article/20120419/NEWS03/120419855?tags=58|278|79|62
Category: Health Care Legislation, Health Insurance, New Hampshire, Plan Sponsor |
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cmonfils | April 20, 2012
The General Accountability Office (GAO) has issued a report recommending that the Labor Department convene an interagency task force with the Treasury Department, IRS, and Small Business Administration (SBA) to coordinate existing research, education, and outreach efforts to foster small employer plan sponsorship.
Category: Plan Sponsor |
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cmonfils | April 3, 2012
The Center for Consumer Information and Insurance Oversight (CCIIO) of the Department of Health and Human Services (HHS) has issued an Essential Health Benefits Bulletin (the CCIIO bulletin)1 that provides a preview of how HHS intends to define “essential health benefits” under the Affordable Care Act.2 Subsequent answers to frequently asked questions (FAQs) about the CCIIO bulletin clarify the impact of the proposal on group health plans.3 Together the documents can be used by plan sponsors to determine when specific benefits may or may not be permitted to contain annual or lifetime dollar limits. This Capital Checkup addresses the implications of the CCIIO bulletin for plan sponsors.
Category: Health Insurance, HHS, Plan Sponsor |
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cmonfils | February 9, 2012
Under health care reform, plan sponsors of self-funded health plans and health insurance issuers will owe a new fee that is first payable for plan years ending after September 30, 2012. For calendar year plans this means the fee applies this year.
Many questions about the fee are currently unanswered, including when it must be paid. Proposed regulations are expected on this and other matters. In the meantime, Notice 2011-35 provides information for plan sponsors and issuers to ensure they have properly budgeted for this expense.
Category: Health Care Legislation, Plan Sponsor, Self-Funding |
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cmonfils | January 18, 2012
Employer’s Guide to Self-Insuring Health Benefits January 2012 | Vol. 19, No. 4
Sponsors and administrators of employer-sponsored health plans will spend lots of 2012 in implementing the health reform law, because there’s still a lot of uncertainty that will decide the fate of self-funded health plans in particular. Plans will have to raise annual limits on essential benefits (as defined by reform rules) to $2 million starting next Sept. 23. Plans won’t have to pay new fees to fund comparative effectiveness research in 2012. But 2012 will be the year plans learn the payment frequency of and the method used to calculate the fees they will start paying in 2013. Similarly, plans won’t have to start issuing summaries of benefits and coverage (SBCs) to all participants, but they will be waiting and watching for rules about the SBC to develop, so they know how to satisfy that requirement. (more…)
Category: Accountable Care Organizations, DOL, Health Care Legislation, HHS, Medicare, Plan Sponsor, PPACA, PPOs, Third Party Administrators |
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cmonfils | January 15, 2012
The Department of Health and Human Services plans to audit 150 plan sponsors and employers to make sure employee health and financial records are adequately protected. Creating appropriate policies and procedures, instituting a risk assessment and training employees are keys to compliance, experts say.
Category: HHS, HIPAA, Plan Sponsor |
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cmonfils | January 12, 2012
Published by the Self-Insurance Educational Foundation, Inc. in cooperation with the Self-Insurance Institute of America, Inc.
Manage your Health Plan as you would manage your business. An introduction to self-funding.
“Become part of the Health Care solution!”
If there were a proven method to managing your health plan costs that over 57% of employees in the U.S. were utilizing today, would you be interested? Well there is a proven method, and it is called self-funding. (more…)
Category: ERISA, Plan Sponsor, PPACA, Self-Funding |
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cmonfils | January 8, 2012
www.myhealthguide.com
MyHealthGuide Source: Fred Hunt, Active Past President, SPBA, 12/2012, www.SPBATPA.org
The state of TPAs and the forecast for the future is the brightest it has been for many years (not to say that it is not an extremely tight marketplace).
Background and Mood
TThis article is useful for perspective in shaping corporate strategy, but also serves as a candid analysis for outsiders such as investors, researchers and others who want to understand the TPA world today and into the future. As a result of hearing often from SPBA members, we have an unmatched repository of real-world hands-on totally-candid insight. (more…)
Category: Health Insurance, Plan Sponsor, PPACA, State Law, Stop Loss, Supreme Court, Third Party Administrators |
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cmonfils | December 30, 2011
The end of the 2011 plan year brings about another opportunity to review group health plan compliance with Patient Protection and Affordable Care Act (PPACA) requirements. This LawFlash describes year-end action items for group health plan sponsors and previews upcoming changes for 2013. This list is not exhaustive, but it is intended to serve as a reminder of items that plan sponsors should review and consider before the end of the year.
Category: Health Care Legislation, Plan Sponsor, PPACA |
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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
www.myhealthguide.com
MyHealthGuide Source: Terrance Killilea, Pharm.D. and Scott Haas, 12/6/2011, www.wellsfargo.com
Pharmacy benefit managers (PBMs) are contractors hired by health plans to administer health plan pharmacy benefits, and PBMs that practice spread pricing, charge plan sponsors (employers) more for prescription drugs than what’s actually paid to the pharmacy. (more…)
Category: Plan Sponsor, Self-Funding |
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cmonfils | November 27, 2011
Good news: As we noted in our September alert about the service provider fee disclosure regulations, in July the Department of Labor extended the deadlines for complying with the new retirement plan fee disclosure regulations.
Bad news: With the extended deadlines just around the corner, plan sponsors should begin now working with plan service providers and advisors to prepare for the considerable amount of information required to be provided in the disclosures.
Category: DOL, Plan Sponsor |
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