Practical HR Tips, News & Advice. Updated Daily.
The summary of benefits and coverage (SBC), while still a work in process, will improve plan participants’ ability to comparison-shop for coverage. That fills a currently unmet need, federal regulators told a recent conference. They were responding to concerns that the SBC — mandated by the health reform law — is redundant, confusing or even […]
Have you asked your doctor or dentist to see his fee schedule? When I did so once, a dentist refused, saying in effect: “my prices are higher, but that’s what you need to get my quality advantage.” What’s a consumer to do? A similar relation exists between large employers and institutional providers (hospitals.) The lack […]
As the government fulfills its promise to create an essential benefit package, employers can be forgiven for thinking the government’s putting a competitor plan out there to lure plan members away from employer-sponsored plans. And it is tempting for them to just say: “Fine! You asked for it; no more funding health benefits!” But paradoxically […]
Employers have different ways of administering COBRA continuation coverage, as evident in a recent news article about a local candidate’s problem when he was found to owe a city government money after it paid some of his COBRA premiums. The Post-Standard reported Oct. 27 how Timothy Lattimore (R), former mayor of Auburn, N.Y. , elected […]
Self-insuring health benefits is a riskier undertaking than just writing a check to a United or Aetna. But despite the risk, employers do it because it gives them more control over plan design and the growth of health costs. For self-insured plans to succeed in controlling costs – and they can – they must analyze […]
Health reform has passed and it was supposed to change the world. But it has yet to take effective action on the biggest problem — the upward spiral of health costs! Raise your hand if you think there is a connection between insurers’ and providers’ lack of transparency on premiums and fees, and that upward […]
Trade legislation that also extends premium subsidies for health coverage under the Health Care Tax Credit (HCTC) program was signed into law by President Obama Oct. 21. The HCTC was enacted as part of the Trade Act of 2002. As originally enacted, it provided a 65-percent tax credit for qualifying health coverage (including COBRA continuation […]
The year 2011 will soon be in the history books so it is not too early to work on the master “to do” list for 2012. Here are a dozen suggestions for benefits and insurance professionals who are involved with flexible benefits, by Rich Glass, JD, Chief Compliance Officer, Infinisource, Inc. Keep an eye on […]
Most U.S. workers are either obese or suffering from at least one chronic condition, which costs employers $153 billion in lost productivity, says a new Gallup-Healthways survey. That’s the bad news. The good news is employers can take steps to lighten their workforce, and I’ll provide a refresher on some of those steps later below. […]
A plan participant cannot pick definitions from various state or federal statutes and impose them on an employer-sponsored health plan where the plan left terms undefined, if the plan applies a common and ordinary meaning to those terms when asked to justify a claims denial. Applying this rule, a Michigan appeals court affirmed a lower […]