Tag: Health plans

Premium Subsidy Extension Passes Congress

A bill that would extend premium subsidies for health coverage under the Health Care Tax Credit (HCTC) program has been passed by both the U.S. House of Representatives and Senate, meaning it’s on the way to President Obama’s desk. The HCTC was enacted as part of the Trade Act of 2002. As originally enacted, it […]

Pulled in 2 Directions: The Cost of Uniform Coverage Summaries

Health reform’s uniform summary of benefits and coverage (SBC) will cost insurers and third party administrators (TPAs) about $160 million over the next three years to develop, update, and provide the SBC and glossary to applicants and enrollees, its agency drafters estimate. That includes $25 million in 2011 , $73 million in 2012 and $58 million in […]

Not Again: SIIA Refutes ‘Misinformation’ About Self-funding

It’s like the Hollywood movie Groundhog Day all over again. The Self Insurance Institute of America (SIIA) wakes up and has to face the same “anti-self-funding” arguments about adverse selection, insolvency and inferior benefits that it refuted last year … the year before … and the year before that. Again in damage-control mode, this time the […]

Small Employer Self-funding Must ‘Stop’: NAIC Adviser Touts Stop-loss Limits

Employers that want to self-fund their health benefits (and the vendors and attorneys who want to serve them) have yet another (as they see it) unreasonable opponent to self-insuring health benefits. An adviser to the National Association of Insurance Commissioners has told NAIC that it should amend its model stop-loss coverage law to prohibit the […]

TRICARE Suffers Texas-sized Data Breach

Stop me if you’ve heard this one — a car is burglarized, and hardware goes missing that turns out to have sensitive personal data on thousands of beneficiaries, employees, patients and customers. Same old story — but in the millions this time. Medical information on nearly 5 million military clinic and hospital patients was on backup […]

Top 5 Health Reform Issues Employers Should Focus on Today

It has now been almost a year since health care reform was first enacted. The first year involved many compliance challenges, not the least of which was keeping up with the many pieces of guidance issued by DOL, IRS and HHS. Plans had to expand coverage (more dependents, fewer dollar limits, no more questions about […]

‘Out of Control’ Employee Screaming Profanities Loses out on COBRA Due to Gross Misconduct

Although the COBRA statute never defined gross misconduct — leaving it up to the courts — no dictionary is needed when an “out-of-control” employee screams profanities at and makes seemingly threatening hand gestures toward another employee, saying she would “get” hers. This behavior was “so manifestly so outrageous and extreme as to constitute gross misconduct,” […]

Based on Latest HHS Data, Young Adults Should Love Health Reform

Health care reform may be responsible for a rise in partisan bickering, but what is also rising is the number of young adults with health insurance — 1 million more since last year,  according to the U.S. Department of Health and Human Services (HHS). In the first quarter of 2011, the percentage of adults between […]

Help the Government Figure If Your Health Coverage is ‘Unaffordable’

Jan. 1, 2014, sounds far away, but some plan sponsors may be hoping that day never comes. That’s the day the “shared responsibility provisions” of the Patient Protection and Affordable Care Act (PPACA) kick in; and it’s the time plan sponsors become subject to health reform’s “unaffordable coverage trigger.” Under the law, if an employee’s […]