Practical HR Tips, News & Advice. Updated Daily.
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 […]
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 […]
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 […]
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 […]
Employers and plan administrators that have a hard time choosing the version of the Form 5500 to file for earlier plan years, and which schedules to file, now have some help. That assistance comes from none other than the Department of Labor (DOL) — one of the agencies that imposes the filing requirement in the first […]
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 […]
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,” […]
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 […]
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 […]
Health care reform is still alive and kicking. Employer-sponsored health plans have implemented many of its thorny provisions, but one provision now looks like the biggest thorn of all. We are talking about Section 2715 of the Patient Protection and Affordable Care Act (PPACA). You must, of course, know all about this section … no? […]