Practical HR Tips, News & Advice. Updated Daily.
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? […]
The sponsor of a self-funded health plan cannot escape its responsibility to ensure that only fully eligible people are enrolled. Illustrating this maxim is a self-funded plan’s sad quest to recover gigantic sums from health providers for services it paid on behalf of a non-beneficiary. The plan paid more than $1 million in claims for a […]
Keep in mind that some individuals may be eligible for COBRA premium subsidies beyond Aug. 31, 2011, the U.S. Department of Labor (DOL) noted today in updated material on its website. The updated frequently-asked-question on the end of the subsidy period follows: Q1: I’ve heard that the COBRA Premium Reduction (Subsidy) ends on August 31, 2011, […]
A quick update on the case involving the state of Vermont’s demand for claims data from Liberty Mutual’s group health plan — the state agreed to drop its immediate demand for this information, pending the ultimate outcome of the lawsuit. The state’s health and insurance agency had issued a subpoena for this data, and Liberty […]
An insurance company recently sued the state of Vermont to block its attempt to get details on the employees and family members enrolled in the company’s group health plan, and the actual claims they’ve submitted. Vermont health care regulators want this information for a database designed to measure and improve the quality of health care […]
In the waning days of the COBRA premium subsidy, The Commonwealth Fund is calling for the program to be resuscitated as a way to help unemployed and uninsured workers until health care reform is fully implemented. In an Aug. 24 issue brief, the Fund noted that “the worst economic downturn since the Great Depression has […]
I often feel like raising a picket sign when I look at my phone bill, but that’s another story — right now, I just want to use the news of the Verizon strike to remind you of its COBRA continuation coverage implications. As has been widely reported, approximately 45,000 unionized Verizon workers went on strike […]
When it comes to implementing health reform, the federal government agencies definitely are not taking a summer vacation. Just this week, new rules on communicating health plan information to consumers, health insurance exchanges and premium tax credits have been issued. Here’s a quick list: 1. Communicating health plan information. The U.S. Departments of Labor, Health […]
A landmark Supreme Court ruling on relief available under ERISA in employee benefit cases is bringing cases back to life that we thought were dead and gone. In CIGNA v. Amara, the U.S. Supreme Court on May 16 ruled that ERISA’s enforcement provision allowing for “appropriate equitable relief” — ERISA Section 1132(a)(3) — aka Section […]
If you run a smaller firm and pay an insurance company to cover your workers’ health, one of your top concerns is probably how to control spiraling health insurance expenses. Just two or three major health expenditures can cause your insurer to radically increase your premiums. And if you’re located in a part of the […]