Practical HR Tips, News & Advice. Updated Daily.
The Consolidated Omnibus Budget Reconciliation Act, which stands for COBRA, has been around for a long time. Still, it remains the source of thorny compliance problems and a fertile ground for litigation. The sheer complexity of the COBRA scheme, and the timing issues involved, can throw off even the most diligent and conscientious employer. COBRA […]
In health care, acronyms abound—ACA, FSA, FMLA, CDHP, HSA, etc. It can be a bit overwhelming.
Plan design can help employer plan sponsors avoid the objectionable task of paying excise taxes on health plan coverage they provide to employees. The Cadillac tax is the Affordable Care Act’s way of taxing health benefits, in part to fund the law’s ambitious coverage objectives. As liability under the tax in 2018 approaches, employers are […]
Insurers and plan sponsors soon will have to report to the government (and list on a web page) their policies on: out-of-network liability and balance billing; enrollee claim submission; claims and denials; recoupment of overpayments; medical necessity; prior authorization; drug exception timeframes; explanations of benefits; and coordination of benefits. Guidance HHS published on Aug. 12 […]
Small employers and certain other plan sponsors can continue to reimburse individual premiums until July 1, without the threat of extreme penalties for offering coverage that does not comply with Affordable Care Act insurance mandates, under new guidance from the Internal Revenue Service. IRS Notice 2015-17 reiterates IRS’ previous warning, in Notice 2013-54, that giving employees […]
Implants — spinal fusion; as well as hip, knee and shoulder replacements — have emerged as major price problems today. Costs are up and so is utilization, which explains the cost surge health plans are undergoing for these procedures, according to three attorneys from The Phia Group in Braintree, Mass., who spoke in a Jan. […]
Participation in high-deductible health plans and health flexible spending accounts grew at a strong pace, according to the National Center for Health Statistics. The findings in “Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January–March 2013” suggest that employees’ interests in consumer-directed health plans is growing, information employers may find useful in […]
An increasing number of employers are examining providing a low-benefits health plan that covers only preventive health services but not high-price major medical claims. Offering this type of low cost or “skinny” plan is allowed under the health reform law. The question is: Will skinny plans trigger a large-employer exodus to de minimis coverage, and if so, […]
Determining whether group health coverage provides “minimum value” is key to avoiding penalties under health reform’s premium tax credit program, so employers will likely welcome new proposed rules that further explain MV criteria. The proposal, to be published May 3 by IRS, would complement language in final rules issued in February on how reform’s MV […]
Employer-sponsored plans that are secondary to Medicare are not subject to health reform’s expensive transitional reinsurance fee, nor are health flexible spending arrangements, health savings accounts and most health reimbursement arrangements. On March 11, 2013, the U.S. Department of Health and Human Services published its final regulation on the transitional reinsurance fee, which takes effect […]