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- Analysis: Tax status, discrimination rules, 3/17 (340.-1)
- Analysis: Health coverage tax credit, 3/16 (329.2.-27)
(Read Intelliconnect) »
- Analysis: Medicare Part D, 3/16 (324.4.-9)
(Read Intelliconnect) »
- Analysis: Federal external claims review, 3/16 (521.1.-9)
(Read Intelliconnect) »
Employees increasingly dissatisfied with current mix of wages and benefits
While most employees report being satisfied with their current health benefits, there is a long-term trend toward wanting more cash and fewer benefits, according to recent research from the Employee Benefit Research Institute (EBRI). The 2015 Health and Voluntary Workplace Benefits Survey (WBS) found that fully a third would change the current mix of wages and health benefits, which may reflect an intensifying desire for real wage growth, EBRI noted….
Medicaid MCOs ABPs, CHIP join the mental health parity party
CMS finalized proposals to strengthen access to mental health and substance abuse services for beneficiaries of certain Medicaid plans and Children’s Health Insurance Plans (CHIP), an initiative that was originally born out of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) (P.L. 110-343). The final rule was announced in connection with President Obama’s attendance at the National Rx Drug Abuse and Heroin Summit. At the same time, CMS released a summary of its “latest efforts to increase access to improve mental health and care for low income individuals, especially in light of the opioid abuse epidemic, which constitute significant health risk and cost drivers in the Medicaid program….”
March 31 reporting deadline has arrived
The deadline for applicable large employers (ALE) to file Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, has arrived. The deadline is today, March 31….
CO-OPs are doing well, even if they are disappearing
Performance and CMS oversight of the nonprofit health insurance issuers known as consumer operated and oriented plans (CO-OPs) has improved over time, despite the fact that the number of CO-OPs is shrinking. Additionally, according to a GAO report on oversight, premiums, and enrollment in CO-OPs, the issuers are averaging lower premiums for 2015 than they were in 2014 and generally have lower premiums than competing issuers. The GAO also found that combined enrollment for the 22 CO-OPs that offered plans in 2015 was more than double the enrollment of the prior year….
Self-insured plans covered 31 million participants in 2013, most recent annual report finds
The number of group health plans that self-insured remained relatively stable from 2012 to 2013, according to a recent report from the Department of Labor (DOL). The sixth
Annual Report to Congress on Self-Insured Group Health Plans found that approximately 50,200 health plans filed a Form 5500 for 2013, an increase of 2 percent from the health plans that filed a Form 5500 for 2012. Self-insured plans that filed a Form 5500 covered approximately 31 million participants in 2013 and held assets totaling about $77 billion….
Investment provider did not breach fiduciary duty by collecting excess fees authorized under contract with plan sponsor
A financial services company that provided investment options under a plan was not subject to suit under ERISA for allegedly excess fees assessed plan participants because the company was not a fiduciary at the time the fees and expenses were negotiated with the plan sponsor, according to the Eighth Circuit U.S Court of Appeals. The plan participants also failed to sufficiently plead a connection between the excess fee allegations and any post-contractual duty to which the company may have been subject….
High court weighs government’s interest in protecting women’s health against hijacking religious organizations’ insurers
The Little Sisters of the Poor and other religious nonprofits finally had their day in court to request relief from a government mandate they claim is a violation of their religious liberty. The Supreme Court heard oral arguments on March 23, 2016, from the Little Sisters of the Poor and many other religious nonprofit organizations in
Zubik v. Burwell. It will now convene to determine whether the HHS contraceptive coverage mandate and its “accommodation” to opt out of providing coverage violate the Religious Freedom Restoration Act (RFRA) by requiring religious nonprofits to self-certify their status or provide notice that they wish to opt out because they believe the accommodation “hijacks” their insurance plans and violates their religious liberty….
Retirement confidence stable, but retirement preparations still lag
While overall confidence about being able to afford a comfortable retirement has plateaued among American workers, preparations to save for retirement are still lagging, according to the
2016 Retirement Confidence Survey (RCS) from the Employee Benefit Research Institute (EBRI) and Greenwald and Associates….
Denial-of-benefits letter’s failure to specify plan’s suit-limitations period rendered that limit inapplicable
The suit-limitations period in an ERISA-governed disability insurance plan was rendered inapplicable by the insurer’s failure to notify a disability benefits claimant of the date by which he must file suit on the denial of his claim for extended benefits, a federal appellate panel instructed. Reversing the Puerto Rico federal trial court’s grant of summary judgment favoring the insurer/plan administrator, the panel held that ERISA’s implementing regulations require that a plan administrator inform a claimant not only of his right to bring a civil action, but also of the plan-imposed time limit for doing so….
Healthcare.gov approves 11 of 12 fake applications, improvement still needed
The Senate Finance Committee held a hearing on March 17, 2016, to discuss findings of watchdog groups detailing issues with the Healthcare.gov website. Both the HHS Office of Inspector General (OIG) and Government Accountability Office (GAO) testified before the Finance Committee and detailed study findings related to HealthCare.gov….