Spencer’s Benefits NetNews – June 28, 2019

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Featured This Week

New Reports

  • Analysis: Self-funding, 6/19 (331.1.-1)

    (Read Cheetah) »

  • Analysis: Consumer-driven health plans, 6/19 (356.-1)

    (Read Cheetah) »

  • Analysis: ACA claims appeals, 5/19 (521.-1)

    (Read Cheetah) »

  • Analysis: DOL’s DFVCP offers reduced penalties for 5500 filers, 6/19 (603.1.-1)

    (Read Cheetah) »

  • News

    Trump’s Executive Order promotes price transparency, but details left to regulations

    Eliminating surprise medical bills, improving transparency in prices, as well as revealing how prices are negotiated were the focus, but details about how information must be provided was left to the regulations, in an Executive Order signed by President Trump on June 24, 2019.

            (Read Cheetah) »

    Self-insured plans must pay PCORI fee by July 31

    Self-insured health plans are required by the Patient Protection and Affordable Care Act (ACA) to pay a fee to help fund the Patient-Centered Outcomes Research Institute (PCORI). The fee for the 2018 plan year is due by July 31, 2019.

            (Read Cheetah) »

    Parity-based challenge to coverage denial of wilderness therapy facility survives dismissal

    A KPMG employee can proceed with his claim alleging his ERISA-governed health plan violated the Mental Health Parity and Addiction Equity Act by denying coverage for his son’s treatment at a wilderness therapy facility and a transitional living facility in Utah, a federal district court in Utah ruled, denying Aetna’s motion for judgment on the pleadings. The employee stated a plausible cause of action because the plan appears to impose more restrictive treatment limitations on mental health and substance abuse benefits than it does on medical/surgical benefits.

            (Read Cheetah) »

    Companies need to take marketing approach when it comes to benefits communication, experts say

    To maximize the impact of employee benefits communication, organizations need to take a marketing approach, according to experts at a recent Segal Benz webinar, Benefits Engagement: The 10 Keys to Unlocking Benefits Communication. At the webinar, Jennifer Benz, SVP communications leader at Segal Benz, and Lindsey Kohler, senior consultant at Segal Benz, provided a framework for using a marketing approach to fully engage employees in employee benefits programs.

            (Read Cheetah) »

    Employers can offer HRAs integrated with individual coverage under final rules

    The Departments of Treasury, Health and Human Services, and Labor have released final rules that allow employers to integrate health reimbursement arrangements (HRA) and other account-based group health plans with individual health insurance coverage or Medicare (individual coverage HRA), if certain conditions are satisfied. The final rules also set forth conditions under which certain HRAs and other account-based group health plans will be recognized as limited excepted benefits. The rules generally apply for plan years starting on or after January 1, 2020.

            (Read Cheetah) »