It can be as easy as handing them a check for a percentage of savings. In last month’s HCU, we discussed the flexibility that self-funding provides – emphasizing that within regulatory parameters, self-funding gives the employer significant power over plan design, selection of providers, ways to incentivize plan members and much more. These days, more [...]
Currently, only 21 states offer some protection against balance billing and most existing laws apply to emergency services required from out-of-network providers. Few, if any, address balance bills received for treatment by an out-of-network provider in an in-network hospital. In Pennsylvania, the Governor and General Assembly have introduced two bills aimed at taking consumers out [...]
This article was published on January 31, 2019 on Employee Benefit News, written by Steve Kelly. Today more than ever before, benefits and human resources professionals are struggling to provide their teams with quality coverage at affordable rates. Costs have skyrocketed for the more than 150 million Americans who receive healthcare coverage through their workplace [...]
Done right, self-funding provides the flexibility needed to control costs. A 2018 Kaiser Employer Survey showed that the cost of employer-based, family coverage rose to $19,616, an increase of 5 percent from the prior year. While this increase may be considered moderate or acceptable by many employers, we work hard to help our self-funded clients [...]
The Patient-Centered Outcomes Research Trust Fund fee is a fee on issuers of health insurance policies and plan sponsors of self-insured health plans that helps to fund the Patient-Centered Outcomes Research Institute (PCORI), which was established by the Affordable Care Act (ACA). The institute assists, through research, patients, clinicians, purchasers and policy-makers, in making informed [...]
Many employers will find it interesting that AHPs will continue to be categorized as MEWAs – Multiple Employer Welfare Arrangements. This consideration will make association health plans subject to some state regulations that severely restrict the formation of self-funded MEWAs. Having to comply with the rules of each state will make AHPs more difficult to [...]
This article was published on January 6, 2019 on ctmirror.org, written by Sujata Srinivasan. Image Source: ctmirror.org With physicians’ compensation from pharmaceutical and medical device companies under increasing scrutiny, payments to doctors in Connecticut for consultant work rose to $8.5 million in 2017, up from $8 million in 2016. Payments for meals, travel [...]
This article was published on December 19, 2018 on NPR.org, written by Sarah Jane Tribble. Photo Source: NPR.org. Europeans have found the secret to making some of the world’s costliest medicines much more affordable, as much as 80 percent cheaper than in the U.S. Governments in Europe have compelled drugmakers to bend on prices and [...]
This article was published on December 13, 2018 on CT News Junkie, written by Jack Kramer. Photo Source: CT News Junkie. HARTFORD, CT — Outgoing Office of Policy and Management Secretary Ben Barnes believes two powerful groups — hospitals and municipalities — are the biggest obstacles to Connecticut’s fiscal stability. Barnes made that statement during [...]
The Patient-Centered Outcomes Research Trust Fund fee is a fee on issuers of health insurance policies and plan sponsors of self-insured health plans that helps to fund the Patient-Centered Outcomes Research Institute (PCORI), which was established by the Affordable Care Act (ACA). The institute assists, through research, patients, clinicians, purchasers and policy-makers, in making health decisions by [...]
