Diversified Group believes that self-funded plans are the most cost effective and transparent health insurance option for most companies. Not only have we been administering self-insured health plans for 50 years, we have a self-funded medical plan for our organization. As a third party administrator (TPA), we provide comprehensive and cost effective solutions that help [...]
Healthcare costs continue to rise at an alarming rate and we all need to be Defining our Health Strategy. We thought it would be helpful to share what we do here at Diversified in regard to our strategy as an employer that has a self- funded medical plan. We like to say at Diversified that [...]
Beginning in 2014 and continuing through 2016, employers and other sponsors of self-funded health plans, as well as insurance companies offering insured health plan products are subject to the Affordable Care Act’s transitional reinsurance fee. This fee was designed to fund reinsurance payments to health insurance issuers to cover high-risk individuals in the individual market. [...]
In a world of increased convenience, you can do your taxes online, you can get breaking news online and you can make reservations for your favorite restaurant online. In recent years, healthcare has followed suit with online resources and digital mechanisms to make your well-being easier to track and medical treatment more convenient to access. [...]
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A recent Notes article from Employee Benefit Research Institute (ebri.org) examines 1996-2015 trends in self-insured health plans among private-sector establishments offering health plans and among their covered workers, with a particular focus on 2013 to 2015, so as to assess whether the Affordable Care Act (ACA) might have affected these trends. The data comes from [...]
In a 6-2 decision on a case involving Liberty Mutual Insurance Company, the Supreme Court, in early March, held that ERISA pre-emption blocks the state of Vermont from requiring self-funded health plans to put claims data into a statewide health claims database. This decision appeared to be consistent with the original intention of Congress to [...]
To help self-funded health plans avoid the risk and burden that arises when an adverse benefit determination is appealed, Diversified Group authorizes Phia Group to serve as a Plan Appointed Claim Evaluator (PACE). A PACE assures that all claims have been correctly paid pursuant to the Plan Document. A PACE reviews the employer’s decisions before [...]
On June 26, 2015, the United States Supreme Court, in Obergefell v. Hodges, struck down all state bans on same-sex marriage. Previously, in 2013, the Supreme Court ruled, in United States v. Windsor, that federal law must recognize a same-sex marriage that was valid under state law. The Obergefell decision will have little impact on [...]
Don’t give your power away. If you’re not paying attention to the detail behind your health plan costs, you open the door for uncontrolled expenses that could derail your business and bankrupt your employees. Why is the detail important? Where do you want your company’s hard-earned profits to go? You can help your employees and [...]
