Medicare Part D Creditable Coverage Notices Due Before Oct. 15


Medicare Part D requires group health plan sponsors to disclose to individuals who are eligible for Medicare Part D and to the Centers for Medicare and Medicaid Services (CMS) whether the health plan’s prescription drug coverage is creditable. Plan sponsors must provide the annual disclosure notice to Medicare eligible individuals before Oct. 15, 2023 — [...]

Medicare Part D Creditable Coverage Notices Due Before Oct. 152023-09-06T17:17:53+00:00

Supreme Court Overturns Roe vs Wade


On June 24, 2022, the Supreme Court issued its much-anticipated decision in Dobbs v. Jackson Women’s Health Organization, which stated that there is not a constitutionally protected right to terminate a pregnancy. Employers are now faced with the task of determining how this decision will impact their workforce and their benefit offerings. Self-Insured Plans — as a self-insured [...]

Supreme Court Overturns Roe vs Wade2022-07-20T21:16:03+00:00

Update on OSHA’s Vaccine Mandate


Late last week, the Sixth Circuit Court of Appeals reinstated the OSHA Emergency Temporary Standard (ETS) mandating employees to be vaccinated or tested weekly. Immediately after the Sixth Circuit ruled on Friday, several of the many plaintiffs who had challenged OSHA’s ETS asked the Supreme Court to intervene as part of its “emergency” docket. Appeals from the Sixth Circuit [...]

Update on OSHA’s Vaccine Mandate2021-12-23T15:54:26+00:00

IRS Issues COBRA Subsidy Guidance


In April, the DOL issued FAQs discussing the American Rescue Plan Act (ARPA) COBRA subsidy. The FAQs left many with questions that were not addressed in the DOL’s guidance. On May 18, 2021, the IRS issued its guidance in Notice 2021-31 and a series of 86 FAQs that solve many of the points left unanswered in the [...]

IRS Issues COBRA Subsidy Guidance2021-05-24T16:44:21+00:00

Self-Funding: The Greatest Benefit is Compassion


Ask any member of our team what sets Diversified Group apart and you’ll likely hear about customer service and our promise to always put our client’s health plan and its members first. Seldom have these qualities been more meaningful than during the uncertainty of the past few months. Fortunately, self-funding provides the flexibility employers have [...]

Self-Funding: The Greatest Benefit is Compassion2020-10-01T14:47:56+00:00

Making Reference Based Pricing Work


Whether you refer to it as Reference Based Pricing, Medicare Reference, Cost Plus or something else, the important thing is to understand what it is and why it’s being used to lower health plan costs. Health plans with reference based pricing provide high quality coverage at a lower cost by using Medicare fee schedules as [...]

Making Reference Based Pricing Work2020-04-23T14:50:48+00:00

Communicate Better. Benefit More.


Communication and helping plan members get the most out of their health plan should be an all year round endeavor. Surveys continue to indicate that even highly educated employees describe benefits, insurance and the enrollment process as “very confusing.” Consider academic research by the Commonwealth Fund and a recent study by Accenture. While one points [...]

Communicate Better. Benefit More.2020-01-23T19:53:00+00:00

Protecting Member’s Health Data


The sensitive nature of information shared with payers and providers makes health plan members prime targets for identify theft. While no legislation is currently moving through Congress, a number of senators are taking steps to learn more about recent breaches of healthcare data involving collection agencies and diagnostics firms. While some employers are taking very [...]

Protecting Member’s Health Data2019-10-02T16:31:01+00:00

Can Your Plan Recover Money It Wasn’t Responsible for Paying?


That’s What Subrogation and Reimbursement Are All About When a plan member requires medical treatment following an injury or accident, their health plan is almost always the first line of defense. In some instances, however, the responsibility for medical treatment should really lie with another insurance plan, such as the member’s auto policy or workers [...]

Can Your Plan Recover Money It Wasn’t Responsible for Paying?2019-08-15T08:00:08+00:00

UnitedHealth will begin passing drug discounts to plan participants


This article was published on March 13, 2019 on BenefitsPro written by Max Nisen. OptumRX, UnitedHealth's PBM, will mandate that all new employer health-plan clients pass the drug discounts it obtains directly to plan participants. The health-care policy environment is shifting in a dangerous way for insurance giants. A seemingly small change in how drugs [...]

UnitedHealth will begin passing drug discounts to plan participants2019-03-15T09:22:22+00:00
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