This article was published on March 21, 2020 in MyHealthGuide, written by Hobson D. Carroll, FSA, MAAA, President, MedRisk Actuarial Services, Inc. After the President signed the Families First Coronavirus Response Act wherein testing for the virus may not attract any element of cost-sharing (think: preventive care), there has begun an additional new drum roll [...]
Section 1332 of the Affordable Care Act (ACA) permits a state to apply for a State Innovation Waiver to pursue innovative strategies for providing their residents with access to high quality, affordable health insurance while retaining the basic protections of the ACA. Recently several states have applied for waivers and have been approved. Among these is the State of [...]
In a recent legislative update from SIIA, it was noted that the New Jersey Department of Banking and Insurance (DOBI) approved regulations lowering minimum stop-loss attachment points for large groups of 51 lives and above, effective in late August. This move allows the large group individual attachment points to be $20,000 per individual, reduced from [...]
The article below was published on October 24, 2017 by Self-Insurance Institute of America, Inc., written by Wrenne Bartlett. The Self-Insurance Institute of America, Inc. (SIIA) is pleased to announce that Governor Andrew Cuomo has signed A.8264 into law, allowing grandfathered stop-loss contracts for groups of 51-100 to renew until January 1, 2019. As background, [...]
In New York, industry efforts to support self-funding for smaller groups have led to legislation extending the grandfathering of existing stop-loss policies for groups of 51 to 100 for an additional year, through January 1, 2019. Other legislation impacting access to stop-loss insurance products by smaller groups has taken effect in Minnesota and is slated [...]
With the costs of maintenance and specialty drugs skyrocketing, why would some employers with self-funded health plans not place prescription drugs under their plan’s stop-loss insurance?
Article is by Erik Engquist, as seen in Crain's New York Business Fears of an insurance death spiral are misplaced, according to industry insiders fighting to preserve stop-loss policies for companies that self-insure. The Assembly and the Cuomo administration have concerns that letting small businesses self-fund—that is, pay their workers’ health-care bills directly—depletes the risk [...]
If you're still on the fence about whether or not you should self-fund the employee benefits plan for your small-to-mid-sized company, here are a few more reasons that should make that decision a little easier. Access to Claims Data Why is claims data so important? Because with it you can identify your biggest cost drivers. [...]
