The Consolidated Appropriations Act of 2021 (CAA), signed into law on December 27, 2020, has far reaching impact, particularly in the area of healthcare financing and delivery. On it’s surface, the CAA was another coronavirus relief effort, including $900 billion of available funding. But it’s impact and focus on healthcare is profound and will impact virtually every American citizen.
If your organization offers, or is in the process of considering a Wellness Program…HOLD THE PHONE! There is pending litigation involving the American Association of Retired Persons (AARP) and the U.S. Equal Employment Opportunity Commission (EEOC) that could profoundly alter the regulatory and compliance requirements associated with certain Wellness Programs. Generally speaking, the rules and regulations affecting Wellness Programs, apply to those defined as “health contingent” and “outcome based”.
The Tax Cuts and Jobs Act, signed into law in late December, 2017, contained some great news for folks that incur significant medical expenses AND itemize deductions on their tax return. Historically, the threshold used to determine the amount of eligible/deductible expenses has been 7.5% of adjusted gross income (AGI), until an increase to 10%LEARN MORE
On Tuesday, December 13th, 2016, the President signed into law the – “21st Century Cures Act” – which includes a provision that will be very good news to many stakeholders, in particular, employers that have fewer than 50 full time/full-time equivalent employees. Now law, the Act addresses a variety of issues including expanded treatment for mentalLEARN MORE
Short Term Major Medical (STMM) coverage, sometimes referred to as Temporary Major Medical, can be an ideal solution to a specific, health insurance related challenge. However, changes brought upon by the Affordable Care Act (ACA) have significantly altered the rules, restrictions, and considerations relative to the purchase and reliance upon STMM coverage. Here is anLEARN MORE
The Supreme Court of the United States (SCOTUS) recently issued separate rulings affecting the health insurance and employee benefits sectors. The “King v. Burwell” decision assures that health insurance subsidies will continue to be provided to eligible individuals in all states, even those that don’t have a “state based health insurance exchange”. And the “Obergefell v. Hodges” ruling held that state laws (in 14 states) banning same sex marriages were unconstitutional. While the former ruling affecting ACA subsidies will primarily assure continuation of previously implemented aspects of the law, and prevent what could have been serious disruption, chaos, and premium rate impact; the later ruling will require examination of, and changes to many policies and procedures. Here’s a brief overview of the more pertinent areas deserving attention…
In the current, post Affordable Care Act (ACA) world, the term – narrow network is often heard, and at times, is a strategy deployed by employers and insurers. There are a variety of other ways to describe narrow networks, such as – carve out network; exclusive provider network; select network; tiered network…you get the idea. From a covered members standpoint, this strategy involves limiting the number of contracted providers plan members can seek care from, and in return, receive the best benefits, and lowest out of pocket costs. From the standpoint of the insurer or employer, narrow networks mitigate risk and reduce expenses.
As we approach the labor day holiday, human resources officials, brokers, consultants, and others begin to think not as much about the end of summer, but rather, the approaching OPEN ENROLLMENT SEASON! Before we know it, that special time of the year will be upon us. Having been involved with so many open enrollments over the years, as an insurance company executive, third party administrator, wholesaler, consultant, and retailer/broker, I have accumulated some insight as to what employees/enrollees should be considering during this important time of the year. Call these my “open enrollment best practices”, or, put another way, the things enrollees/employees should consider as they enter open enrollment season…
This week (June 30, 2014) the Supreme Court ruled in favor of plaintiffs – Hobby Lobby, Mardel, and Conestoga Wood Specialties – in their respective challenges to the Affordable Care Act;s (ACA) contraception mandate. The basis for their cases was simple in nature, but sweeping in scope, as there are over 90 similar cases currently pending in courts around the country. The court's decision was quickly followed by a tremendous amount of media coverage, some of which is patently false and misleading. Here's an overview of what we know at this point.
The Affordable Care Act (ACA) contains a provision requiring most employers to cover a range of contraception drugs and devices in their health plans, AT NO COST TO THEIR FEMALE EMPLOYEES.
Within just the past decade or so, Workplace Wellness has become an industry within an industry. In fact, as a benefits broker/consultant, I get as many calls from Wellness program vendors as I do from insurance companies, seeking new client opportunities. Recently I came upon an article that made some interesting points relative to Workplace Wellness programs, and the potential outlay of employer dollars in the interest of reducing health care related claims costs. Here are some thoughts for readers and stakeholders to ponder:
On average, U.S. citizens consume about 2,700 calories per day.
Healthy food costs significantly more than unhealthy food.