26 01, 2021

Changes for 2021 Summary of Benefits and Coverage

By | 2021-01-26T09:49:17-08:00 January 26th, 2021|Uncategorized|0 Comments

There are new Summary of Benefits and Coverage notice requirements for health plans starting with the 2021 coverage year. The requirements, released by the Department of Labor, have new model templates, new instructions and new information that affects the coverage examples that are required to be in SBC documents that employers with group health plans [...]

25 01, 2021

Demand for Voluntary Group Benefits Grows During Pandemic

By | 2021-01-25T11:38:51-08:00 January 25th, 2021|Uncategorized|0 Comments

As the COVID-19 pandemic drags on and many Americans see unmet needs outside of their health insurance, more and more workers are increasingly signing up for the voluntary benefits their employers offer. While many workers in the past had skipped on voluntary benefits, they have grown concerned that a good group health insurance plan may [...]

13 01, 2021

COVID-19 Relief Bill Extends Unemployment Benefits, PPP and More

By | 2021-01-13T05:33:33-08:00 January 13th, 2021|Uncategorized|0 Comments

The $900 billion COVID-19 relief bill, passed by Congress and signed into law on Dec. 27, includes a number of provisions that affect employers and their workers in terms of paid sick leave and Emergency Family and Medical Leave Act provisions. The legislation also boosts unemployment benefits to out-of-work Americans, as well as reopening and [...]

30 12, 2020

New Law Bans Surprise Billing

By | 2020-12-30T18:33:23-08:00 December 30th, 2020|Uncategorized|0 Comments

Part of the COVID-19 relief package that Congress passed in late December includes a notable provision that bans surprise medical bills when out-of-network doctors work on insureds at in-network hospitals. This so-called “balance billing” occurs when an out-of-network provider is involved in a patient’s care at a hospital that accepts their insurance, often without the [...]

9 12, 2020

New Rules Require Health Plans to Cover COVID-19 Vaccines, More

By | 2020-12-09T15:57:35-08:00 December 9th, 2020|Uncategorized|0 Comments

The Trump administration has issued new interim final rules that set out accelerated coverage requirements for COVID-19 preventative services and covering out-of-network testing for the coronavirus. There are two parts to the interim final rules: One requires that COVID-19 preventative services - including vaccines - be covered without any cost-sharing on the part of plan [...]

2 12, 2020

New Rule Requires Greater Health Plan Transparency

By | 2020-12-02T16:43:24-08:00 December 2nd, 2020|Uncategorized|0 Comments

The Trump Administration has issued a new rule that will require greater price transparency on the part of health insurers, including the rates charged by in-network physicians and copays and costs of drugs. The final rule requires health plans and health insurers to disclose on a public website their in-network negotiated rates, billed charges and [...]

24 11, 2020

The Big Question: Can Employers Require Workers to Vaccinate?

By | 2020-11-24T12:26:45-08:00 November 24th, 2020|Uncategorized|0 Comments

As the COVID-19 pandemic rages on and more employers bring staff back to the workplace, many businesses are considering implementing mandatory vaccination policies for seasonal flus as well as the coronavirus. A safe and widely accessible vaccine would allow businesses to open their workplaces again and start returning to a semblance of normalcy. But employers [...]

17 11, 2020

Uncertainty Weighs on Group Plan Cost Expectations

By | 2020-11-17T04:24:20-08:00 November 17th, 2020|Uncategorized|0 Comments

U.S. employers are expecting their group health insurance costs to climb 4.4% in 2021, despite the ravages of pandemic and a likely uptick in health care usage next year, according to a new survey. The expected rate increases are on par with much of the last few years when insurance premium inflation has hovered between [...]

11 11, 2020

How to Distribute Group Health Plan Rebates to Your Staff

By | 2020-11-12T03:30:02-08:00 November 11th, 2020|Uncategorized|0 Comments

Group health plan insurers are paying out $689 million in rebates to plan sponsors this year, as required by the Affordable Care Act's "medical loss ratio" provision. The provision requires insurance companies that cover individuals and small businesses to spend at least 80% of their premium income on health care claims and quality improvement, leaving [...]