Headlines about "Health plans - mandated benefits"
Gathered from the web by the editors at BenefitsLink.com.
San Francisco Clarifies Health Care Spending Rules
Excerpt: "San Francisco regulators have provided further guidance on how to comply with a controversial ordinance that imposes a health care spending requirement on employers. The latest guidance, which was issued in response to questions from employers, clarifies how much employees must earn in order for them to qualify as exempt employees, for whom employers do not have to make the required contributions." (Workforce Management; free registration required)
[Guidance Overview] Enhanced Mental Health Parity Legislation Awaits Action During 110th Congress's Final Days
Excerpt: "Although less burdensome than previous proposals to enhance the mental health parity requirements, the compromise bill still would significantly broaden the scope of those requirements. If enacted, many employers likely would need to change their group health plan designs in order to comply." (Deloitte via BenefitsLink.com)
Coverage for Autism Therapy Prompts State Mandates and Lawsuits Against Blues Plans
Excerpt: "An explosion in the number of children diagnosed with autism has led to lawsuits against Blue Cross and Blue Shield plans and other carriers over health insurance coverage for controversial therapies. Concerns over autism therapy also have prompted several states, such as Arizona, Florida and Pennsylvania, to enact new autism benefit mandates, forcing Blues plans to revise coverage policies." (AISHealth.com)
[Opinion] The Pioneering Massachusetts Program to Provide Health Insurance for All Citizens
Excerpt: "The number of uninsured has dropped -- Massachusetts now has the lowest rate in the nation -- and so have the number of those who turn to costly emergency rooms for routine care. And while the state has had to seek additional sources of revenue -- mainly because of the program's popularity -- the gains in the first 21 months suggest that the plan could become a model for universal health coverage for other states or the nation." (The New York Times; free registration required)
[Opinion] Comments to Massachusetts Connector Board on Minimum Creditable Coverage Requirements (PDF)
7 pages. Excerpt: "The proposed minimum creditable coverage (MCC) guidance approved by the Connector Board in July provides valuable and welcome guidance in many areas. However, we are concerned about the impact these requirements will have on the Massachusetts employees and retirees of many national employers. As of the date of these comments, we have reviewed the health programs of approximately 20 large national employers, several of whom are headquartered in Massachusetts. Although these employer plans provide comprehensive benefits, most of the employer programs we have reviewed have one or more options that fail to satisfy the MCC requirements based on the regulations and the comments we have received from the Connector." (Buck Consultants)
[Guidance Overview] New Hampshire Mandates Obesity Coverage and Bariatric Surgery
Excerpt: "New Hampshire health insurers and HMOs must soon cover medically necessary treatments and services related to morbid obesity, including bariatric surgery, if the insured is age 18 or older and meets [certain] standards . . . . Other related services to be covered include pre-operative psychological screening and counseling, behavior modification, weight loss and exercise regimens, and post-operative follow-up." (Mercer)
Rule Would Toughen Massachusetts Health Care Coverage Requirement
Excerpt: "Massachusetts Gov. Deval Patrick's administration has issued a regulation that would tighten the rules employers in the state must meet to avoid paying an assessment to the state to help provide coverage to the uninsured." (Workforce Management; free registration required)
Senate Blocked from Considering Tax Extenders Legislation with Mental Health Parity Compromise
Excerpt: "After weeks of negotiations, a compromise mental health parity bill was inserted into an omnibus tax and energy extenders package (S.3335, The Jobs, Energy, Families, and Disaster Relief Act of 2008) that stalled last week after Senate Democrats failed to break a Republican filibuster." (The ERISA Industry Committee)
Massachusetts Gov. Patrick Signs Sweeping Health Care Legislation
Excerpt: "Massachusetts Gov. Deval Patrick (D) on Sunday signed into law broad health care legislation that will raise $100 million in state funds and fees on private companies to fund the state's health insurance law, the Boston Globe reports." (Kaiser Family Foundation)
Illinois Governor To Extend Maximum Age Child Can Be Covered Under Parents' Health Insurance
Excerpt: "Illinois Gov. Rod Blagojevich (D) on Wednesday announced that he will use his amendatory veto to allow children to remain insured under their parents' health plans until they turn age 26, the AP/Chicago Tribune reports. Under the revision, parents would be allowed to keep their children on their insurance up to age 30 if the child is a veteran." (Kaiser Family Foundation)
New Mexico Attorney General Upholds Health Coverage Requirement in State Contracts
Excerpt: "Attorney General Gary King issued a decision upholding the authority of the Governor's Office to require state contractors to demonstrate health coverage for their employees. Gov. Bill Richardson issued the executive order, which went into effect in July. It requires contractors with six or more employees to demonstrate that they offer health coverage in order to do work with the state." (New Mexico Business Weekly via bizjournals.com; free registration required)
[Guidance Overview] Massachusetts Provides Revised Guidance on Minimum Creditable Coverage Requirements (PDF)
5 pages. Excerpt: "Starting January 1, 2009, Massachusetts residents who do not have health coverage that satisfies certain minimum creditable coverage requirements will be subject to tax penalties. The Massachusetts Connector recently issued important new guidance on these minimum creditable coverage requirements. If an employer's plan does not satisfy these requirements, employees and their family members age 18 and older enrolled in the plan will be subject to the tax penalties." (Buck Consultants)
Massachusetts Employers Spared Higher Health Assessments
Excerpt: "Legislation nearing final approval by Massachusetts lawmakers imposes new assessments on insurers and hospitals to help fund part of the state's health care reform law, but it spares employers -- at least for now -- from making bigger contributions." (Workforce Management; free registration required)
Senate Democrats Unable to End Filibuster on ERISA Amendments Regarding Mental Health Parity
Excerpt: "Falling nine votes short of the 60 needed to overcome a Republican-backed filibuster on July 30, the Senate was unable to advance a House and Senate compromise over mental health parity language which was attached to pending energy and tax legislation (S. 3335)." (The Recovering Life)
Massachusetts House Approves Bill to Raise $89M from Insurers, Health Care Providers
Excerpt: "The Massachusetts House on Tuesday voted 135-21 to approve a bill that would require insurance companies and health care providers in the state to contribute more money to close a funding gap in the state's health insurance law, the AP/Boston Globe reports." (Kaiser Family Foundation)
Mental Health Parity Provisions Added to Tax Bill
Excerpt: "Like earlier parity measures cleared by the House and Senate, the parity provisions in the tax bill would require group health care plans to provide the same coverage for mental disorders as they do for other medical conditions." (Workforce Management; free registration required)
Massachusetts Governor Wants Employers to Pay More to Fund Universal Health Plan
Excerpt: "How Massachusetts employers would pay more under Patrick's proposal: To avoid a $295 per-employee assessment, employers would have to enroll at least 25 percent of full-time employees in their health plans and pay at least 33 percent of premiums for individual coverage. If revenue from Fair Share assessments does not generate $38 million a year, the per-employee assessment would be increased. Fair Share assessments would be paid quarterly." (Workforce Management; free registration required)
[Guidance Overview] Proposed Mental Health Parity Bill Chart, Updated July 25, 2008 (PDF)
5 pages. (American Benefits Council)
Pennsylvania Gov. Signs Law Requiring Private Health Insurers To Cover Treatment for Autism
Excerpt: "A bill recently signed by Pennsylvania Gov. Ed Rendell (D) will require private health insurance companies in the state to provide diagnosis and treatment coverage of up to $36,000 per year for residents under age 21 with autism spectrum disorder, the Philadelphia Inquirer reports. The law, which is scheduled to take effect in July 2009, also requires insurers to provide coverage for applied behavioral analysis therapy that experts say is a key element in treatment of the disorder." (Kaiser Family Foundation)
House Panel OKs Heath Coverage Extension for Ill College Students
Excerpt: "The measure, H.R. 2851, approved on a 40-0 vote, would allow college students to retain coverage for up to 12 months after they take a leave of absence. Coverage would continue on the same basis as prior to the student going on leave." (Workforce Management; free registration required)
House Panel Votes To Extend Medical Leave Coverage for Students
Excerpt: "The House Energy and Commerce Committee on Wednesday voted 40-0 to approve a bill (HR 2851) that would allow college students who take medical leave to continue to receive health insurance under the policies of their parents, CQ Today reports." (Kaiser Family Foundation)
Massachusetts Proposes Changes to Health Reform Rules
Excerpt: "More employer plans will likely meet requirements of Massachusetts' health care reform law if draft rules approved Thursday, July 10, are implemented. The rules were unanimously approved by the Massachusetts Health Insurance Connector Authority board, the state agency charged with implementing key elements of the 2006 law." (Workforce Management; free registration required)
Senate, House Reach Agreement on Policy Framework for Mental Health Parity Legislation
Excerpt: "Under the agreement, the terms of which will be set this week, mental health benefits would be required to be on par with medical and surgical benefits, including treatments such as hospital stays, physician visits and cost sharing such as copayments, deductibles and out-of-pocket expenses. If a plan offers medical coverage for treatment outside its provider network, it must offer the same for mental health treatment." (Kaiser Family Foundation)
House Panel Votes To Extend Health Coverage for College Students Who Take Medical Leave
Excerpt: "The House Energy and Commerce Health Subcommittee on Wednesday by voice vote approved to extend a bill (HR 2851, S 400) that would allow college students who are forced to leave school for a serious illness to continue to receive health care benefits under their parents' health insurance policies, CongressDaily reports." (Kaiser Family Foundation)
Coverage Mandates Included in Massachusetts Health Insurance Law Cost $1.3B Annually, Report Finds
Excerpt: "Coverage of 26 health benefits mandated under Massachusetts' health insurance law account for 12 cents of every $1 paid for health insurance, and statewide, the mandates cost about $1.3 billion annually, according to a report released on Monday by the state Division of Health Care Finance and Policy, the Boston Globe reports." (Kaiser Family Foundation)
New Jersey Extends Age Gap for Children on Parents' Coverage
Excerpt: "Legislation signed into law Monday, July 7, by New Jersey Gov. Jon Corzine will allow employees' children to retain coverage through a parent's group health insurance plan until age 31." (Workforce Management; free registration required)
North Carolina Mental Health Parity Law Takes Effect
Excerpt: "North Carolina health care insurers must provide the same amount of coverage for certain mental conditions as they do for physical ailments under a state law that took effect on Tuesday, the Winston-Salem Journal reports." (Kaiser Family Foundation)
[Guidance Overview] Heroes Earning Assistance and Relief Tax Act Adds Benefits for Those in Military Service (PDF)
Pages 3- of 8 pages. Excerpt: "The HEART Act deals principally with the tax treatment of military personnel, with provisions applying to a wide range of Internal Revenue Code ('Code') provisions. This article will deal primarily with those provisions which have an effect on qualified retirement or Section 125 plans, and IRAs." (Trucker Huss)
New Hampshire Governor Mulling Bariatric Surgery Insurance Mandate
Excerpt: "One measure requires health insurers to offer bariatric surgery as an option. Patients must pass a number of medical and psychological hurdles first. Not surprisingly, health insurers oppose the measure sponsored by state Sen. Bob Clegg, who lost over 100 pounds after having bariatric surgery at his own expense. They argue the mandate could result in higher premiums. Supporters claim the procedure can cure diabetes and other ailments that cost insurers more over time." (AP via Geo. J. Forster Company)
Health Care Reform in Massachusetts — Expanding Coverage, Escalating Costs
Excerpt: "There are still many difficulties with access to primary care and other services. However, Massachusetts has made some strides, and given sufficient resources, more can be done. This includes identifying and reaching people who are still uninsured and helping them gain coverage, expanding employer-sponsored insurance, and improving the options for part-time employees, for low-paid workers who are offered insurance by their employers but who earn less than 300% of the federal poverty guideline and cannot afford it, and for others with hardship exemptions." (The New England Journal of Medicine)
Anorexia and Bulimia May Soon Be Covered Under Mandatory Health Insurance in Illinois
Excerpt: "Illinois lawmakers can't do much about the physical and emotional toll, but they did move to ease the financial burden on families, recently approving legislation that would require insurance companies to pay for treatment of anorexia and bulimia. If Gov. Rod Blagojevich signs the bill, Illinois will become the 17th state to mandate such coverage." (Chicago Tribune)
Mental Health Parity Bill Moving Closer to Final Passage
Excerpt: "House and Senate negotiators have resolved the remaining differences in the benefit-related provisions in mental health care benefits parity legislation . . . ." (Workforce Management; free registration required)
New San Francisco Health Benefit Mandate May Force Employees Into Consumer-Directed Health Plans
Excerpt: "The legal challenges to the new law -- which mandates that employers spend a minimum amount on worker health care regardless of employment status -- is being closely watched throughout the country. Although the law does not require account-based benefits, a CDH approach may be the most prudent way for most small companies to comply." (AISHealth.com)
President Signs Heroes Earnings Assistance and Relief Tax Act of 2008 into Law
Excerpt: "In addition to provisions that may affect benefits under 401(k) plans for certain participants in military service (such as survivor benefits, differential pay, and elective deferrals), the Act allows cafeteria plans to provide qualified reservist distributions from health FSAs. It also extends the mental health parity provisions of the Code, ERISA, and the PHSA." (Employee Benefits Institute of America)
Bush Signs Bill Extending Mental Health Parity Act Through End of 2008
Excerpt: "Legislation that extends the Mental Health Parity Act's (MHPA) sunset date until Dec. 31, 2008, was signed June 17 by President Bush. The Heroes Earning Assistance and Relief Tax (HEART) Act of 2008 (Pub. L. 110-245) extends the MHPA provisions of ERISA, the Public Health Service Act and the Internal Revenue Code, which had expired Dec. 31, 2007." (Thompson Publishing Group Inc.)
[Opinion] Massachusetts's Pioneering Plan to Provide Universal Health Coverage Off to Good Start
Excerpt: "The state requires that all residents take out health insurance or suffer tax penalties if they don't. It also requires employers to offer coverage to their workers or make alternative payments if they don't. As it enters what could be a critical year in determining its viability, the plan can claim some substantial successes." (The New York Times; free registration required)
Amputees Bump Up Against Coverage Limits for Artificial Limbs
Excerpt: "Vermont Gov. Jim Douglas recently signed into law a bill making Vermont the 10th state to require insurance companies to cover prosthetics as fully as they do other medical procedures. A similar measure is pending in Congress. These laws say that if an insurance policy covers, say, 80 percent of the cost of any other medical procedure _ whether a doctor's office visit or open-heart surgery _ it must do the same for prosthetic limbs." (Associated Press WorldStream via NewsEdge via Human Resource Executive Online)
Pay or Play: State Mandated Health Care Laws (PDF)
Pages 7-10 of 11 pages. Excerpt: "Currently, twenty-eight states (see http://www.epionline.org/hc_symposium.cfm) have introduced legislation that requires employers to: (i) pay for a minimum level of health care benefits for their employees; or (ii) pay an assessment to the government sponsoring the law. These laws not only increase the cost for employers doing business in these states, but also increase the burdens imposedon human resource personnel, often requiring additional reporting and disclosure requirements." (Proskauer Rose LLP)
Massachusetts Employers, Insurers Lobby Against Higher Employer Fees for Uninsured Workers, Support Cost Control Efforts
Excerpt: "Massachusetts businesses and most of the state's health insurers on Wednesday announced the formation of the Coalition for Affordable Health Coverage, a lobbying group that will work to control rising health care costs in the state and prevent cost-shifting to employers, the Boston Globe reports." (Kaiser Family Foundation)
[Guidance Overview] Miller & Chevalier's Focus on Employee Benefits, June 5, 2008 (PDF)
6 pages. The newsletter offers articles on: Health FSA and Mental Health Parity; Qualified Plan Queries: Differential Pay Now Compensation Under Code Section 415 and New Distribution Feature; Qualified Plan Queries: Military Survivor and Disability Benefits Under Tax-Qualified Plans; Exec Comp Corner: New Code Section 887A Impacting Withholding on Certain Expatriates' Deferred Compensation. (Miller & Chevalier Chartered)
Study Finds Massachusetts Gains with Mandatory Health Insurance
Excerpt: "Massachusetts reduced its proportion of uninsured adults by nearly half in the first year of mandatory health coverage and made gains in the share of people receiving routine preventive care, according to the first major study of the 2006 law." (The New York Times; free registration required)
New Legislation Enhances 401(k) Benefits for Military Personnel, Allows Qualified Reservist Distributions from Health FSAs, and Extends MHPA
Excerpt: "For some 401(k) plans, the Act's rule requiring enhanced survivor benefits may trigger accelerated vesting of matching and profit-sharing contributions for short-service participants. While not previously mandatory, treating differential military pay as plan compensation was already available for 401(k) plans in the final regulations under Code Section 415. (And while not specifically addressed, the Act may also facilitate pre-tax cafeteria plan salary reductions from differential pay.)" (Employee Benefits Institute of America)
House Lets Go of Key Provision in Mental Health Parity Bill
Excerpt: "In an attempt to reach a compromise on mental health parity legislation, U. S. House conferees agreed to drop a major provision in its version of the new law. According to Business Insurance, in an offer to the U.S. Senate, the conferees deleted a provision in the parity bill the House passed last year that would require group plans to provide coverage for all mental health care services listed in the most recent edition of a diagnostic treatment manual published by the American Psychiatric Association . . . . The Senate was unwilling to accept the House provision since employer groups opposed it." (PLANSPONSOR.com; free registration required)
[Guidance Overview] Updated Employer's Guide to the 2006 Massachusetts Health Care Reform Act
Excerpt: "This version of the guide is updated to include the following items: Division of Insurance Notice 2008-02 (Requirements for Disclosure of Minimum Creditable Coverage); Department of Revenue TIR 07-16 (Personal Income Tax Treatment of Employer-Provided Health Insurance Coverage for an Employee's Child); and Chapter 205 of the Acts of 2007, Section 40 (relating to Young Adult products)." (Mintz, Levin, Cohn, Ferris, Glovsky, and Popeo P.C.)
Massachusetts Refines Health Care Coverage Rules
Excerpt: "Massachusetts regulators plan to clarify final rules soon on the design requirements of health plans state residents must be enrolled in to avoid financial penalties." (Workforce Management; free registration required)
Terms of California's Proposed Wellness Program Mandate
Excerpt: "California's A.B. 2360 would require that employers bidding on state contracts provide their employers with one or more wellness or fitness benefits." (Workforce Management; free registration required)
Presidential Candidates Respond to American Medical Association Questions About Their Health Care Reform Proposals (PDF)
10 pages; responses from Clinton, McCain and Obama. Excerpt: "How would your Administration address rising health care costs? . . . How many Americans would have health care coverage under total costs and sources of financing for your proposal? . . . What are the roles and responsibilities of individuals, employers, or other relevant stakeholders under your proposal? . . . What, if any, provisions are included in your proposal for changing the health insurance market, and how would they improve the market, especially for people with predictably high medical costs?" (American Medical Association)
Fact Sheet on Massachusetts Health Care Reform: Two Years Later
Excerpt: "This fact sheet provides a progress report two years since Massachusetts enacted landmark legislation to provide health care coverage to nearly all state residents." (Kaiser Family Foundation)
[Opinion] Economists Ask, Do Individual Mandates Matter?
Excerpt: "In this policy brief from the Urban Institute, health economists Linda Blumberg and John Holahan contend that it is not possible to achieve universal coverage without an individual mandate." (Robert Wood Johnson Foundation)
[Opinion] Universal Mandatory Health Insurance in The Netherlands: A Model for the United States?
Excerpt: "Not a single-payer system -- a policy approach often considered a nonstarter in U.S. policy circles -- the Dutch approach combines mandatory universal health insurance with competition among private health insurers." (The Commonwealth Fund)
[Opinion] Where Does The Insurance Industry Stand On Health Reform Today?
Excerpt: "With another national health care debate on the horizon, many assume that health plans will present a major source of opposition to universal coverage and other reforms. But a closer look reveals signs of change." (Health Affairs)
Massachusetts Health Insurance Connector Considers Expanding State-Subsidized Coverage to Low-Income Residents Who Cannot Afford Employer-Based Coverage
Excerpt: "Between 30,000 and 40,000 Massachusetts residents are offered health insurance by their employer but have incomes less than 300% of the federal poverty level and cannot afford the premiums, according to a report released Thursday by the Commonwealth Health Insurance Connector, the Boston Globe reports." (KaiserNetwork.org)
[Guidance Overview] Text of 'Compliance Quarterly' for California HR Professionals
Excerpt: "In this issue: San Francisco Health Care Security Ordinance in effect - for now; New laws impact California employers; New leaves for military families in Californina . . . ." (Mercer)
Maine Employers Fight Health Plan Bailout
Excerpt: "The coalition, Fed Up With Taxes, comprises a dozen business trade groups and is leading a drive to put a proposal on the November ballot to repeal the taxes that state legislators approved in April." (Workforce.com)
[Opinion] State Health Insurance Mandates
Excerpt: "Keith R. McMurdy has some interesting comments on state insurance benefit mandates. [See http://insurancebloggers.com/state-health-insurance-mandates-2008/]" (Health Plan Law blog by Attorney Roy F. Harmon III)
Trends in State Mandated Benefits, 2008 (PDF)
2 pages. Excerpt: "Since CAHI closely monitors mandate legislation, we see mandate 'trends' developing long before many others. The purpose of this short report is to periodically identify some of those trends: which state mandates are growing in popularity among state legislators and in which states." (The Council for Affordable Health Insurance)
Health Insurance Mandates in the States 2008 (PDF)
8 pages. The report provides a state-by-state breakdown of health insurance mandates and their costs. (The Council for Affordable Health Insurance)
[Guidance Overview] Municipal Regulation of Group Health Plans now Reality for Employers with 20 or More Employees in San Francisco (PDF)
8 pages. Excerpt: "This overview of the ERISA preemption controversy concerning the ['San Francisco Health Care Security Ordinance'], as well as the compliance guide, is intended for the use of employers that have covered employees in San Francisco. Until a federal court rules otherwise, San Francisco 'covered employers' must take steps to comply with the Healthy San Francisco Ordinance." (Jones Day)
San Francisco Firms Adjust to Health Care Law
Excerpt: "Despite the challenges, public-health experts say San Francisco's ordinance is making headway. About 18,000 people -- one-quarter of the uninsured -- have enrolled in the city's health-services program, and local businesses are seeking ways to cover health-care costs for hard-to-insure workers." (The Wall Street Journal)
[Opinion] Obama's Health Care Voting Record
Excerpt: "By my count, during Mr. Obama's tenure in the state Senate, 18 different laws came up for a vote and passed that imposed new mandates on private health insurance. Mr. Obama voted for all of them." (Scott Gottlieb via The Wall Street Journal)
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