Headlines about "Health plans - mandated benefits"
Gathered from the web by the editors at BenefitsLink.com.
[Opinion] ERISA Preemption, Health Care Pay or Play, and the Supreme Court
Excerpt: "I have said it time and time again on this blog, that ERISA preemption serves the admirable, even if perhaps inadvertent, role of forcing health care to be tackled at the only level it can be adequately addressed, the federal one, and not at the level of state governments, which simply don't have the resources to pull it off . . . ." (Stephen Rosenberg of The McCormack Firm, LLC)
Setting a National Minimum Standard for Health Benefits: How Do State Benefit Mandates Compare with Benefits in Large-Group Plans?
Excerpt: "This issue brief considers what a broad federal minimum standard might look like by comparing existing state benefit mandates with the services and providers covered under the Federal Employees Health Benefits Program (FEHBP) Blue Cross and Blue Shield standard benefit package, an example of minimum creditable coverage that reflects current standard practice among employer-sponsored health plans. With few exceptions, benefits in the FEHBP standard option either meet or exceed those that state mandates require -- indicating that a broad-based national benefit standard would include most existing state benefit mandates." (The Commonwealth Fund)
[Guidance Overview] Supreme Court Review of San Francisco Health Insurance Mandate Sought by Restaurateurs
Excerpt: "The case involves San Francisco's 'fair share' ordinance, which requires employers with at least 20 employees to provide health coverage for their San Francisco workers. If they do not comply, employers must pay a fee to support city health clinics." (Law.com)
Self-Insured Employers Are Particularly Concerned the Mental Health Parity Act May Increase Their Healthcare Costs
Excerpt: "On an employer-by-employer basis, the financial impact of the act can be evaluated by considering two factors: the current level of mental-health and substance-abuse coverage; and the percentage of covered members reaching the current treatment limits. Plans that have comprehensive mental-health and substance-abuse benefits in place already will be less likely to experience an increase in costs than plans that offer limited services or have high co-pays and deductibles." (Human Resource Executive Online)
Loopholes in Massachusetts Health Care Law Leave Room for Limits on Coverage
Excerpt: "The state's pioneering healthcare law requires residents to have insurance that meets minimum standards, but regulators are discovering many employers' plans test the limits by exploiting loopholes in the rules. Regulators yesterday said that reviews of scores of health plans show many cap the benefits insurers pay each year on prescription drug coverage, exclude maternity coverage for dependents, or place an annual overall dollar limit on benefits. Jamie Katz, general counsel for the Connector Authority, which oversees the state's health initiative, said the gaps raise 'difficult issues' because companies are assuming their plans are adequate in the absence of specific regulations that say otherwise." (The Boston Globe)
Small Companies Seen as Benefiting from Healthcare Reform
Excerpt: "Small businesses in the United States are suffering great harm under our current healthcare system and will likely fare far better under a substantially reformed system along the lines of what is currently being debated in Washington -- as long as such a system offers appropriate levels of assistance to small businesses in meeting their healthcare obligations." (Small Business Majority)
Supreme Court Asked to Decide Legality of San Francisco Health Care Rule
Excerpt: "The Golden Gate Restaurant Association filed a petition v on Monday asking the U.S. Supreme Court to make the final decision on whether San Francisco's mandate that employers pay for health care coverage is legal. The city's first-of-its-kind universal health care program, dubbed Healthy San Francisco, began two years ago and requires that employers with at least 20 employees provide health insurance, set up health care spending accounts or pay into the city's fund." (San Francisco Chronicle)
Restaurant Owners' Group to Ask Supreme Court to Review San Francisco Health Care Spending Law
Excerpt: "A San Francisco-area restaurant trade association intends to file a petition next week with the U.S. Supreme Court asking it to review a 2008 federal appeals court decision upholding the legality of San Francisco's health care spending law." (Workforce Management; free registration required)
[Opinion] Comments of American Benefits Council, U.S. Chamber on Implementation of Wellstone-Domenici Mental Health Parity Act (PDF)
9 pages. Excerpt: "We recommend that the Agencies adopt a non-enforcement policy or good faith compliance period for the first plan year for which the Act applies to any particular plan. The Act is generally effective for plan years beginning after October 3, 2009. . . . The regulations should confirm that the classification of a mental health or substance use disorder is a matter of plan design as determined by the plan sponsor. . . . Compliance with the Act will be virtually impossible if the provision of limited mental health or substance use benefits under an EAP must be compared with the medical benefits provided under the employer's medical benefit option." (American Benefits Council)
[Opinion] Kilpatrick Stockton Comments Regarding the Application of the Mental Health Parity and Addiction Equity Act (PDF)
5 pages. The letter addresses the use of employee assistance programs. (Kilpatrick Stockton LLP)
[Opinion] ERIC Urges Balance on Implementing Regulations under Mental Health Parity Act
Excerpt: "The ERISA Industry Committee (ERIC) . . . submitted comments to the Department of Labor's Employee Benefits Security Administration in response to a 'request for information' regarding the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). . . . ERIC makes recommendations on the terms and provisions of implementing the MHPAEA, disclosure requirements, and the effective date and transition rules of the forthcoming regulations under the MHPAEA, including " (The ERISA Industry Committee)
Health Insurance Mandates in the States, 2009 (PDF)
24 pages. Excerpt: "The mandate chart is broken down on a state-by-state basis into three categories: benefits, providers and covered populations. Boxes with a 'Y' indicate that the state has passed that particular mandate. Totals for each state and mandate are also included. Thus anyone can easily determine how many mandates and which ones each state has passed." (Council for Affordable Health Insurance)
The Massachusetts Commonwealth Health Insurance Connector: Structure and Functions
Excerpt: "This issue brief describes the structure and functions of the Connector, providing a primer to policymakers interested in exploring similar reforms at the state and national level. The authors describe how the Connector works to promote administrative ease, eliminate paperwork, offer portability of coverage, and provide some standardization and choice of plans. National policymakers looking to achieve similar policy goals may find some of the structural components and functions of the Connector to be transferable to a national health reform model, say the authors." (The Commonwealth Fund)
An Update on Health Reform in Massachusetts, Fall 2008
Excerpt: "More than two years after implementation of its landmark health insurance reforms, Massachusetts had achieved historically high levels of coverage and widespread improvements in access to care, according to this study . . . on implementation of the state's reforms. The authors find, however, that constraints on provider capacity and rising health care costs -- trends that predate reform -- have eroded some of the gains. Massachusetts is now seeking ways to contain costs and expand provider capacity, including a proposal to shift from fee-for-service provider payments to global fees that emphasize care coordination and collaboration" (The Commonwealth Fund)
EBSA Semiannual Regulatory Agenda Addresses Mental Health Parity
Excerpt: "The Employee Benefits Security Administration (EBSA) has released its semiannual regulatory agenda, which outlines regulations that have been selected for review or development during the next year, as well as any regulations that have been finalized during the last six months. . . . [Among t]he prerule and proposed rule EBSA agenda items are . . . The review of the plan assets-participant contributions regulation in accordance with section 610 of the Regulatory Flexibility Act; The development of regulatory guidance pursuant to ERISA ?712, as amended by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (P.L. 110-343) . . . ." (Wolters Kluwer)
Wisconsin Insurance Coverage Mandate for Ear-Implants Draws Dissent
Excerpt: "A law signed Thursday will make Wisconsin the second state in the nation to require insurers to cover the costs of cochlear implants for children. But advocates for the deaf are among those criticizing the measure." (Wausau Daily Herald)
Agencies Seek Comments on Mental Health Parity Law (PDF)
2 pages. Excerpt: "Agencies Seek Comments on Mental Health Parity LawThe IRS, Department of Labor (DOL), and Department of Health and Human Services (HHS) have jointly issued a Request for Information concerning the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). Comments are due by May 28, 2009. . . . Regulations on MHPAEA are due by early October 2009." (Buck Consultants)
Pennsylvania Governor Set to Sign Dependent Health Care Coverage Measure
Excerpt: "Pennsylvania Governor Edward Rendell is expected to sign a bill extending health care coverage under a parent's policy for dependent children up to age 30. . . . To qualify, dependents must be unmarried, have no dependents of their own, and be residents of Pennsylvania or full-time students. Dependents also cannot have other health insurance coverage nor be eligible for government-provided health benefits." (PLANSPONSOR.com; free registration required)
Few Firms Will Drop Mental Health Coverage, According to Survey
Excerpt: "Only a few employers are considering dropping mental health coverage in response to new parity rules that take effect for plan years beginning after Oct. 3, according to a survey. Meanwhile, nearly 38% of responding employers plan to increase the promotion and use of employee assistance program services to help them achieve mental health parity, which is required under a 2008 law, concludes the survey conducted by the Partnership for Workplace Mental Health, a program of the American Psychiatric Foundation in Arlington, Va." (Business Insurance)
Text of Paper Prepared for Senate Finance Committee; 63-Page 'Description of Policy Options' (PDF)
63 pages. The paper is entitled 'Expanding Health Care Coverage: Proposals to Provide Affordable Coverage to All Americans." (Staff of U.S. Senate Finance Committee)
[Guidance Overview] Preparing for Parity: Investing in Mental Health Insurance Benefits (PDF)
4 pages. (Milliman)
Golden Gate Restaurant Association Rejects San Francisco's Offer To Drop Lawsuit
Excerpt: "The Golden Gate Restaurant Association has refused to drop its lawsuit against the city of San Francisco involving the city's Healthy San Francisco program, the San Francisco Chronicle reports . . . . In the lawsuit, GGRA claims that the program violates the federal Employee Retirement Income Security Act, which pre-empts certain state and local government requirements regarding employer-sponsored benefits. . . . San Francisco Public Health Chief Mitch Katz last week offered to freeze the employer contribution rates to the program if GGRA would drop the lawsuit. However, GGRA Director Kevin Westlye said that the board rejected the offer in part because Katz could not guarantee how long the freeze would be in effect. Katz said he was open to discussing a permanent freeze . . . ." (Kaiser Family Foundation)
[Official Guidance] Text of Request by Federal Agencies for Information Regarding Mental Health Parity and Addiction Equity Act of 2008 (PDF)
4 pages. Excerpt: "The Departments are requesting comments . . . with respect to the following specific areas: (i) What policies, procedures, or practices of group health plans and health insurance issuers may be impacted by MHPAEA? What direct or indirect costs would result? What direct or indirect benefits would result? Which stakeholders will be impacted by such benefits and costs? (ii) Are there unique costs and benefits for small entities subject to MHPAEA (that is, employers with greater than 50 employees that maintain plans with fewer than 100 participants)? What special consideration, if any, is needed for these employers or plans? What costs and benefits have issuers and small employers experienced in implementing parity under State insurance laws or otherwise? . . . The Departments [also] are seeking comments to aid in the development of regulations regarding MHPAEA." (U.S. Department of Health and Human Services)
[Official Guidance] Text of Request by Federal Agencies for Information Regarding Mental Health Parity and Addiction Equity Act of 2008 (PDF)
Excerpt: "The Departments are requesting comments . . . with respect to the following specific areas: (i) What policies, procedures, or practices of group health plans and health insurance issuers may be impacted by MHPAEA? What direct or indirect costs would result? What direct or indirect benefits would result? Which stakeholders will be impacted by such benefits and costs? (ii) Are there unique costs and benefits for small entities subject to MHPAEA (that is, employers with greater than 50 employees that maintain plans with fewer than 100 participants)? What special consideration, if any, is needed for these employers or plans? What costs and benefits have issuers and small employers experienced in implementing parity under State insurance laws or otherwise?" (U.S. Department of Health and Human Services)
San Francisco Raises Health Care Law Payment
Excerpt: "The city of San Francisco's controversial universal health care initiative is raising its required employer contribution. A Business Insurance story said employers with 100 or more employees will be required to spend $1.96 per hour per covered employee on health care, up from $1.85 in 2009, beginning on January 1, 2010." (PLANSPONSOR.com; free registration required)
[Guidance Overview] Minnesota Posts Employer Opt-Out for Cafeteria Plan Mandate
Excerpt: "Minnesota employers can use a new form to opt out of the state's mandate to offer employees a cafeteria plan option. Starting July 1, most employers with 11 or more full-time equivalent Minnesota employees that don't offer employee health benefits must establish a cafeteria plan. Employers don't have to offer or contribute to health insurance, but they generally must provide a premium-only plan so workers can purchase coverage with pretax contributions. Employers may opt out by certifying that they understand the advantages of Section 125 plans and have chosen not to offer one." (Mercer LLC)
State Health Care Reform Update
Excerpt: "For the last few years, states have been leading the way toward more comprehensive health care coverage to ensure that more people have or can obtain health insurance. Because of the potential impact of this ongoing activity on employer-provided health insurance benefits, Spencer's Benefits Reports provides regular updates about state health care reform." (Wolters Kluwer)
[Guidance Overview] San Francisco's Health Care Security Ordinance Filing Deadline (PDF)
4 pages. Excerpt: "Every covered employer is required to provide information to San Francisco on an annual basis regarding its health care expenditure compliance. April 30, 2009, is the due date for the first Annual Report Form ('ARF'). This information must be reported on the Office of Labor Standards Enforcement's Health Care Security Ordinance mandatory annual reporting form, which will be mailed to all businesses registered to do business in San Francisco. Please note that only one ARF is to be filed for all entities within the same 'group of controlled corporations' (as defined for purposes of income tax filing)." (Jones Day)
[Opinion] The Folly of Health Insurance Mandates
Excerpt: "Many of the nearly 46 million uninsured say they are unable to afford health insurance. Advocates of various state regulations claim their proposals would make health coverage more affordable. These regulations include mandates that employers offer their employees health insurance or that individuals obtain health coverage, and requirements that health plans and insurers cover specified benefits or accept anyone who applies for insurance. However, rather than make coverage more affordable, these regulations drive up the cost of insurance." (National Center for Policy Analysis)
Supreme Court Denies Restaurant Association's Stay Request on Mandatory Employer Health Fee
Excerpt: "The U.S. Supreme Court refused Monday to stop San Francisco from requiring employers to help pay for health coverage of the uninsured, rejecting restaurant owners' bid for an emergency stay while the court weighs a legal challenge to the groundbreaking program. The 800-member Golden Gate Restaurant Association argues that the mandatory employer fee conflicts with nationwide regulation of health benefits and will hurt businesses already battered by the economy." (San Francisco Chronicle)
Supreme Court Refuses to Stay San Francisco Health Spending Law
Excerpt: "U.S. Supreme Court Associate Justice Anthony Kennedy on Monday denied a request from a San Francisco-area restaurant trade association for an emergency order to halt enforcement of San Francisco's health care spending law. The Golden Gate Restaurant Assn. sought the order in the wake of a ruling earlier this month by the 9th U.S. Circuit Court of Appeals not to review a unanimous 2008 decision by a three-judge appeals court panel upholding the legality of San Francisco law. In denying the request, Justice Kennedy did not comment." (Business Insurance)
Opposition to Request for Stay Filed with SCOTUS in Health Benefits Case
Excerpt: "We've blogged about the 9th Circuit case of Golden Gate Restaurant Ass'n v. City an County of San Francisco . . . . Most recently, the 9th Circuit denied a petition for rehearing . . ., and the restaurant association applied for a stay in the Supreme Court, pending resolution of the certiorari process. [On March 27], the defendants filed [a] joint response to that motion . . . . Essentially, the defendants argue that the medium and large employers covered by the program have been complying with the healthcare spending requirements for 15 months, and there is no sign that any business is being harmed by it. The application is before Justice Anthony M. Kennedy as Circuit Justice; it is up to him to decide the stay issue himself or to refer it to his colleagues for action." (Workplace Prof Blog)
San Francisco Health Care Mandate Inches Toward Supreme Court
Excerpt: "The 9th U.S. Circuit Court of Appeals' decision this month not to review a 2008 appeals panel ruling upholding a San Francisco health care spending law brings one step closer a potential U.S. Supreme Court review and perhaps a final resolution on the legality of employer spending mandates. In a case followed by employers nationwide due to its potential impact on the design, cost and administration of corporate health plans, a majority of appeals court members rejected a request for the full appeals court to review a unanimous ruling by a three-judge panel of the court that the law could stand." (Workforce Management; free registration required)
Not All San Francisco Restaurants Back Suit Over Health Care Law
Excerpt: "[S]ome city officials say you either support the city program or you don't - and restaurant owners should be up front with their customers. Supervisor David Campos sent a letter Friday to the restaurant association asking it to drop its suit in light of the contradiction. 'That restaurants make supportive statements about Healthy San Francisco, while simultaneously fighting in court to undermine this very program, raises questions about whether they are dealing with their customers in good faith,' he wrote. Campos also implies in the letter that the varying surcharges raises questions about whether some restaurants are spending all the extra money on health care. Piallat, the owner of Zazie, said her experience of having money left over after charging $1 a customer tells her that restaurants with 4 and 5 percent fees are profiting." (San Francisco Chronicle)
With Pretzel Logic, Restaurant Owners Attack San Francisco Health Care Law
Excerpt: "Talk about twisted logic. A group of San Francisco restaurant owners wants the U.S. Supreme Court to block the city's pioneering health care program because it somehow threatens national health care reform. On top of that, the Golden Gate Restaurant Association cites the recently passed American Recovery and Reinvestment Act to back up its claims." (AFL-CIO)
The Continuing Challenge to the San Francisco Mandatory Health Care Ordinance
Excerpt: "[W]hile the ordinance immediately impacts only employers in the City and County of San Francisco, the effect of letting the decision stand may adversely impact employers nationwide. As the dissent stated, '[i]f upheld, [the decision] will undoubtedly serve as a roadmap in jurisdictions across the country on how to design and enact a labyrinth of laws requiring employer compliance on health care expenditures, thereby creating the very kind of health care expenditure balkanization ERISA was intended to avoid.'" (Nixon Peabody)
[Opinion] The Growing Trend Toward Mandating Autism Coverage (PDF)
2 pages. Excerpt: "While health insurance does and should cover health-related aspects of autism, policymakers who want to ensure that families facing the real financial and other challenges posed by autism should develop safety net programs that meet their needs, rather than trying to impose autism-related costs on health insurance." (The Council for Affordable Health Insurance)
[Guidance Overview] Presentation: Welfare Plan Compliance Checklist, Legislative and Regulatory Update, and HIPAA Title II (PDF)
86 pages. Federal legislative changes for 2009 starts on page 2; A LEGISLATIVE AND REGULATORY UPDATE FOR HEALTH AND WELFARE PLANS starts on page 23; and, HIPAA TITLE II starts on page 56. (Marin Legal PC)
[Guidance Overview] CHIP Requires All Health Plans to be Amended by April 1, 2009 (PDF)
3 pages. Excerpt: "Of significance for employers, the [Children's Health Insurance Program Reauthorization Act of 2009] (1) requires that employer-sponsored group health plans provide special enrollment rights to employees and dependents, (2) establishes a new premium assistance program for individuals enrolled in an employer-sponsored plan, and (3) imposes new notice and disclosure requirements on employers and plan administrators." (Miller & Chevalier Chartered)
[Guidance Overview] Ninth Circuit Declines Additional Review of Ruling That ERISA Does Not Preempt San Francisco's Fair Share Law
Excerpt: "EBIA Comment: Is this case headed for the Supreme Court? We wouldn't be surprised if that's the next step, particularly given the importance this issue holds for employers subject to the San Francisco law and others like it across the country. The dissenting judges, in particular, emphasized the high stakes involved, noting the tension between ERISA's goal of nationally uniform plan administration and the view that the San Francisco law, if left standing, may be viewed as a 'roadmap' for other state and local governments seeking to regulate employee health plans without running afoul of ERISA preemption." (Employee Benefits Institute of America)
[Guidance Overview] Children's Health Insurance Program Reauthorization Act of 2009 (PDF)
5 pages. Excerpt: "The Act creates two new Special Enrollment rights for eligible but unenrolled employees and dependent children who either (1) lose coverage under a Medicaid Plan or State Plan; or (2) become eligible for group health plan premium assistance under a Medicaid Plan or State Plan. Unlike the current 30-day time frame for employees to request enrollment upon an existing HIPAA special enrollment event, the Act gives such employees 60 days to request enrollment in the group health plan. Under the Act, an employee may request enrollment in the group health plan within 60 days of the date coverage terminates under the Medicaid Plan or State Plan, or within 60 days after the employee or dependent is determined to be eligible for state premium assistance." (Alston & Bird LLP)
Healthy San Francisco Wins Another Court Round
Excerpt: "San Francisco's groundbreaking universal health care program withstood a legal challenge from restaurant owners today, setting up the possibility for a showdown before the U.S. Supreme Court. In a split decision, the 9th U.S. Circuit Court of Appeals rejected an appeal from the Golden Gate Restaurant Association, which challenged the program's employer-spending requirement." (Hearst Communications Inc.)
[Guidance Overview] New California Law Requires Continuation of Dependent Health Coverage During Medical Leave from School (PDF)
Excerpt: "Last year, Congress enacted Michelle's Law to require group health plans and insurers to continue dependent health coverage for college students who would otherwise lose eligibility because of a medically necessary leave from school. The federal law takes effect later this year. Last September, Governor Schwarzenegger signed into law California's version of Michelle's Law, which is now in effect for HMOs and other insured coverages purchased in California." (Buck Consultants)
Bill Introduced in House and Senate to Raise Lifetime Health Insurance Cap to $10 Million
Excerpt: "Lawmakers in both the House and Senate introduced a bill that will raise the required lifetime health insurance cap to $10 million. The Health Insurance Coverage Protection Act (H.R. 1085 and S. 442) was introduced by Reps. Anna Eshoo (D-Calif.) and Jim Langevin (D-R.I.) in the House and Sens. Byron Dorgan (D-N.D.) and Olympia Snowe (R-Maine) in the Senate." (AISHealth.com)
[Guidance Overview] San Francisco Health Care Law Survives 9th Circuit, but May Face High Court
Excerpt: "San Francisco's universal health care law officially survived the 9th U.S. Circuit Court of Appeals on Monday, but with eight conservative judges now raising the specter of a circuit split, business interests hope the Supreme Court will step in. The court, led by Judge William Fletcher, denied en banc review to the Golden Gate Restaurant Association, which had challenged San Francisco's ordinance in November 2006 after the county board of supervisors gave it unanimous approval. But Judge Milan Smith Jr. and seven colleagues sharply critiqued the majority's decision, saying it contradicts the 4th Circuit's ruling in a similar case and flouts Congress' 35-year-old Employee Retirement Income Security Act." (The Recorder via The National Law Journal)
[Guidance Overview] CHIP Reauthorization Imposes New Notice and Disclosure Obligations on Employers (PDF)
Excerpt: "BUCK COMMENT. Because CHIPRA makes it easier for states to establish premium assistance subsidies, some employers may see an increase in enrollment by individuals who otherwise may have opted out of the employer plan because of state coverage. In addition, plan administrators may see increased state requests for information to determine whether the plan is cost-effective, which could be particularly burdensome for multistate employers." (Buck Consultants)
[Guidance Overview] CHIP Expansion Affect on Employer Health Plans
Excerpt: "CHIP . . . is a federal-state program designed to increase the number of low-income children who have health coverage. States may still provide that coverage directly. Under the expanded CHIP, however, states now have the option of subsidizing the cost of coverage available to eligible children under employer-sponsored health plans. This premium assistance provision of CHIP takes effect as of April 1st. This premium subsidy may be paid either to the employee or to the sponsoring employer, although an employer may opt out of receiving these payments. In that event, the subsidy would go to the employee, who would be expected to use the subsidy to help pay for the child's health coverage. . . . Employers cannot opt out of the other CHIP requirements." (Spencer Fane Britt & Browne LLP)
House and Senate Lawmakers Introduce Bill To Raise Lifetime Coverage Caps to $10M
Excerpt: "Lawmakers in both the House and Senate have introduced a bill to raise lifetime health insurance caps to $10 million, CQ HealthBeat reports. Reps. Anna Eshoo (D-Calif.) and Jim Langevin (D-R.I.) introduced the legislation in the House, while Sens. Byron Dorgan (D-N.D.) and Olympia Snowe (R-Maine) sponsored the bill in the Senate." (Kaiser Family Foundation)
[Guidance Overview] Recent Legislation Requires Numerous Changes to Group Health Plans
Material covered includes coordination with SCHIP and Medicaid and New Privacy Restrictions in the Stimulus Package. (Troutman Sanders LLP)
Expanding Health Insurance Coverage for Dependents (PDF)
12 pages. Excerpt: "Young adults are one of the fastest growing groups without health insurance. Those between the ages of 19 and 29 make up about one in three people who are uninsured. Young adults need health coverage to shelter them from medical debt and ensure they get essential care. One solution is simple: change state laws to allow young people to remain on their parents' health insurance plans beyond age 18. This is a smart strategy during a fiscal crunch, as there is no cost to the state and typically little extra cost to parents and insurers. This policy is particularly important in a time of an economic downturn, when many people are losing jobs and health insurance." (Community Catalyst, Inc.)
State Laws Mandating or Regulating Mental Health Benefits, Updated February 12, 2009
Excerpt: "There is not a general consensus that state government should require coverage for mental health. 46 states currently have some type of enacted law but these laws vary considerably and can be divided roughly into three categories: mental health 'parity' or equal coverage laws; minimum mandated mental health benefit laws; mandated mental health 'offering laws'." (National Conference of State Legislatures)
Massachusetts' Plan: A Failed Model for Health Care Reform (PDF)
19 pages. Excerpt: "While the number of people lacking health insurance in Massachusetts has been reduced, several recent surveys demonstrate that substantial problems in access to care remain in the state. While the new health insurance improved access to care for some residents, many low-income patients who previously received completely free care under the state's old free care program now face co-payments, premiums and deductibles that stop them from getting needed care. In addition, cuts to safety-net providers have reduced health resources available to the state's remaining uninsured, as well as to others who rely on safety-net providers for services in short supply in the private sector. These safety-net services include emergency room care, chronic mental health care, and primary care. The net effect of this expensive reform on access to care is at best modest, and for some patients, negative." (Physicians for a National Health Program)
State Health Care Reform Update
Excerpt: "For the last few years, states have been leading the way toward more comprehensive health care coverage to ensure that more people have or can obtain health insurance. Because of the potential impact of this ongoing activity on employer-provided health insurance benefits, Spencer's Benefits Reports provides regular updates about state health care reform." (Wolters Kluwer)
Kentucky Lawmakers Consider Retiree Health Care Mandate Delay
Excerpt: "A committee of the Kentucky state house has approved a measure doubling the amount of time local government agencies have to fully fund their retiree health-care costs. A Louisville Courier-Journal news report said state Representative Mike Cherry's bill would increase the time limit from five years to 10 to give cities, counties and school districts time to figure out how to pay for their retiree health costs." (PLANSPONSOR.com; free registration required)
[Opinion] The Role of Individual Mandates in Health Care Reform (PDF)
2 pages. Excerpt: "The Massachusetts experience is being carefully watched, and interest in individual mandates continues to be high. Several national reform proposals include an individual mandate, and a number of states have considered moving in this direction as well. Yet much of the discussion of mandates has occurred without a careful consideration of the evidence supporting arguments for and against them, without discussion of their nuances in practice, and without a review of the available evidence on their effectiveness. In this essay I review all three of these topics." (Jonathan Gruber via National Institute for Health Care Management Foundation)
Cost-Effective Implementation of the Mental Health Parity and Addiction Equity Act
Excerpt: "The Mental Health Parity and Addiction Equity Act of 2008 requires group health plans that offer mental health or substance abuse coverage to provide those benefits on par with medical and surgical benefits. The parity mandate, effective for plan years starting after Oct. 3, 2009, applies to cost-sharing terms and treatment limits. The act also makes permanent a 1996 law's ban on lower annual and lifetime dollar limits for mental health coverage and extends this protection to substance abuse benefits. This Perspective discusses the new law and related benefit design issues for employers." (Mercer LLC)
New Health Care Legislation Would Require Disclosures from Employers
Excerpt: "Both houses of Congress have passed new legislation that would, among other things, require employers to amend their health care coverage rules and disclose health plan information to state officials or face a $100 per day fine. The Children's Health Insurance Program (CHIP) Reauthorization Act of 2009 (H.R. 2) would amend the Employee Retirement Income Security Act (ERISA) to require that employer plans and insurers permit employees and their dependents who are eligible for coverage but not enrolled in a plan to enroll if they become ineligible for coverage under Medicaid or a state child health plan, according news reports. Employers and insurers would also have to permit employees and their dependents who are eligible but not enrolled to enroll if they become eligible for financial assistance from Medicaid or a state child health plan." (PLANSPONSOR.com; free registration required)
[Guidance Overview] 2009 Brings Changes to the San Francisco Health Care Security Ordinance
Excerpt: "The effect of the 2009 changes to the Ordinance will be to increase the cost of a covered employer's compliance with the Ordinance. The decrease in the number of hours an employee must work per week in San Francisco (from 10 hours to 8 hours) to qualify as a covered employee and the increase in the dollar threshold for the managerial, supervisory and confidential employees exemption mean that more employees will qualify as covered employees in 2009. Moreover, for each covered employee, a covered employer must now spend a greater amount on health care expenditures." (Cooley Godward Kronish LLP)
[Guidance Overview] New York State Insurance Department Mandates Equal Treatment For Same-Sex Spouses Under Insured Benefit Plan
Excerpt: "[T]he New York State Insurance Department recently issued a 'Circular Letter' in which it indicated that all insurers licensed to do business in New York must re-write or amend their New York polices to recognize the marriages of same-sex couples legally performed in other jurisdictions, regardless of the gender of the spouses." (Bond, Schoeneck & King, PLLC)
[Guidance Overview] State Health Care Reform Update
Excerpt: "For the last few years, states have been leading the way toward more comprehensive health care coverage to ensure that more people have or can obtain health insurance. Because of the potential impact of this ongoing activity on employer-provided health insurance benefits, Spencer's Benefits Reports provides regular updates about state health care reform." (Wolters Kluwer Law & Business)
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