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Replace Obamacare, Stat!

"With a uniform tax credit, 90 percent of the problems the Obamacare exchanges are now having would go away in a flash. Signing up for insurance would be easy. Insurance companies and brokers would be able to sign people up outside the exchanges without asking privacy-invading questions about their income and assets.... Further, with a tax-credit approach, employers and employees would no longer face perverse incentives to buy wasteful insurance. (Under the current system, the more costly the insurance, the greater the tax benefit.) Instead, they could buy insurance that meets their core needs and increase take-home pay with the savings, with no tax penalty. This would lower the cost of employment and encourage hiring."

2022 Stop-Loss Stats and Health Plan Design Considerations

"71% of all stop-loss claims came from 10 procedures; over the last four years, 37% of claims came from the top three procedures ... Ideas to consider: [1] A cancer navigation program and a focus on specific cancer procedures that can be performed through bundled (fixed) costs. [2] Treatments, like dialysis infusion, done at home versus a medical facility ... [3] Ensuring access to detailed claims data to assess new strategies."

Some Comforting Stats for Retirement Plan Investors

"Data from leading retirement plan recordkeepers shows 401(k) and IRA accounts have seen smaller losses than retail brokerage accounts, thanks in no small part to the efforts of plan sponsors and their advisers. Corporate pensions have also fared better than their public counterparts."

DOL 2018 Enforcement Stats Send Wake-up Call for Complacent Fiduciaries

"The [DOL] recovered $1.6 billion in 2018. There were 1329 civil investigations, 64% of which resulted in a monetary recovery or corrective action. 111 of these went into litigation. There were also 268 criminal investigations.... What are some of the issues that might be uncovered by the [DOL]?"

Individual Mandate Penalty Stats Now Available: 2% of Americans Paid It and 300,000 Shouldn't Have

"300,000 taxpayers overpaid the penalty by a total of $35 million by failing to accurately apply one of the, now, 32 exemptions to the mandate.... [T]he IRS has not yet decided if it will issue a refund for those overpayments or pocket the cash. 10.7 million taxpayers did make use of one of the 32 exemptions.... 2.6 million Americans received an average of $3,000 each to buy a PPACA Exchange plan."

Quality Now Trumps Quantity in Stats on Uninsured

"For years, the Current Population Survey conducted by the U.S. Census Bureau overestimated the number of people without health insurance. Last year, the Census Bureau revised the survey to correct the error, which was likely caused by the way the government asked Americans about their coverage. The fix ... should produce more-accurate estimates. But responses obtained with the new methodology aren't compatible with responses collected using the previous approach, making it harder to examine uninsured rates over the years at a crucial moment -- as Americans try to gauge the success of the Affordable Care Act."

Stats on Retirement Plan Coverage Require Careful Assessment

"One of the most commonly cited data points about retirement is that 'only about half of working Americans are covered by a workplace retirement plan.' ... The data point is relatively simple math: the number of workers who say they participated in a workplace retirement plan divided by the total number of workers. But when you take a closer look at the numbers, it's not really that straightforward -- especially since there are various types of workers, and that makes a huge difference in retirement coverage."

FMLA Stats Will Help Your Company Feel Better -- Unless You're in One of These Five Industries

"[T]he five industries where FMLA leave is most rampant ... Casinos (49% of employees take FMLA leave in a year), Health care (39%), Government (36%), Call centers (33%) and Manufacturing (23%). For comparison purposes, ... only 7% of employees in professional services firms take FMLA leave in a year -- one of the lowest industry percentages the study found."

2007 Stats for IRA Assets and Contributions; Facts and Background on Domestic Partner Benefits (PDF)

Excerpt: IRAs are the largest repository of U.S. retirement wealth .... [and this Issue Brief] updates previous research by EBRI providing information on why employers offer domestic partner health benefits, legal issues involved, recent developments, and current data.

First Issue of Annual OECD Newsletter with International Private Pension Stats: 'Pensions in Focus' (PDF)

12 pages. Excerpt: [T]he availability of an accurate, comprehensive, comparable and up-to-date body of international statistics [on privately funded pensions is] a necessary tool for policy makers, regulators and market participants. The first issue of this new OECD newsletter is an important step in that direction.

The Actuarial Game of Baseball: 'Stat of the Art' (PDF)

Excerpt: When Billy Beane became general manager of the Oakland A's in 1997, he set about turning conventional baseball wisdom on its ear. With the second lowest payroll in the major leagues, he put together a team of undervalued rejects who came close to breaking the American League record for consecutive wins in 2002. He did it not with advance scouting reports or hunches or gut feelings ... He did it the way any actuary would. With numbers.

Employers Drop Obesity Drug Coverage as Cash-Pay Programs Grow

"Doctors and groups representing employers said they're increasingly hearing about companies cutting weight loss drugs out of health plans next year as costs mount.... Some [employers] are starting to wonder whether they're paying more for obesity drugs than the cash prices being offered, which range from $200 to $450 a month depending on the dose ... That's leading companies to think it makes more sense for workers to get the drugs on their own[.]"

Insurers, Courts Grapple with How and When to Pay for Wilderness Therapy

"Many of the parents who sue over wilderness therapy ... argue insurers are violating [the MHPAEA] in their refusals to cover it. The law requires plans to cover behavioral health treatments at the same level as comparable medical and surgical procedures. What makes that legal tactic tricky, though, is it’s hard to find a medical analogue to wilderness therapy[.]"

Experts Pitch Four Big Ideas for Changing Health Care

"What if health tech companies could use the human body to power devices? ... Health care needs to take a cue from 'Moneyball' and invest in data analytics ... How can we overcome medical mistrust? ... The U.S. needs to learn from the U.K.'s anonymized health data programs "

How to Choose Between High-Deductible Health Plans and Traditional Health Plans

"Consider the ages of your employees.... [L]ook at enrollment stats, spending behavior, and other information from previous years ... [C]hoosing what health insurance options to offer could have a major impact on labor costs -- as well as employee satisfaction."

Pharma CEOs Shower GOP Senators with Campaign Cash

"Top pharmaceutical CEOs have targeted a small group of Republican senators with roughly $200,000 in campaign donations in the past year ... The focus on Congress comes as drug executives are holding back on donations to presidential candidates."

A Doctor Tells Pharmacy Benefit Managers: Stop 'Treating' My Cancer Patients

"Pharmacy benefit managers were supposed to help bring down the cost of drugs by negotiating with competing drug companies and by 'encouraging consumers to use the most cost-effective drugs.' But they have done the opposite, fueling higher drug prices through manufacturer rebates and by extorting fees from pharmacy providers."

Amazon Alexa Now HIPAA-Compliant, Allows Secure Access to Data

"Perhaps more significant than the individual uses is Alexa's ability to now traffic in patient information that is protected by [HIPAA] ... The company said its Alexa Skills Kit, a cloud-based service used to build voice tools, can be used by health firms to create products that transmit and receive patient data. The move will embolden hospitals, insurers, and other health care firms to expose Alexa to more sensitive details of patients' lives and medical conditions, and potentially embed the technology deeper into clinical settings."

Supreme Court Deals a Fatal Blow to Maryland Drug 'Price Gouging' Law

"The law, which the Maryland General Assembly passed in 2017, would have prohibited generic drug manufacturers from raising prices in a manner the state deemed 'unconscionable.' It was nullified in April 2018, when an appeals court held it was unconstitutional because it regulated commerce beyond Maryland's borders. The Supreme Court on Tuesday formally declined to hear the appeal from the state's Democratic attorney general[.]"

Automobile Insurer Not Required to Reimburse Group Health Insurance Plan Under Automobile Liability Policy's Medical Expense Coverage

"[To] invoke the 'right to recovery' provisions, the coverage provided by both Security Health and American Family has to be a 'plan' as defined under [Wisconsin statutes]. The court ... ruled that American Family's [automobile liability] coverage was not a 'plan' for two ... reasons: [1] the medical expense coverage in the American Family policies was not 'required by law' because Wis. Stat. Section 632.32(4)(bc) specifically states that a named insured may reject medical expense coverage; and [2] the American Family medical expense coverage was not a 'no-fault' contract because 'no-fault' did not refer to medical expense coverage in an automobile insurance policy issued in Wisconsin." [Security Health Plan of Wisconsin, Inc. v. American Standard Ins. Co. of Wisconsin, No. 2017AP1914 (Wis. App. Ct. Oct. 25, 2018; unpub.)]