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80 Matching News Items

1.  Agreements to Individually Arbitrate ERISA Claims After EPIC Systems Corp. v. Lewis (PDF)
Greensfelder Link to more items from this source
Sept. 5, 2018
"The U.S. Supreme Court's blessing of class and collective action waivers in mandatory arbitration agreements related to employment claims brings some long-awaited clarity to this topic and opens the door to waiver of class actions arising under [ERISA].... Before employers rush to implement mandatory arbitration programs, a variety of factors touching on the legal, social, and practical implications of such a decision merit careful consideration." [Epic Systems Corp. v. Lewis, No. 16-285 (U.S. May 21, 2018)]
2.  Oklahoma Employer/Employee Partnership for Insurance Coverage -- O-EPIC
AcademyHealth Link to more items from this source
Dec. 1, 2006
Excerpt: O-EPIC premium assistance has two different strategies for covering low wage workers. The Employer Sponsored Insurance program helps low wage workers at small firms purchase qualified insurance offered by their employer. The Individual Plan will help qualified individuals get health insurance coverage even if they are not able to get coverage through their employer.
3.  2021 Off to an Epic Start for DB Risk Takers
Principal Financial Group Link to more items from this source
Apr. 22, 2021
"A typical 'traditional' allocation of 60 percent equities and 40 percent core bonds ... with a 70 percent funding ratio on January 1 has totally shredded it, riding the rail closer to 80 percent after only three months.... Many economic forecasters are calling for a few more quarters of tasty waves, so it may be tempting to continue the ride. But glide path theory suggests that DB investors tend to become more risk averse as funding ratios improve."
4.  The 'Classic 105' Medical Reimbursement Scheme: An Epic Fail, Promoters Indicted
Lockton Link to more items from this source
July 1, 2019
"The case serves as a reminder to employers to be wary of promoters of schemes promising too-good-to-be-true tax savings. The operators of the Classic 105 scheme had promised employers large tax savings under the guise of a medical reimbursement arrangement. The operators pleaded guilty to money laundering, conspiracy to defraud the IRS and improperly marketing a multiple-employer welfare arrangement (MEWA)."
5.  Audio and Text: Epic Auto Contract Talks Focus on Health Care
National Public Radio [NPR] Link to more items from this source
Sept. 14, 2007
Excerpt: At midnight [tonight], the current contract between the United Auto Workers and Detroit's three car companies ends. Both sides are trying to work out a new deal that would help the struggling firms and protect workers' benefits. Some people who follow the industry say its future is at stake.
6.  Checklist of Key Requirements in 2021 for Health and Welfare Benefit Plan Sponsors (PDF)
EPIC Link to more items from this source
Oct. 1, 2020
"Complying with the many rules that govern health and welfare benefits can be a challenge for benefits administrators. EPIC has prepared this compliance checklist to help administrators manage their 2021 benefits compliance efforts."
7.  ICHRA: Not Your Parents' Employee Benefits
EPIC Link to more items from this source
Feb. 28, 2024
"Thanks to ICHRAs, employee benefits' role in retention has recently taken a giant leap forward by helping employers be more strategic about funding the cost of employee benefits while giving employees more plan choices and flexibility than they've had in a long time.... Who's a good candidate, and what are the advantages?"
8.  Cost Control Options for Employers Facing Rising Health Insurance Premiums
EPIC Link to more items from this source
Oct. 3, 2023
"With large trend rates impacting renewal costs, employers should closely examine alternative funding options -- especially those where maximum costs are capped. Under these programs, the employer is not responsible for paying excessive amounts if these projected costs do not materialize, yet there is downside protection if they do. Captive Insurance programs can also mitigate individual client risk. Another alternative is using Individual Coverage Health Reimbursement Arrangements (ICHRAs)."
9.  What Does Blue Shield of California's New Unbundled Pharmacy Model Mean to Employers?
EPIC Link to more items from this source
Sept. 5, 2023
"Blue Shield of California's recent decision to unbundle its pharmacy benefit program and work with multiple vendors ... wiped out $20 billion in market capitalization of the owners of the three largest pharmacy benefit managers within hours of the announcement.... This new model is a great opportunity [for employers] to request stronger guaranteed discounts, rebates, and even trend guarantees.... [E]mployers should request the right to audit these guarantees to ensure transparency and accountability."
10.  Are Your Employees Asking About Weight-Loss Drug Coverage? They Will Be
EPIC Link to more items from this source
June 29, 2023
"A simple, 'This just isn't covered,' won't quell the grumbling.... [W]ellbeing programs must evolve to have a better focus on behavior modification, nutrition education, and support systems in place to help individuals achieve sustainable weight loss. While GLP-1 drugs do work, employers must consider refining the alternatives to ensure employees have equitable access to other effective weight management tools."
11.  All-Payer Claims Databases: Should Self-Funded Employers Participate?
EPIC Link to more items from this source
May 8, 2023
"APCDs serve as a way for employers, consumers, legislators, and various stakeholders to examine healthcare spending and utilization by analyzing claims data across payers, providers and plan designs. This can lead to greater transparency, improved preventive measures, and cost-saving decision-making for all stakeholders involved."
12.  Navigating the Maze of Employee Leave Programs
EPIC Link to more items from this source
Feb. 21, 2023
"The proliferation of state-based paid family leave programs, each with their own nuances, add enormous complexity for HR professionals who have already been contending with existing disability benefits. Explaining these benefits to employees can create confusion or ill-will if they are misinterpreted, especially for an employee who is unable to work due to illness or injury, whether to themselves or a close family member."
13.  Stay Close to Your Self-Insurance Advisor
EPIC Link to more items from this source
Jan. 19, 2023
"Self-insurance ... entails assuming more risk of adverse claims. And the terms of this type of coverage are about to get even more complicated.... 25% of large employers now report claims of over $1 million.... The emergence of gene therapy drugs is not significant enough to disrupt the market, but the pipeline of these curative medications is extensive."
14.  Get Your Employer-Sponsored Group Health Plan Ready for 2023
EPIC Link to more items from this source
Dec. 1, 2022
"The [IRS] increased plan contribution rates for spending accounts and minimum deductibles high deductible health plans (HDHPs). Two Supreme Court decisions in 2022 may impact employer group health plan designs moving forward. Gender discrimination continues to be an important topic."
15.  Section 4980H Employer Mandate Requirements and Penalties
EPIC Link to more items from this source
Dec. 1, 2022
"Applicable large employer (ALE) status is determined year-by-year on a calendar year basis. All ALEs are subject to Section 4980H offer of coverage requirements and Section 6056 employer reporting requirements on Form 1094-C and Form 1095-Cs. ALEs may count hours of service using one of two measurement methods, the monthly measurement method or the look-back measurement method. ALEs must provide minimum essential coverage to employees that is affordable and offers minimum value to avoid penalties under the [ACA]."
16.  A Look at the Complexities of PBM Satisfaction
EPIC Link to more items from this source
Nov. 8, 2022
"[W]hile plan sponsors -- which include health plans, employers, labor unions, and health systems -- express high satisfaction with the item retail network options that meet the needs of members (4.5/5, 83% somewhat or very satisfied), they are notably less satisfied with their PBM's willingness to integrate with other pharmacy solutions (3.7/5, 52% somewhat or very satisfied)."
17.  Guide to Compliance Considerations for Level-Funded Plans
EPIC Link to more items from this source
Oct. 28, 2022
"One of the most common sources of compliance errors for level-funded plans is that the employer forgets the plan is self-insured.... [1] PCORI fees ... [2] ACA reporting ... [3] ERISA preemption ... [4] COBRA ... [5] Year end refunds as plan assets ... [6] Nondiscrimination testing ... [7] Prescription drug data collection reporting ... [8] Compliance checklist."
18.  Departments Release Guidance on Surprise Billing and Machine-Readable Files
EPIC Link to more items from this source
Oct. 2, 2022
"[FAQs Part 55] clarified employers are not required to post a link to the data files on their organization's website if there is a written agreement in place that ensures that the carrier or administrator will make the relevant files publicly available in compliance with the requirements.... There is currently no specific guidance on what constitutes a valid written agreement between the employer and their carrier or TPA. Employers may be able to meet this requirement in a variety of ways."
19.  Inflation Reduction Act May Impact Employer Health Plans
EPIC Link to more items from this source
Sept. 14, 2022
"While there is no direct impact on employer-sponsored health plans, caps on Medicare Part D out-of-pocket limits and other cost reductions could affect prescription drug coverage creditable status. Employers must provide notice of a health plan's creditable coverage status at different times, and at least annually before October 15."
20.  ERISA Preemption of State PBM Laws
EPIC Link to more items from this source
Sept. 7, 2022
"In what is now nearly a year and a half since the Rutledge decision, more than 40 states have introduced upwards of 100 pieces of legislation intended to regulate PBMs. The laws are all different and aim to regulate the PBM industry in different ways."
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