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Health plans - design

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Is Enrollment in HSA-Eligible Health Plans Growing or Not? (PDF)
"Recent low health insurance premium increases combined with low unemployment may have caused employers to hold off on plans to move to HSA-eligible health plans.... Recent research has found that HSA-eligible health plans may be associated with a reduction in appropriate preventive care and medication adherence.... Growth in HSA-eligible health plans may be held back because what constitutes an HSA-eligible health plan does not provide employers their desired level of flexibility around the design of the health plan." (Employee Benefit Research Institute [EBRI])
Administration Proposes to Loosen Restrictions on Short-Term Health Plans
"The new rule is expected to entice younger and healthier people from the general insurance pool by allowing a range of lower-cost options that don't include all the benefits required by the federal law -- including plans that can reject people with preexisting medical conditions. In addition, according to the proposed rule, the plans would not be required to sell to everyone, so people with medical problems may not be able to get this coverage." (Kaiser Health News)
Review of Efforts by Several States to Close the Health Coverage Gap
"This review examines prominent state efforts to expand health coverage to the remaining uninsured. It analyzes and compares efforts in Massachusetts, Vermont, Colorado, California, and Nevada and highlights insights and themes that emerge. It explores the context and climate for reform within the state, stakeholder involvement, political coalitions, financing, and possible opposition. As such, it serves as a case study in how different states build, or fail to build, the popular and political will towards health care coverage for all residents." (The Leonard Davis Institute of Health Economics (LDI) at the University of Pennsylvania)
[Guidance Overview] Proposed Regs on Short-Term Health Insurance Provide Relief to Americans Facing High Premiums, Fewer Choices
"The rule proposes to expand the availability of short-term, limited-duration health insurance by allowing consumers to buy plans providing coverage for any period of less than 12 months, rather than the current maximum period of less than three months. The proposed rule, if finalized, will provide additional options to Americans who cannot afford to pay the costs of soaring healthcare premiums or do not have access to healthcare choices that meet their needs under current law." (U.S. Department of Health and Human Services [HHS])
[Official Guidance] Text of Agency Proposed Regs: Short-Term, Limited-Duration Insurance
40 pages. "This rule contains proposals amending the definition of short-term, limited-duration insurance for purposes of its exclusion from the definition of individual health insurance coverage. This action is being taken to lengthen the maximum period of short-term, limited-duration insurance, which will provide more affordable consumer choice for health coverage." (Internal Revenue Service [IRS]; Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]; and U.S. Department of Health and Human Services [HHS])
Section 1557 Rule on the Horizon; Focus on Employer Mandate
"HHS continues to make progress, however slowly, in revisiting the Section 1557 rule.... Because Section 1557 includes a private right of action, covered entities -- such as hospitals, clinics, or state Medicaid programs -- that fail to comply with the regulations could be sued by someone that has faced discrimination and makes a claim under Section 1557.... [S]ome members of Congress are considering an additional push to repeal or delay the employer mandate ... In the meantime, the IRS continues to implement the employer mandate and recently submitted an information collection request to [OMB] regarding reporting requirements under the employer mandate." (Health Affairs)
HHS Provides a Glimpse of Mental Health Parity Enforcement
"[HHS] released its report of enforcement actions under the Mental Health Parity and Addiction Equity Act ... primarily [for] governmental plans and, in certain states, health insurance issuers.... The key takeaways are: ... [1] If you get wind of a requirement that seems to be imposed more restrictively on mental health/substance use disorder benefits, raise it with your insurer or third party administrator. [2] Make sure your plan documents reflect reality. If you are imposing rules on participants, the plan documents should reflect that." (HUB International)
HHS Sidesteps Idaho Dispute on Health Insurance
"Health and Human Services Secretary Alex Azar told the Senate Finance Committee he doesn't yet know if Idaho's insurance regulator will approve a plan by Blue Cross of Idaho to sell insurance that doesn't follow ACA requirements. Democrats have been pressing the agency to block the move as a violation of existing law." (The Wall Street Journal; subscription may be required)
Anthem Alters Controversial Emergency Room Coverage Policies
"Anthem's program was meant to deter members from using the emergency room for illnesses or injuries that aren't life-threatening. But critics say patients shouldn't be forced to self-diagnose, warning that the new policies will encourage people to avoid seeking care for serious medical conditions out of fear that their claim will be denied." (FierceHealthcare)
Prescription Drug Coupons: A One-Size-Fits-All Policy Approach Doesn't Fit the Evidence
"Drug manufacturer coupons used by consumers to reduce the size of their prescription copayments are increasingly under fire by federal and state policy makers, as well as by insurers and pharmacy benefit managers (PBMs). Medicare and Medicaid consider them kickbacks and completely ban their use. Massachusetts has considered a similar move, and California recently outlawed coupons for branded drugs where a generic equivalent exists. New Jersey is considering similar legislation to California's." (Health Affairs)
Middle Market Companies Want More from Insurers
"Employee benefits represents enormous opportunity for forward-thinking insurers who want to partner on deals with benefits providers. Selected by 48 percent of respondents, it ranked No. 1 among a lengthy list of support services companies are interested in receiving from insurers." (
[Opinion] A Transformative Year for Health Care
"The time has come to think beyond using a carrier-administered narrow network or having a health system and its TPA partner market directly to the employers using the system's Accountable Care Organizations (ACO) platform. Rather than replicate old models with broad-based PPOs (and their primary focus on discounts), or imposing higher, HDHP-style employee cost sharing (believing the covered members will magically become better health care consumers) a new approach is necessary for these AHPs (or any employer-sponsored health plan for that matter) to succeed and be self-sustaining." (Findley Davies | BPS&M)
[Opinion] A Few Suggestions to Simplify Healthcare
"The front door to healthcare delivery should be an easy-to-use smartphone application which is pre-populated with a healthcare calendar, set up with you and your doctor, to remind you of milestones including appropriate checkups for medical, dental and vision care.... Selecting your provider has to be easier.... [D]rug costs are too confusing.... Doctors' offices should be paperless." (Frenkel Benefits)
The Bipartisan Budget Act Boosts Medicare: Flexibility and Financing for Healthcare Plans and Providers
"[Changes made by the Act] include: [1] the addition of non-medical services ... and telehealth services to the range of MA-covered services that an MA plan can offer to its members; ... [2] disbanding the Independent Payment Advisory Board (IPAB), a board comprised of presidential appointees whose sole authority and responsibility was to cut Medicare costs and expenses; and [3] an increase in the discounts that pharmaceutical companies must give seniors enrolled in Medicare Part D drug plans by making the so-called 'doughnut hole' disappear in 2019." (Sheppard Mullin)
Amazon 'Pouring Gasoline on the Fire': Health Plans Must Respond
"Health plans may be facing the same upheaval that Amazon brought to retailers.... Customer service will become a top priority ... as consumers gravitate toward ... whatever turns out to be the healthcare equivalent of free two-day delivery for your books and other purchases.... That could include everything from leveraging Amazon's Echo technology into the electronic medical record to using the company's delivery expertise to improve the supply chain and its purchasing power to lower the cost of drugs[.]" (HealthLeaders Media)
Idaho Blue Cross Jumps Into Controversial Market for Plans That Bypass ACA Rules
"Blue Cross of Idaho unveiled a menu of new health plans that break with federal health law rules in several ways, including setting premiums based on applicants' health.... The firm filed five plans to the state for approval and hopes to start selling them as soon as next month." (Kaiser Health News)
DOL Issues Proposed Regs to Expand Association Health Plans
"[T]he proposed rule would broaden the definition of 'employer' under ERISA and related regulations by: [1] Relaxing the requirement that associations sponsoring AHPs must exist for a reason other than offering health insurance; [2] Relaxing the requirement that association members share a common interest ... [3] Allowing associations whose members are in the same industry but in different areas to sponsor AHPs; [4] Clarifying that 'working owners' (the self-employed) and their dependents may participate in AHPs.... Comments on the proposed regulations are due by March 6, 2018." (Willis Towers Watson)
District Court Finds Dialysis Is Not 'Essential Health Benefit' Under ACA
"[T]he court ruled that it could not conclude that dialysis was an essential health benefit in 2013 under the category of chronic disease management because [HHS] had not yet said that it was.... When it prohibited plans from excluding coverage for certain categories of services such as 'chronic disease management,' Congress did not mandate that plans cover any specific benefit within those categories, and Congress left it to [HHS] to identify what products or services were covered within each of the categories it set forth." [Fresenius Medical Care Midwest Dialysis LLC v. Humana Ins. Co., No. 16-711 (E.D. Wisc. Feb. 5, 2018)] (Wolters Kluwer)
Employees Are More Likely to Stay If They Like Their Health Plan
"56 percent of U.S. adults with employer-sponsored health benefits said that whether or not they like their health coverage is a key factor in deciding to stay at their current job. 46 percent said health insurance was either the deciding factor or a positive influence in choosing their current job." (Society for Human Resource Management [SHRM])
Are Limited Networks What We Hope and Think They Are?
"Across health plans, CPR found no consistent formula for selecting providers by type, below a certain price point, or above a specific level of quality.... [H]ealth plans primarily consider which hospital or provider group will agree to a certain price ... whether excluding others is feasible given each provider's market power or 'must have' status, and whether exclusions create access issues.... Health plans may consider quality while developing a limited network, but it is secondary to other criteria." (Health Affairs)
California Regulators to Investigate Aetna's Medical Coverage Decisions
"The Department of Managed Health Care, which regulates the vast majority of health plans in California, said Monday it will investigate Hartford, Ct.-based Aetna after CNN first reported Sunday that one of the company's medical directors had testified in a deposition related to the lawsuit that he did not examine patients' records before deciding whether to deny or approve care. Rather, he relied on information provided by nurses who reviewed the records -- and that was how he was trained by the company, he said." (Kaiser Health News)
Status of ADA and GINA Wellness Regs
"It is not clear yet whether the EEOC will revise the current regulations, issue new regulations, or let the regulations be vacated without taking further action. Without regulations, employers will face uncertainty about whether a wellness program that asks for medical information (e.g., biometric screenings and health risk assessments) and/or that inquire about a spouse's medical conditions (e.g., spousal health risk assessments) would be considered voluntary." (Conduent)
[Opinion] Association Health Plans: Self-Funded vs. Fully Insured
"[The DOL] invites comments on whether the standards that govern fully-insured AHPs should be extended to self-funded AHPs. Such an extension would be a step into unchartered regulatory territory ... If groups and associations have the option to self-fund, it is a safe bet that they will flock to self-funded arrangements. The savings are too big to pass up. There are consequences, however, which cut both ways: [1] Who is the primary regulator? ... [2] State mandated benefits ... [3] State insurance protections ... [4] Options for State policy-makers and regulators." (Mintz Levin)
[Opinion] American Academy of Actuaries Comment Letter to EBSA: Modeling the Potential Impact of Association Health Plans (PDF)
"[The Committee's] comments offer considerations that should be made when analyzing the potential impacts of these more broadly defined AHPs on individuals, employer groups, and the individual and small group health insurance markets. Different stakeholders will be affected differently, depending on allowable rating factors, plan design flexibility, and strategic considerations." (Individual and Small Group Markets Committee of the American Academy of Actuaries)
Understanding Short-Term Limited Duration Health Insurance
"[S]hort-term policies are generally considered to be 'major medical' coverage; however short-term policies are distinguished from other comprehensive major medical policies because they only provide coverage for a limited term, typically less than 365 days.... Late last year, Congress repealed the individual mandate penalty under the [ACA] ... It is possible this change could lead more consumers to consider purchasing short-term policies." (Henry J. Kaiser Family Foundation)
New Bill Would Mean More Flexibility for High-Deductible Health Plans
"[T]he Chronic Disease Management Act of 2018 [H.R. 4978], would amend the IRS tax code so that high-deductible health plans paired with health savings accounts could cover chronic disease prevention and treatment on a pre-deductible basis.... The existing IRS regulations ... permit a 'safe harbor' that allows for the coverage of preventive services prior to satisfaction of the plan deductible. But that exception doesn't include clinical services meant to treat an existing illness or condition, which narrows plan options and can stifle consumers' ability to benefit from the financial advantages of a tax-free health savings account." (FierceHealthcare)
New Budget Bill Eliminates ACA's Independent Payment Advisory Board
"The bill does not include broader ACA market stabilization measures -- such as payments for cost-sharing reductions or reinsurance funds -- that have received bipartisan support.... [This article] focuses on the repeal of the [Independent Payment Advisory Board (IPAB)], cuts to the Prevention and Public Health Fund, and the delay of Medicaid cuts to disproportionate share hospitals." (Katie Keith, in Health Affairs)
Are You Smarter Than Your Smart Phone?
"Employers can play a role in promoting smart use of smart devices to help enhance their employees' health: [1] Analyze data to identify the top health challenges in the workforce ... [2] Conduct an inventory of existing partners' available applications and available alternatives, with a 'mobile first' priority. [3] Validate effectiveness and identify mobile solutions that will overcome classic barriers to healthy behaviors change ... [4] Provide periodic communication to promote opportunities ... using technology and partner/provider support for confidentiality." (Conduent)
Budget Brings Pension and Health Care Relief (PDF)
"The bill includes some helpful relief for plan sponsors and participants of qualified plans: [1] Expanded hardship relief.... [2] California wildfire relief.... [3] Relief for improper federal tax levy.... [4] Joint Select Committee on multiemployer plans.... [The bill] makes no changes to the [ACA] tax provisions nor does it include provisions related to market stabilization. It does, however, make keys changes to Medicare and provide funding for a number of popular domestic health programs." (Groom Law Group)
Idaho Wants to Sell Non-PPACA Compliant Plans
"Idaho is going to allow plans to potentially deny coverage to individuals based on pre-existing conditions or charge more for higher risk patients. This could make these non-compliant plans much more attractive to young, healthy individuals but it could also create an environment that exacerbates adverse selection and sets up a premium death spiral." (Hill, Chesson & Woody)
The New Mission of Amazon/JPMorgan/Berkshire
"Nobody knows what this new alliance might bring. The best way to suss out Buffet, Bezos, and Dimon's intentions might be to take a look at what their companies could contribute to the cause. It's clear enough what JP Morgan and Berkshire bring to the table. Aside from a certain old-guard capitalist respectability, both companies have healthy revenues, and expertise in finance and insurance. What really gets us wondering is -- how will Amazon lend its weight?" (mpirica)
[Opinion] Idaho's Proposal for State-Based Plans Violates the ACA
"On January 5, Idaho Governor Butch Otter issued an executive order directing the Idaho Department of Insurance to authorize the issuance of 'state-based health benefit plans' that comply with state insurance requirements that existed before the ACA -- but not with the ACA itself.... The PHSA provides that states may, but are not required to, enforce its requirements.... If a state fails to enforce the ACA, however, [HHS] is required to do so. Insurers that fail to comply with the law face penalties of up to $100 per day per member." (Timothy Jost, via The Commonwealth Fund)
High-Deductible Plans More Common, But So Are Choices
"For 2018, 70 percent of large employers offered at least one HDHP -- either in addition to a traditional health plan (65 percent) or exclusively as a full replacement for traditional health coverage (5 percent).... When employees at large organizations were given options, 35 percent selected an HDHP while 48 percent chose a PPO for 2018.... In 2018, the average HDHP enrollee is paying a 42 percent lower monthly premium than PPO enrollees for single-coverage plans and a 40 percent lower premium than PPO enrollees for family-coverage plans." (Society for Human Resource Management [SHRM])
National ACA Marketplace Signups Dipped a Modest 3.7 Percent This Year
"As a group, the 15 states plus the District of Columbia with state-based marketplaces, including those using the enrollment platform, exceeded last year's totals this year by 0.2 percent, while the 34 states that relied on the federal marketplace saw total signups drop by about 5.3 percent.... Rhode Island (12.1%), Kentucky (10.4%), and Washington State (7.6%) saw the largest share increases in signups, while Louisiana (-23.5%), West Virginia (-19.5%), and Arizona (-15.6%) had the largest drop in shares of signups." (Henry J. Kaiser Family Foundation)
Court Ruling Creates New Uncertainties for Wellness Programs
"The EEOC has told the [United States District Court for the District of Columbia] it intends to issue new proposed rules by August 2018. The new proposed rules may provide guidance on which employers could rely in designing their 2019 wellness programs. However, the new proposed rules most likely will not be finalized until sometime in mid-to-late 2019, and their effective date will likely be a year or two after that time." (Ice Miller LLP)
Employer Enthusiasm for HDHPs Appears to be Weaker Than Once Predicted
According to [one] report, only 5 percent of large employers (those with at least 1,000 employees) currently offer HDHPs as the sole health plan option. That rate was roughly the same each of the previous two years, as well. [A second survey now] reports that less than 30 percent of employers are considering full replacement -- a significant decline in the interest expressed in 2014. Meanwhile, HDHPs have still become more common among employers, but only as an option alongside more traditional health plans like PPOs and HMOs." (Benefitfocus)
Four Steps to Creating a Better Mental Health Benefit Plan
"[1] Depression alone has an estimated economic cost of over $200 billion.... [2] You can reduce the stigma surrounding mental health issues by promoting good mental health as a natural extension of overall health.... [3] Improve affordable, quality, integrated support ... [4] Move toward a culture of well-being." (The Alliance)
Wellness Programs on Trial
"[W]orkers who joined the wellness program became likelier not only to seek screening for health issues but also to say they thought their employer placed a high priority on employees' health.... Even when employees did not use the EAP, they were less likely to take sick days, and returned to work more quickly if they were out than workers whose employers did not offer an EAP." (Human Resource Executive Online)
Measuring the Importance of Employer-Provided Health Coverage (PDF)
42 presentation slides. "[1] Most [employees] (63%) are satisfied with the health insurance system ...And even more (71%) are satisfied with their plans.... [2] The benefits that matter most: prescription drugs, preventive care, and emergency care.... [3] Employer-provided coverage is important for recruiting, but even more important for retention. [4] Consumers underestimate employer contributions ... [5] The top value-added services employers can provide: wellness discounts and health or flexible savings accounts." (America's Health Insurance Plans [AHIP])
Improving Workplace Wellness
"In an ideal scenario, corporate wellness programs will always lower health costs, enhance productivity, boost employee engagement and reduce employee absenteeism and turnover.... A significant barrier is the ability to motivate behavior change, which influences everything from employees' daily health habits to their adoption of a wellness initiative. Fortunately, the field of behavioral economics offers new insights that can help address this challenge." (Human Resource Executive Online)
[Opinion] Is the Amazon, JPMorgan, Berkshire Hathaway Venture Armageddon for Healthcare as We Know It?
"The new venture will focus on the collective buying power as employers of healthcare for the 1.15 million employees in their organizations. Their approach features five strategies widely used by large self-insured employers to contain their employee health costs. This one is expected to leverage technology in a unique way[.]" (Paul Keckley)
Management Carve-Outs in Group Health Plans
"Employers value flexibility in designing their group health benefits so as best to attract and retain qualified personnel. One issue that remains perpetually murky ... is the legality of management carve-outs, whereby an employer offers certain group health insurance options or classes of coverage only to management or other highly paid groups. [This article] discusses some of the rules that come into play." (E is for ERISA)
Does a New Study Underestimate Wellness Programs?
"The key take-aways from the first year of the Illinois Workplace Wellness Study: The program failed to reduce health care claims or lower plan premium costs, at least in the short term.... Advocates of wellness programs in general ... said that the first-year results didn't reflect the potential benefits employers can derive from encouraging healthy habits among workers." (Society for Human Resource Management [SHRM])
[Guidance Overview] Summary of Qualified Small Employer Health Reimbursement Arrangements (QSEHRAS)
"The QSEHRA provides a permitted benefit to eligible employees -- the maximum amount of the payment or reimbursement available to each employee. The permitted benefit cannot exceed statutory dollar limits that are indexed for inflation for years after 2016.... Unused permitted benefits from one year can be carried-over to the next year ... [If] the carryover amount from a prior year plus the current year's permitted benefit exceeds the current year's statutory limit, some portion of the carryover is forfeited." (Ice Miller LLP)
Workers Rank Health Care as the Most Critical Issue in the United States (PDF)
"31 percent of workers rank health care as the most critical issue in the United States.... 60 percent of workers report that health insurance is extremely important when considering whether to stay in or choose a new job, whereas only 42 percent report that a retirement savings plan is extremely important.... One-half of workers with health insurance coverage are extremely or very satisfied with their current health plan.... [J]ust 22 percent are extremely or very satisfied with the cost of their health insurance plan, and only 18 percent are satisfied with the costs of health care services not covered by insurance." (Employee Benefit Research Institute [EBRI])
Preventive Dental Benefits Save Employers Money, Studies Find
"[R]egular trips to the dentist can aid in early detection of potentially serious medical conditions.... [G]um disease has been linked to cardiovascular risks and preterm low-birth-weight babies, tooth decay with osteoporosis and oral infections with diabetes." (Society for Human Resource Management [SHRM])
Why Employers Should Offer Health Insurance and Other Employee Benefits
"Nearly a quarter (23%) of full-time employees do not receive any benefits from their employers. Over half (55%) of employees say that health insurance is the most important benefit in terms of their job satisfaction. Childcare benefits are rare, with only 21% of full-time workers receiving paid parental leave. Just 8% receive some kind of childcare stipend." (Clutch)
Employer Health Insurance: Often-Hated, Sometimes Pioneering, and Now on Amazon's Radar
"Employer health insurance tends to be more expensive than public insurance, and its growth has traditionally followed the trajectory of other parts of the health industry. Some employers simply select from standard offerings, essentially outsourcing any innovation potential to notoriously risk-averse insurance companies. But there is also a robust history of employer experimentation.... Amazon and friends would be building on this tradition." (The New York Times; subscription may be required)
ACA Cadillac Tax Delayed by Two More Years
"The Cadillac Tax was originally intended to go into effect in 2018, but President Obama delayed the effective date until 2020. The Act now delays the Cadillac Tax until 2022. The Act also affects implementation of two other ACA taxes: the medical device tax has been delayed until 2020; and while the Health Insurance Tax will be collected this year, it will be suspended during 2019 and then come back in 2020." (Morgan Lewis)
Why Investing in an HSA Is Not the Same as a 401(k) (PDF)
14 pages. "The HSA market has grown rapidly since its inception in 2004, garnering comparisons to the early 401(k) market which has exceeded $5 trillion in assets ... While the two accounts are often compared at a high level, [this whitepaper takes] an in-depth look at the benefits and limitations of each account highlighting three reasons investing in an HSA is more nuanced than its 401(k) counterpart." (Devenir)
The CHIP Extension: Potential Impacts for Employers
"Increased costs and reduced eligibility in CHIP will force families utilizing this coverage to re-evaluate their options as the program adjusts to these changes.... Employers could see an increase in the number of children covered on their plans as impacted families look for alternative coverage options." (Hill, Chesson & Woody)
[Opinion] How Amazon, JPMorgan and Berkshire Hathaway Might Repackage Health Care
"Though details regarding the undertaking are thin, the companies said in a release that their partnership's intent is to improve employee satisfaction and hold down costs by bringing 'their scale and complementary expertise to this long-term effort.' ... KHN asked a variety of health policy experts their thoughts on this venture, and what advice they would offer these CEOs as they go forward." (Kaiser Health News)
[Opinion] Proposed Federal Changes to Short-Term Health Coverage Leave Regulation to States
"An upcoming proposed rule will likely rescind the minimal restrictions on short-term plans ... which were put in place to prevent insurers from siphoning healthy enrollees away from the individual marketplace. If these changes are finalized, regulation of short-term policies will be left almost entirely to states. But many states currently have few, or no, standards for short-term plans." (The Commonwealth Fund)
Amazon Wades In: A 'Disruption' in Healthcare?
"Given its outsize influence on Americans' daily lives, [Brian Marcotte, CEO of the National Business Group on Health] said it will be intriguing to watch how Amazon can overcome the 'fragmented and complex' nature of the current healthcare-delivery system. And while the independent healthcare company proposed in the partnership will only cover employees of the three participating companies, Marcotte said it would not be a surprise if the end result -- if successful -- is someday made widely available all consumers." (Human Resource Executive Online)
Self-Funding of Ancillary Benefits Helps Control Plan Cost
"The most commonly self-funded ancillary benefits are dental and short-term disability, followed by vision. These employee benefits are relatively low risk.... Short-term disability is a popular benefit for employees needing maternity leave. However, if you plan accordingly, these claims won't drastically affect the benefit spend." (Corporate Synergies)
Trends to Watch in Employer Health Benefits for 2018
"Appealing to multiple generations in the workplace ... Savings from utilization slows, pressure to hold down prices grows ... Recognizing patients as consumers and customers." (healthstat)
[Opinion] Text of Comment Letters to DOL on Proposed Regs Defining 'Employer' Under Section 3(5) of ERISA: Association Health Plans
The 79 letters posted to the DOL website as of Jan. 31, 2018 were submitted to DOL in response to its request for comments on proposed regs for association health plans. Deadline for comments is March 6, 2018. (Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL])
[Opinion] Medicare Advantage Versus ACA Marketplaces: Which Is Better?
"Based on MA's success relative to the ACA marketplaces in terms of marketplace strength and long-term stability, there are five policies that could be useful for the ACA marketplaces: [1] Raise enrollment in marketplace plans by increasing premium and cost-sharing subsidies and eliminating short-term plans; [2] Cap provider payment rates at Medicare rates or a fixed percentage above them; [3] Standardize cost-sharing within metal tiers, or limit the number of plan designs available; [4] Lift the budget neutrality requirement for risk adjustment in the marketplaces; and [5] Use a higher benchmark than the second-lowest-cost silver plan for calculating premium tax credits." (Robert Wood Johnson Foundation)
Oscar Health's Telemedicine Consultations Up 32% in 2017 as More Members Access Virtual Touchpoints
"Oscar Health saw a 32% increase in telemedicine consultations among its members last year amid an overall increase in virtual services. Telemedicine consults are less utilized than the other digital services offered by the company: 25% of members used the service in 2017, up from 17% in 2016. But those figures outpace other telemedicine leaders." (FierceHealthcare)
Amazon, Berkshire and JPMorgan Chase to Partner on Health Care
"Amazon, Berkshire Hathaway and JPMorgan announce a partnership to cut health costs and improve services for employees. The idea is to create a company that would be "free from profit-making incentives." News of the deal slammed suppliers in the industry including Express Scripts, Cigna, CVS, United Health and Aetna." (CNBC)

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