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<< Older News  |  September 25, 2020

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All News > Health Plan Design

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Employers' Sense of Responsibility for Employees' Financial Wellness Increased Significantly Over the Last Decade (PDF)
Bank of America Link to more items from this source
Sept. 24, 2020

28 pages. "62% of employers feel extreme responsibility for their employees' financial wellness, up from 13% in 2013. 83% of employers believe financial wellness tools lead to greater productivity.... 67% of eligible employees contribute to their Health Savings Account (HSA). 47% of employers are promoting workplace wellness with established diversity and inclusion programs."

Tags: Health Plan Design  •  Retirement Plan Design

Employee Benefits in the United States, March 2020
U.S. Bureau of Labor Statistics [BLS] Link to more items from this source
Sept. 24, 2020

"Private industry workers: ... Medical care was available to 27 percent of workers in the lowest 10th percent wage category and 94 percent of workers in the highest 10th percent wage category had access to this benefit. Sixty-seven percent of workers in an establishment with less than 100 employees had access to paid sick leave and 88 percent of workers at establishments with 500 or more employees had access to paid sick leave.... State and local government workers: Seventy-six percent of workers participated in defined benefit plans.... Eighteen percent of workers participated in defined contribution plans and employee contributions were required for 69 percent of these workers.... Medical care and retirement benefits were not available to 1 percent of primary, secondary, and special education school teachers and 99 percent of these workers had access to both benefits."

Tags: Health Plan Design  •  Retirement Plan Design  •  State and Local Government Plans

DOL Publishes Proposed 'Independent Contractor' Rule
Ballard Spahr LLP Link to more items from this source
[Guidance Overview]
Sept. 24, 2020

"The rule would give businesses additional clarity in using economic reality factors when determining whether a worker is an employee or independent contractor. Many state laws follow different standards, and the tests used by other federal agencies, such as the [IRS], and under other federal laws are different as well. So businesses should be aware of the law in the jurisdictions where they operate and be sure to analyze these issues under all applicable laws."

Tags: Health Plan Design  •  Retirement Plan Design

Editor's Pick Workplace Weight Management in the New Normal
Northeast Business Group on Health Link to more items from this source
Sept. 24, 2020

36 pages. "Employers can play a key role in guiding employees to prevent, manage and treat weight issues, whether onsite at an organization or in a work-from-home environment.... [This] guide is designed to provide you with a better understanding of the causes and consequences of unhealthy weights, guidance on choosing and implementing a range of interventions, and insight into innovative solutions employers are using today."

Tags: Health Plan Design

DOL's Proposed Rule Provides Framework for Employers to Classify Workers as Independent Contractors
Duane Morris LLP Link to more items from this source
[Guidance Overview]
Sept. 24, 2020

"The DOL's newly proposed regulations are intended to provide clarity to employers by adopting a simplified model framework for determining independent contractor status under the 'economic realities' test. The economic realities test, which often has been used by courts deciding worker classification issues, generally considers whether a person performing services for a potential employer as an independent contractor truly operates his or her own independent business that is not economically dependent on the employer."

Tags: Health Plan Administration  •  Health Plan Design  •  Retirement Plan Administration  •  Retirement Plan Design

Annual Dilated Eye Exams Should Be Integral -- Not Supplemental -- to Employee Medical Plans (PDF)
American Optometric Association Link to more items from this source
[Opinion]
Sept. 24, 2020

"A benefit plan that includes regular dilated eye exams as a preventive service -- with no co-pay or deductible charge -- lowers barriers to detecting a host of serious conditions early enough to prevent or diminish their impact. This includes conditions that threaten the eyes directly, such as glaucoma, diabetic retinopathy, and macular degeneration, as well as those with broader impact on overall health, such as diabetes, high blood pressure, autoimmune diseases, and various cancers."

Tags: Health Plan Design

Telehealth Should Be Expanded -- If It Can Address Today's Health Care Challenges
Shantanu Agrawal and Tejal Gandhi, via Health Affairs Blog Link to more items from this source
[Opinion]
Sept. 23, 2020

"Uptake of telehealth is likely to persist to some degree. The main question is how to integrate this modality into the health care system such that it achieves promised goals and improvements. [The authors] argue that policies supporting continued adoption and integration must be deliberate and focus on measurable improvements to clear, systemic shortcomings in health care."

Tags: Health Plan Design

Editor's Pick Potential Impact of California v. Texas Decision on Key Provisions of the ACA
Henry J. Kaiser Family Foundation Link to more items from this source
Sept. 23, 2020

"[A] table summarizes the major provisions of the ACA, illustrating the breadth of its changes to the health care system, and public attitudes towards those changes. If all or most of the ACA is struck down, many of these provisions could be eliminated. Due to differences in populations and policies across states, the potential repeal of the ACA would play out differently from state to state."

Tags: Health Plan Design  •  Health Plan Policy

Almost Paradise: Health Coverage in Hawaii
HUB International Link to more items from this source
[Guidance Overview]
Sept. 23, 2020

"Hawaii requires that plans covering individuals in the state be approved for issue in the state.... [E]mployees in Hawaii may need to be subject to different eligibility terms than employees in the continental US.... [The Hawaii Prepaid Health Care Act (PHC)] requires that employee-only coverage cannot cost the employee more than 1.5% of the employee's monthly wages.... [T]he PHC also requires employers to contribute at least 50% towards the cost of coverage."

Tags: Health Plan Design  •  Local Regulation

Overpaying and Undersaving: Correlated Mistakes in Retirement Saving and Health Insurance Choices (PDF)
TIAA Institute Link to more items from this source
Sept. 22, 2020

10 pages. "A large majority picks one of two more expensive plans, even when, for all possible spending realizations, lower costs are more likely in the cheapest plan. Employees who do not choose the low-cost plan overpay for health insurance by nearly $1,700 in expectation.... About one-third of employees forgo matching contributions, and a large majority saves below reasonable benchmarks.... People who spend too much on health insurance are 23% more likely to forgo matching contributions than are people who choose the low-cost plan."

Tags: Health Plan Design  •  Retirement Plan Design

Aflac Survey: Pandemic Has 49% of Employees Rethinking Benefits
InsuranceNewsNet.com Link to more items from this source
Sept. 22, 2020

"[N]early half (49%) of employees said the pandemic has been a wake-up call to invest more time researching and selecting the best coverage options for their situation. This represents a significant shift in employee behavior considering a vast majority of employees (92%) choose the same benefits year after year and on average spend 33 minutes on the task -- statistics that haven't changed meaningfully over the years of the survey."

Tags: Coronavirus (COVID-19)  •  Health Plan Administration  •  Health Plan Design

Editor's Pick Tracking Telehealth Changes State-by-State in Response to COVID-19
Manatt, Phelps & Phillips, LLP Link to more items from this source
Sept. 21, 2020

Updated Sep. 18, 2020. "As states and federal agencies continue to combat the COVID-19 pandemic, they are also beginning to develop and implement permanent telehealth policy changes in order to continue to expand access to telehealth services beyond the pandemic period. [A set of charts describes current and proposed] state and federal guidance, regulations, and legislation."

Tags: Health Plan Design

Pandemic Sharpens Focus on Employee Financial Wellness
Strategic Benefits Advisors Link to more items from this source
Sept. 21, 2020

"To gauge how well employees are utilizing their benefits, plan sponsors can ask their administrators to answer [specific] questions ... If the data shows employees aren't taking full advantage of the financial features of their benefits, additional employee education and communication may be in order."

Tags: 401(k) Plans  •  Health Plan Design  •  Retirement Plan Design  •  Stock Plans

Portable Benefit Solutions: Financial, Health & Retirement (PDF)
Women's Institute for a Secure Retirement [WISER] Link to more items from this source
Sept. 18, 2020

16 pages. "One of the challenges in building an entrepreneurial ecosystem is that the new jobs created rarely offer employee benefits.... [This] project aimed to assess the feasibility of an online platform to serve as a virtual human relations department for entrepreneurs, self-employed workers, independent contractors, freelancers and other workers without access to benefit resources.... The use of online, fintech platforms hold great promise for bridging this gap and connecting independent workers with information, services and opportunities to build a stronger financial future."

Tags: Health Plan Administration  •  Health Plan Design  •  Retirement Plan Administration  •  Retirement Plan Design

Editor's Pick Plan Coverage of COVID-19 Testing: Issues Remain After June Guidance
Mercer Link to more items from this source
[Guidance Overview]
Sept. 18, 2020

"[E]mployers should take the following into consideration: [1] Review notice and need for clarification.... [2] Check vendor claims processing and assist employees.... [3] Steer employees to providers with transparent costs.... [4] Return-to-the-workplace considerations.... [5] Review compliance requirements for stand-alone telehealth.... [6] Mental health parity considerations."

Tags: Coronavirus (COVID-19)  •  Health Plan Design

COVID-19 Recession Caused Loss of Employer-Sponsored Health Insurance Coverage
Urban Institute Link to more items from this source
Sept. 18, 2020

"We find that [between April 23-May 12 and July 9-21, 2020], the number of nonelderly adults with ESI fell by 3.3 million, while the number of uninsured adults increased by 1.9 million.... [G]roups experiencing larger losses in ESI coverage experienced corresponding increases in public coverage or uninsurance rates, with smaller observed changes in private nongroup coverage rates."

Tags: Coronavirus (COVID-19)  •  Health Plan Design

2020 Trend: Businesses Help Provide Stability Through Employee Benefits
Principal Financial Group Link to more items from this source
Sept. 17, 2020

"Fewer than 15% of businesses plan to reduce benefits ... One-fifth of businesses are even boosting health care benefits.... 21% of surveyed businesses plan to boost mental health and well-being programs this year -- think EAPs, access to therapists and clinicians, or support for major life transitions, such as elder care."

Tags: Health Plan Design

Not Your Normal Benefits Enrollment Cycle
Buck Link to more items from this source
Sept. 17, 2020

"[M]any employers are focusing this year's open enrollment on adding clinical support to members who need it the most.... Employers are also reviewing specialty drug utilization because of the wide variety of costs for the same treatments given at different sites of care ... [E]mployers are upping members' access to virtual care in different areas and removing barriers to receiving that care. Virtual care has exploded in light of social distancing measures."

Tags: Coronavirus (COVID-19)  •  Health Plan Design

Taskforce on Telehealth Policy: Findings and Recommendations
National Committee for Quality Assurance [NCQA] Link to more items from this source
[Opinion]
Sept. 17, 2020

"Policymakers should make permanent the following specific COVID-19 policy changes: [1] Lifting geographic restrictions and limitations on originating sites. [2] Allowing telehealth for various types of clinicians and conditions. [3] Acknowledging, as many states now do, that telehealth visits can meet requirements for establishing a clinician/patient relationship if the encounter meets appropriate care standards or unless careful analysis demonstrates that, in specific situations, a previous in-person relationship is necessary. [4] Eliminating unnecessary restrictions on telehealth across state lines."

Tags: Health Plan Design

Attacking Out-of-Network Spending
EPIC Link to more items from this source
Sept. 16, 2020

"[United HealthCare is] partnering with its sister company, Naviguard ... to provide the member advocacy around negotiating the balance bill levels should the provider deem the reimbursement too low. This clever tactic has been deployed by reference-based pricing companies ... to eliminate provider networks in general. UHC is now introducing it to support Medicare-based reimbursements for out-of-network services."

Tags: Health Plan Costs  •  Health Plan Design

Overpaying and Undersaving: Correlated Mistakes in Retirement Saving and Health Insurance Choices
TIAA Institute Link to more items from this source
Sept. 15, 2020

"Many employees pick a more expensive health plan option, even when, for all possible spending realizations, lower costs are more likely in the cheapest plan. People who make mistakes in health insurance choices are more likely to save too little for retirement and forgo employer-matching funds. Employees with lower salaries and longer tenure have higher rates of shared mistakes. Employees who are younger and have shorter tenure and higher salaries are less likely to make mistakes in either domain."

Tags: 401(k) Plans  •  Health Plan Design  •  Retirement Plan Design

Leasing Healthcare Employees? Don't Overlook the Benefits Traps, Part I
Bradley Link to more items from this source
[Guidance Overview]
Sept. 15, 2020

"Several states that broadly regulate employee leasing place significant limitations on the ability of the lessor to offer self-funded group medical plan coverage to the leased employees. A few states bar the use of a self-funded group medical plan for leased employees. In other states, the compliance burdens make offering such a plan impracticable."

Tags: Health Plan Design

Sirens and Flashing Lights: With No Legal Guardrails for Patients, Ambulances Drive Surprise Medical Billing
Kaiser Health News Link to more items from this source
Sept. 14, 2020

"[S]tudies show the majority of ambulance rides leave patients saddled with hundreds of dollars in out-of-network medical bills. Yet ground ambulances have mostly been left out of federal legislation targeting 'surprise' medical bills, which happen when out-of-network providers charge more than insurers are willing to pay, leaving patients with the balance."

Tags: Health Plan Costs  •  Health Plan Design

What Have Pandemic-Related Job Losses Meant for Health Coverage?
Henry J. Kaiser Family Foundation Link to more items from this source
Sept. 11, 2020

"[E]nrollment in the fully-insured group market dropped by just 1.3% from the end of March through the end of June ... Part of the explanation for this apparent discrepancy could be that many of the people who lost employment were never enrolled in employer-based coverage in the first place, as lower-wage workers are less likely to be covered by their employer's plan. Even so, there are some reasons this 1.3% drop may even overstate employer coverage losses during the early months of the pandemic."

Tags: Coronavirus (COVID-19)  •  Health Plan Design

Editor's Pick What It Means to Cover Preexisting Conditions
Katie Keith, in Health Affairs Blog Link to more items from this source
[Opinion]
Sept. 11, 2020

"This post discusses what it means to cover preexisting medical conditions, offers a tool to assess candidate claims, and reviews a set of congressional proposals that purport to offer [ACA] alternatives that protect people with preexisting conditions but that ultimately fall short."

Tags: Health Plan Design  •  Health Plan Policy


<< Older News  |  September 25, 2020

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