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[Guidance Overview]
Can Preexisting Condition Insurance Plans Help Employers Control Health Care Costs?
Excerpt: "An employer could be subject to sanctions if it offers financial incentives to enrolled individuals who end up in the [Preexisting Condition Insurance Plan]. Would the comparisons of eligibility periods and coverage costs be sufficient to constitute 'disincentives'? The PCIP rules do not appear to preclude the employer from steering new employees to the program. Any reasons why it should not?"
(Tax Management Inc.)
[Guidance Overview]
Regulations Regarding Internal Claims and Appeals and External Review Processes
Excerpt: "The new claims and appeals requirements under health care reform will impose more time-consuming and expensive rules on plan administrators. Plan sponsors considering the benefits of retaining grandfathered status will want to carefully consider these costs. These additional costs may encourage employers to retain grandfathered status. However, in many cases, if an employer has multiple benefit options, only some of which may be grandfathered, it may make more sense to apply all of the new claims procedures to all applicable group health plans in order to make the process consistent for everyone."
(Sherman & Howard)
Healthy Employees Shave $14M from Trihealth Costs
Excerpt: "'It's more than just about the medical claims cost -- we look at absence costs, productivity savings, short-term and long-term cost savings, clinical indicators,' . . . ."
(Cincinnati Business Courier)
Faced with Rising Health Costs, Large Employers Plan to Shift Burden to Workers
Excerpt: "Seventy percent of large employers said they will eliminate lifetime dollar caps on overall benefits, according to the latest annual survey conducted by the National Business Group on Health (NBGH), while 63 percent plan to increase premium rates in 2011, up from 57 percent this year."
(Capitol Hill Publishing Corp.)
New York State Requires Discussion on Options Before Breast Removal Surgery
Excerpt: "[A] state law signed on Sunday by Gov. David A. Paterson will require New York hospitals and doctors to discuss the options for breast reconstruction with their patients before performing cancer surgery, to give them information about insurance coverage and to refer them to another hospital, if necessary, for the reconstructive surgery."
(The New York Times; free registration required)
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Our subscribers care about employee benefit plan compliance, administration, costs and design. Roles include in-house benefits directors and administrators, TPAs, consultants, attorneys, trust officers, auditors and investment managers.
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Benefits in General; Executive Compensation
Federal Compensation Critics Keep the Debate Alive
Excerpt: "[A Cato Institute budget analyst], responding to [the Office of Personnel Management Director's] comments to The Washington Post, says his colleagues and other critics are citing data from the Bureau of Economic Analysis instead of the Bureau of Labor Statistics because the BEA provides a comprehensive analysis of the financial impact of a worker's benefits package."
(The Washington Post; free registration required)
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