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BenefitsLink Health & Welfare Plans Newsletter
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[Official Guidance]
Text of 11th Circuit Opinion Ruling Mandated Health Insurance Unconstitutional; Other Aspects of Health Care Law Stand
304 pages; State of Florida, et al. v. U.S. Department of Health & Human Services, et al. "[T]he individual mandate exceeds Congress's enumerated commerce power and is unconstitutional. This economic mandate represents a wholly novel and potentially unbounded assertion of congressional authority: the ability to compel Americans to purchase an expensive health insurance product they have elected not to buy, and to make them re-purchase that insurance product every month for their entire lives."
(The New York Times; free registration required)
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[Guidance Overview]
Health Care Law Individual Mandate Ruled Unconstitutional by 11th Circuit Court of Appeals
"The court found that Congress exceeded its powers to regulate commerce when it decided to require people to buy health insurance, a provision of the health care law known as the 'individual mandate.' But the court held that while that provision was unconstitutional, the rest of the wide-ranging law could stand."
(The New York Times; free registration required)
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[Guidance Overview]
Claims and Appeals Rules for Non-Grandfathered Health Plans Amended (PDF)
"Issued in response to the feedback elicited by the original July 23, 2010, interim final rules, the amendments [include] the following major changes: The decision-making deadline for urgent pre-service claims is extended from not later than 24 hours after receipt of the claim, to 72 hours. The requirement to include diagnosis and treatment codes in denial notices is replaced with the requirement to provide a statement regarding the claimant's right to obtain such information upon request."
(Trucker Huss, APC)
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Health Care Premium Credit Rules Proposed
"The proposed regulations are part of a 'next step' announced Friday by the Treasury Department and the Department of Health and Human Services (HHS) to establish 'affordable insurance exchanges' that under the health care acts will allow individuals and small businesses to purchase private health insurance coverage, also starting in 2014."
(American Institute of Certified Public Accountants)
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[Guidance Overview]
HHS Proposes Rules on Tax Credits, Health Exchanges
"HHS awarded $185 mil.lion to 13 states and the District of Columbia to help them build Affordable Insurance Exchanges and, with Treasury, posted three proposed rules that outline exactly how consumers can use the exchanges to purchase private health insurance."
(BenefitsPro)
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Growing Number of Employers Want You to Get Fit—or Else
"Employers are increasingly saying, 'We want you to take some responsibility, and if you don't do certain things we want you to do, you'll only be eligible for the bad [health insurance[ plan with a $3,000 deductible as opposed to the $1,000 deductible,' . . . ."
(Sun-Times Media, LLC)
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The High Cost of Public Employee Health Benefits
"This report explores the reasons that government-employee benefits cost more, and it makes concrete recommendations for how costs can be brought into line with those of the private sector."
(Manhattan Institute for Policy Research)
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Employers Adjust Retiree Drug Plans As Tax Break Ends
"The value of the tax break has been significant. 'For corporate America, this makes a world of difference,' said Michael S. Jacobs, national clinical practice leader at Buck Consultants L.L.C. in Atlanta. If a company receives a $500 per retiree subsidy for providing prescription drug coverage to a retiree, the subsidy's tax-free status makes it equivalent to $1,500, he said."
(Business Insurance)
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Press Releases
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