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[Official Guidance]
Text of HHS Final Rule on Medical Loss Ratio Requirements under the Patient Protection and Affordable Care Act (PDF)
"This final rule with comment period revises the regulations implementing medical loss ratio (MLR) requirements for health insurance issuers under the Public Health Service Act in order to address the treatment of 'mini-med' and expatriate policies under these regulations for years after 2011; modify the way the regulations treat ICD-10 conversion costs; change the rules on deducting community benefit expenditures; and revise the rules governing the distribution of rebates by issuers in group markets."
(U.S. Department of Health & Human Services via U.S. Employee Benefits Security Administration)
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[Guidance Overview]
DOL Press Release Summarizes Proposed EBSA Regs Providing Enhanced Reporting Requirements and Enforcement Authority on Multiple Employer Welfare Arrangements (MEWAs)
"The promoters, marketers and operators of MEWAs often have taken advantage of gaps in the law to avoid state insurance regulations, such as a requirement to maintain sufficient funding and adequate reserves to pay the health care claims of workers and their families. In the worst situations, operators of MEWAs have drained their assets through excessive administrative fees or outright embezzlement, resulting in harm to participants and their families. In some cases, individuals incur significant medical bills before they learn that claims are not being paid — and that they are liable and need to pay their medical bills themselves. The Affordable Care Act includes provisions designed to remedy these gaps."
(U.S. Employee Benefits Security Administration)
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[Guidance Overview]
Health Care Reform Spotlights Need for Medical Stop Loss Insurance
"ACA adds new federal taxes on health insurer providers beginning in 2014. These new taxes will add to state insurance premium taxes and make the savings from self-funding more compelling for many fully insured medical plans. Second, the ACA requirement to remove annual and lifetime limits beginning in 2014 will increase interest in stop loss coverage for self-funded groups without stop loss coverage in force."
(Segal)
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[Guidance Overview]
Health Reform: Fine-Tuning the Medical Loss Ratio Rules
"On December 2, 2011, the [HHS] released both a final rule and an interim final rule updating the medical loss ratio rule that it issued almost exactly a year ago. [DOL] simultaneously issued a technical release giving direction to employer-sponsored health plans governed by [ERISA] as to how to handle rebates provided by insurers who fail to meet the targets established under the MLR rule."
(Health Affairs)
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Final MLR Rule Will Help Health Insurers Avoid Taxes
"Under the final rule, insurers' medical loss ratios should come in modestly higher than under the prior rule, all other things being equal. Most notably, plans will be allowed to include a small portion of ICD-10 conversion costs in medical expenses. Broker and insurance agent fees will also still be included in insurer's allowable administrative costs."
(The International Business Times Inc.)
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Employers Consider Cutting Health Insurance Premiums for Lower-Paid Workers
"At most companies, employee health insurance premiums vary only by family size and type of plan. At a small percentage of firms, however, another variable is taken into account: salary. At these companies, workers' premiums are pegged to how much they earn. Workers who earn less, pay less."
(The Washington Post; free registration required)
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Employers Offer Carrots to Get Workers Healthier
"Wellness is on many executives' minds. Two-thirds of employers in the Towers Watson survey said they feel their main challenge to affordable healthcare is the poor health habits of their employees. The easiest move for many employers appears to be taking action to cut down on smoking. Baptist gives its nonsmokers a carrot, a $30 reduction in premium payments per biweekly pay period. Florida Power & Light offers a $5 biweekly reduction for nonsmokers."
(Miami Herald Media Co.)
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Exploring the Relationship Between Health System Reform and Decisions by Businesses to Offer Health Coverage (PDF)
"In a 2005 grant proposal to RWJF, the Center for American Progress, a Washington-based nonpartisan research and education organization, noted the following: . . . . Business leaders had largely remained on the sidelines rather than play a key role in the health care debate, rarely contributing to policy solutions or advocating for change. The center designed this project partly to help bring corporate leaders into the national dialogue on health system reform."
(Robert Wood Johnson Foundation)
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Annual Cost of Unhealthy Behavior: $623 Per Employee
"The 'Thomson Reuters Workforce Wellness Index' finds the decline in overall population health is contributing to rising healthcare costs and lost productivity for U.S. employers."
(Business and Legal Resources)
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Implementing an HSA with HDHP: How Hard Could it Be?
"This post explores some of the general eligibility questions we are asked most frequently. It is the first in a series on HDHP/HSA arrangements, and we hope that together these posts will provide a useful overview on implementing an HDHP/HSA arrangement."
(Verrill Dana, LLP)
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Benefits in General; Executive Compensation
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Severance and Change-in-Control Plans
"[The survey research was] designed to better understand the prevalence and perceptions of severance programs within organizations."
(WorldatWork / Innovative Compensation and Benefits Concepts, LLC)
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Pros and Cons of Severance Agreements
"[M]ost employers who use severance payouts ask their employees to sign a document essentially releasing the company from any and all legal liability upon acceptance. This way, the relationship can be considered to be completely and forever severed, each party moving on in the world, never again to have to deal with each other."
(Fisher & Phillips LLP)
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Cutting Retiree Benefits a Sore Subject for Military
"Military retiree benefits cost the Pentagon $50 bil.lion a year. . . . There are 1.9 mil.lion military retirees drawing pay and benefits, compared to 1.5 mil.lion in the active duty force. In 2010, then-Defense Secretary Robert Gates said those costs are 'eating the Defense Department alive.'"
(NPR)
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Nearly Half of Workers Predict Benefits to be Cut in 2012
"According to the Randstad Employee Attachment Index, 41% of workers also believe their companies will lay off workers in 2012 and 24% of employees are willing to lose their bonuses or work longer hours to keep their current jobs."
(PLANSPONSOR.COM)
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Press Releases
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