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BenefitsLink Health & Welfare Plans Newsletter
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[Guidance Overview]
Internal Claims, Appeals and External Review: a Refresher for 2012
"The new year brings new claims and appeals obligations for non-grandfathered group health plan sponsors, as the enforcement grace periods established over the past two years begin to expire. Let's start 2012 with a refresher on what's new and what's ahead."
(Beyond Health Care Reform Blog)
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Self-Insured Group Health Plans: Stop-Loss Insurance and Adverse Selection (PDF)
Published October 4, 2011. "In the course of considering changes to its Stop-Loss Model Act, the National Association of Insurance Commissioners (NAIC) has received formal comments containing substantive inaccuracies regarding self-insured group health plans, stop-loss insurance, and how smaller self-insured group health plans may contribute to adverse selection in the health insurance marketplace. Similar comments have been made by federal regulators responsible for implementing the Affordable Care Act (ACA). This White Paper identifies and corrects several inaccurate comments in order to assist policy-makers at both the state and federal level to properly assess legislative/regulatory proposals related to self-insured group health plans."
(Self-Insurance Institute of America, Inc.)
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Numerous 'Friend of the Court' Briefs Filed in Support of PPACA's Individual Mandate
"On the central issue of whether the individual mandate / minimum coverage requirements of the PPACA are valid, over two dozen amicus briefs were filed in support of the provisions, including briefs by constitutional law scholars, health law scholars, civil rights organizations . . ., health provider organizations . . ., and small business organizations . . . ."
(Deloitte via BenefitsLink.com)
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Five Reasons to Offer LTC Insurance in 2012
"According to EM-Power Services, a provider of long-term care insurance and employee benefits services, LTCI is an important benefit that should be offered by employers in 2012, especially as the U.S. is expected to face rapid growth among the age 65 and older population."
(BenefitsPro)
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The Calculating Required Before Buying a Long-Term Care Policy
"The question of whether to get long-term care insurance bedevils consumers and their advisers. Unlike medical insurance, it is intended primarily to cover people who need assistance with so-called activities of daily living . . . ."
(The Henry J. Kaiser Family Foundation)
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Wellness Incentives, Equity, and the Five Groups Problem
"Wellness incentives are an increasingly popular way for employers to encourage participation in prevention programs, which can both improve workers' overall health and reduce costs. Employees may receive a discount on premium costs for participating in an exercise, weight loss, or smoking cessation program, for instance. Or, alternatively, incentives, such as premium reductions, may be linked to meeting certain targets, like appropriate body mass index (BMI) or blood pressure. With provisions in the Affordable Care Act designed to increase employers' ability to use wellness incentives, some are questioning whether these programs may lead to equity concerns."
(The Commonwealth Fund)
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Benefits in General; Executive Compensation
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Seniors Decide Retirement Doesn't Suit Them, Keep Working
"Baby Boomers are starting to . . . work past conventional retirement age, a trend fueled by an uncertain economy, improved health in older life and an understanding that staying engaged leads to a better sense of well-being. . . . The percentage of people who work and people who want to work . . . for 65 and older was 17.9% [in 2011] compared with 10.8% in 1985. For 75 and older, the rate jumped from 4.3% in 1990 to 7.5% in 2011.
(USATODAY.com)
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Which Governments Pay Public Employees the Most? (PDF)
"New Jersey and Michigan had the narrowest range of salaries for top salaries for public officials. . . . In New Jersey, top salaries range from $180 thousand a year to $275 thousand a year. For Michigan employees, high earners made between $120 thousand a year and $235 thousand a year."
(Sunshine Review)
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Press Releases
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