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BenefitsLink Health & Welfare Plans Newsletter
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[Guidance Overview]
Health Plan Quality Improvement Strategy Reporting Under The Affordable Care Act: Implementation Considerations
"A provision of the [Affordable Care Act] requires health plans to submit reports each year demonstrating how they reward health care quality through market-based incentives in benefit design and provider reimbursement structures.... Both employer group health plans, including self-insured plans, individual market plans, and qualified health plans sold through the insurance exchanges are required to submit such reports."
(The Commonwealth Fund)
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The Fact Checker: President Obama's Selective Memory of Supreme Court History
"[W]e don't know whether the president's factual error was a mere slip-up or a purposeful attempt to mislead, and we generally don't beat people over the head for off-the-cuff remarks. Let's take a look at the president's message in light of his clarifying remarks to see whether it holds up any better under scrutiny."
(The Washington Post; free registration required)
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Do You Really Need That Medical Test?
"Among items on [lists of tests and treatments whose elimination for major categories of patients would save the most money quickly without depriving any patient of meaningful medical benefit] are: cardiac stress tests for annual checkups in asymptomatic patients; brain imaging scans after fainting; antibiotics for uncomplicated sinus infections that are almost always caused by viruses, which are not treatable with antibiotics; imaging of the lower spine within the first six weeks after suffering back pain; and bone scans for early prostate and breast cancer patients at low risk of metastasis."
(The New York Times; free registration required)
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Health Care Budget Deficit Calculator Predicts Budget Deficits Will Explode
"The government, through programs like Medicare and Medicaid, pays for approximately half of the country's health care, almost all of which is actually provided by the private sector. Thus, the bulk of our projected rising budget deficits are due to skyrocketing private health care costs."
(Center for Economic and Policy Research)
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Costs of Many Preventive Medical Exams Vary As Much As 700%
"Over the past year, health plans and self-insured employers began paying for wellness exams — diabetes screening, mammographies, Pap smears and colonoscopies — as required by the law, without charging consumers a deductible or co-payment. But in looking at 15,000 consumers, a research group has found cost differences of hundreds of dollars charged for the same tests. Colonoscopy costs, for example, ranged from $786 to $1,819."
(USA TODAY)
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Medicare Coverage Less Generous Than Coverage in Large Employer Plans, When Available
"Medicare requires multiple deductibles and coinsurance based on service type, whereas a typical large employer plan requires a single deductible for all medical services ... In 2011, for an inpatient hospital stay Medicare required a $1,132 deductible and no coinsurance for the first 60 days whereas the typical large employer plan required 20 percent coinsurance beginning from the first day."
(Wolters Kluwer Law & Business / Health Reform Talk Blog)
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Supreme Court Hears Oral Arguments on Health Care Reform: Will the Affordable Care Act Survive?
"What, if any, provisions of the sweeping health care reform law will survive remains very much in question after the historic arguments. The questioning revealed deep divisions within the Court about the constitutionality of the law's so-called 'individual mandate' and whether the rest of the Act should stand if the mandate is struck down. Even after the Supreme Court renders its decision, which is expected in June, the debate over the landmark legislation likely will continue for years to come."
(Littler Mendelssohn LLC)
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Providing 'Professional Courtesies' Can Land Health Care Facilities in Hot Water
"Many health care practices or facilities waive or discount co-pays or deductibles for other physicians, the physician's family members, or the physician's staff as a "professional courtesy." Although often well-intentioned, such practices can violate state and federal laws and managed care contracts."
(Holland & Hart)
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Health Costs Projected to Increase Less Than 10% for 2012
"Costs for all types of medical plans in the U.S. are expected to increase by 9.9 percent for 2012, according to a survey by Buck Consultants. This is the first time since 2001 that Buck's survey has projected cost increases less than 10 percent for any type of plan."
(Society for Human Resource Management)
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Employer-Provided Life Insurance Benefits, 2011
"In March 2011, 58 percent of private industry workers were offered life insurance benefits by their employers; of these, 97 percent chose to enroll in this benefit. Among full-time workers, 73 percent were offered life insurance and 97 percent participated in the benefit; among part-time workers, by contrast, 14 percent were offered life insurance and 91 percent participated."
(U.S. Bureau of Labor Statistics)
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[Opinion]
Surprise, Illinois! You Owe Another $54 Bil.lion
"Beyond that $83 bil.lion in unfunded pensions, [Illinois] state government alone faces an unfunded liability of more than $54 bil.lion in retiree health liabilities over the next 30 years.... [O]nly 8 percent of private-sector retirees are offered health insurance benefits, and those retirees pay an average of 54 percent of the cost. Similarly requiring Illinois retirees to pay an average of 54 percent of insurance costs ... would shrink the anticipated $54 bil.lion shortfall by $21 bil.lion."
(Chicago Tribune)
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Benefits in General; Executive Compensation
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In Chief Executives' Pay, a Rich Game of Thrones
"IS any C.E.O. worth $1 mil.lion a day? That's roughly $42,000 an hour. Or $700 a minute. Or $12 a second.... At Apple, the answer to that question is an emphatic yes, and then some.... [Timothy D. Cook] was paid a cash salary of roughly $900,000 in 2011. On its own, that would have been a ho-hum paycheck for a top American C.E.O. in recent years. But then came a wild extra, a one-time award, in the form of Apple stock. It was initially worth a staggering $376.2 mil.lion. As of the end of last week, it was valued at roughly $634 mil.lion[.]"
(The New York Times; free registration required)
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Best Practices for Using the Talent and Experience of Older Workers (PDF)
"A report ... points to wide-ranging flexible workplace options that can retain older workers, tap into the experience of retired workers and help employers fill skills and knowledge gaps. Success is dependent, though, on matching flexibility initiatives with the needs of employers and their older employees."
(Sloan Center on Aging & Work at Boston College )
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Press Releases
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