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Employer Can't Pin COBRA Compliance on Insurer, District Court Points Out
"A qualified beneficiary's claim for equitable estoppel survived a motion to dismiss due to the court's finding that the employer was grossly negligent when it did not know that it was not subject to federal COBRA requirements because it employed fewer than 20 employees.... Generally, insurance companies that provide fully insured benefits automatically couple the coverage with COBRA coverage—it is part of the 'product' offering.... it is important for insurers and brokers to know enough to instruct their clients on the basic rules and then have the employer make that determination." [Hanysh v. Buckeye Extrusion Dies, Inc., 2012 WL 3852569 (N.D. Ohio, Sept. 5, 2012)]
(Thompson SmartHR Manager)
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Employer Health Costs Grow 4.6%—Slowest Rate in Past Five Years
"According to the report, medical and pharmacy costs for employees and their dependents from 2010 to 2011 increased at a rate of 4.6 percent, the smallest increase in annual employer healthcare costs over the last five years. The research also projects that allowed amounts will continue to grow at a moderate rate of 4 to 5 percent in 2012 and 2013. The relatively modest 2011 cost trend of 4.6 percent reflects the impact of PPACA and Mental Health Parity regulations effective in 2011."
(Truven Health Analytics; free registration required to download full paper)
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Numbers Don't Bode Well for Blue-Collar Health
"With a new report showing blue-collar workers are more prone to illness than other groups, experts say HR's challenge is to understand the unique aspects of their own workforces' well-being as well as the unique things they're going to have to do as an employer to address its workers' needs."
(Human Resource Executive Online)
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Former IRS Commissioner Says IRS Confronts Long List of Challenges with ACA Enforcement
"The Government Accountability Office has said the IRS faces 'a massive undertaking'.... under the new law, the IRS will be sharing taxpayer information with many additional parties, some of which (like the exchanges) will be going through growing pains of their own. A significant data breach would shake America's faith in the IRS and hurt revenue collection.... Even a large organization like the IRS has a limited number of executives capable of directing major activities. To the extent that healthcare absorbs their time, tax administration will suffer."
(The Hill)
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Three Benefits Compliance Areas Employers Need to Watch For
"Here are [the author's] top three employee benefits legal areas where we see employers out of compliance the most often: No health & welfare plan document.... Thinking the certificate booklets/evidence of coverage documents provided by health insurance carriers are ERISA-compliant Summary Plan Descriptions.... Incomplete Section 125 cafeteria plan information."
(Employee Benefit News)
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Affordable Care Act Trumps Recession's Impact on Health Insurance Coverage
"Overall, the rate and number of people without insurance coverage dropped in 2011 for the first time since 2007, in spite of the recession, contrary to ... the assumption that loss of employer supported insurance due to job loss might increase the rate of uninsurance ... The largest drop in the uninsured was among the 19-25 age group, clearly fueled by the ACA provision allowing young adults to stay on their parents' health insurance as dependents up to age 26."
(The Huffington Post)
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Poor Health Costs U.S. Economy $576 Billion (PDF)
"[P]oor health and its impact on productivity costs the U.S. economy $576 billion per year.... 39 percent—or $227 billion—is due to lost productivity associated with poor health. Lost productivity results when employees are absent due to illness or when they are underperforming due to poor health[.]"
(Integrated Benefits Institute)
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Almost Half of Ireland is Privately Insured Despite Free National Health Insurance
"Despite the fact that all individuals have access to public health insurance, a near majority of Irish residents also buy private health insurance as well. In June 2012, 2,123 million people—or 46.3 percent of the population—held private health insurance.... In June 2012 there were 61,000 less people privately insured than in June 2011."
(John Goodman's Health Policy Blog)
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House Bill Would Weaken the Medical Loss Ratio Standard
"[Under a] bill that the House Energy and Commerce Committee's Health Subcommittee approved last week and that the full Committee is expected to consider this week ... insurers wouldn't have to count the commissions they pay to agents and brokers as part of their overhead. Insurers could spend more of the premium on costs that don't affect patients' health or medical care, including greater profits, so consumers would be paying more for less value in their health insurance."
(Center on Budget and Policy Priorities)
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Young, Healthy Individuals to Bear the Cost of Health Reform
"While the health care law included a number of market reforms making it easier for individuals to purchase coverage, these reforms are associated with higher costs.... [T]his is especially true for younger, healthier individuals who will be hit the hardest by rising costs. '...there will be winners and losers. And without taking steps to balance the score, the losers—the young and healthy—could see prices increase by as much as 135 percent.'"
(Generic Pharmaceutical Association)
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The Non-Problem that ObamaCare Didn't Fix: Pre-Existing Condition Exclusions
"HIPAA—which most people think of as a law about medical records—in fact had rules about exclusions for pre-existing conditions.... [T]he problem is that it's complicated to find, and expensive to buy, not that you are uninsurable.... [I]nsurance being expensive—it is, even at group rates—is a very different problem from people being uninsurable. They imply very different solutions."
(The Daily Beast)
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Benefits in General; Executive Compensation
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Pensions, Medicaid, and State Budgets: Any Solution In Sight?
"The growing costs of Medicaid ... seem 'almost inexorable.' The growing cost of pensions have the potential for 'dramatically negative' effects.... It's a challenging time, and it will require states to reexamine their entire approach to government[.]"
(Governing)
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Press Releases
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