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[Guidance Overview]
ACA Implementation Round-Up: Insurer Quality Ratings and More
"For 2017, star ratings will only be available in the FFM in five states: Michigan, Ohio, Pennsylvania, Virginia, and Wisconsin.... CMS hopes that the further pilot testing will give it additional time to better ascertain how consumers will use quality reporting, to develop technical assistance and educational tools to facilitate the use of quality ratings, and to allow insurers to measure and improve the quality of their QHP offerings."
(Health Affairs)
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Have You Reviewed Your Employee Handbook for ACA Compliance?
"While employers are undoubtedly already fatigued by ACA compliance, there are several reasons to take on this exercise. [1] The handbook can be used to help document an 'offer of coverage.' ... [2] The employer is not in compliance with the ACA, and the handbook reveals that.... [3] The employer IS in compliance with the ACA, but the handbook does not reflect that.... [4] If an employer is audited, the IRS or DOL will probably ask to see the handbook."
(Mintz Levin)
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Rx Drugs and Telemedicine Maximize Self-Funded Plan Value
"Virtually all brand name pharmaceutical manufacturers provide rebates to PBMs.... Negotiating with the PBM to pass on these rebates (in whole or in part) to the employer can have a significant impact on lowering prescription spend.... Many insurance carriers who offer self-funded services have recently introduced telemedicine as an option.... The value proposition of telemedicine is that it improves productivity by giving employees immediate 24/7 access to board-certified physicians who can diagnose and write prescriptions for common conditions."
(Corporate Synergies)
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Eligibility and Coverage Trends in Employer-Sponsored Health Insurance
"Between 2000 and 2015, the share of workers covered by health benefits offered by their employers dropped from 63 percent to 56 percent, with some firms not offering coverage and some employees not enrolling when coverage is offered. The biggest decrease occurred among employees working for small firms (3-199 workers)."
(Henry J. Kaiser Family Foundation)
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Healthcare Benefit Designs: How They Work
"All payment methods have strengths and weaknesses, and how they affect the behavior of health care providers depends on their operational design features and how they interact with benefit design.... This report analyzes the nuances of how seven different benefit designs work. These designs include narrow networks, tiered networks, reference pricing, high-deductible health plans, centers of excellence, value-based insurance design, and alternative sites of care."
(Urban Institute)
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A Typology of Healthcare Benefit Designs
"In this report, [the authors] develop a new typology of benefit designs under two categories -- cost sharing and contingent coverage -- and focus only on designs that have the potential to change consumer behavior and its alignment with payment reform."
(Urban Institute)
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HealthCare.gov to Feature Simplified Plans and Pilot Star Ratings
"Simple Choice Plans are standardized health plans with uniform deductibles, out-of-pocket limits and standard copayments that are options for insurers to offer.... Health insurers opposed them, arguing that they may inhibit their ability to promote more economical plans, such as those that have narrow provider networks.... And congressional Republicans wrote Andy Slavitt, acting administrator of [CMS], saying they are concerned the policy 'will continue a pattern of allowing Washington bureaucrats to pick winners and losers by propping up plans that meet arbitrary requirements, instead of preserving choice and encouraging consumers to select plans that best meet their unique needs.' "
(Bloomberg BNA)
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Benefits in General
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Executive Compensation and Nonqualified Plans
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[Guidance Overview]
FASB Updates Accounting Standards for Stock-Based Awards
"Among other changes, the updated standards permit employers to withhold stock for tax purposes upon settlement of stock-based awards -- such as stock options and RSUs -- at up to the maximum individual statutory tax rate without triggering adverse accounting consequences."
(Wilson Sonsini Goodrich & Rosati)
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[Guidance Overview]
Can You Amend Your Stock Plan to Allow Tax Withholding Up to the Maximum Statutory Rate?
"[A] company could not apply an amendment to allow tax withholding up to the maximum statutory rate unless it applies the change to future accounting for tax deductions attributable to current equity awards and other ASU 2016-09 changes. Companies should double-check with their auditors as to when these amendments should be adopted and applied."
(Winston & Strawn LLP)
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Press Releases
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BenefitsLink.com, Inc.
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Lois Baker, J.D., President
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager
BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2016 BenefitsLink.com, Inc. All materials
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