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August 22, 2016 logo logo LinkedIn logo Twitter logo Facebook logo
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Webcasts and Conferences

Today's Plan Changes Create Tomorrow's Fiduciary Problems

Statewide Pension Fund Seminar Fall 2016
September 22, 2016 in NY
Bond, Schoeneck & King, PLLC

Davis Bacon Prevailing Wage Retirement Plans
November 3, 2016 WEBCAST
ASPPA [American Society of Pension Professionals & Actuaries]

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[Official Guidance]

Text of CMS Bulletin on Network Breadth Information for Qualified Health Plans on (PDF)
Unnumbered document, dated Aug. 19, 2016. "[D]uring the open enrollment period for the 2017 coverage year, information on the relative size of provider networks will display for plans in a limited number of states on The consumer experience is a priority for CMS, and the goal of the network breadth pilot is to help CMS understand how consumers make use of the network breadth information."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]


Webinar: Offering the Right Mix of Medical Plan Choices

Sponsored by Fidelity Health

Get tips from a benefits expert and a step-by-step guide on how to offer your employees the right mix when it comes to medical plans without increasing your administrative burden. Sign up now.

[Guidance Overview]

Opt-Out Payments Under the ACA
"[U]nconditional opt-out payments increase the employee's cost of coverage (and, accordingly, impact whether the coverage is affordable under the ACA), [but] conditional opt-out payments made pursuant to an 'eligible opt-out arrangement' do not. So, what is a conditional payment under an eligible opt-out arrangement?"
Jackson Lewis P.C.

Making HSAs Relevant to Millennials (PDF)
"[M]any Millennials are in the financial wellness game, but they're not accessing the HSA's full value.... [S]ome tips for tailoring the HSA message.... [1] Paint a picture.... [2] Highlight the unique now- or-later nature of HSAs.... [3] Illustrate the long-term impact.... [4] Tell the story differently ... [5] Encourage them to take action."
HSA Coach

Employees Have Positive Attitudes Toward Workplace Wellness Programs, But Participation Is Low
"Most (81%) participants saw a positive impact on their physical wellbeing and more than 60% agreed or strongly agreed that including family in such programs would be likely to increase their participation. For those who did not participate, 37% did not find them personally relevant and 20% did not know they were available.... A great majority (91%) said they would engage in healthier behaviors if they were rewarded. Almost all employees under age 35 agreed (98%), but those over 55 (85%) were somewhat less motivated by rewards."
American Journal of Managed Care

Does Digital Health Need Reimbursement?
"[T]he reimbursement environment is changing for the better for telemedicine reimbursement ... But do digital health tools need direct reimbursement under third-party payment programs to thrive?.... With the push by the federal government and private payers for value-based purchasing, population health management and bundled and capitated payments (collectively, APMs), digital health tools can be valuable simply for the efficiencies improved quality they can bring to the delivery of health care services."
McDermott Will & Emery

Some Small Businesses Restore Group Health Coverage
"Some small companies that dropped group health insurance for their employees are reversing course, driven by a tightening labor market and rising costs and fewer choices for individual coverage.... Questions about the merits of individual versus group coverage are intensifying as changes continue to roil the insurance market."
The Wall Street Journal; subscription may be required

CMS Focuses on Provider Steering of Medicare- and Medicaid-Eligible People to Marketplaces
"On August 18, CMS [addressed] a concern expressed by insurers that providers and provider-affiliated organizations are steering people eligible for Medicare and/or Medicaid coverage to individual marketplace plans to obtain higher provider payment rates.... [CMS asked] for comments on the extent and nature of this practice and on what can or should be done about it. CMS also sent letters to all Medicare-enrolled dialysis facilities expressing the concerns found in the information request."
Health Affairs

Think Your Obamacare Plan Will Be Like Employer Coverage? Think Again
"[S]ix years into the health law, the reality is that a typical Obamacare plan looks more like Medicaid, only with a high deductible. The typical marketplace plan covers a small number of low-cost doctors and hospitals, and offers fewer frills than employer plans. The recent high-profile exits of many of the national insurers from markets around the country will only heighten the shift."
The New York Times; subscription may be required

Blue Cross Plans May Be Obamacare's Fire Wall
"The nation's Blue Cross and Blue Shield plans could be the biggest benefactor of insurers leaving public exchanges under the [ACA]. So far, most Blue Cross plans have said they remain supporters of public exchanges and will maintain offerings for 2017. This includes the nation's biggest Blue Cross plan, Anthem, which operates in 14 states and will expand to more markets should it win regulatory approval of its Cigna acquisition."

Marketplace Plan Payment Options for Dealing with High-Cost Enrollees
"This paper considers potential modifications of the HHS risk adjustment methodology to maintain plan protection against risk from high-cost cases within the current regulatory framework.... [M]odifications of the transfer formula and of the risk adjustment model itself are mathematically equivalent to a conventional actuarially fair reinsurance policy. Furthermore, closely related modifications of the transfer formula or the risk adjustment model can improve on conventional reinsurance by figuring transfers or estimating risk adjustment model weights recognizing the presence of a reinsurance function."
National Bureau of Economic Research [NBER]


How to Rescue Obamacare as Insurers Drop Out
"[If] the federal exchange and all of the other state exchanges were to adopt the 'one big marketplace' rule, the risk that insurers such as Aetna and UnitedHealth would selectively abandon customers in Obamacare exchanges would evaporate. Merging the relatively healthy individuals who now buy coverage outside the exchanges with those using Obamacare would help stabilize insurance for the whole group."
The Washington Post; subscription may be required

Executive Compensation and Nonqualified Plans

Stock Compensation: 2016 Assumption and Disclosure Study (PDF)
36 pages. "This study presents [an] analysis of the 2015 calendar year-end assumptions and disclosures separately for large, non-high tech US public companies and for high tech US public companies."

Press Releases

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2016, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of, Inc., or in the case of third party materials, the owner of that content. You may not alter or remove any trademark, copyright or other notice from copies of the content.

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