Health & Welfare Plans Newsletter

March 5, 2019

BenefitsLink.com logo
EmployeeBenefitsJobs.com logo
Search   ·   Past Issues   ·   Get Message Boards Digest   ·   Get Retirement News

Jobs

Senior Pension Administrator - Combo DB / DC Plans
Primark Benefits
in Burlingame CA / Telecommute

Plan Administrator
BSP Retirement Services
in Oldsmar FL

Senior Consultant, Compliance - Retirement
The Segal Group
in San Francisco CA

►See All Jobs

►Post a Job


Webcasts, Conferences

Supplemental Pay Essentials: Severance Pay, Deferred Compensation, Recordkeeping, and Fringe Benefits
March 21, 2019 WEBCAST
Clear Law Institute

HSA University
May 2, 2019 WEBCAST
Ascensus

Health Care Management Conference
May 6, 2019 in MA
International Foundation of Employee Benefit Plans [IFEBP]

►See 181 Upcoming Webcasts and Conferences

►See 1489 Recorded Webcasts


Discussions

New Topics on the BenefitsLink Message Boards

New Comments and Topics

All Topics, Grouped by Forum


This Newsletter:
Subscribe Now

BenefitsLink Retirement Plans Newsletter:
Subscribe Now

Message Boards Digest:
Subscribe Now


Employers Striving to Sustain Competitive, Affordable Health Benefits

"[Employers] have tried and exhausted many tactics to contain healthcare costs, and are looking for other alternatives -- beyond putting their health plan out to bid to optimize network discounts and/or reduce fixed costs, such as Administrative Services Only (ASO) fees and stop loss premiums. [A] diagram shows a range of possibilities an employer can consider[.]"
Findley

[Advert.]

Register for a Free Webcast on Building Resilience

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

Celebrate National Employee Benefits Day by learning about the importance of building resilience in your employees. Register for a free webcast on April 2: Building Resilience: Practical Tools to Help Your Workplace Thrive. Learn More.


Paying Patients to Use Lower-Price Health Providers Can Result in Savings

"Examining a program that pays patients $25 to $500 for using a lower-price medical provider for each of 135 elective procedures, researchers found the effort led to a 2.1 percent reduction in the average price paid of all eligible services. The decrease in prices paid was greatest for MRIs (4.7 percent), ultrasounds (2.5 percent) and mammograms (1.7 percent)."
RAND Corporation

Insurer Skips Doctors, Sends Checks Directly to Patients, Prompting Lawsuit

"The suit by Sovereign Health highlights part of an ongoing war between insurance companies and [health care] providers over payment and billing issues, one that puts the patient right in the middle of the fighting by sending payments straight to patients after they seek out-of-network care. Patients are supposed to send the money on to providers. Many times, they do; other times, they don't."
CNN

Insurance Companies Win Important Ruling on Payment of ACA Cost-Sharing Reductions

"[T]he U.S. Court of Federal Claims held that ACA Section 1402 'sets forth an unambiguous mandate' that the government 'shall make' CSR payments to insurers. The Court further rejected the government's argument that Congress' failure to appropriate money for these payments in any way extinguished the obligation.... The Court likewise found that the statutory obligation created an 'implied-in-fact' contract between the government and insurers, further obligating the government to make the payments." [Community Health Choice v. U.S., No. 18-5C (Ct. Cl. Feb. 15, 2019)]
Faegre Baker Daniels

OCR Report to Congress on HIPAA Compliance for 2015-2017 (PDF)

40 pages. "[This] report summarizes [OCR's] compliance and enforcement activities with respect to the HIPAA Privacy, Security, and Breach Notification Rules [for 2015, 2016 and 2017] ... OCR completed desk audits and its examination of documentation for 166 covered entities in September 2017 and 41 business associates in December 2017. These audits found that all types of audited entities fail to implement effective risk analysis and risk management strategies pursuant to the HIPAA Security Rule, and most audited entities fail to adequately safeguard protected health information and ensure individual access as required by the HIPAA Privacy Rule."
Office for Civil Rights [OCR], U.S. Department of Health and Human Services [HHS]

[Advert.]

Wellness Programs: EEOC Enforcement Actions and Complying with Federal and State Laws

Sponsored by Lorman and BenefitsLink

Apr. 11 webinar. Review design and taxation of incentives, laws that prohibit discrimination based on health factors, and exceptions for certain wellness and supplemental plans. BenefitsLink discount.


How Affordable Are 2019 ACA Premiums for Middle-Income People?

"Marketplace enrollment among subsidized enrollees rose from 8.7 million in 2015 to 9.2 million in 2018. However, premiums increased significantly, and the number of unsubsidized enrollees in ACA-compliant plans has fallen over this same period from 6.4 million to 3.9 million.... [A]ffordability challenges are particularly acute for older adults with incomes just above the premium subsidy cutoff (400% of poverty), particularly in rural areas where premiums are highest."
Henry J. Kaiser Family Foundation

Benefits in General

[Guidance Overview]

Final Balloted Draft of Employee Benefit Plan Audit Standards Released by Auditing Standards Board

"[T]he Final Balloted Draft standard shouldn't affect the nature and extent of audit procedures performed by compliant auditors. However, the standard formally memorializes the objectives of the audits and the responsibilities of the auditor and management, to provide a clear framework of accountability for all parties involved."
Belfint Lyons Shuman

Respondeat Superior in the ERISA Context (PDF)

"Respondeat superior claims in the ERISA context may be made in one of two ways; while there is no circuit split on this issue, there is a split of authority as to the manner in which these claims should be addressed, and this article considers these rulings."
The Wagner Law Group, via Benefits Law Journal

Press Releases

Most Popular Items in the Previous Issue

Text of EBSA Information Letter: Application of the Authorized Representative Provisions of DOL Benefit Claims Regs (PDF)
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

Connect   LinkedIn logo   Twitter logo   Facebook logo

BenefitsLink.com, Inc.
1298 Minnesota Avenue, Suite H
Winter Park, Florida 32789
(407) 644-4146

Lois Baker, J.D., President  loisbaker@benefitslink.com
David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
Holly Horton, Business Manager  hollyhorton@benefitslink.com

BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2019 BenefitsLink.com, 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 BenefitsLink.com, Inc., or in the case of third party materials, the owner of those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.

Links to web sites other than BenefitsLink.com and EmployeeBenefitsJobs.com are offered as a service to our readers; we were not involved in their production and are not responsible for their content.

Unsubscribe  |   Change Email Address  |   Privacy Policy