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Health & Welfare Plans Newsletter May 7, 2019 |
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Webcasts, Conferences Regular Rate Regulations and Keeping Benefits out of the Calculations
May 2019 Policy Forum
Next Generation of Technology Buyers
What You Don't Know About Paid Sick and Paid Family Leave Can Hurt You!
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Discussions |
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This Newsletter:
BenefitsLink Retirement Plans Newsletter:
Message Boards Digest:
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[Guidance Overview]
"The notice includes important final rules and parameters for the operation of the individual and small group health insurance markets in both 2020 and potentially 2021. This paper summarizes key provisions of the final notice, and other related information recently released by HHS."
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Out-of-Pocket Costs Go Through the Roof for Neurology Drugs "The fastest rise in monthly out-of-pocket costs occurred with MS drugs, which climbed from $15/month in 2004 to $309/month in 2016. Cumulative 2-year out-of-pocket costs for MS patients were an average of $2,238, which varied considerably from patient to patient: 5% of MS patients paid an average of $90, while another 5% paid $9,855 or more. Expenditures for dementia, epilepsy, peripheral neuropathy, and Parkinson's disease drugs also increased considerably, particularly for patients with high-deductible health plans."
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Cost Savings for Telemedicine Estimated at $19 to $120 Per Patient Visit "The bulk of the cost savings from the telemedicine program was generated in diverting patients from emergency departments. Each avoided emergency department visit garnered cost savings ranging from $309 to more than $1,500. Cost savings from other alternate care types was below $114 average savings per visit."
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$3 Million OCR Touchstone Settlement Warns Health Plans of Perils of HIPAA Violations "Around May 9, 2014, the [FBI] and OCR notified Touchstone that one of its FTP servers allowed uncontrolled access to PHI that allowed search engines to index the PHI of more than 300,000 of Touchstone's patients, which remained visible on the Internet even after the server was taken offline.... Touchstone did not provide notice of the breach until October, 2014, months after OCR and FBI notified it of the breach.... Covered Entities should learn from the painful lesson learned by Touchstone by reconfirming the adequacy of their current HIPAA compliance and using care to timely and adequately investigate and provide notification if and when a breach occurs."
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Update to Texas v. United States: DOJ Files a Brief in Support of Eliminating the ACA "The Brief explains that after further review of the district court's opinion, the United States now takes the position that the provisions of the ACA are 'highly interdependent' and that they 'would not 'function in a coherent way and as Congress would have intended' in the absence of the individual mandate and the guaranteed-issue and community-rating provisions.' As such, the individual mandate is inseverable from the rest of the ACA and the entire ACA should be struck down."
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[Opinion]
"The impact of allowing cross-state insurance sales on the number of insurance plans available to consumers and the cost of coverage depends on how these plans are regulated and whether other changes are made to insurance market rules."
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Selected Discussions |
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Retiree Health Insurance Premiums -- Employer Wants to Pay Former Employee's Share of Cost The employer is a school division. They have a retiree health plan. The employer subsidizes a very small portion of the premium. Most is the retired employee's share. The superintendent has recently retired. The school board would like to pay the employer and the retired employee's share of the premium until the retired superintendent reaches Medicare eligibility. Is this permissible? I thought that these types of arrangements (employer pays or reimburses an employee for premium cost) were banned by the ACA.
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Press Releases |
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SageView Expands Florida Team with Addition of Lisa Garcia
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Most Popular Items in the Previous Issue |
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The Importance of Retaining and Protecting Employee Benefit Plan Records (PDF)
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CalSavers and ERISA: An Analysis of Howard Jarvis Taxpayers Association v. the California Secure Choice Retirement Savings Program (PDF)
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Connect
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BenefitsLink.com, Inc.
1298 Minnesota Avenue, Suite H
Winter Park, Florida 32789
(407) 644-4146
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 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.
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