Employers: Beware When Calculating Your Health Premiums for 2020
"A failure to consider whether your plan is affordable when passing through any premium increases could result in an unintended penalty for each employee who enrolls in exchange coverage and qualifies for financial assistance.... [F]or 2020 the cost of single coverage must be less than 9.78% of an employee’s household income in order to be affordable.... [E]mployers could end up with an unaffordable plan this year when it was affordable last year even if everything else stayed exactly the same."
Graydon
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HSAs: What Is 'Disqualifying Health Coverage'? (PDF)
"Employers providing HSA contributions are responsible for determining that employees are not covered by any HSA-disqualifying coverage sponsored by the employer. Clear communications about HSA qualifications and safeguards for preventing enrollment in HSA-disqualifying coverage are essential for avoiding HSA eligibility issues."
EPIC
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Trump Administration 'Open for Business' on Drug Imports from Canada
"[M]anufacturers could import versions of any FDA-approved drugs from foreign countries -- including insulin -- and sell them at a lower cost than the same U.S. versions. This appears to be a way drugmakers could avoid some of the contracts they have with drug middlemen, known as pharmacy benefit managers."
Kaiser Health News
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Administration Announces Plan to Permit Drug Importation
"[T]he plan relies on others -- states, wholesalers, and manufacturers themselves -- to do the federal government’s work for it, to demonstrate the potential for importation to be done safely and effectively.... [T]he state-based importation programs would be only demonstration projects, which (in addition to only applying in a geographic subset of the country) would be time-limited and require renewal."
Rachel Sachs, in Health Affairs
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What's the Cost of Telemedicine?
"[T]he cost of telemedicine varies greatly among providers, and the true cost -- and true benefit -- of telemedicine can oftentimes be difficult to calculate. There are several factors to consider when evaluating the real cost of a telemedicine service: [1] Per employee per month (PEPM) fee; [2] Employee, or member, co-pay or consultation fees; [3] Engagement campaign costs; [4] Usage limits, onboarding fees and other miscellaneous costs; [5] Soft costs and soft benefits."
First Stop Health
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New Lawsuit Places Dallas Paid Sick Leave Ordinance on the Chopping Block
"On Tuesday, July 30, 2019, businesses filed a federal lawsuit ... challenging the Dallas PSL ordinance on many of the same grounds used to successfully halt PSL in Austin and San Antonio. The plaintiff businesses asked the court to postpone the Dallas ordinance’s August 1, 2019 effective date, and ultimately to declare the ordinance unconstitutional and unenforceable."
Seyfarth Shaw LLP
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The Sharp Corners of ACA Premium Tax Credit Provisions
"[The Tax Court recently considered] whether an SSDI lump sum catch-up payment had to be counted in calculating PTC eligibility when the taxpayers had made an election ... to reallocate the lump-sum payment from current year into prior years. The Court looked at the text of Section 36B and said 'yep, gotta include the lump sum.' ... While the interpretive choice made by the Court was understandable, it was not inevitable." [Johnson v. Comm'r, No. 1394-16 (T.C. Mar. 11, 2019)]
Bryan Camp, via SSRN
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[Opinion]
Private Health Insurance Saves Americans Money
"[1] Health insurance accounts for only a small fraction of American health-care costs.... [2] Money that insurance companies spend on administration reduces the overall cost of the health-care system.... [3] In the Medicare system, private plans give enrollees better-quality medical care at 10% less cost."
Manhattan Institute
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Selected Discussions on the BenefitsLink Message Boards
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Very Small HRA for Governmental Employer
A very small governmental employer (app. 7 or 8 employees) thinks they want to set up an HRA for one person. Well, this won't fly because the one person is a "Highly Compensated Individual" under the testing rules (is in the top 25% by compensation). I don't know why they want to do this anyway (apparently something to do with Medicare, but that's unclear) -- but because they can't do that, they wanted to make everyone eligible and pay their group health premiums with HRA funds. That can't be done either. And a QSEHRA isn't available if the employer provides group insurance. I think they can't have their cake and eat it too, but I'm wondering if I'm missing something obvious?
BenefitsLink Message Boards
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Most Popular Items in the Previous Issue
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