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Health & Welfare Plans Newsletter September 17, 2019 |
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This Newsletter:
BenefitsLink Retirement Plans Newsletter:
Message Boards Digest:
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The Individual Coverage HRA Notice: What Are the Requirements? "The notice, which must be sent to all eligible employees 90 days before the benefit is offered, is primarily intended to inform eligible employees of how the ICHRA affects premium tax credits. This information will help employees make an informed decision on whether to participate in the ICHRA or opt out. It also notifies employees that a benefit is being offered and what they can expect from the ICHRA."
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Will New Price Transparency Rules Have an Impact? "Nearly 38% of all respondents believe the rules will lead to lower costs for hospital services, while an identical number are unsure about the impact and the remaining 24% believe it would have none.... A slight majority (57%) are confident health plan members will use the information to make better value-based healthcare decisions.... A resounding 61% of employers think the rules will lead to more patients being steered to lower cost, higher quality hospitals."
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Wasteful Drug Spending Contributes to High Prescription Costs "[R]educing the use of high-cost, low-value drugs could lead to $63 million in annual savings among the 15 plan sponsors, which represents approximately 3% to 24% of overall pharmacy spending.... Wasteful prescriptions represented 3% to 12% of total claims per sponsor evaluated, with an average savings of $413 per script ... Brand-name drugs made up 42% of wasteful prescriptions, with an average savings of $682 per wasteful script."
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Health Insurance Tax Will Be Reinstated in 2020 "[T]he Health Insurance Tax (HIT), which was suspended by the [IRS] for 2019, will become relevant again next year.... The tax is meant to raise over $15.5 billion collectively from health insurance carriers in 2020, almost double that of the 2014 fee.... This is expected to add around 2.5-3% to your fully-insured plan's premium."
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Ninth Circuit: Hawaii Laws Prevent Health Plan's Insurer from Being Reimbursed "Although the federal courts have been deciding ERISA preemption claims for decades, this case illustrates the complexity -- and unpredictability -- of litigating an ERISA preemption dispute in the health plan subrogation/reimbursement space.' [Rudel v. Hawai'i Management Alliance Association, No. 17-17395 (9th Cir. Sept. 11, 2019)]
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"Leaders of the House Energy and Commerce Committee [on September 16] announced a bipartisan investigation of business practices they say have fueled the rise of surprise medical billing, including the role of private equity firms that own physician staffing and emergency transportation companies."
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Health Insurance Costs 'Wildly Inflated' for Government Workers in California "A new analysis of public spending on employee health insurance ... found that workers toiling in California's cities, counties, special districts and state offices received health benefits costing about 50 percent more than the average in California, which is $9,476. And, surprisingly often, benefits cost two, three, four, up to even eight times as much."
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Benefits in General |
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Can Employee Agreements Mitigate ERISA Fiduciary Exposure? "[The district court] opened the door to a few questions, such as how much education and experience does it take for someone to be sophisticated enough to sign a release, the extent to which the release was valid against plan trustees, and whether a shorter timeline for signing would be equally sufficient. Further, the court noted that the employee's release did not bar the plan itself from asserting claims against the plan fiduciaries in the future." [Innis v. Bankers Trust Co. of South Dakota, No. 16-650, (S.D. Ia. Apr. 30, 2019)]
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Press Releases |
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Marcia Wagner to be Inducted in Top Women of Law Circle of Excellence
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Cecilco 401(k) Managed Solutions is Certified to Industry Best Practices
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Most Popular Items in the Previous Issue |
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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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