"The [FAQs Part 52] provide that if a plan or issuer is unable to temporarily provide adequate access through a direct coverage program due to supply shortage, but has otherwise established a compliant direct coverage program, such plan or issuer will not be out of compliance with the direct coverage safe harbor.... [P]lans and issuers can establish a policy that limits coverage of OTC COVID-19 tests ... to tests purchased from established retailers that would typically be expected to sell OTC COVID-19 tests."  MORE >>

"Employers must review carefully and communicate OTC COVID-19 test coverage details to participants, especially if they offer plans from multiple carriers.... Seven of the 13 largest insurers are currently using various reimbursement policies, and six have direct coverage options.... [E]ach process is slightly different and both direct coverage and reimbursement options come with nuances."  MORE >>

"Health plans and insurers must regularly verify the information in their provider directories and promptly update that information ... In the event an enrollee is misled by a provider directory and mistakenly receives care from an out-of-network provider, the enrollee's liability will be limited to an in-network cost-sharing amount, with that amount applied to the in-network deductible and out-of-pocket maximum."  MORE >>

"Although the proposed bill is similar to Senate Bill 95, which expired on September 30, 2021, there are some significant differences."  MORE >>

"According to the Second Circuit, the September 11, 2018 'letter announced [the plaintiff's] new disability classification and provided a termination date for benefits based on that disability … follow[ing] [Liberty's] initial termination of her long-term disability benefits and subsequent reversal of that decision. As a result, the letter did not mark a "reduction" of her benefits but rather a continuation of her benefits under a different classification.' " [Ruderman v. Liberty Mutual Group, Inc., No. 21-817 (2d Cir. Jan. 27, 2022)]  MORE >>

"The most common financial sacrifices made by respondents regarding household necessities included cutting back on groceries (51%) and utilities (22%). Alarmingly, one in ten report a significant medical expense has even caused them and their families to skip meals/go hungry. Significant medical expenses also caused problematic behaviors among those making financial sacrifices, such as taking on credit card debt (60%), completely depleting savings (37%) and borrowing from retirement accounts (23%)."  MORE >>

"24% of respondents report having no money in their savings accounts and 48% say they have less than $1,000.... 33% of insured Americans cannot go more than one week without a paycheck, while 71% cannot endure a month without pay, leading many (25%) to have to borrow money in the event of a medical emergency.... [M]ore than three-quarters (78%) of insured respondents underestimate their financial exposure to common medical challenges, such as heart disease and breast cancer."  MORE >>

"Introduction of the program was associated with a 1.3% reduction in prices during the first year and a 3.7% reduction in the second year of access. Use of the program and price reductions are concentrated among magnetic resonance imaging (MRI) services ... MRI prices were 3.7% and 6.5% lower in the first and second years, respectively. [The authors] did not observe differential impacts related to enrollment in a consumer-directed health plan or the degree of market-level price variation. [They] also did not observe a change in utilization."  MORE >>

"Amazon Care launched in 2019 as a pilot program for employees in and around its Seattle headquarters. The program provides a suite of in-person and virtual-care services."  MORE >>

"Increased health insurance information can help inform uninsured Millennials or new members ... Millennials highly value digital health and wellness resources ... Health insurers can use mobile apps to appeal to Millennials."  MORE >>

"The League of Minnesota Cities plans to push again in the next legislative session for a bill that would fully reimburse cities for the cost of insurance for police officers and firefighters on disability pensions ... Since August 2020, about 80% of disability pension applicants say they can't do their jobs due to post-traumatic stress disorder. When a worker gets a disability pension, Minnesota law requires cities to continue paying for their health insurance until age 65, with the state reimbursing a portion of the costs."  MORE >>