"[The transparency in coverage] rules require plans and insurers to publish an in-network rate file. This file must express rates as a dollar amount and may include negotiated rates, underlying fee schedule rates, or derived amounts for covered items and services. Because some plans and insurers report rates under 'percentage-of-billed charges' or some other alternative arrangement, [FAQs Part 53] establish[es] two safe harbors."  MORE >>

"Following in the footsteps of the District of Columbia, the Maryland law will create a mandatory statewide benefit that will be funded by payroll taxes. In contrast, the Virginia law will create a voluntary benefit program whereby employers may choose to purchase insurance plans to provide paid family and medical leave benefits to employees if they so wish."  MORE >>

"[T]he court found no need to remand the claim to the plan trustees for reconsideration.... The court did not find bad faith on Central States' part, but the plan 'repeatedly failed to handle Garner's claim in a sensitive and fair-minded manner.' Central States had three opportunities to give the claim reasoned consideration and it did not do so." [Garner v. Cent. States, SE & SW Areas Health & Welfare Fund Active Plan, No. 21-1602 (4th Cir. Apr. 20, 2022)]  MORE >>

"[T]he general approach usually starts with a pre-tax employee contribution at least nominally funding some kind of employee benefit. The dollar amount of that employee contribution is later repaid to the employee, sometimes in exchange for doing a very simple task ... The payment for this very minimal activity is, at least according to these scheme promoters, not taxed. The end result is that the employee has the same (or almost the same) gross pay, but artificially reduced payroll taxes sometimes result in an actual increase in take-home pay.... The IRS has made clear that these arrangements are impermissible[.]"  MORE >>

"Despite their importance to the supply of prescription drugs, there has been limited research on pharmacy benefit managers (PBMs) and their vertical relationships to insurers and drug manufacturers. This paper provides an overview of the current state of research on this topic, motivates why further research is needed, and discusses promising theoretical and empirical directions for that research."  MORE >>

"During the pandemic, as employees became responsible for home-schooling children or caring for immediate or extended family members, they and their employers discovered that they could be productive while juggling work and home responsibilities. Employers are now weighing changes to their company policies to reflect what they've learned."  MORE >>

"So far, state policy makers concerned about high medical prices that may result from market power (or other causes) have focused on the use of regulations to force prices down. In this article, [the authors] argue that taxation provides another policy tool, and in some instances one more targeted at the harm of excessive prices for health care."  MORE >>

"Prioritize consistent and clear communication ... Keep working for human connection ... Hire hybrid talent with purpose ... Set productivity and workflow expectations ... Don't compromise culture."  MORE >>