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Health & Welfare Plans Newsletter

August 20, 2024

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[Guidance Overview]

CMS Releases New Discounted Prices for 2026 Selected Drugs

"The negotiated prices range from 38% to 79% discounts off the 30-day supply list prices.... CMS commented that if the new prices had been in effect last year, Medicare would have saved an estimated $6 billion, or approximately 22%, across the 10 Selected Drugs.... CMS has until March 2025 to publish an explanation for the negotiated prices for each Selected Drug that go into effect on January 1, 2026. By February 2025, CMS will select up to 15 more drugs covered under Part D for negotiations for 2027."  MORE >>

Wiley Rein LLP

[Sponsor]

Compliance Courses Available Live and On Demand

Lorman Education Services leads the industry in providing the highest quality, cutting-edge educational seminars through various media.
Live webinars: COBRA (Aug. 26) and Section 125 plans (Sep. 13).
Discount for BenefitsLink readers

Sponsored by Lorman Educational Services

Eleventh Circuit Affirms Summary Judgment in Favor of Employer in FMLA Suit

"[W]hile the Eleventh Circuit acknowledged that the district court’s sanction did hinder Browning’s ability to show damages and contribute to the dismissal of his case, the Court’s sanction was the exclusion of evidence, not the dismissal of his case. Browning could have presented evidence that he had suffered damage in other ways.... [The court]  found that the district court correctly ruled that since Browning could not establish damages under the FMLA, he also could not establish damages under an alleged breach of contract." [Browning v. Bay Radiology Associates PL, No. 23-13842 (11th Cir. Jun. 27, 2024; unpub.)]  MORE >>

Hall Benefits Law

Survey Reveals Almost 8% in Projected Health Care Trend for 2025

"Projected health care cost trend jumped to almost 8% for 2025, the highest amount in more than a decade ... The predicted surge in employer health care spending -- actual health care costs have grown a cumulative 50% since 2017 -- comes against a backdrop of inflation, heightened demand for expensive drugs such as GLP-1s, potentially curative but high-cost cell and gene therapies, and the ongoing burden of treating cancer and other chronic conditions."  MORE >>

Business Group on Health

Questions for Employers to Consider with Trending High-Cost Healthcare Claims

"Are your health benefits plans able to provide sufficient access to new healthcare treatments like medications or therapies? ... Do employees have easily accessible educational information and healthy living resources in a variety of formats?  ...   Are your health and wellness efforts sensitive to employees with differing abilities, conditions and levels of health? ...   Are employees using the programs and services you offer? ...   Are employees satisfied with the benefits and support offered? "  MORE >>

Forbes; subscription may be required

Employee Engagement in Healthcare Benefits Is a Top Priority But Barriers Exist

"While 66% of benefits professionals state engagement as a top priority, only 20% say their organization is nearing or achieving the best-case scenario when it comes to healthcare benefits. 66% of employers also report that healthcare navigation services from an independent provider are an effective tool to increase or support employee engagement with health and healthcare benefits."  MORE >>

Quantum Health

[Opinion]

The First-Ever Government Negotiation Process for Drugs Has Finished, But the Politics Are Ongoing

"In the near term, it may be difficult to assess the extent to which CMS was truly able to drive a hard bargain on each of these drugs, mainly because CMS is unable to publish the net prices that Medicare drug plans currently pay for the selected drugs (including rebates and other price concessions), due to the proprietary nature of these data.... [This article focuses] on the political implications of the Drug Price Negotiation Program, what role it might play in upcoming elections, and what the outcome of the election might mean for the fate of drug price negotiations in the future."  MORE >>

Health Affairs Forefront

Employee Benefits Jobs

View job as Chief Benefits Officer for Kansas Public Employees Retirement System  (KPERS)

Chief Benefits Officer

Kansas Public Employees Retirement System (KPERS)

Topeka KS / Hybrid

View job as Chief Benefits Officer for Kansas Public Employees Retirement System  (KPERS)

Press Releases

Koa Health Launches Proactive Mental Health Solution For Employers to Unify and Simplify the Continuum of Care

Koa Health

OneDigital Captives Solution Announces National Partnership with ParetoHealth

OneDigital

Webcasts and Conferences
(Health & Welfare Plans)

ERISA: It's Not Just About Retirement

September 10, 2024 WEBINAR

UBA [United Benefit Advisors]

What are Level Funded Plans?

September 17, 2024 WEBINAR

UBA [United Benefit Advisors]

Last Issue's Most Popular Items

Section 1557 Suffers Challenges as Agency Deference Dissolves in Loper Bright's Wake (PDF)

Gallagher

Using HSAs, Health FSAs and HRAs for Over-the-Counter Items

Bolton

FMLA Leave Administration Tuneup

Sun Life

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BenefitsLink® Health & Welfare Plans Newsletter, ISSN no. 1536-9595.

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