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Which Will Better Serve Your Business: A Broker or an Actuarial Consultant?

"Your objective is to control costs, yet a reduction in your costs (premiums) lowers your broker's commission income.... [And] your costs increase each year in proportion to your rate increases. Commissions also grow as your company grows. In contrast, consultant fees do not rise in tandem with your premiums or number of employees.... Most brokers will assist their clients in complying with ACA regulations, but will not take the extra step of determining the best options for an individual company."

October 15th Deadline for Medicare Part D Creditable Coverage Notices

"When you must provide notices: [1] Before the annual Medicare Part D enrollment period (10/15 -- 12/7 each year), [2] Before the individual's initial Medicare Part D enrollment period, [3] Before group health plan enrollment, [4] When group health plan coverage ends (i.e., plan termination) or creditable status changes, and [5] Upon the individual's request. For the first two events, employers can satisfy the requirement by providing the notice to all plan participants before October 15th each year. The notice may be included in open enrollment packages and new hire or new enrollee materials."

The Truth About Voluntary Benefits

"Some voluntary benefits, such as disability or term life insurance, may make financial sense for employees if the potential loss is more than they can cover with their savings. The problem with many other voluntary products is that employees trade a reduction in their monthly take-home pay to protect against a very small risk of incurring a large claim. In many cases, employees are already protected against a large financial loss by their health plan, group disability plan, and other employer-provided benefits.... Voluntary benefits often provide the broker with a first-year commission exceeding 60%, compared to a 3-7% commission for health plans."

March 1 Deadline Nears for Submission of Creditable Coverage Disclosures to CMS

"[E]mployer-sponsored group health plans that offer prescription drug coverage to Part D-eligible individuals are required to submit an electronic Disclosure Notice to [CMS] on an annual basis. This requirement applies not only to employer-sponsored Retiree Health Plans (unless the plan applied for the Retiree Drug Subsidy Program), but also to employer-sponsored plans extended to active employees (and their covered spouses) who are enrolled or are Medicare-eligible (generally speaking, age 65 or over). This annual notice provides CMS with current information regarding the plan's creditable or non-creditable coverage status.... A plan sponsor must submit a new disclosure to CMS no later than 60 days after the beginning of each plan year -- i.e., by March 1, 2015 for calendar year plans."

Innovations in the Setting for Health Care Delivery: Will Expanding Care Options Increase or Decrease Costs?

"Historically, there were two options if you needed health care: your doctor or the emergency room. As demand for primary care increased and costs for emergency care soared, a third option appeared: urgent care. Recently, there has been an explosion of options to improve access to health care, including retail clinics at drug stores and telemedicine. In theory, these new options could reduce overall health care costs by treating conditions earlier and preventing more expensive care. The concern is, however, that people may increase their utilization of health care, thereby leading to higher overall costs."

HHS Announces New Health Plan Out-of-Pocket Limits for 2017

"Applicable to non-grandfathered health plans, the OOP limits for plan years beginning on or after January 1, 2017 are $7,150 for single coverage and $14,300 for family coverage, up from $6,850 single/$13,700 family in 2016. The OOP maximum includes the annual deductible and any in-network cost-sharing obligations members have after the deductible is met.... In addition to the new OOP maximum limits ... employers offering high deductible health plans need to be particularly mindful of the embedded OOP maximum requirement."

Employers: Be Prepared to Respond to Exchange Notices of ACA-Subsidized Employees

"Beginning in Spring 2016, the Affordable Care Act (ACA) Exchanges will begin to send notices to employers whose employees have received government-subsidized health insurance through the Exchanges.... Although CMS has provided these guidelines to apply only to the Federal Exchange, it is likely that the state-based Exchanges will have similar notification programs. Employers should be prepared in advance by developing a process for handling the Exchange notices, including appealing any incorrect information that an employee may have provided to the Exchange. Advance preparation will enable you to respond to the notice promptly and help to avoid potential employer penalties."

October 15 Deadline Nears for Medicare Part D Creditable Coverage Notices

"There have been no revisions to the 2015 model notices provided by [CMS] and [employers] should continue to use the 2011 model notices.... Notices do not have to be sent as a separate mailing; they can be provided as part of enrollment/renewal or other plan information materials."

Combining HSAs with High-Deductible Health Plans: A Cost Control Strategy

"While about half of large employers offered an HDHP in 2009, nearly three out of four did so in 2014. In addition to saving on health care costs, HSA-HDHPs may help employers avoid triggering the so-called 'Cadillac Tax.' ... To achieve significant savings, an employer may need to completely replace its health plan options with an HSA-HDHP.... Employees may adapt to the change more easily if it is phased in over several years."

Medical Tourism -- Not Just Cheap Dental Care in Costa Rica

"While savings is the main driver for setting up medical tourism programs, safety and service must be the primary consideration for engaging these services. Choosing appropriate procedures to cover, using accredited and acceptable facilities, and ensuring follow-up care are just some of the things to consider. The top medical tourism facilitators work with Joint Commission International -accredited providers to ensure quality of care, and coordinate with the patient's insurance and US-based providers for a seamless transition."