Headlines about "Health plan costs - misc"
Gathered from the web by the editors at BenefitsLink.com.
For 11 States and Puerto Rico, Cost of Employee Benefits Is One of Three Top Fiscal Issues for 2012 (PDF)
"Dealing with unfunded liabilities, increasing employee contributions and making significant reforms lie in the year ahead for state lawmakers." (National Conference of State Legislatures)
[Opinion] Health Care Consumers Have Uphill Battle in Pushback Against High Prices
"To an economist it is astonishing that Americans have been content for so long to allow an economic sector that has absorbed an increasing portion of their incomes -- 18 percent of their gross domestic product now and 20 percent before too long -- to operate without any meaningful price transparency." (New York Times; free registration required)
[Opinion] Patients Facing Unaffordable Premiums And Consumer Advocates Launch Historic All-Volunteer Signature-Gathering Effort for Health Insurance Rate Regulation Initiative
"The Insurance Rate Public Justification and Accountability Act will reform an unaccountable insurance industry by requiring health insurance companies to open their books, publicly justify rate hikes, and get approval before an increase can take effect. 35 states have the power to reject unjustified health insurance rate increases but California does not." (Consumer Watchdog)
Providence Is Now on 'the Brink of Bankruptcy,' Mayor Taveras Warns
"Taveras said the city's retirees must accept reduced pension and health care benefits to save the city from financial ruin. A decree signed in 1991 by Mayor Buddy Cianci pushed the city's pension liability 'into the stratosphere' by giving annual cost-of-living increases of 5% and 6% to more than 600 retirees, he said." (WPRI.com)
Providence, R.I., Mayor Proposes Benefit Cuts to Avert Bankruptcy
"Mayor Angel Taveras, a Democrat, outlined plans to reduce pensions for retired municipal workers and vowed to appeal a recent state court ruling preventing the city from forcing its retirees to switch to the federal Medicare health insurance program when they turned 65." (New York Times; free registration required)
[Opinion] Where the CBO Report on Federal Pay Went Wrong
"[The federal] employees that the report claims may be overcompensated are hardly those whom people would think of as 'government bureaucrats in Washington.' No, these 'bureaucrats' are among the lowest-paid federal employees, doing unglamorous but critical work around the country." (Washington Post)
Mayor Says Pensions and Benefits for Uniformed Workers Will Cost New York City More Than Their Actual Salaries
"Pensions and fringe benefits for uniformed workers are going to cost the city more next year than their actual salaries, Mayor Bloomberg revealed [on Thursday, Feb. 2] as he made another strong pitch for Albany to enact pension reforms." (NYPOST.com)
Larger Employers Increasingly Covering Cost of Gender Changes
"[J]ust like depression, having gender identity disorder is diagnosed by doctors, and the American Medical Association asserts that when discriminatory financial barriers are placed between the transgender community and proper health care by dismissing treatments as 'cosmetic' or 'experimental' -- even when covered for other patients with other recognized medical conditions -- more expensive problems can develop as a result, such as depression, substance abuse problems and stress-related illness." (Employee Benefit News)
Congressional Budget Office Expects Health Spending to Double in Ten Years
"CBO's economic outlook predicts that federal spending on Medicare, Medicaid and other healthcare programs will climb to $1.8 trillion -- or about 7 percent of the entire economy -- by 2022." (The Hill)
Next Steps for Accountable Care Organizations
"This new approach is already affecting how other health plans pay providers and resulting in a number of ACO contracts between providers and private health plans. . . . This Health Policy Brief provides an overview of ACOs, their origins, and the current status of adoption by Medicare and private health insurance plans." (Health Affairs)
[Opinion] Employers Need Health Care Cost Transparency
"[A] growing number of employers recognize that transparency is needed to change the unsustainable dynamics of the health care industry. Unfortunately, many of these employers are being blocked by health insurance companies that benefit from keeping things the same." (The Hill)
Government Health Spending Seen Hitting $1.8 Trillion
"[R]esearchers warned that the longer term prospects for rising healthcare spending could have dire consequences for the U.S. deficit when combined with the cost of Social Security, if current revenue levels remain unchanged." (Reuters)
[Opinion] Over-the-Counter (OTC) Medicine Saves Healthcare System Billions
"[T]he study findings underscore the importance of reversing a provision in the 2010 Affordable Care Act (ACA) that prohibits consumers from using their flexible spending arrangements (FSAs) to purchase OTC medicines without first getting a prescription. At the time this provision was enacted, an estimated 19 million working American families purchased OTC medicines, relying on these accessible and affordable medicines to keep their families healthy." (Consumer Healthcare Products Association)
[Opinion] Living Well with Chronic Illness: A Call for Public Health Action
"Chronic disease has now emerged as a major public health problem and it threatens not only population health, but our social and economic welfare." (Institute of Medicine)
Patients in Consumer-Driven Health Plans Show More Cost-Conscious Behavior (PDF)
"[T]hose in [consumer-driven health plans] were more likely to say they had checked whether their plan would cover care; asked for a generic drug instead of a brand name drug; talked to their doctor about treatment options and costs; talked to their doctor about prescription drug options and costs; developed a budget to manage health care expenses; checked a price of service before getting care; and used an online cost-tracking tool." (Employee Benefit Research Institute)
[Opinion] Cleveland Clinic: 'Why We Won't Hire Smokers'
"Job candidates are told that the offer is subject to a nicotine-free urine test. If a candidate tests positive for nicotine, the offer is rescinded, and he or she is offered a free tobacco-cessation program and may reapply in 90 days. . . . At Cleveland Clinic, we have a unique perspective on the burden of chronic disease. We not only treat disease, but we also play a vital role in educating patients and employees about lifestyle choices. It is only right to practice what we preach." (USATODAY.com)
[Opinion] Not Hiring Smokers Crosses Privacy Line
"Treating smoking, in essence, like illegal drug use takes . . . employers down a dangerous road, one that extends far too deeply into the private lives of prospective workers." (USATODAY.com)
Downgrades in Ratings Loom for G20 Nations on Health Costs, S&P Warns
"Ratings agency Standard & Poor's warned it may downgrade 'a number of highly rated' Group of 20 countries from 2015 if their governments fail to enact reforms to curb rising healthcare spending and other costs related to ageing populations." (Reuters)
[Guidance Overview] Disenrollment Was Proper After Ignored Document Requests
"A plan participant's disregard of health plan requests to verify dependent eligibility was a proper basis of a plan's action to remove his dependents from coverage and garnish wages to recover about $23,000 in benefits overpayments, a federal court ruled in Muhammad v. Ford Motor Co. . . . (E.D. Mich., Jan. 12, 2012)." (SmartHR)
Are Accountable Care Organizations a Way to Fix a Fragmented and Expensive Health Care System?
"While health reform's primary focus on [Accountable Care Organizations] revolves around Medicare, many insurance carriers now have or are in the process of developing ACO options for the commercial sector. In fact, some ACOs have been around even before they recently began to gain more attention . . . ." (BenefitsPro)
Saving Company Retiree Health Plans
"Bankruptcy judges usually let companies terminate such plans, figuring the move will make it more likely that creditors will be paid and that the company's chances of turning itself around will be enhanced if it can shed millions or even billions of dollars in retiree obligations at the stroke of a pen. Retirees, who are unsecured creditors, always are vulnerable." (The Wall Street Journal)
Health Care Reform Law Requires Greater Collaboration Between HR and Finance Executives
"According to a Towers Watson/Forbes Insights survey of more than 300 HR and finance executives, both groups of respondents see changes ahead in their own roles when it comes to reward programs, as the provisions of the 2010 Affordable Health Care Act take effect." (Human Resource Executive Online)
[Guidance Overview] Prepare for Health Plan Participant Fee
"Many questions about the fee are currently unanswered, including when it must be paid. Proposed regulations are expected on this and other matters. In the meantime, Notice 2011-35 provides information for plan sponsors and issuers to ensure they have properly budgeted for this expense." (Dorsey & Whitney LLP)
Health Insurance Deductibles Doubled in 7 Years, Study Finds
"A recent study by the Commonwealth Fund shows just how much more consumers are paying for employer-provided health insurance." (The New York Times; free registration required)
[Opinion] It Takes a CEO to Save the U.S. Health Care System
"Forget Washington and the political debate over Obamacare. The real battle for the future of health care is being fought in the world of business, where tens of thousands of companies have seen their financial well-being undermined by skyrocketing employee health costs." (Bloomberg L.P.)
America's 'Screwed Up' Health Care Spending
"Speaking at [a conference, the] co-director of the Emory Center on Health Outcomes and Quality in Atlanta explained that health care costs can be broken down into two simple areas: the change in the prevalence of treated diseases, such as hypertension and diabetes, and how much does it cost to treat those problems. To fix it simply, he says, there needs to be averting, detecting and managing chronic diseases." (Employee Benefit News)
Psychiatric Group Pushes to Redefine Mental Illness Sparks Revolt
"The draft is sparking a backlash among practitioners concerned the expanding mandate will increase the number of patients treated with drugs. The guide would loosen diagnostic criteria on some existing ailments and brand as mental disorders some common behaviors . . . ." (Bloomberg)
State Progress toward Health Reform Implementation: Timely Analysis of Immediate Health Policy Issues (PDF)
"In this paper, we combine information from the National Conference of State Legislatures . . . and [HHS] to group states based on their progress toward implementing health insurance exchanges. All designations are current as of January 17, 2011." (Robert Wood Johnson Foundation)
Medical Care Benefits for Private Industry Workers, March 2011
"In March 2011, more than two-thirds of private industry workers had access to medical care benefits, and 51 percent of all workers participated in a medical care plan. Employers paid 80 percent of premiums for single-coverage medical care benefits and 69 percent of premiums for family coverage. Among these workers, access and participation rates varied widely by wage category." (U.S. Bureau of Labor Statistics)
U.S. Consumers Tell Insurers to Cover Experimental Drugs
"62% of Americans 'oppose decisions by the government or health insurance plans' to deny care if those entities determine that the benefits of that care do not justify its costs." (Reuters via Employee Benefit News)
Health Care Reform: Small Health Insurance Companies Feel Squeezed By New Law
"critics say the administration's stepped-up reviews and heightened scrutiny are more about showcasing the value of the new health law in the run-up to the 2012 elections, a charge the Department of Health and Human Services denies." (Chicagotribune.com)
[Opinion] U.S. Chamber of Commerce's Comments on Final HHS Regs for Medical Loss Ratio (MLR) Requirements Under the Patient Protection and Affordable Care Act
"[T]he Chamber . . . offers the following suggestions to further improve the rule with regard to rebate distribution requirements: 1. Simplify the rebate distribution rules for the group markets; 2. Extend the time frame during which rebates can be applied to premiums; and 3. Simplify rebate notice requirements." (U.S. Chamber of Commerce)
Government Report Details Slowdown in U.S. Health Care Expenditures
"U.S. health care expenditures continue to ease, as spending in 2010 rose a modest 3.9%, a dramatic showdown compared with the explosive growth in expenditures of just a few years ago, according to a government report. The report, produced by the Centers for Medicare & Medicaid Services' Office of the Actuary, explores the reasons for the slowdown in costs, as well as details on costs by health care sector." (Business Insurance)
Self-Insured Group Health Plans: Stop-Loss Insurance and Adverse Selection (PDF)
Published October 4, 2011. 'In the course of considering changes to its Stop-Loss Model Act, the National Association of Insurance Commissioners (NAIC) has received formal comments containing substantive inaccuracies regarding self-insured group health plans, stop-loss insurance, and how smaller self-insured group health plans may contribute to adverse selection in the health insurance marketplace. Similar comments have beenmade by federal regulators responsible for implementing the Affordable Care Act (ACA). This White Paper identifies and corrects several inaccurate comments in order to assist policy-makers at both the state and federal level to properly assess legislative/regulatory proposals related to self-insured group health plans." (Self-Insurance Insurance Institute of America, Inc.)
[Guidance Overview] ERRP Reminder: March 30 Deadline for Submission of Full-Replacement Claim List
"Last month the CMS announced that the ERRP would be closed for claims incurred after December 31, 2011, due to the projected exhaustion of funds." (Deloitte via BenefitsLink.com)
New Cancer Drugs Affordable By The 1 Percent?
"[A]n economic drama . . . is playing itself out in cancer wards and oncologists' offices across the country. Unaffordable new drugs, even when they're covered by insurance, are being rationed by price as patients, doctors and hospital officials struggle with what is likely to be the most pressing problem for the nation's health care system over the next decade: how to pay for the spectacular rise in the cost of cancer care, especially drugs and diagnostic tests." (The Fiscal Times)
What to Make of The 'That's What PBMs Do' PR Campaign
"On the whole the campaign is accurate. On the whole the campaign is accurate. . . . But there are certain omissions and misleading statements. . . . Rebates -- which represent revenue from the pharmaceutical industry to PBMs -- are not discussed." (Health Care Solutions And Benefits Management)
Number of Retirees Underlies Kodak Bankruptcy Filing
"Here's one way of understanding Eastman Kodak Co.'s problems: The company has twice as many retirees drawing benefits in the U.S. as it has active employees world-wide." (Wall Street Journal)
U.S. Health Care Hits $3 Trillion
"[H]ave we tamed the cost beast with real legislation -- or is it just legislation around the edges? . . . Obamacare took the payers out to the woodshed. Medical Loss Ratios (or basically what the insurance companies pay out for actual healthcare services) will be mandated -- but is this really going to dent our [national health expenditures]?" (Forbes)
Economist Uwe E. Reinhardt Asks, Is U.S. Health Spending Finally Under Control?
"[A]s the fraction of G.D.P. devoted to health care increases, the added satisfaction, or utility, that people derive from added health care is likely to diminish relative to the added satisfaction derived from consuming more of other things. It could explain a gradual decline in the excess growth of health care spending." (New York Times; free registration required)
[Opinion] Bending the Health Care Cost Curve: New Era in American Health Care?
"Staying the course toward a high performance health system shows promise of at long last bending the health care cost curve. It offers a far more promising approach to containing health care costs than increasing deductibles, cutting benefits, and shifting more of the financial burden of health insurance premiums and medical bills to working families and elderly and disabled Medicare beneficiaries." (The Commonwealth Fund)
Government Employees Face Benefits Changes, Study Shows
"The report, Containing Health Care Costs: Proven Strategies for Success in the Public Sector, funded by a grant from Colonial Life & Accident Insurance Company, identified strategies government employers are using to manage the quality and cost of their employee benefits programs." (Wolters Kluwer Law & Business / CCH)
How a Defined Contribution Approach Can Help Employers Control Health Costs and Give Employees Wider Range of Options
"[I]n a defined contribution approach, the employer designates a fixed amount of money, or a defined contribution, to each employee. Employees then use that money to purchase individual health care insurance, selecting products that specifically meet their needs and those of their dependents." (Smart Business Network Inc.)
California Regulators Still Have Little Power Over Insurance Rate Hikes
"California regulators last year won expanded authority to scrutinize health insurance rate hikes, but their continued lack of real power has consumers gearing up for a new battle with the insurance industry over rate regulation. The new law permits regulators to conclude a rate hike is excessive, but they can only try to persuade or shame insurers into backing off." (San Jose Mercury News)
Ernst & Young Steps Up for Same-Sex Partners
"While the company began offering same-sex domestic partner benefits in 2002, like most other employers, it taxed the amount spent as income, while other family policies come out of pre-tax income. But as of January 1 this year, the company will reimburse employees for those taxes for the 2011 tax year, and for tax years going forward." (Thomson Reuters)
[Guidance Overview] Medical Loss Ratio Requirements Rules
"As of January 6, 2012, seventeen states have requested adjustments. Six states have received relief from application of the 80 percent MLR (Georgia, Iowa, Kentucky, Maine, Nevada, and New Hampshire).[See footnote 4] The relief allows each of these states to implement an MLR that is lower than 80 percent." (Epstein Becker & Green, P.C.)
The Expansion of Private Insurance
"[Looking at how health benefits are managed, rather than how they are financed ? it becomes clear that in some ways] we are increasingly relying on the private insurance industry to provide health coverage. And, even when coverage is publicly-managed, health care services are primarily purchased from private providers." (The Henry J. Kaiser Family Foundation)
[Guidance Overview] How to Handle Medical Loss Ratio Rebates: Guidance for Insured Plans Subject to ERISA
"Insurance companies will report data in June 2012, and pay rebates in August 2012. Plan sponsors with insured arrangements should be alert for communications from their insurance carriers during the summer of 2012, and should be prepared to address rebate distribution." (The Segal Group, Inc.)
Massachusetts Residents without Health Insurance to Face Higher Penalty in 2012
"Under the guidelines . . . the maximum penalty this year for those with incomes that exceed 300% of the federal poverty level will be $105 for each month that an individual is not covered by health insurance, or $1,260 a year." (Business Insurance)
Report Shows 25% Premium Hike with No Individual Mandate
"Without the individual mandate -- the requirement for most Americans to have health insurance or face a penalty -- the analysis reveals costs would rise and fewer individuals would be uninsured." (Employee Benefit News)
[Guidance Overview] IRS Issues Form to Claim Small Business Health Care Tax Credit
"The Internal Revenue Service has released the final 2011 version of Form 8941, which eligible small employers may use to calculate the small employer health care tax credit, as provided under the Patient Protection and Affordable Care Act (ACA)." (Wolters Kluwer Law & Business / CCH)
Regulations, Costs, and Uncertainty in Employer Provided Health Care (PDF)
Print of October 13, 2011, hearing. 'It is clear our system of employer-provided health care is experiencing dramatic changes due in large part to a deeply flawed health care law. Today's hearings provide members of the subcommittee an important opportunity to examine these changes, their impact on workers and employers, and to discuss the solutions our nation needs to chart a better course." (U.S. House Committee on Education and the Workforce Subcommittee on Health, Employment, Labor and Pensions)
[Guidance Overview] Two Important ERRP Deadlines
"[1.] [CMS] requests Plan Sponsors that have received reimbursement under the Early Retiree Reinsurance Program (ERRP) to complete a survey located at https://www.research.net/s/CMS-ERRP-Survey. [2.] [HHS] is requiring Plan Sponsors that have been reimbursed with ERRP funds to submit a full-replacement Claims List that passes the automated edits introduced on October 1, 2011 and an associated reimbursement request by March 30, 2012 for each plan year." (Cheiron, Inc.)
[Guidance Overview] Update on Fiscal Year Health FSAs and the $2,500 Limit
"On January 10, 2011 I posted about how employers with health FSAs that follow a fiscal year might comply with the $2,500 deferral dollar limit going into effect on January 1, 2013. This post updates and corrects the earlier post as follows: Notice 2012-9, which provides updated guidance on Form W-2 reporting of the value of group health care, exempts most health FSAs from the reporting requirement. The specific exemption applies to health FSAs that are exempt from HIPAA because they are funded entirely by employee salary deferrals, or because any employer contribution is $500 or less." (E is for ERISA)
Which Industries Pay the Highest Health Care Cost Per Employee?
"The 2011 Society for Human Resource Management . . . Health Care Benchmarking Survey examined health care costs for U.S. employees and found that costs vary widely, depending on the industry. . . . Some of the industries that the survey found 'spent the most on health care per covered employee during plan year 2010' were: Utilities; Insurance; Real Estate; Government; and Manufacturing." (J.P. Farley Corporation)
Kodak Retirees Fear for Benefits
"For many Eastman Kodak Co. retirees, the company's financial trouble is shaking the very foundation on which they built their careers, lives and nest eggs. . . . While retirees have reason to be worried about their health care, their pensions should be safe, according to several financial experts." (www.democratandchronicle.com)
Massachusetts Cities Face $4.5B Unfunded Retiree Health Care Costs
"'Without reforms, over the next 30 years municipalities would be forced to siphon tens of millions from education, public safety and other critical services simply to fund the annual costs of retiree healthcare, leading to the layoffs of hundreds if not thousands of municipal employees,' the report said, according to The Herald News." (PLANSPONSOR.COM)
[Guidance Overview] IRS Clarification of Previous Guidance on Form W-2 Informational Reporting Requirement
"Employers should continue to work with payroll administrators to determine their level of preparedness to administer this new reporting requirement. Employers should determine which of their benefit arrangements must be reported so as to accurately capture the correct benefit values for the 2012 Forms W-2." (Proskauer Rose LLP)
[Guidance Overview] Updated Guidance on Form W-2 Reporting of Health Care Coverage
"Employers should review their benefit plans to determine which plans meet the definition of 'applicable employer-sponsored coverage.' For example, employers should consider whether their EAPs, wellness programs, or on-site medical clinics would be considered group health plans and, further, whether they should report such coverage (consideration also should be made as to whether COBRA should be offered for such programs)." (Morgan, Lewis & Bockius LLP)
[Guidance Overview] IRS Clarification of Form W-2 Reporting Obligations for Employer-Provided Health Coverage
"Although mandatory reporting on Form W-2 is a year away, the time for action is now. Employers should now (or very soon) begin discussions with their payroll departments (or outside payroll service providers) and create a schedule of what information is needed, who will provide it, and who will take the lead in overseeing all tasks, so that compliance with the reporting requirement does not slide to the end of the year, and become an overwhelming endeavor." (Davis Wright Tremaine LLP)
The links shown above have been gathered from the web by the editors at BenefitsLink.com. Each article's publisher is shown above in parentheses. Opinions expressed in each article are those of the article's publisher, not necessarily those of BenefitsLink.com, Inc. or any web site that displays these headlines in a "frame." You should contact the listed publisher for copyright information about any particular article or to inquire into the right to use the article in any manner.