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New Transparency Requirements for Health Plans

AssuredPartners

Departments of Health and Human Services, Labor and the Treasury (together, the Departments) issued a final rule under the Patient Protection and Affordable Care Act (PPACA) and in furtherance of an executive order issued in 2019.

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How Does an Employee Benefits Survey Help a Company Grow?

Vantage Circle

Benefits include health insurance, retirement plans, flexible work arrangements, professional development stipends, and other offerings to support well-being and life outside work. What aspects of our health benefits work well for you? What aspects of our health benefits are most frustrating or confusing?

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What PBM-carrier Mergers Mean for Employers and Benefits Plans

Corporate Synergies

There are plenty of reasons to be skeptical about the so-called benefits of PBM-carrier mergers. Consolidation in the insurance industry—integrating pharmacy benefit managers (PBMs) into carriers—is bringing change to the way employers buy health insurance and how employees and consumers use it.

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Medical Marijuana Within the Context of Workers’ Compensation Claims

The Workcomp Writer

The Court indicated that because the Board had not cited any legal authority for its conclusion, much less identify a federal statute that exposed the insurance carrier to criminal prosecution, it would vacate the Board’s determination that the reimbursement would violate federal law. Workers’ Comp. It had chosen not to do so.

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New Health Plan Prescription Drug Reporting Mandate

AssuredPartners

For fully insured plans, health insurance carriers will be responsible for making the necessary reporting from a legal standpoint. Employers who sponsor self-funded health plans should coordinate with their self-funded TPA and pharmacy benefit manager (PBM) to ensure timely reporting of the required data.

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Adjusted Community Rating and Its Role in Health Care Costs

Insperity

This ratio compression is expected to result in higher premiums for younger individuals, as insurers account for the drop in premiums for older individuals. Most small businesses should expect to see an increase in their health insurance premiums due to this age ratio compression. Early bird special? Strength in numbers.