3 Tips to Interpreting Your Health Insurance Carrier’s Language

Corporate Synergies

A former carrier underwriter gives 3 handy tips to help you interpret your health insurance carrier’s language. The post 3 Tips to Interpreting Your Health Insurance Carrier’s Language appeared first on Corporate Synergies.

Health Insurance Carriers to Begin Mailing Out Rebate Checks


In 2021, many health insurance plans may be eligible for a rebate. Your organization may qualify if you've sponsored a fully-insured health plan in the past three years. What other factors are impacting your chances of receiving a rebate in 2021? Find out more. Benefits & Healthcare


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Biden Admin to Require Insurance Carriers to Cover At-Home COVID Tests


Biden’s administration has officially announced that insurance carriers, beginning on Jan. 19, are required to provide reimbursement coverage for at-home COVID tests.

What is an EDI 834 File?


Put as simply as possible, an Electronic Data Interchange (EDI) 834 file is the standard format in which employers can communicate their employees’ health insurance enrollment and maintenance data to insurance carriers. Carrier Connectivity Solution

Transparency Rules Deadline Approaching for Employers to Conform by July 1

Griffin Benefits

Most fully-funded employers are conforming to this rule by simply ensuring that their carrier partners are making this information publicly accessible. Note most large TPAs will require that the sponsor of the self-insured medical plan post the files on their public website.

How To Promote an Employee Assistance Program (EAP)


Be sure to check with your insurance carrier to see what employee benefits may be offered under your policy, and whether an EAP is available to you.

Expect More Difficulty Obtaining Fiduciary Insurance

McDermott Will & Emery Employee Benefits

Increasing retirement plan-focused litigation has put insurance carriers and fiduciary service providers in difficult positions. The post Expect More Difficulty Obtaining Fiduciary Insurance appeared first on EMPLOYEE BENEFITS BLOG.

Why your integrated HRA shouldn't be tied to one carrier


For many employers offering a group health insurance plan, adding a supplemental benefit in addition to the group plan can help offset your employees’ out-of-pocket costs. Group Health Insurance Group Coverage HRA

Adequately Insuring Commercial Saltwater Disposal Operations


{"ops":[{"insert":"Commercial Saltwater Disposal (SWD) operations open for third party disposal are quickly becoming the new taboo for insurance carriers.

5 Questions to Ask During Your Renewal


This creates an issue for truck insurance carriers, as the industry is not equipped to handle the rapid growth. With over 431,000 active trucking companies all renewing their insurance on an annual basis, it is more important now than ever to partner with the right insurance agency. Here are five simple questions you can ask as part of your renewal process: How many insurance carriers will they be checking with, and how much volume do they have with each carrier?

Dear Valued Participant, we’re here for you

Benefit Resource Inc.

Lately, we’ve seen an uptick in questions around the roles of responsibilities of your company’s broker, your TPA (that’s us), and your health insurance provider. And where does your health insurance carrier play into this? What is a health insurance carrier? A health insurance carrier administers your health insurance plan. An insurance carrier is a risk-bearing entity.

How Your Employees Can Get Free COVID Test Kits

InterWest Insurance Services

With that in mind, you may want to disseminate information to them about how they can be reimbursed by their insurer for COVID-19 tests they purchase. In these cases, the employee will have to pay for the test upfront and then seek reimbursement from their health insurer.

Is Your Water Damage Claim Now Subject to a Higher Deductible?


nProperty insurance carriers have seen an uptick in the number of water damage claims in recent years. In response to this, insurance carriers may choose to amend the definition of flood to include other types of water damage situations. Insurance carriers may also choose to include a separate water damage deductible that is higher than the property deductible.

This Company Is Changing the Employee Benefits Game


Are you an employer looking for a new and innovative health insurance plan to offer your employees? Wouldn’t it be amazing if there was a new company in the market that actually did something different from all the traditional insurance carriers?

Does Your Insurance Program Cover All Insurance Requirements in the Contracts You’re Signing?


A great question to stop and ask yourself - how certain are you that in the event of a claim your insurance program will trigger coverage? But, if you aren’t checking your insurance program’s fine print ahead of signing a contract you may be signing something that could be the beginning of a major problem later on. Your insurance carrier could “deny” coverage to the parties you’re contracted with, which could result in a breach of contract suit/litigation.

Broker Compensation Disclosure Rule: New Legislation for Brokers

Total Employee Benefits

Beginning December 27, 2021, as part of the Consolidated Appropriations Act, covered service providers – insurance providers, benefits brokers, agents, and consultants – are required to disclose any compensation they expect to receive over $1,000.

The Ins and Outs of Contractors Professional & Pollution Liability Coverage


Does standard General Liability insurance provide coverage for design activities or modifications and. Additionally, more subcontract insurance agreements require Contractor’s. carrier change occurs it is important that the ‘retroactive date’ on the new policy goes back to the. In recent years, more insurance carriers have offered rectification. insurance carrier as soon as practical so the circumstances around the claim can be reviewed and.

ACA Affordability to Extend Beyond Employee-only Coverage

Griffin Benefits

The ACA requires Applicable Large Employers (“ALEs”) who average 50 or more full-time equivalent employees in the prior calendar year to offer health insurance to their full-time employees. Although as a practical matter, insurance carriers may direct employers to do so under policy terms.).

Taxes 71

Traditional Claims Management Is Not Always Enough

Assurance Agency

“I have insurance, so I’m covered, right?” Because your insurance costs are actually dictated in part by your loss history. Claims are typically handed off to your insurance carriers once they’re filed.

Your Staff Are Susceptible to Medical Identity Theft

InterWest Insurance Services

And the majority of documents criminals steal are the same ones your employees receive from their group health insurers. The most important advice for your staff is that they should take good care of their health insurance card. This includes: Health insurance enrollment forms.

What does the new era of insurer-owned PBMs mean for the benefits industry?


Check out this column in Employee Benefits Adviser : Very soon, all of the major insurance carriers will have an in-house pharmacy benefit manager, a trend that could reshape consumer access to prescription drugs and impact the negotiations between insurers, drug manufacturers and pharmacies. Carriers may be following in UnitedHealthcare’s footsteps, which has operated its OptumRx PBM since 1990.

Our Take on the CVS Health Hubs Concept

Corporate Synergies

“Our Take” is Corporate Synergies commentary on employee benefits and insurance topics that are in the news. Since CVS announced its plans to buy insurance carrier Aetna in December 2017, many experts, including ours , speculated how the acquisition and other similar ones would change healthcare. Read: What PBM-Carrier Mergers Mean for Employers and Benefits Plans.

US Supreme Court to Conference Medical Marijuana Preemption Case

Workers' Compensation

The issue is whether employers and their insurance carriers could be compelled to reimburse costs for medical marijuana in light of the Controlled Substances Act (CSA or Act), Pub.

US Supreme Declines to Review Medical Marijuana Reimbursement Issue

Workers' Compensation

The issuepresented was whether employers and their insurance carriers could be compelled to reimburse costs for medical marijuana in light of the Controlled Substances Act (CSA or Act), Pub.

January HR News Worth Review


of Labor, Health and Human Services (HHS) and the Treasury issued FAQ guidance regarding the requirements for group health plans and health insurance issuers to cover over-the-counter (OTC) COVID-19 diagnostic tests. Agencies Issue Guidance on Coverage of OTC COVID-19 Tests. On Jan.

Myths, Pros, & Cons Of Working With A PEO

Genesis HR Solutions

We offer several health insurance products plus a bevy of other plans for you to choose from. You can read more about PEOs and health insurance in myth #7, below.). As your PEO, we’ll administer payroll, your benefits and health insurance, your 401k plan, and more.

Want to Save on Insurance? Be a Smarter Healthcare Consumer


Most health insurance plans outside of a Health Savings Account (HSA) have a list of copays for healthcare expenses. To minimize your health plan’s renewal increase, think twice about how you’re spending the insurance company’s money with the following healthcare options.

Vendor Contracts – Beware of These Five Pitfalls in Employee Benefits Agreements

Griffin Benefits

Anyone who has ever signed up for cellular phone service with a mobile phone carrier knows what a burdensome service agreement looks like. If the liability exists, the vendor or the vendor's insurance carrier should handle it.

How to lower employee stress about health insurance


Health insurance is often the biggest-ticket item in any company’s benefits package, and the cost of health insurance rises on average each year , historically. A recent Business News Daily article underscores the importance of educating employees about their health insurance benefits.

2022 Health Insurance Outlook, Changes

InterWest Insurance Services

In addition, new rulemaking is likely to be introduced in 2022 that will affect health plans, including non-discrimination rules for wellness plans and new rules governing what must be included on insurance plan ID cards. Blog InterWest Insurance Services health insurance

Co-fiduciary Can’t Be Sued for Indemnification in 8th or 9th Circuits First Reliance Standard Life Ins. Co. v. Giorgio Armani Corp. U.S. No. 21-861, Cert. Denied 2/22/22

Benefits Notes

In this case, there was an enrollment error in signing up an employee for life insurance coverage with his employer – Georgio Armani Corp. The surviving spouse, Soohyun Cho sued the insurance carrier – Reliance for the balance of the $500,000 death benefit after Reliance paid her only $50,000 on the claim. In the District Court, Reliance was found liable for the $500,000 coverage amount under the group life insurance plan.

June HR News Worth Review


Most employers have already been contacted by their carrier or third-party administrator (TPA) and will rely on their insurance carriers or TPAs to provide the MRFs. Transparency in Coverage Requirement to Post Machine-Readable Files Begins July 1, 2022.

Workers’ compensation for remote employees: a guide


In general, to have a compensable claim that is accepted by your company’s workers’ compensation carrier, the employee has to be in the course and scope of their job and the accident has to arise out of their job-related activities.

Texas Court Stresses Comp Carrier is Entitled to Full “First Money” in Worker’s Third-Party Tort Settlement

The Workcomp Writer

The appellate court added, however, that the trial court should also have required the carrier to pay its proportionate share of the non-attorney’s fee expenses associated with securing the malpractice settlement. Texas Mutual, the workers’ compensation carrier for Stevenson’s employer, paid workers’ compensation benefits to and on behalf of Stevenson for his injuries. Insurance Co. Carrier Was Not Estopped from Recovering Full Amount.

New York Man

Florida Workers' Comp

Based upon those submissions, it is alleged that "the carrier continued to pay benefits" over many weeks. Then, the insurance carrier "noticed that many of the positive test results used the same specimen ID." Tragically, a vast number of people have been infected with SARS-C0V-2, the "novel coronavirus" which causes the disease we all know as COVID-19. We have lived through lockdowns, travel bans, roadblocks, mask mandates, testing requirements, vaccination waits, and more.

5 Steps To Take After Your Worker Got Injured On The Job


Once the claim is approved, the injured victim will receive medical and financial assistance from your workers’ compensation insurance carrier. Cooperate With The Insurance Carrier.

3 Critical Keys to Negotiating Benefit Renewals

Corporate Synergies

Knowing how to approach the annual renewal with health insurance carrier, pharmacy benefits manager (PBM) and other players can help the savvy employer save some money while maintaining the same level of benefits as before. Here are three keys to negotiating the annual renewal with your carrier: A great way to gain control of what happens at the end of the benefit plan year is to set the tone from the beginning. The Why, What and How of Insurance Premium Increases.