QSEHRA Revives Employer Payment Plans For 2017

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On December 13, 2016, President Obama signed the 21st Century Cures Act into law. Called “the most important bill of the year,” the bipartisan Act makes changes to a wide range of healthcare issues. These include allocating billions for cancer research, easing the FDA drug approval process, and allowing doctors to test medical devices without a patient’s informed consent in certain situations. One item that will be of interest to finance and human resource professionals at small employers ...

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DOL proposes changes to Form 5500

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The U.S. Department of Labor plans to revise Form 5500 to require insurers and health plans to report more information. The proposed changes focus on five broad goals: modernizing financial reporting, providing greater information regarding group health plans, enhancing data mineability, improving service provider fee information, and enhancing compliance with ERISA and the tax code. One element that is sure to attract the attention of smaller employers is a proposal to eliminate the exemption ...

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Drug Costs Continue To Rise

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Although the rate at which overall health costs are rising is historically low, employers, experts, and politicians are expressing alarm at the rising cost of prescription drugs. According to a recent Aon analysis, the average health care rate increase for mid-size and large companies in 2015 was 3.2%. Prescription drug costs, however, jumped by 10% last year according to a report by Truveris that was publicized by the Business Health Care Group.

In general, hospital expenses account ...

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PACE Act Passage Elicits Praise and Frustration

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Earlier this month, President Obama signed the bipartisan PACE Act to stop the Affordable Care Act (ACA) from changing rules that apply to employers with between 51 and 99 employees. This is important both as a rare example of bipartisan cooperation to reform Obamacare, as well as a preservation of the status quo for employers in this mid-market segment. The Act has been praised by insurance brokers and business groups, but has ...

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Big Changes at Assurant

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Last week, Assurant, Inc. announced an agreement to sell its employee benefits business to Sun Life Assurance Company of Canada, a subsidiary of Sun Life Financial, Inc., for $940 million. This transaction comes just three months after Assurant shut down operations at Milwaukee-based Assurant Health. It also coincides with the announcement of increased dividends to shareholders and a rise in the company’s stock price.

The employee benefits business purchased by Sun Life includes Assurant’s voluntary and employer paid dental, ...

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National Uninsured Rate Falls Below 10%

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Two national surveys show that the percentage of people without health insurance has dropped steadily since the Affordable Care Act’s public insurance exchanges launched in 2013. A separate analysis focused on Wisconsin concluded that while the state now has fewer uninsured than it did in 2014 and a lower uninsured rate than the national average, progress has not been as great as hoped. These findings come at a time when all viable legal challenges to the law have been resolved ...

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Aetna-Humana merger drives fee-based model

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With Aetna poised to acquire Humana in 2016, industry observers have noted how industry consolidation generally and Aetna’s growing market share in particular will lead more intermediaries to adopt a fee-based compensation model. Although fee-based compensation for intermediaries is not a new concept, it is far less common than traditional commission based compensation. However, it appears increasingly likely that fee-based compensation will become much more widespread in the coming years.

Traditionally, insurance agents and brokers have been paid for ...

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2016 Rate Review Submissions Filed

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The Affordable Care Act (ACA) requires individual and small group rate increases that exceed 10% to be published, reviewed, and approved by state or federal regulators. This requirement does not apply to grandfathered health plans that predate the ACA. This rate review process is one of two ways the ACA addresses the issue of health plan costs, with the 80/20 Medical Loss Ratio being the other.

Rates for 2015 and 2016 are now available for public viewing at Continue Reading →

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Arise to offer AboutHealth plans

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AboutHealth, one of two new health system partnerships in Wisconsin, recently announced plans to sell health plans to individuals and employer groups through a co-branding agreement with Arise Health Plan. Early announcements from AboutHealth have focused on efforts to improve clinical integration and cooperation among its members. The agreement with Arise marks the first instance in which AboutHealth member systems have negotiated a single contract with a health insurance company.

Arise Health Plan is a wholly owned subsidiary of ...

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Many reasons for Milwaukee area’s high health costs

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An article by Guy Boulton in Friday’s edition of the Milwaukee Journal Sentinel looked at four studies on health costs and concluded that the Milwaukee area has some of the highest health care costs in the nation. The studies were conducted by the Government Accountability Office, BSG Analytics, Milliman Inc. and the Institute of Medicine over different periods of time with different methodologies.

Despite these differences, the article is correct that Southeastern Wisconsin health care costs are not competitive when ...

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