Employer Issues

Wondering How Long You Can Keep Your Pre-2014 Plan?

The answer: Probably at least through 2017. The time table for small employers still offering a health plan issued prior to 2014 (and technically doesn’t comply with all the provisions of the Affordable Care Act) could extend well into 2017.

In March, the Obama administration released guidance extending the renewal of health insurance policies that don’t meet all the ACA standards through October 1, 2016. This means that health policies that exist today, but do not comply with ACA provisions that went into effect in 2014, can be maintained through 2017.

It’s up to the individual states and respective insurance companies to adopt the extension.  Those states (all but a handful) that have chosen to allow carriers to renew non-compliant policies for policy years starting after January 1 of this year are likely to adopt the extension.

To read more about this extension go to The Extended “Fix” for Cancelled Health Insurance Policies: Latest State Action on the The Commonwealth Fund Blog.

June 12 Post - Map

Getting ahead of ACA Strategies

The IRS is trying to keep employers in the group health market. The new ruling is somewhat complicated. What a big surprise, huh?

The IRS is saying that the ACA requires that plan sponsors ensure that there are no limits on the mandatory essential health benefits ACA requires, also known as “lifetime maximums.” If a group plan does not guarantee that the insured has all the essential health benefits required by ACA, then the plan is not qualified.

This article seems to be based on a premise that the plan sponsor, in this case, the employer, has no idea what the insured actually has. Therefore, if a benefit is issued, but th member does not have the ACA essential health benefits, then the plan does not qualify and is subject to tax.

But, if the plan sponsor does guarantee that the insured does possess the ACA minimum benefits, then the group sponsor is compliant.

The administration does not want employers simply giving money to employees to pay claims. This will get them further, rather than closer, to achieving their goal that Americans have coverage that will not run out due to lifetime limits.

To read the entire article, read IRS Bars Employers From Dumping Workers Into Health Exchanges.

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Big Pharma Companies Prescribe Higher Prices

An article about big pharma companies and their pricing policies show a trend toward sharply rising drug prices. It doesn’t seem likely that it will slow down any time soon. I warn you – there’s tons of details to consider when it comes to pharmaceutical drug costs. Here are some key takeaways:

  • Big Pharma is in a period of intense consolidation
  • The cost of brand-named drugs is soaring
  • Starting prices of new drugs are escalating
  • More concentration in a therapeutic area = higher prices
  • Generic drugs now make up 86% of all medicines used in the U.S. but that hasn’t reduced total spending on prescription drugs
  • The economics of prescription drugs are unique compared to other major markets
  • Turf wars between drug makers are driving costs higher
  • Rising prices of brand-named drugs is roughly equal to losses due to patent expirations

If you or your employees are concerned about the rising cost of drugs, stay tuned…you’ll see more about this hot topic from us.

To read the entire article, read Big Pharma’s Favorite Prescription: Higher Prices as seen on BusinessWeek.com

Employers are on the hunt! Says a new survey…

Seems like everyone wants to know what’s on the minds of employers and what they are thinking about insurance. A new survey conducted by Wells Fargo Insurance interviewed 70 employers across the U.S. Results show that as employers and their employees face higher costs, deductibles and copays the employers are searching for ways to control costs and help employees improve their health.

The survey findings also show the top three employer product innovations this year include:

  • Accountable Care Organizations (ACO’s)
  • increased wellness programs
  • narrow provider network offerings

47% of survey respondents say they will develop their own private proprietary exchange by 2015.

Read the full article at Wall Street Journal online, Survey: Cost of Healthcare Claims Continue to Rise; Interest in Private Exchanges Increases

Are you an employer? What are you thinking about insurance?

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