May 2013 - Employee Benefits I AP Benefit Advisors

Health Status Explains 75-85% of Medicare Cost Variations

As single-payer advocates cry, “Medicare for all”, and then begin efforts to “eliminate the waste and over-treatment”, we get caught up in the argument and we just accept their premise–that there is vast cost variations and that they are tied to over-aggressive physicians/providers and their billing practices. PPACA/Obamacare was “influenced” by this thinking.  Yet, a […]

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EEOC Gets Tough With Companies on Genetic Privacy

Corporate Counsel, Law.com The U.S. Equal Employment Opportunity Commission filed its first lawsuit earlier this month accusing an employer of gathering illegal genetic information during a job applicant’s medical exam. It was quickly settled. The agency followed it up last Thursday by filing its first class action suit against another employer on similar grounds. The […]

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DOL – PPACA Implementation FAQs Part 14 and 15

The month of April saw two more sets of PPACA-related FAQs (Frequently Asked Questions) from the Department of Labor. Part 14 / Part XIV This part deals with the new SBC requirements.  As we look to the 2nd year of applicability (that is for plans beginning on or after January 1, 2014 and before January […]

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Your OOPMax, Your PBM and Your Non-Grandfathered Health Plan

Your first plan year that begins on or after January 1, 2014 will be subject to cost-sharing limitations under PPACA.  All non-grandfathered plans, and by all we mean all self-insured and insured plans in the large-group market, will need to comply with annual out-of-pocket limits, referred to as OOPMaxes (Out-Of-Pocket Maximums).  (See, ER-Timeline, 2014, letter […]

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Webinar: Final Regulations on HIPAA HITECH and ACA

The Department of Health and Human Services (HHS) has released final regulations on the HITECH Act, the Health Information Technology for Economic and Clinical Health Act. The final regulations are similar to the proposed regulations, some of which are already in effect, though additional components were added that can and likely will have an impact […]

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New HHS Memo on Federally Facilitated Exchanges

HHS/CMS recently issued a memo focusing on the role of agents and brokers in federally facilitated Exchanges now being established by the federal government in states that opt not to have their own state-based Exchanges. The memo, referring to both Exchanges and Marketplace, also addresses certain questions related to state-based Exchanges. Previous final regulations addressed […]

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Employer Must Advertise the New Federal Exchanges – Model Notices Released

Last evening the US Department of Labor (“DOL”) released guidance regarding the notice you must provide to employees about the state exchanges (now being called “marketplaces”).  You may recall from our Healthcare Reform timelines (2013, letter “f”) that employers were scheduled to begin distributing these notices in March of 2013, but the DOL delayed the […]

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CMS Releases Hospital Pricing Data

Yesterday, the Centers for Medicare & Medicaid Services took an unprecedented step in making public extensive hospital cost data. This action shocked healthcare providers, payers, and consumers alike. The massive file contains what is commonly referred to as “sticker price” for the 100 most common Medicare inpatient diagnostic related groups or DRGs. The data does not […]

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Underwhelming Results from Leapfrog Group

The Leapfrog Group has encountered unsettling issues recently, and unveiled its third controversial hospital safety report card Wednesday showing miniscule improvement over last November’s grades. “So far, these numbers aren’t really moving,” said Leapfrog Group president and CEO Leah Binder. “It’s depressing,” she added, because even though the scores for acute care facilities reflect measures from 2011 and 2010, […]

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IRS Releases 2014 HSA Limits

Breaking news!   The Internal Revenue Service has just released the 2014 cost-of-living-adjusted HSA limits.  The following takes effect for calendar year 2014. Annual contribution limits $50 increase (EE Only): The annual limitation on deductions for an individual with employee-only coverage under a high deductible health plan (HDHP) is $3,300 — up $50 from 2013. $100 […]

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