Benefit plan design

A majority of employers – regardless of workforce size – are planning to keep their health plan coverage going into next year as the Affordable Care Act’s employer mandate takes effect.

Commentary: Private exchanges are not the one-size-fits-all solution some in the benefit industry think they are, says broker Judy Miller. The veteran adviser shares her opinion about the promises and pitfalls of the private exchange solution.

Benefit advisers are prepared to make significant investments in internal systems in 2015 to better manage their workload, improve existing relationships with employers and better market themselves to prospects.

Blue Cross Blue Shield is requiring all agents in the individual market in one state be certified to sell in the state’s federally facilitated marketplace — even those who only sell outside of the exchange.

A majority of brokers have seen some of their employer clients drop group coverage altogether in reaction to the ACA and double-digit rate increases. That trend, they say, will rise and advisers need to adjust the way they do business if they hope to survive.

Commentary: Are private exchanges just a flex benefits reboot? Lockton’s Mike Smith shares what he thinks will affect their success and adoption.

With an expected 5.5% rise in health care costs in 2015 – the same year the Affordable Care Act’s employer mandate takes effect – employers have high hopes that spending can be reined through increased employee consumerism.

On Saturday, the first day of enrollment for 2015 Obamacare plans, the federal insurance website was working well enough that 100,000 people submitted applications, U.S. health secretary Sylvia Mathews Burwell reported.

As an effort to comply with the ACA, some employers have been considering offering employees a lump sum of cash to purchase health care coverage on the exchanges, but the DOL now says such an arrangement isn't going to cut it.

The U.S. Supreme Court has agreed to review a challenge to the tax subsidies allowed under the Affordable Care Act, but legal experts predict any high court ruling will have little effect on the law or employers.

The U.S. Supreme Court agreed to consider a challenge to the subsidies that are a linchpin of President Barack Obama’s health-care overhaul, accepting a case that suddenly puts the law under a new legal cloud.

As the Affordable Care Act’s employer mandate becomes effective, applicable large employers that utilize third-parties are faced with figuring out of what it means to make an offer of minimum essential coverage.

In a surprise move, CMS has delayed its enforcement of the use of health plan identifiers in HIPAA transactions. What does this mean for your employer clients and HIPAA compliance?

The IRS said Tuesday it plans to close a major loophole in the ACA by banning employers who offer medical plans without hospitalization coverage from qualifying as minimum value plans under the health reform law.

A little-known special enrollment period under the Affordable Care Act allows for small employers to pick up group health care coverage regardless of whether they meet minimum participation or contribution requirements.

After multiple delays, early access to the federally-facilitated Small Business Health Options Program launched Monday in five states.

Although open enrollment for 2015 Obamacare plans opens in just over three weeks, the uninsured remain unclear about the dates and possible financial assistance available.

With mental health and substance abuse disorder services deemed an essential health benefit under the Affordable Care Act, employee assistance program providers are taking on a new role – helping employers and health plans sniff out fraudulent health care activity among substance abuse and mental health treatment facilities.

While pharmacy benefits utilization was roughly the same during the first half of 2014 for individuals enrolled in public health insurance exchanges and traditional insurance market plans, a new analysis shows the utilization of specialty drugs is much higher in the HIX marketplace.

For employers fighting to maintain grandfathered status, consultants and benefit managers predict the Affordable Care Act’s ongoing implementation will mean the end of these health plan structures in the near future.