Healthcare plans

The possibility of specialty drug pricing financially overwhelming business and union health plans is very real.

Although the U.S. Supreme Court’s 2014 ruling in the Burwell v Hobby Lobby Stores case addressed in broad terms how exceptions to the Affordable Care Act’s mandate for contraceptive benefits coverage can be granted in the private sector, it left some unresolved questions both in the for-profit and in the nonprofit world.

Commentary: The midpoint of the tax year is almost upon us, and many still have work to do to prepare for the new IRS 1094-C and 1095-C filings.

Commentary: When executed efficiently, this strategy can bring a variety of benefits, says AmWINS’s Sam Fleet.

Is your PBM contract up for renewal? Here’s what you need to know.

Brokers need to change the conversations they are having with clients away from the Affordable Care Act and toward other topics, including voluntary, since little will change with the law until the next presidential inauguration, a carrier rep says.

Health care consumers in some parts of the U.S. may face higher premiums next year if some insurers struggle to cover their costs and Congress continues to require that the risk-corridors program established under the ACA be self-sustaining.

Commentary: Expatriate health plans are — here are key definitions and relief as well as the recent IRS guidance on calculations for the 2014 and 2015 fee years.

It’s not enough to simply post a summary plan description on an employer’s intranet to satisfy the ERISA requirement that such information be “furnished” to plan participants.

Covered California’s Small Employer Health Options Program (SHOP) is growing, but a private-sector competitor to the state-run HIX is growing even faster.

Commentary: This is due in large part to improvements in health care, more ways to accommodate people with disabilities and changes in the workplace itself — especially the growing acceptance of telework, says Aetna’s Liz Incze.

Commentary: Smart brokers provide awesome service, killer expertise and modern technology solutions that can compete with any online platform.

For many benefits professionals, the different private exchange offerings and the varied value propositions they present can be overwhelming. So let’s take a step back and examine the issues one at a time.

Commentary: Countless conversations with brokers struggling with 6055 and 6056 concerns show many find their applicable large employer clients are challenged to find practical solution for this reporting, says EmployeeTech’s Michael Weiskirch.

Commentary: At the end of an unsuccessful enrollment campaign, an adviser may wonder why participation was so low after they spent time and money on communications. It’s simple, says David Melton: Brokers employing the same old strategy will not succeed.

Only 10% of some 480 employers in 36 industries responding to a recent poll have implemented an in-house or outsourced solution to comply with Affordable Care Act reporting requirements.

Does giving employees multiple choices of health plans drive competition and empower them pick plans offering the greatest value and highest quality care –the theory underlying the Affordable Care Act and many employers’ benefit plan designs?

Whether participating in private exchanges or not, some say similar programs have been in place for decades, pointing to the government’s 50-year-old Federal Employee Health Benefit Plan as early example of what many employers are dealing with today.

Whatever employers have spent to comply with the Affordable Care Act so far, some feel the costliest years are yet to come.

Analysts predict Aetna is planning to acquire another carrier in the near future, likely Humana or Cigna, a move that promises to disrupt the industry.