Healthcare plans

Aetna has agreed to reduce out-of-pocket payments for most HIV and AIDS medicines after pressure from an advocacy group, revising coverage that had some patients paying $1,000 a month for the drugs.

After two enrollment seasons under the Affordable Care Act's exchanges, the easily accessible and amenable are signed up for health care. With year three starting this fall, the task will be tougher to target the remaining uninsured, who are harder to reach. Who better to drive the message home, Washington state thinks, than brokers?

Michelle Capezza, a member of law firm Epstein Becker Green, highlights new changes to the ACA's Summary of Benefits and Coverage and what steps plan sponsors should be taking to prepare.

Commentary: Some of the nation’s most comprehensive health care cost transparency requirements going into effect in New York are setting a solid precedent for other states to follow, says FAIR Health’s Robin Gelburd.

The DOL has stayed true to a planned increased in enforcement and investigation of ERISA criminal violations, including indictments of employers and service providers, that should serve as a cautionary tale for any individual involved with the administration of these plans.

Commentary: Making the “people and profits” case for integrated safety, health and wellness.

Commentary: In response to confusion over the IRS’s role in verifying employers are meeting minimum essential coverage and employer shared responsibility requirements, dozens of ACA reporting have entered the market in the last two years. EmployeeTech’s Michael Weiskirch shares how to find the right tracking solution for your clients.

The push for accountable care organizations is driven in large part by the Affordable Care Act and its emphasis on quality care and downward pressure on overall health costs. But how viable are they, and should your organization consider using one?

If there was a most-improved public HIX award, Maryland Health Connection certainly would be in the running for such an honor. Nearly twice as many state residents enrolled for 2015 in half as much time compared to the previous year.

The “profoundly evil” impression the fastest growing small-group employee benefit brokerage in the country has made on some firms is wrong, says Zenefits’ Parker Conrad. The outspoken CEO shares where Zenefits is headed — and why he wants you to work for him.

Commentary: From mournful reflection to birthday celebration, the bottom line is your attitude about health reform affects your clients, says David C. Smith

Commentary: Critical considerations that make a stop-loss plan successful for clients of all sizes, according to Sun Life’s Brad Nieland.

The fight over the Affordable Care Act in Washington is as fierce as ever, with a Republican budget plan that would repeal the health care law Democrats passed five years ago. In the rest of the country, opposition to the law appears to be easing.

An Affordable Care Act-fueled surge in self-insurance for medical benefits among smaller employers appears to have leveled off somewhat, but not due to any disenchantment with the cost-management strategy.

California's struggling to pay for health care for retired state employees, with an estimated $72 billion in medical costs coming in the next 30 years. Gov. Jerry Brown's solution: Make workers start contributing money to pay for the health care they'll need after retiring.

It’s time to talk about something that most benefits professionals have left on the backburner for the last couple of years: the impending Cadillac tax.

The departments of Labor, Treasury and Health and Human Services today published final rules amending the definition of excepted benefits to include certain limited coverage that wraps around individual health insurance.

Worksite clinics and private exchanges might appear to be mutually exclusive approaches to rising cost pressures, yet they can be integrated to achieve the same goal – improved health outcomes and lower health care cost trend.

Controlling rising health care costs is crucial for all employers, and conducting regular dependent eligibility audits can help.

Novartis’ Zarxio is the first biosimilar product approved in the United States, ushering in a new era for the drug industry, consumers and third parties who manage medical and drug benefits.