Articles

  • Small Employers Can Reimburse for Medicare Part B, D Premiums

    September 17, 2019
    As the workforce ages and many employers want to keep on baby-boomer staff who have the experience and institutional knowledge that is irreplaceable, one issue that always comes up is how to handle health insurance. Once your older workers reach the age of eligibility for Medicare, under current law you can help them pay for Part B and D premiums with a Medicare Premium Reimbursement Arrangement. These types of arrangements became legal after legislation was signed into law in 2013 to help employers provide benefits to their Medicare-eligible staff. But the issue surfaced again recently when the Trump administration came out with new guidance for health reimbursement arrangements that paves the way for employers to set up HRAs to reimburse staff for health premiums ...
  • IRS Eases Access to Chronic Disease Treatment

    September 10, 2019
    New guidance from the IRS will help people enrolled in high-deductible health plans get coverage for pharmaceuticals to treat a number of chronic conditions. Under the guidance, medicinal coverage for patients with HDHPs that have certain chronic conditions – like asthma, heart disease, diabetes, hypertension and more – will be classified as preventative health services, which must be covered free with no cost-sharing under the Affordable Care Act. The background The guidance, which takes effect immediately, is the result of a June 24 executive order issued by President Trump directing the IRS to find ways to expand the use of health savings accounts and their attached HDHPs to pay for medical care that helps maintain health status for individuals with chronic ...
  • Circuit Court Seems Poised to Shoot Down Individual Mandate

    September 4, 2019
    It’s looking more and more likely that a federal appeals court will strike down the Affordable Care Act’s individual mandate, which requires Americans to carry health insurance, either through coverage they receive from their employer or buying it themselves. The case challenging the landmark health insurance law is currently before the 5th U.S. Circuit Court of Appeals and is being heard by a three-judge panel. Two of the judges, appointed by Republicans, have signaled that they would strike down the individual mandate but not the remainder of the law, including the employer mandate, because of the lack of an individual penalty. The Justice Department would normally be defending the law of the land, but it has stepped away from the task and signaled that ...
  • How Employers Can Fight the High Cost of Diabetes

    August 26, 2019
    Diabetes is a devastating illness – and not just for those with the disease. Employers are also shouldering massive and increasing direct and indirect costs due to diabetes. Diabetes afflicts more than 11% of the adult population, including about 6.3% of full-time workers and 9.1% of part-time workers. Adults with diabetes incur more than $8,480 in direct treatment costs, on average. Those who are insured spend even more. A 2016 report from the Health Care Cost Institute estimated that insured workers with diabetes spend more than $16,000 on health care costs per year. Those without diabetes, on average, generate about $4,396 in medical costs per annum. Indirect costs Employers aren’t just paying more in direct health care costs and insurance premiums. They also pay via ...
  • The Costliest Claims for Catastrophic Conditions and the Drugs Used to Treat Them

    August 20, 2019
    A new report by Sun Life Insurance Co. highlights the top high-cost claim conditions that plague the U.S. health care system and account for more than half of all catastrophic or unpredictable claims costs. The top 10 costliest claim conditions comprised over half (51.8%) of the $3 billion that Sun Life reimbursed to stop-loss policyholders from 2014 to 2017. Stop-loss insurance (also known as excess insurance) is a product that provides protection against high-cost claims. It is purchased by employers that self-fund their own health plans, but do not want to assume 100% of the liability for losses arising from the plans. The “2018 Stop-Loss Research Report,” which Sun Life has been publishing annually for the past six years, provides a glimpse into the ...
  • New Health Savings Account, HDHP limits for 2020

    August 13, 2019
    The IRS has announced new health savings account contribution maximums for the 2020 health insurance plan year. Employees who have an HSA linked to a high-deductible health plan (HDHP) will be able to contribute to their HSA up to a certain level to help pay for health care and pharmaceutical expenses. Funds going into your employees’ HSA accounts are deducted before taxes during each paycheck and the balance can be carried over from year to year. Many HSAs also allow employees to invest the funds like they would with a 401(k). Because of this, HSAs have become a savings vehicle of sorts for people who are saving for health care expenses they are expecting in retirement. HSAs can only be offered with an attached HDHP. If you as an employer ...