How to Get the Benefits of Self-Funding without the Risks
November 12, 2019
There are typically two approaches to securing health coverage for your staff – group health insurance or self-funding.
Self-funding, however, can be costly and risky and is usually only done by larger organizations with thousands of employees. But there is a hybrid model that can help small and mid-sized employers provide their staff with affordable health coverage: partial self-insuring.
To understand how partial self-insuring works, we should start with the basics of what a self-insured plan is. In a fully self-insured plan, the employer bears the risk of all costs incurred under the plan for claims and administration.
In essence, the employer acts as the insurer and pays claims from a fund that it pays into along with employees, who pay their share of premiums into ...
Your Last-Minute Open Enrollment Checklist
November 8, 2019
By now you should be prepared and ready to go for your 2020 employee benefits open enrollment. You should have all your plan documents and have prepared or held presentations for your staff to explain the benefits package and any major changes to the plans that you offer.
Employees should be familiar with how to use the enrollment portal and who they should talk to if they have questions.
To be on the safe side, there are a few things you should do to make sure you maximize enrollment, that your employees have the correct materials and that you are in compliance with the law.
Take an active role — Most of the policy selection is done online, but that doesn’t mean you can’t support your employees and let them know you are there in case they have any questions or are ...
New Directives Order Price Transparency, FSA Changes
October 29, 2019
President Trump has issued a multi-faceted executive order to reduce costs and increase pricing transparency in the health care and insurance system.
The parts of his order that could affect benefits that are part of employer-sponsored plans include:
Helping people with chronic conditions
The order directs the Treasury Department to issue guidance that can help people with chronic conditions who are enrolled in high-deductible health plans (HDHPs) with attached health savings accounts.
The guidance, which was issued in July, requires HDHP insurers to pay for a number of preventative services and medications with no copay or outlay by the enrollee.
Increasing health FSA carryover amount
The current maximum amount that someone can carry over ...
Many Workers Struggle with Medical Bills, Despite Having Insurance
October 22, 2019
A new survey has found that many American workers are struggling with medical bills even though they have employer-sponsored health plans.
The good news from the survey was that 81% of respondents said they had health insurance, which meant they were 19% more financially fit than people without insurance. They were also happier.
The survey found that:
One in 10 employees who have insurance and pay part of the premiums, also have annual out-of-pocket medical bills of more than $10,000.
33% of insured employees carry medical debts that they are trying pay down.
Insured employees that carry medical debt are 42% less financially fit than those who do not have such debt.
Carrying debts related to medical care also affects employees’ health. The ...
Short-term Health Plans Skimp on Medical Payments
October 15, 2019
A new report by the trade publication Modern Healthcare shows just how little short-term care plans spend on enrollees’ medical claims.
The report found that some plans spent as little as 9 cents of every premium dollar they collected on medical care.
The average paid out among the short-term plans analyzed in a report by the National Association of Insurance Commissioners was 39.2%. That’s a far cry from the 80% of premiums health plans are required to spend on medical care to comply with the Affordable Care Act.
The figures shine a harsh light on just how little short-term health plan policyholders benefit from the plans they purchase.
The Trump administration issued regulations in 2018 that extended the amount of time someone can enroll in a ...
The ‘Cadillac Tax’ May Finally Be Repealed
October 8, 2019
The much-maligned “Cadillac tax,” which was supposed to be implemented as a tax on high-value group health plans with premiums above a certain level, may finally be seeing the end of the road.
Already the implementation of the tax, which was created by the passage of the Affordable Care Act, has been postponed twice. It was originally supposed to take effect in 2018 under the ACA. The tax was delayed two years by Congress in 2016, pushing implementation ahead to 2020. It was delayed again in 2018 and is currently scheduled to take effect in 2022.
But now the House has overwhelmingly voted to ditch it once and for all.
The Cadillac tax is an excise tax that applies to any group health policy that would cost more than $11,200 for an individual policy, or ...