Moves Afoot to Improve Prior Authorization Times, Efficiency
The Centers for Medicare and Medicaid Services has proposed new rules aimed at streamlining the prior approval process for most health plans in the U.S. Under the proposal, starting in 2026, insurers would be required to render a decision within seven
Most Employees Spend Little Time Choosing Their Health Plan
A new study has found that individuals enrolled in high-deductible health plans (HDHPs) are more engaged than their traditional plan counterparts during open enrollment, spending more time on choosing plans and using employer-provided tools to help them make their choices. Despite
Is Health Plan Self-Funding Right for Your Firm?
As group health costs continue climbing and more employees struggle with the cost of premiums and out-of-pocket expenses, some employers are starting to take a second look at self-funded, or partially self-funded plans. These plans give employers more skin in the
Time to Comply with Health Plan Transparency Rules
July 1 was the deadline for health plans to make public their in-network negotiated rates, out-of-network billed charges, and more. While health plans will be required to post this information, employers who sponsor their group health insurance for their employees will
Many Employees Choosing the Wrong Health Plans
A new study has found that many people in employer-sponsored health plans are enrolling in plans that are costing them more than they ought to be paying. Many employees choose pricey plans with low deductibles, which force them to spend more
What You Need to Know About New Health Plan Transparency Rules
Regulations are slated to take effect over the next few years that will greatly increase the transparency requirements for group health plans. The regulations issued under the Trump administration will require health insurers in the individual and group health markets to
Few Health Plan Enrollees Know About New Price Transparency Rules
Despite a new law requiring hospitals to post detailed pricing information for their treatments and procedures online, fewer than 10% of U.S. adults are aware of the requirement. That's a problem considering that a growing number of Americans have high-deductible health
New Rule Requires Greater Health Plan Transparency
The Trump Administration has issued a new rule that will require greater price transparency on the part of health insurers, including the rates charged by in-network physicians and copays and costs of drugs. The final rule requires health plans and health