Tag: health care costs

Why Private Exchanges Haven’t Taken Off As Predicted | PA Benefit Advisors

While the health care affordability crisis has become so significant, questions still linger—will private exchanges become a viable solution for employers and payers, and will they will continue to grow? Back in 2015, Accenture estimated that 40 million people would be enrolled in private exchange programs by 2018; the way we see this model’s growth … Continued

CMS Allows States to Extend Life of “Grandmothered” or Transitional Health Insurance Policies | PA Benefit Consultants

On February 23, 2017, the Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS) released its Insurance Standards Bulletin Series, in which it re-extended its transitional policy for non-grandfathered coverage in the small group and individual health insurance markets. States may permit issuers that have renewed policies under the transitional policy continually … Continued

Who Are You Benchmarking Your Health Plan Against? | PA Benefit Advisors

Many employers benchmark their health plan against carrier provided national data. While that is a good place to start, regional cost averages vary, making it essential to benchmark both nationally and regionally—as well as state by state. For example, a significant difference exists between the cost to insure an employee in the Northeast versus the … Continued

Solving the Prescription Puzzle | PA Benefit Advisors

Determining how an employer develops the most effective formulary, while protecting the financial stability of the plan, is certainly the challenge of this decade. Prescription management used to mean monitoring that the right people are taking medications to control their disease while creating strategies to move them from brand name to generic medications. With the … Continued

Regulations Regarding Short-Term Limited-Duration Insurance, Excepted Benefits, and Lifetime/Annual Limits | PA Benefit Advisors

Recently, the U.S. Department of the Treasury, Department of Labor (DOL), and Department of Health and Human Services (HHS) (collectively the Departments) issued final regulations regarding the definition of short-term, limited-duration insurance, standards for travel insurance and supplemental health insurance coverage to be considered excepted benefits, and an amendment relating to the prohibition on lifetime … Continued

Ask the Experts: Dealing With FSA Carryover Funds | PA Benefit Advisors

Question: If an employee has a small health flexible spending account (FSA) balance with a carryover to the next year, and the employee chooses not to participate in the new FSA year, can the employer force the employee to use those funds so as not to incur additional administrative fees in the next plan year? Answer: … Continued

Mandated Health Benefits – Oral Chemotherapy Medication | PA Benefit Advisors

On July 8, 2016, Pennsylvania Governor Tom Wolfe signed legislation (H.B. 60) regarding health insurance coverage for oral chemotherapy medications. Pursuant to the bill, whenever a health insurance policy provides coverage that includes coverage for intravenously administered or injected chemotherapy medications which have been approved by the U.S. Food and Drug Administration for general use … Continued

 

Fairmount Benefits Company

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