Minimum essential coverage (MEC) is the type of coverage that an individual must have under the Patient Protection and Affordable Care Act (ACA). Employers that are subject to the ACA’s shared responsibility provisions (often called “play or pay”) must offer MEC coverage that is affordable and provides minimum value. In the fall of 2015 the … Continued
Diabetes is an expensive disease: $322 billon in America! Costs are compounded because diabetes is the leading cause of heart disease, stroke, kidney disease, lower limb amputation, and blindness, and also has connections with some cancers, arthritis, gum disease and Alzheimer’s disease. To add some perspective, consider these facts: Today, 3,835 Americans will be diagnosed … Continued
The Health Insurance Portability and Accountability Act (HIPAA) established national standards to secure and protect the privacy of health information. The Health Information Technology for Economic and Clinical Health Act (HITECH) requires the Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) to conduct audits of covered entities and business associates in … Continued
The 2016 UBA Health Plan Survey contains the validated responses of 19,557 health plans and 11,524 employers, who cumulatively employ over two and a half million employees and insure more than five million total lives. Of the preliminary findings, we see that employees continue to take on more cost for coverage. The median in-network deductible … Continued
In 1990, Health Affairs* reported “The escalating costs of prescription drugs and competition among pharmaceutical firms for customers are drawing the attention of policymakers, pharmacies, and individual and institutional purchasers. Mail-order pharmacies recently have grown in prominence as a competitive alternative to the local community pharmacy.” With the improvements in retail pharmacy pricing, that motivation … Continued
Section 701 of the Bipartisan Budget Act of 2015 contains the Federal Civil Penalties Inflation Adjustment Improvements Act of 2015, which requires the Occupational Safety and Health Administration (OSHA) and most other federal agencies to implement inflation-adjusted civil penalty increases. The Inflation Adjustment Act also allows OSHA a one time “catch-up adjustment” to adjust for inflation … Continued
In the early 2000s, prescription costs were around 20 percent of total medical claim spend. This number stayed relatively unchanged for a number of years. Recently, this number has been increasing at an alarming rate. In the early- to mid-2000s, prescription costs were largely held in check with the rise of generic utilization, meaning the … Continued
From 2013 to 2015, a series of Supreme Court cases and government updates have changed the landscape of the way employers must consider same-sex spouses in relation to employee benefits. Most recently, in June 2015, the Supreme Court ruled in Obergefell v. Hodges, that the 14th Amendment requires a state to license a marriage between … Continued
With the drive of healthcare reform to make sure the U.S. population is insured and address the shortage of primary care physicians increasing as high as 31,000, where will people receive their primary care, and at what cost? What if there were a more efficient and cost effective way to deliver care to populations that lack access or don’t have the ability to easily access care.
On October 21, 2015, the Internal Revenue Service (IRS) announced cost-of-living adjustments affecting dollar limitations for pension plans and other retirement-related items for tax year 2016. In general, the pension plan limitations will not change in 2016 because the increase in the cost-of-living index did not meet the statutory thresholds that trigger their adjustment. The … Continued
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