United Benefit Advisors Insight and Analysis Blog

Mail Order or Not?

Posted by: Mary Delaney, MSPT, CWP    Jul 29, 2016 10:37:19 AM

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.”

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Topics: prescription drug cost, mail order drug benefits, prescription drug trends, Brenda Motheral, Mary Delaney

How to Complete the IRS/SSA/CMS Data Match Report

Posted by: Danielle Capilla    Jul 26, 2016 10:30:00 AM

Data Match is a program coordinated by the Internal Revenue Service (IRS), Centers for Medicare & Medicaid Services (CMS), and the Social Security Administration (SSA) to identify Medicare beneficiaries who received Medicare benefits with Medicare as the primary payer when Medicare should have been the secondary payer. We recently covered background on this program in a previous blog posting. Employers are required to complete the Data Match report within 30 days of receipt of the Data Match Personal Identification Number (PIN), unless an extension has been requested and approved. The letter directs employers to the Data Match Secure Website, where the questionnaire can be accessed after entering the employer identification number and PIN.

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Topics: compliance, Medicare, Danielle Capilla, IRS-SSA-CMS Data Match Program

See Which Employers Are Aggressively Increasing Rx Tiers for Cost Savings

Posted by: Bill Olson    Jul 21, 2016 10:30:00 AM

The Latest UBA Survey data shows employers are flocking to two strategies to control rising prescription drug costs: moving to blended copay/coinsurance models vs. copay only, and adding tiers to the prescription drug plans. Almost half (48.9%) of prescription drug plans utilize three tiers (generic, formulary brand, and non-formulary brand), 4.3% retain a two-tier plan, and 44.1% offer four tiers or more. The number of employers offering drug plans with four tiers or more increased 34% from 2014 to 2015. The fourth tier (and additional tiers) pays for biotech drugs, which are the most expensive. By segmenting these drugs into another category with significantly higher copays, employers are able to pass along a little more of the cost of these drugs to employees. Over the last two years, the number of plans with four or more tiers grew 58.1%, making this a rapidly growing strategy to control costs.

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Topics: UBA Health Plan Survey, prescription drug plans, prescription drug cost, benefits cost control, Rx

Avoid Increased Penalties by Filing Annual Benefit Plan Reports on Time

Posted by: Jennifer Kupper    Jul 19, 2016 12:56:38 PM

Form 5500 is the annual report that group benefit plans use to report required information about the plan’s financial condition and operations. Most group and pension plans that are subject to ERISA are required to file a Form 5500. With the July 31 deadline for calendar year plans fast approaching, and higher penalties for not filing taking effect in August, this is a good time to review this important plan filing.

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Topics: Form 5500, ERISA, Jennifer Kupper, benefit plan reporting, group benefit plans

New Benefits Target Employee Debt

Posted by: Geoff Mukhtar    Jul 14, 2016 2:44:48 PM

Today, most new full-time hires expect a company to offer certain standard benefits – health, dental, vision, and life insurance, paid vacation and sick days, and a 401(k) or pension. Some companies go beyond this and provide other benefits such as profit sharing, parking reimbursement, mobile phone reimbursement, wellness programs, and even on-site daycare. So what does the future hold for employees when it comes to their expectations of a traditional benefits package?

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Topics: employee benefits, group benefits, tuition reimbursement, student loan

ALE Employers Ask: Should Benefits Be Offered to Variable Hour Employees?

Posted by: Danielle Capilla    Jul 12, 2016 10:30:00 AM

UBA’s compliance team leverages the collective expertise of its independent partner firms to advise 36,000 employers and their 5 million employees. Lately, a common question from employers is: How does an ALE determine whether or not a newly hired variable hour employee should be offered benefits?

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Topics: group health insurance, Danielle Capilla, applicable large employers, variable-hour employee, benefits compliance

Industry Trends Emerge in Mail Order Drug Benefits

Posted by: Mary Drueke-Collins, FSA    Jul 8, 2016 11:19:18 AM

Mail order has always been a convenient way for individuals to keep their maintenance drug prescriptions filled. Employers often wonder, are there other advantages to using mail order other than convenience? As an employer, should we be incentivizing mail order? The answers to some of these questions can be found in results from the latest UBA Health Plan Survey.

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Topics: UBA Health Plan Survey, prescription drug plans, prescription drug cost, mail order drug benefits, Mary Drueke-Collins

Affordability Safe Harbors May Not Be As Safe with New Overtime Exemption Rules

Posted by: Carol Taylor    Jul 5, 2016 10:00:00 AM

The new Department of Labor (DOL) overtime exemption rules increase the salary threshold from $23,660 a year to $47,476 annually, beginning December 1, 2016. This means that employees earning less than the threshold can no longer be considered salaried and exempt from overtime pay.

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Topics: ACA, minimum value coverage, Federal Poverty Level safe harbor, W-2 Box 1 safe harbor, rate of pay safe harbor, affordability safe harbor, overtime exemption

Employers Split on Whether to Self-Fund Prescription Drug Plans

Posted by: Bill Olson    Jun 30, 2016 10:30:00 AM

On average, 11.9% of prescription plans are self-funded, with the vast majority (88.1%) of employers choosing to fully insure their prescription plans, according to UBA’s new Special Report: Trends in Prescription Drug Benefits, based on data from the latest UBA Health Plan Survey of more than 10,000 employer-sponsored health plans. Although self-funding has increased 9% from the past survey year, the move to self-funding is slow but positive among small groups (10 to 199 employees), while large groups are actually moving away from this model.

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Topics: self-funding, UBA Health Plan Survey, prescription drug plans, prescription drug cost, Scott Deru

Soaring Specialty Pharmacy Drug Prices Leave Consumers Feeling Rather Ill

Posted by: Carol Taylor    Jun 28, 2016 12:31:22 PM

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.

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Topics: Carol Taylor, UBA Health Plan Survey, prescription drug cost, specialty pharmacy drug prices, medical claim spend, medical claims costs, UBA Special Report