United Benefit Advisors Insight and Analysis Blog

When the C-Suite Gets Seriously Sick

Posted by: Bill Olson    Nov 24, 2015 12:00:00 PM

Someone in the C-Suite of a company gets sick. I’m not talking about a cold or flu; I’m talking about a major, possibly even terminal, illness. Depending on the level of severity, what can the human resources department do to help communicate this information properly to the company’s employees?

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Topics: executive illness, critical illness, C-Suite, succession planning

Who’s Eligible for Coverage? UBA Survey Looks at Dependents, Spouses, Hours Worked

Posted by: Bill Olson    Nov 23, 2015 12:00:00 PM

The UBA Health Plan Survey looks at over 18,000 health plans sponsored by nearly 11,000 employers nationwide to offer the largest data source on plan costs and design. While headlines talk about issues related to same sex and dependent coverage, the 2015 Health Plan Survey looks at the facts. When it comes to who is being covered, we also look at how many employers are complying with the requirement to cover employees working 30 hours or more. The findings may surprise you. The option to waive coverage altogether is fading but bonuses to do so are on the rise. Here are the statistics on these issues.

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Topics: UBA Health Plan Survey, dependent coverage, health insurance eligibility, UBA Health Plan Survey Executive Summary, coverage waiver bonus

UBA Health Plan Survey: Plans Popular with Employers Aren’t Always Tops with Employees

Posted by: Bill Olson    Nov 19, 2015 12:00:00 PM

The UBA Health Plan Survey tracks plans offered by region as well as enrollment by region. From a prevalence perspective, preferred provider organization (PPO) plans are most prevalent in the Central U.S., though they generally dominate nationwide, except in the Northeast where consumer-directed health plans (CDHPs) are most prevalent.

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Topics: health plan benchmarking, UBA Health Plan Survey, health plan trends, health plan costs, health plan enrollment

Healthcare Cost Reduction: Community Paramedicine as a New Primary Care Delivery Model

Posted by: Peter Freska    Nov 17, 2015 12:00:00 PM

I recently read an article on what some say is the conventional wisdom of healthcare costs in the United States which, as a percent of gross domestic product, are higher than most other countries. The article works to demonstrate that the reason for the higher than average cost and the lack of “better” health outcomes in light of significantly higher spending is attributable to non-healthcare issues such as lack of access, especially for the poor. 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 (“Physician Supply and Demand Through 2025: Key Findings,” Association of American Medical Colleges, April 1, 2015), 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.

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Topics: health care costs, Peter Freska, paramedicine, emergency medicine, paramedics, community paramedicine, EMT

CMS Provides Clarity on PACE Act Implications for States

Posted by: Danielle Capilla    Nov 12, 2015 12:00:00 PM

The Providing Affordable Coverage for Employees (PACE) Act amended the Patient Protection and Affordable Care Act (ACA) and redefined small employers as those with 50 or fewer employees; it also gives states the option to expand the definition to include employers with up to 100 employees (or, practically speaking, those with 51 to 100 employees, also called "mid-size employers"). Prior to the ACA, all states defined small employers as those with 1 to 50 or 2 to 50 employees; however, many have passed legislation redefining the group size up to 100 employees beginning in 2016. States are now in the process of determining what they define as "small employer."

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Topics: SHOP, small business, Danielle Capilla, Providing Affordable Coverage for Employees Act, PACE Act

DOL Issues FAQ on Mental Health Parity and ACA Market Reform Provisions

Posted by: Danielle Capilla    Nov 10, 2015 12:00:00 PM

The Department of Labor (DOL) recently provided an informational FAQ relating to the Mental Health Parity and Addiction Equity Act (MHPAEA) and Patient Protection and Affordable Care Act (ACA) market reform provisions. Non-grandfathered group health plans and individual or group market health insurance must cover a variety of preventive services without any cost-sharing requirements. Required preventive services include "breastfeeding comprehensive support and counseling from trained providers, and access to breastfeeding supplies," obesity screening and weight management services for certain individuals, colonoscopies for certain age groups, and contraception coverage for women.

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Topics: ACA, wellness programs, Danielle Capilla, Affordable Care Act, health screening, contraception coverage accommodation, Mental Health Parity and Addiction Act, lactation counseling

2015 UBA Health Plan Survey Executive Summary Now Available!

Posted by: Bill Olson    Nov 5, 2015 12:00:00 PM

The data are in for the 2015 Health Plan Survey! See our news release with the top cost trends. Download the UBA 2015 Health Plan Survey Executive Summary with more detailed findings. For quick reference, here’s a brief punch list of the top trends:

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Topics: wellness, health plan survey, ACA, Cadillac Tax, UBA Health Plan Survey, Affordable Care Act, health plan trends, insurance costs

Reporting and Plan Documents Under ERISA and Cafeteria Plan Rules

Posted by: Danielle Capilla    Nov 3, 2015 12:00:00 PM

The Employee Retirement Income Security Act (ERISA) was signed in 1974. The U.S. Department of Labor (DOL) is the agency responsible for administering and enforcing this law. For many years, most of ERISA’s requirements applied to pension plans. However, in recent years that has changed, and group plans (called “welfare benefit plans” by ERISA and the DOL) now must meet a number of requirements.

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Topics: ERISA, Danielle Capilla, cafeteria plan, welfare benefit plans

IRS Proposed Regulations Recognize Same Sex Marriage

Posted by: Danielle Capilla    Oct 29, 2015 12:00:00 PM

In June 2015, the Supreme Court ruled in Obergefell v Hodges that the 14th Amendment requires a state to license a marriage between two people of the same sex, and to recognize a marriage between two people of the same sex when their marriage was lawfully licensed and performed out of state. The IRS has issued proposed regulations to reflect that holding, which will impact married couples, employers, sponsors, and administrators of employee benefit plans and executors.

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Topics: ACA, IRS, same sex marriage, Danielle Capilla, Obergefell v Hodges

Transitional Reinsurance Fee for Self-funded Group Health Plans

Posted by: Jennifer Kupper    Oct 27, 2015 12:00:00 PM

The Patient Protection and Affordable Care Act (ACA) established the Transitional Reinsurance Program to help stabilize premiums in the individual private and public marketplaces. The Transitional Reinsurance Fee (TRF) applies to fully insured and self-funded major medical plans for 2014, 2015, and 2016, regardless of the policy or plan year. Insurers of fully insured major medical plans and sponsors of self-funded major medical plans are responsible for filing and submitting contributions for the Transitional Reinsurance Program.

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Topics: ACA, TRF, Patient Centered Outcomes Research Institute, Transitional Reinsurance Fee, Jennifer Kupper, self funded health plans, Group health plans, PCORI Fee, Transitional Reinsurance Program