United Benefit Advisors Insight and Analysis Blog

Top 10 Blogs of 2014

Posted by: Bill Olson    Jan 16, 2015 1:00:00 PM


We’ve rounded up the most popular UBA blogs of 2014, which have garnered thousands of views.


10. UBA Releases 2014 Health Plan Survey Executive Summary.

Recent survey data from the 2014 United Benefit Advisors Health Plan Survey, the nation's largest health plan survey, shows that employers continue to shift a greater share of expenses to employees through out-of-pocket cost increases and reductions in family benefits, as well as delay many effects of the Patient Protection and Affordable Care Act (PPACA) by utilizing an early renewal strategy. More


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Topics: health plan survey, UBA, section 125 plans, PPACA Affordable Care Act, IRS, Self-Funded, HHS, EEOC, blog, Skinny Plans, out-of-pocket limits, top 10

Proposed 2016 Benefit and Payment Parameters

Posted by: Linda Rowings    Dec 23, 2014 1:00:00 PM

The Department of Health and Human Services (HHS) has issued its proposed Benefit and Payment Parameters for 2016. While these amounts and dates are not yet final, they may be of help for planning purposes. At this time, HHS expects:

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Topics: Linda Rowings, HHS, 2016, Benefit, Payment, Parameters, UBA PPACA Advisor

Can Employers Assist Employees with Premiums for Individual Plans?

Posted by: Carol Taylor    Nov 13, 2014 8:56:00 AM

On November 6, 2014, the collective Departments of Health and Human Services (HHS), Labor (DOL) and the Treasury released three Frequently Asked Questions (FAQs) directed at employer payment plans for the purchase of individual insurance. While the departments had previously released several other pieces of guidance about these arrangements, this latest round exclaimed an emphatic no!

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Topics: HHS, DOL, employers, employees, premiums, individual plans, Carol Taylor, FAQ

Reference-Based Pricing and Cost-Sharing Limits

Posted by: Linda Rowings    Nov 11, 2014 10:19:00 AM

The Department of Labor (DOL), the IRS, and the Department of Health and Human Services (HHS) have jointly issued a FAQ that addresses how "reference-based pricing" works with the Patient Protection and Affordable Care Act's (PPACA) restrictions on out-of-pocket maximums. PPACA limits the out-of-pocket maximum a non-grandfathered plan may impose, and generally requires that co-pays, coinsurance, and deductibles be counted toward this limit. However, premiums, balance billed amounts for non-network providers, and non-covered services do not need to be applied to the out-of-pocket limit. (For 2015, the limits are $6,600 per individual or $13,200 per family.) The new FAQ explains how the out-of-pocket limit applies to plans that use reference-based pricing--i.e., a design under which the plan pays a fixed amount for a particular procedure (such as a knee replacement), which certain providers have agreed to accept as full payment.

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Topics: Linda Rowings, IRS, HHS, DOL, Reference-Based, Pricing, Cost-Sharing, Limits, Department of Labor, Department of Health and Human Services

Deadline Approaching for Larger Self-Funded Health Plans To Obtain a Health Plan Identifier Number

Posted by: Linda Rowings    Oct 21, 2014 11:08:00 AM

To meet federal requirements, large health plans must obtain a national health plan identifier number (HPID) by November 5, 2014. For this requirement, a large health plan is one with more than $5 million in annual receipts. The Department of Health and Human Services (HHS) has said that since health plans do not have receipts, insured plans should look at premiums for the prior plan year and self-funded plans should look at claims paid for the prior plan year. Small health plans (those with less than $5 million in claims during the prior plan year) have until November 5, 2015, to obtain an HPID.

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Topics: Self-Funded, HPID, Deadline, HHS, Centers for Medicare and Medicaid Services, Form 5500