Can selling across state lines work?
- Saturday, 09 March 2019 09:52
The Washington Post reports that “The Trump administration is seeking ways to allow more health insurance plans to be sold across state lines — an effort that could involve implementing a part of the Affordable Care Act the Obama administration left untouched.
“The Centers for Medicare and Medicaid Services invited insurers and other stakeholders to give input over the next 60 days on how to “eliminate regulatory, operational and financial barriers to enhance issuers’ ability to sell health insurance coverage across state lines” in a request for informationissued yesterday afternoon.”
The problem, IMHO, is two-fold. Rates vary state to state because different states have different mandated benefits, the people in their pool have varying levels of health, and the costs for healthcare vary greatly state to state.
As an example, a hernia repair in Iowa averages $6900, while in NY it is 15% higher at $7900. Would your insurance bought in another state pay the local usual and customary rate? if so you will have $1000 uncovered, and MD’s might drop the plan due to lower reimbursement rates. OR would they pay the higher rate, therefore having to raise the premiums to cover these higher costs?
And if the rates all rise to meet the more expensive costs of healthcare, what have we accomplished? This is a very complicated topic, and sound bites on the nightly news are not solutions. Our system remains badly broken and in need of a comprehensive solution – one that actually controls costs, doesn’t drive physicians away, provides americans with access to care, and at a reasonable cost.
United and Quest move to improve, simplify, your experience
- Monday, 18 February 2019 07:17
UnitedHealthcare is growing its national network of participating laboratory providers and launching an innovative value-based approach to laboratory services focused on ways to create more personalized care recommendations and a simpler consumer experience for the more than 48 million people it serves. We have renewed our long-term strategic agreement with LabCorp, and we are establishing an expanded relationship with Quest Diagnostics.
LabCorp will continue to serve as our exclusive national laboratory provider until Jan. 1, 2019;1 Quest will be available as a network provider for all plan participants beginning Jan. 1, 2019.1
UnitedHealthcare will collaborate with both providers on a variety of value-based programs, bringing the same type of aligned incentives and enhanced patient experience to lab services that exist today in accountable care arrangements between UnitedHealthcare and more than 1,100 hospitals and 110,000 physicians.
These expanding relationships will strategically change the way we support the health care needs of consumers by using real-time data sharing to better anticipate people’s care options – and reducing gaps in care – similar to the model UnitedHealthcare already uses to integrate medical and pharmacy data.
Tax Credit for employees on FMLA
- Sunday, 10 February 2019 07:47
The Internal Revenue Service (“IRS”) recently issued the 2018 Form 8994 for eligible employers to complete to receive the Employer Credit for Paid Family and Medical Leave (“Employer Credit”). The Employer Credit was signed into law by President Trump on December 22, 2017 as part of the Tax Cuts and Jobs Act. The Employer Credit enables eligible employers to claim a general business credit for employees on paid family and medical leave. The Employer Credit is available for years beginning after 2017 and before 2020, and ranges from 12.5% to 25% of wages paid to a qualifying employee while the employee is on family and medical leave. Employers that qualify may claim or elect not to claim the Employer Credit any time within three (3) years from the due date of their return on either an original return or an amended return.
For the complete article and more information, click here or call our office.
Choosing Funds in your 401(k) Plan
- Sunday, 10 February 2019 07:42
A recent First Circuit Court of Appeals decision puts a special light on the fiduciary standards for selecting, monitoring and changing the investments in your 401k plan. It also supports our ongoing approach to this for our clients. For the full article, click here.
“Moreover, any fiduciary of a plan such as the Plan, in this case, can easily insulate itself by selecting well-established, low-fee and diversified market index funds. And any fiduciary that decides it can find funds that beat the market will be immune to liability unless a district court finds it imprudent in its method of selecting such funds, and finds that a loss occurred as a result. In short, these acts are not matters concerning which ERISA fiduciaries should cry ‘wolf.’”
Average US Life Insurance Policyholder 74% Under-Insured
- Thursday, 07 February 2019 08:25
A new study by Atidot found that “Policyholders are generally unaware that they are underinsured.” In fact, according to LIMRA, 46% of americans have no life insurance at all – even through work. And while a third believe they need more, the data says its three quarters that need more! This has an enormous impact on families if the primary wage earner dies…
Give us a call if you think this might apply to you…