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Proposed Rules Would Affect Prescription Drug Plans

The Centers for Medicare and Medicaid Services has floated proposed regulations that would affect drug benefits for group plans and association plans and attempt to reduce drug expenses for health plan enrollees and drug plans. While the rules seem to be focused on individual plans sold on government-run exchanges, three of the changes would also…

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Regulators Take Steps to Help Grandfathered Plans

Regulators are in the early stages of creating rules that make it easier for health plans that were grandfathered in before the Affordable Care Act took effect to continue providing coverage. The number of workers enrolled in plans that were in effect before the ACA was enacted in 2010 has been shrinking, and as of…

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As More Employers Rethink High Deductible Plans, They Tackle Other Costs

A new study has found that more and more large employers are ditching high-deductible health plans as the job market tightens and they need to boost improve their health insurance offerings to retain and attract talent, and saddle their employees with less of the cost burden. The change is also in response to the increasing…

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Surprise Medical Bills and ‘Balance Billing’ in Crosshairs

When your medical care provider charges more than your insurance company is willing to reimburse, you may get a bill asking you to pay the difference – a practice called “balance billing.” The Trump administration is moving to put a stop to the practice. In a recent White House round table on limiting health care…

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Most Drugs Inflation Covered in Increased Premiums

Retail prescription drug spending grew 36% over the four-year period ended Dec. 31, 2016, but out-of-pocket spending for health plan enrollees remained steady, according to a recent study by the Pew Charitable Trusts. The study, “The Prescription Drug Landscape, Explored,” found that patients are covering the lion’s share of the cost through higher premium outlays,…

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HDHP Enrollees More Likely to Consider Costs and Quality

A new study has found that people enrolled in high-deductible health plans (HDHPs) actually are more likely to consider costs and quality when considering non-emergency care. The 14th annual “Consumer Engagement in Health Care” study by the Employee Benefits Research Institute and market research firm Greenwald & Associates surveyed 2,100 adults, most of whom receive…

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Helping Your Staff Get the Most from Their HSA Plans

As more employers adopt high-deductible health plans, which leave their employees with more “skin in the game,” it’s important that you educate them on how to get the most out of the attached health savings accounts. Unfortunately, your employees may not be using the funds in their HSAs as efficiently as they should, and they…

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Trump Administration Issues Proposed Rules for Short-Term Plans

As promised, the Trump administration has issued proposed rules that would allow individuals to skirt Affordable Care Act regulations and buy short-term, low-coverage health plans. Under the proposal, individuals would be able to purchase short-term plans that last up to 12 months, compared to the three-month maximum under the ACA. The proposal would also exempt…

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Benefits in a Multi-generational Workplace

With multiple generations working side-by-side in this economy, the needs of your staff in terms of employee benefits will vary greatly depending on their age. You may have baby boomers who are nearing retirement and have health issues, working with staff in their 30s who are newly married and have had their first kids. And…

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Ohio Auditor’s Report on PBMs Sparks Changes

An audit carried out for Ohio Medicaid found that large pharmacy benefit managers that contract with the state’s Medicaid program have been pocketing a larger and larger share of drug pricing. In fact, PBMs charged Ohio Medicaid plans 31% more for generic prescriptions than the amount they paid pharmacists for the drugs, the audit found,…

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