Ga., Calif. Hospitals Sue Blue Cross Plan For Sending ER Reimbursements To Patients

By Andy Miller Blue Cross and Blue Shield of Georgia faces separate lawsuits accusing it of sending reimbursement money for emergency room care directly to patients — and not to the hospital because it isn’t part of the insurer’s network. Read more…    
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Register Now for The Phia Group’s July 2016 Webinar!

Plan Language 101 (Part 2)  Wednesday, July 13th, 2016 1:00 PM (EST) to 2:00 PM Join Us – Register Now!  When we think of hot topics in the self-funded industry, plan document drafting is hardly the first thing that come to mind. Instead, issues such as fiduciary duties, referen
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High-Deductible Health Plans Dominate Employer Offerings

By Vera Gruessner Research shows that more than four out of ten employers are likely to begin offering only high-deductible health plans over the next three years. Today, the consumer or employee is left with much higher out-of-pocket costs than in previous years. Within the Kaiser Fa
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Latest Plan to Cut Medicare Drug Payments Leaves Senators Skeptical

By Robert Pear WASHINGTON — Under fire from senators in both parties, a senior federal health official told Congress on Tuesday that the Obama administration would adjust its plan to reduce Medicare payments for many prescription drugs, but those assurances did not fully allay deep co
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Average out-of-pocket costs for hospital visit top $1,000, with insurance

By Beth Mole Having health insurance can be a comfort, putting your mind at ease that you’ll be covered if you get sick or injured—until you actually have to use it, that is. Insured Americans are having to shell out more and more for healthcare, particularly, hospital visits, researc
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Why Payers Should Include Consumer Engagement in Health Plans

By Vera Gruessner Consumer engagement remains a key goal of the health insurance industry. In order to ensure that the health insurance exchange successfully reduces healthcare spending, it may be necessary to strengthen consumer engagement and education so that policyholders continua
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9 FAQs about the DOL’s overtime rule

By Archana R. Acharya Last month, we discussed the U.S. Department of Labor’s recently published final rule making changes to the so-called “white collar” overtime exemptions under the Fair Labor Standards Act. We also presented a webinar on June 2, 2016, discussing the recent changes
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Are private exchanges meeting employer expectations?

By Bruce Shutan In the emerging private health insurance exchange market, some blue-chip companies are pioneering their way through a space that was seen as transformative just a few short years ago. The expectation was that it would become a mainstream offering across active employee
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Majority of workers cannot define copay, deductible

By Vlad Gyster Very soon, thousands of employees across the United States will be choosing their health insurance. That’s scary, because there’s an emerging body of data that shows that most people don’t understand the basics of how health plans work. That knowledge gap may be causing
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Docs may bolt from merit-based Medicare

By Chris Woodward The comment period for a controversial rule involving doctors and medicine is drawing to a close, and one organization wants more people to voice their opposition. At issue is the proposed Medicare program known as Merit-Based Incentive Payment System (MIPS). Read mo
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