Why Plan Sponsors should be Upfront with Workers about Self-funding

By Zack Pace, Senior Vice President, CBIZ, Inc., Employee Benefit News (Full text) (EBN) Self-funded health plans don’t have health insurers, only health plan administrators. The knowledge that their employers are paying the claims of the plans dramatically changes employees ent
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Court: Third-Party Administrator Is Proper Defendant

MyHealthGuide Source: Bloomberg BNA Pension & Benefits Daily, 11/8/2013, www.BNA.com Case: Nystrom v. AmerisourceBergen Drug Corp., 2013 BL 308000, D. Minn., No. 0:13-cv-00557-DSD-JJK, 11/6/13 Article referred by John Eggertsen, Esq. Attorney at Law, Eggertsen Consulting, P.C. A h
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Plan Sponsors Working Diligently and in Good Faith on the Summary of Benefits and Coverage Will Not Face Penalties During the First Year

On May 11, 2012, the Departments of Labor, Health and Human Services and Treasury issued answers to Frequently Asked Questions (FAQs) about the new Summary of Benefits and Coverage (SBC) requirements of the Affordable Care Act.1 The FAQs are the ninth set of questions and answers abou
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New Fees Payable by Health Plan Sponsors and Insurers

One of the ways the 2010 Affordable Care Act (“ACA”) was designed to slow the growth of health care costs is through an emphasis on quality of care.  For instance, the ACA created a “Patient-Centered Outcomes Research Institute,” which is charged with advancing research into comparati
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Plan Sponsors Must Pay New Annual Health Plan Fee for 2012 and Beyond

This is part of our series of alerts intended to help guide employers and plan sponsors through their new obligations under the health care reform laws and related guidance. On April 12, 2012, the IRS released proposed regulations regarding the implementation of the comparative effect
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DOL’s ‘good faith’ compliance standard for SBC rules fails to relieve burden on employer plan sponsors

WASHINGTON, DC — We are very disappointed that guidance issued today by the departments of Health and Human Services, Labor and Treasury has reiterated that employers will have as little as six months to comply with the Patient Protection and Affordable Care Act’s (PPACA) Summary of B
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Essential Health Benefits Proposal Presents Challenges for Plan Sponsors

The Center for Consumer Information and Insurance Oversight (CCIIO) of the Department of Health and Human Services (HHS) has issued an Essential Health Benefits Bulletin (the CCIIO bulletin)1 that provides a preview of how HHS intends to define “essential health benefits” under the Af
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Prepare for Health Plan Participant Fee

Under health care reform, plan sponsors of self-funded health plans and health insurance issuers will owe a new fee that is first payable for plan years ending after September 30, 2012. For calendar year plans this means the fee applies this year. Many questions about the fee are curr
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HIPAA Audits Coming

The Department of Health and Human Services plans to audit 150 plan sponsors and employers to make sure employee health and financial records are adequately protected. Creating appropriate policies and procedures, instituting a risk assessment and training employees are keys to compli
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Group Health Plans: Year-End Action Items, Upcoming Changes

The end of the 2011 plan year brings about another opportunity to review group health plan compliance with Patient Protection and Affordable Care Act (PPACA) requirements. This LawFlash describes year-end action items for group health plan sponsors and previews upcoming changes for 20
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