TPA of Self-Insured Health Plan Not Subject to Texas Prompt-Pay Law

From the February 18, 2016 EBIA Weekly [Health Care Serv. Corp. v. Methodist Hosps. of Dallas, 2016 WL 530680 (5th Cir. 2016)] Available at http://www.ca5.uscourts.gov/opinions/pub/15/15-10154-CV0.pdf The Fifth Circuit has ruled that a third-party administrator (TPA) of employer-spons
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The Problem with Wraps

By Adam V. Russo, Esq. (As published in Thompson Information Services’ Employer’s Guide to Self-Insuring Health Benefits) If you are a long time reader of mine, I would first like to say thank you for being the only person other than my mother to read what I write.  It is
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Ready or Not, Here it Comes! The Employer Mandate is Finally Applicable

By Kelly E. Dempsey, Esq. (As published within The Self-Insurer)  The Employer Shared Responsibility provision of the Patient Protection and Affordable Care Act (“ACA”) went into effect for certain applicable large employers on January 1, 2015.[1]  The Employer Shared Responsibility p
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Self-funded Health Plans: A New Challenge for Hospitals

MyHealthGuide Source: Emily M. Scott, 6/29/2015, Hirschler Fleischer Attorneys at Law<https://t.e2ma.net/click/hcsgk/l7ixcb/17924f>   Editor’s Note:  A view of self-funding from the perspective of a hospital advocate.   Hospitals should be on the lookout for a ne
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Federal Court Keeps TPA As Third-Party Defendant in Suit Between Stop Loss Carrier and Group: A Walk Through the Procedural Thicket

MyHealthGuide Source: Thomas A. Croft, Esq., 1/10/2015, StopLossLaw.com Article Case: Unimerica Insurance Company v. GA Food Services, Inc., et al., No. 8:14-cv-2419-T-33TBM, In the United States District Court for the Middle District of Florida, Tampa Division, December 10, 2014) Cou
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Incentives for Small Firms to Self Fund Their Healthcare Plans

By: Robert C. Pozen and Anant Vinjamoori When firms offer healthcare plans to their employees, they have two main choices. They can buy insurance from traditional health insurers like Aetna or Blue Cross Blue Shield, or they can self-fund their own healthcare plan. Read more…
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Obama administration floats new prescription contraceptive rules

By Jerry Geisel The Obama administration sought Friday to end a long-running controversy by proposing new ways to enable employees of nonprofit religiously affiliated organizations — such as hospitals — and private closely held corporations to obtain coverage for prescription contrace
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SIIA Requests Delay in ACA Contraceptive Coverage Mandate Rule

Rule Will Disrupt Self-Insured Plans Sponsored by Religious Organizations       November 26, 2013 – In a formal letter submitted today to the U.S. Departments of Health & Human Services, Labor and Treasury (“Tri-Agencies”), the Self-Insurance Institute of America
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Direct negotiation with health care providers helps Oklahoma firms save money

By Joanne Wojcik A handful of self-funded middle-market employers in Oklahoma are finding they can reduce employees’ health benefit costs by contracting directly with select medical providers. Read more…
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MyHealthGuide Newsletter 10/28/13

Published weekly by MyHealthGuide, LLC HCC Insurance Holdings To Acquire Centris Group for $171 Million Source New York Times, 10/13/2013, NY Times Article HOUSTON — HCC Insurance Holdings Inc. agreed to acquire Centris Group Inc. for $12.50 a share, a total of $171 million. Cen
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