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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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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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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PPACA’s big business for TPAs

By Allen Greenberg CHICAGO – Love it or hate it, the Patient Protection and Affordable Care Act offers a slew of business opportunities to third-party administrators and others serving self-insured group health plans. That was the message Wednesday from Adam Russo, the CEO of the Phia
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From the Bench

By Thomas A. Croft, Esq. Caught with Your Pants Down: Why the Attorney-Client Privilege Matters The “advice giving” marketplace in the self-insured world is populated with all sorts of folks with all sorts of expertise – outside auditors, consultants of various stripes, cost containme
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Guardian releases stop-loss coverage for the self-insured

By Tristan Lejeune Traditionally a funding option preferred by large employers, self-insured health plans are becoming more and more common for small- and medium-sized companies and firms as well. According to a Kaiser Family Foundation study, 60% of American workers covered by employ
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New HIPAA rules go into effect

By Tristan Lejeune The deadline for compliance with the Health Insurance Portability and Accountability Act’s new notification standards has come and gone, but employers’ efforts to toe the line with the latest privacy and security regulations have just begun. In essence,
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