Health Care Benefits
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Will That Knee Replacement Cost an Arm and a Leg?
With more employees enrolling in high-deductible health plans, a nonprofit business group endeavors to pull back the curtain on health costs. In a statement, the Catalyst for Payment Reform pushes for not only more information but also better cost-calculating tools for consumers.
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So This Is 30: How Health Care Rules Are Changing for Part-Timers
While part-time workers make up 23 percent of the total workforce, only 15 percent of them are eligible for health coverage, survey reveals.
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IRS Releases Final Rules on Health Care Reform Costs
The affordability test applies to employer-sponsored health plans. An employee is eligible to receive a federal subsidy to purchase insurance through an exchange if his or her employer's plan premium contribution exceeds 9.5 percent of his or her household income, according to IRS guidelines.
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Employers' Deadline to Inform Employees of Health Exchanges and Cost-Sharing Plans Extended
The March 1 deadline for businesses to notify employees of their benefits cost-sharing plans and government-run health insurance exchanges has been postponed. A new deadline is expected by fall.
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New Changes Made to HIPAA Privacy and Security Rules
Health and Human Services has issued final regulations that address recent legislative changes to the HIPAA privacy and date security rules. Compliance by employers will be required by Sept. 23, according to a press release.
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Valuing Value: California Mines New Health Coverage Plan Concepts
SeeChange Health and Blue Shield of California are two San Francisco insurance companies that are stepping up efforts to market value-based insurance design plans to large employers.
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HHS Gives $1.5 Billion in Grants to 11 States to Set Up Health Exchanges
The U.S. Department of Health and Human Services said it is giving $1.5 billion in grants to 11 states to launch or further develop health insurance exchanges. Those states are California, Delaware, Iowa, Kentucky, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oregon and Vermont.
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Workers' Wellness Goes Wireless With Activity Trackers
Unlike its predecessor the pedometer, which tracked only steps and whose data couldn't be uploaded or easily shared, the accelerometer monitors steps, distance and calories burned. It even tracks sleep.
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Certifications Aid Navigation of the Affordable Care Act Maze
Finding a qualified partner in the employee benefits industry can help companies adjust to the ACA regulatory landscape. Accreditations are enhancing their knowledge.
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Tobacco Cessation Report Lights Up Coverage Gaps, Confusing Language
Researchers found 'significant variation in how private health insurance coverage works for tobacco cessation treatment' when analyzing 39 insurance contracts in six states.
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Higher Financial Penalties Proposed for Uninsured Massachusetts Residents
In 2012, the maximum penalty for non-compliance was $105 a month, or $1,260 a year. The maximum penalty this year for those with incomes that exceed 300 percent of the federal poverty level will be $106 for each month that an individual is not covered by health insurance, or $1,272 a year.
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Certifications Aid Navigation of the Affordable Care Act Maze
Finding a qualified partner in the employee benefits industry can help companies adjust to the ACA regulatory landscape. Accreditations are enhancing their knowledge.
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Narcotic Pain Drugs Remain Atop List of Workers' Comp Insurer Concerns
Concern over the long-term implications of prescribing narcotic pain medications to injured workers has grown during the past two years.
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Specialty Drugs and the Cost Conundrum
Steep prices of specialty drugs—such as Humira or Enbrel, which can cost more than $14,000 annually—are prompting employers to focus on managing the expense. But the question is how.
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IRS Rules Ease Compliance With Health Reform Law Employer Mandate
The massive $2,000-per-full-time-employee penalty will not apply so long as employers offer coverage to at least 95 percent of their full-time employees and their dependents up to age 26, the IRS said.
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Group Benefits Costs to Rise at Slowest Rate in 11 Years: Study
A survey of 123 insurers and benefits administrators, released Dec. 17, indicated that group health care plan cost increases through June 2013 will be between 0.2 percent and 0.6 percent lower than they were in the first half of this year.
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Minnesota, Rhode Island Get OK to Launch Health Insurance Exchanges
The U.S. Department of Health and Human Services has given tentative approval to applications filed by Minnesota and Rhode Island to launch health insurance exchanges in 2014.
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Domino's Pizza Founder Wants Exemption From Contraceptive Mandate
The U.S. Department of Health and Human Services law requires most employers to provide cost-free coverage for birth control prescriptions, sterilization, preventative screenings and other forms of women's preventative care.
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Weighing in on Wellness Incentives
The American Heart Association and American Cancer Society are among the groups providing guidance on how organizations can design outcomes-based incentives programs that don't discriminate against employees.
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Cabinet-maker Among Firms Adding Wellness to Health Care Cupboard
For companies considering healthy programs, it's important to create a wellness culture, one executive says. “If you're doing it just to attack claims, don't do it. It won't succeed.”
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Find Great Rank-and-File Workers
Recruiting strategically can give employers an edge and reduce costly turnover.
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Workers' Spending on Health Premiums Surges 74 Percent in 8 Years
A worker, on average, spent $3,962 on family premiums in 2011, an increase of 74 percent from 2003. Meanwhile, the average family premium totaled $15,022, an increase of 62 percent from 2003, the report said.
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Pharmaceutical Giant Puts Medical-Home Concept to the Test
Working with a nonprofit program, GlaxoSmithKline is giving its North Carolina employees the opportunity to test a medical home's efficiency. The pharmaceutical company will see whether the two-year pilot program could mean cost savings.
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The Medical Home Evolves From Recordkeeping to a Community of Care
A patient-centered medical home practices preventive medicine and helps manage chronic illnesses through a partnership between patients and their primary care physician and other health professionals
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Employee Opinion of Health Care Benefits Value Drops: Mercer
Thirty-six percent of employees polled in Mercer's annual Workplace Survey indicated that their out-of-pocket costs were 'definitely' commensurate with the health benefits they receive through their employer, down from 44 percent in 2011 and 38 percent in 2010.
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HHS Details Fees to Be Paid, Provides Guidance for Transitional Reinsurance Program
Much of the $25 billion in assessments—to be paid annually over a three-year period—will be used to partially reimburse commercial insurers writing policies for individuals with high health care costs.
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The Last Word: Spending the Holidays With Obamacare
There is a large contingent of HR and benefits managers who face implementation now, during the holiday season no less.
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Mercer to Launch Health Insurance Exchange for Medicare-Eligible Employees
The exchange, which Mercer is offering along with Connextions Inc., a technology solutions company, will provide assistance to retirees during enrollment periods and throughout the year.
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Depression Leads in Top Risk Factors for Employer Health Spending
Annual medical spending for an employee with depression is $2,185 higher, or 48 percent more, than for a worker without depression, according to a new study.
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Medicare Beneficiaries Face Boost in Out-Of-Pocket Expenses
Medicare beneficiaries will face higher out-of-pocket expenses next year, according to the U.S. Department of Health and Human Services.
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HHS Proposes Rules on Employee Wellness, Essential Health Benefits
Officials said the proposed rules on wellness programs are designed to give employers greater flexibility to design programs that will positively affect their employees' overall health while providing individuals with enhanced protections against discriminatory practices.
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Health Care Reform Timeline
Implementation of the Patient Protection and Affordable Care Act has been slow since its passage in March 2010. That will change starting in January when more regulations and requirements begin kicking in. Here is a list:
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Obamacare Health Exchanges Could Take a Big Bite Out of Broker Commissions
State-run health care exchanges could offer one-stop shopping experiences for small businesses, which usually pay more for insurance because they lack the buying power of bigger companies.
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Group Health Plan Costs Up 4.1 Percent in 2012, Smallest Increase in 15 years: Mercer
The 4.1 percent increase brought health plan costs to an average of $10,558 per employee in 2012, compared with $10,146 per employee in 2011, according to the survey.
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HealthPass New York Selects Bswift to Provide Exchange Technology, Services
Bswift Inc. will provide HealthPass New York clients and members with functions and capabilities including reporting tools, dashboards and alerts for employers, as well as shopping tools, decision and enrollment support for employees.
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Obama Re-election to Accelerate Release of Health Care Reform Law Guidance
Some health care reform law issues may be discussed during the remaining weeks of the current legislative session as lawmakers look for ways to reduce the federal budget deficit.
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Obama Win Seen as Victory for Health Care Reform
President Barack Obama's victory serves as a vindication for the Patient Protection and Affordable Care Act, industry experts said soon after the president won re-election Nov. 6.
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With Election Near, Romney, Obama Take Very Different Stances on Health Care Reform Law
Republican challenger Mitt Romney said numerous times during the campaign that one of his first acts, if elected, would be to seek repeal of the Patient Protection and Affordable Care Act.
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Out of Sight but Not Out of Mind
Employers are tailoring wellness offerings to suit staffs that aren't in the office. Programs must be “highly timely, personalized and relevant,” an expert says.
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Aging Workforce Not as Costly as Some Think: NCCI Report
The new report adds to NCCI Holdings Inc. research findings published in 2011 concluding that on average costs for workers aged 35 and older tend to be similar.
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Most Employers to Continue Offering Health Benefits: Survey
Out of 111 Midwestern employers surveyed in August, only 8 percent said they intend to drop health care coverage for active employees in 2018, when the last of the federal health care reform act's provisions are expected to take effect, according to the Chicago-based business group's report.
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Employer-Sponsored Health Benefits for Retirees Dying Out
Data from the Employee Benefits Research Institute showed that in 1997, 10.2 percent of private-sector employers provided health insurance to Medicare-eligible retirees and that 11.3 percent provided such coverage to early retirees. As of last year, those numbers fell to 6.1 percent and 6.
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Expedia Constructing Work-Site Clinic at Headquarters
The clinic is being constructed by Qliance Medical Management Inc., a Seattle-based health care firm that contracts with employers to provide primary care to employees and their dependents through its network of clinics.
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A Perk the Boss Can't Afford
New York City wants to give small business workers paid time off—a benefit some of their employers can rarely take.
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Benefit Tech Tools Aim to Turn Employees Into Smart Shoppers
Health care consumerism—a movement to empower employees with information to help them choose plans, providers and treatments—is giving rise to online decision-support tools that assess the best benefit plan for their needs.
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Guidance on Health Reform Law's Transitional Reinsurance Program Requested
Many questions remain unanswered about the Transitional Reinsurance Program, the Washington-based benefits lobbying group noted in a letter sent this month to the U.S. Department of Health and Human Services, which will enforce the program.
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Rising Health Care Costs to Pinch Employees
The average cost to insure an employee is projected to jump to $11,283 in 2013, from $10,616 this year, according to the report by the unit of London-based Aon Corp.
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Lack of Health Care Reform Guidance Hampers State Lawmakers: Letter
For employers, final regulatory guidance has yet to come in a number of areas, including whether employers will be assessed a penalty of $2,000 per full-time employee if they do not offer coverage to all full-time employees, and how much they will have to pay to fund a three-year health care reform...
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Group Health Care Plan Costs to Rise 6.3 Percent in 2013: Aon Hewitt
The average group health care plan cost per employee is projected to rise to $11,188 per employee next year, according to an analysis released Oct. 3 by Lincolnshire, Illinois-based Aon Hewitt.
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Romney Reform Repeal Would Mean More Uninsured: Commonwealth Fund
Under Romney's plan, 30 percent or more of the under-65 population in nine states—Arkansas, California, Florida, Louisiana, Mississippi, Nevada, New Mexico, South Carolina and Texas—would be left uninsured by 2022, which the report says would increase the number of uninsured in every...
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Connecting Wellness-Program Participation and Incentives
Many companies offer incentives and tie them to plan design, specific health outcomes or apply surcharges when employees don't take part in particular programs.
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Health Care: Going Radical?
The option, which gives employees more autonomy, could revolutionize employer-provided health benefits, proponents say.
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Sutter Health Seeks Approval to Offer HMO in California
Under California's Knox-Keene Health Care Service Plan Act, health plans must obtain a license from the Department of Managed Health Care to operate as HMOs in the state.
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Employees Will Need to Be Educated About Benefits Eligibility
Fortunately, most payroll and human resource information system vendors either already have a robust time and attendance system or are building one to meet the new employer record-keeping requirements mandated by the Patient Protection and Affordable Care Act.
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IRS Notice Gives Employers Clarity on Definition of 'Full Time'
Under the notice, which will remain in effect at least through 2014, employers can use a retrospective measurement period lasting between three and 12 months to determine whether an employee's hours meet the definition of “full time” under the Patient Protection and Affordable Care Act.
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Employers Developing Reliance on Direct Primary Care Providers Like Qliance
Health care reform is opening the door to companies like Washington state's Qliance, which offers unlimited access to primary care for a monthly fee.
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It's Not All Coffee and Computers as Health Care Innovation Thrives in Washington State
The medical-homes concept, direct primary care firms and a university that produces some of the nation's best physicians help bolster Washington's position as a health care leader.
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Health Care Premium Increases Ease in 2013 for Federal Employees
The increase for the Federal Employees Health Benefits Program is down from this year's 3.8 percent average increase and sharply lower than 2011, when premiums rose by an average of 7.3 percent.
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Health of Long-Term-Care Business Questionable: Report
The field of long-term-care insurance providers is shrinking as companies exit the business or limit their sales. Of the 15 companies that generated the most statutory earned premiums for long term care insurance in 2010, five either no longer sell the product or have curbed sales.
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What Gen X and Y Employees Want
A new MetLife survey shows younger employees don't mind paying for a wide array of benefits.
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Consultancies Are Eager to Enter Private Health Exchanges
For employers, an exchange ideally will expand health benefits choice for workers while holding down their health costs, advocates for the concept say.
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Consumer-Driven Health Plans Pass HMOs in Popularity of Plans Offered: Survey
Fifty-eight percent of more than 1,800 employers surveyed by Aon Hewitt offered some type of CDHP in 2011, while 38 percent offered HMOs, 15 percent offered point-of-service plans, 12 percent offered exclusive provider organization plans and 5 percent offered indemnity plans.
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Contraceptive Coverage Legal Battle Looms for Missouri
Missouri lawmakers on Sept. 12 overrode Gov. Jay Nixon's veto of legislation that would allow employers and insurers to deny contraceptive coverage, setting the stage for yet another legal battle over contraceptive coverage.
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Hobby Lobby Lawsuit Seeks to Block Enforcement of HHS Contraceptive Coverage Rule
Oklahoma City-based Hobby Lobby Stores, a privately held, self-described Christian-owned and -operated retail chain with more than 500 stores and 22,500 employees in 41 states, says it is the first non-Catholic owned business to challenge the HHS edict.
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Certain Health Care Reform Provisions Should Be Kept: Romney
Mitt Romney says that while he would seek to repeal the health care reform law if he were elected, he could keep the provision that bans health care plans from denying coverage of pre-existing medical conditions and perhaps even expand a provision that requires health care plans to provide coverage...
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Employers Should Ignore the Rhetoric and Focus on the Reality of Health Care Reform, Experts Say
With the presidency and 33 Senate seats up for grabs in 2012, how the battle over health care reform will play out is anyone's guess, but employers are watching the tussle closer than most.
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Health Care Reform a 'Badge of Honor' for Democrats: HHS Secretary
During her speech, Kathleen Sebelius detailed what she said are some of the achievements of the Patient Protection and Affordable Care Act.
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The Last Word: 'Papa John,' Can You Spare a Dime for Health Care?
Politics apparently has joined the menu—at least through November—alongside pepperoni and pineapple as a new pizza topping.
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Global Push for Wellness
Health programs get off the ground internationally, but local conditions can create challenges.
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Repeal and Replace Health Care Reform Law: Romney
Republican presidential candidate Mitt Romney called for a repeal of the Patient Protection and Affordable Care Act during his speech at the Republican National Convention August 30.
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Health Care: A Real Fixer-Upper
Employers are helping to rebuild the health care system with a do-it-yourself approach that takes picking the right tool. The new options include value-based design, workplace clinics and direct primary care.
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Penalty for Not Completing Health Risk Assessment Does Not Violate ADA: Court
Broward County began offering an employee wellness program in 2009 through its group health insurer. The county required all employees to take a health risk assessment and provide a blood sample to determine glucose and cholesterol levels.
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Rochester Business Alliance Fosters the Links for Health Care
The Rochester Business Alliance Health Care Initiative brings together business and community leaders to find ways to improve the health care system and patient outcomes.
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GOP Platform Includes Repeal of Health Care Reform Law
As expected, the Republican Party promises massive changes to the Medicare and Medicaid programs if former Massachusetts Gov. Mitt Romney and Rep. Paul Ryan (R-Wisconsin) are elected president and vice president.
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Many Moms Leave Maternity Leave Behind Early
When Divya Gugnani, founder of accessories e-commerce site Send the Trend, gave birth to her son in May, she took two weeks of maternity leave—far less than the 12 weeks of leave that many corporate women get.
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After Aetna fires Rush, Rush drops Aetna
The change comes after Aetna late last year canceled its contract with Rush to provide care to Aetna patients, effective January 1. Rush refused to accept a roughly 30 percent cut in reimbursement rates.
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No Penalties for Employers Not Offering Dependent Coverage: Employer Group
Under the Patient Protection and Affordable Care Act, employers are to be assessed $2,000 per full-time employee if they do not offer coverage to employees in 2014. Regulators have yet to issue definitive guidance on the penalty.
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Self-Funded Employers Will Pay Billions for High-Cost Coverage
The first-year assessment paid by very large employers—those with at least 100,000 employees—will run into millions of dollars, for which employers will receive no direct benefit.
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Most Employers to Continue Offering Health Care Plans in 2014: Survey
Eighty-eight percent of employers surveyed by Towers Watson & Co. said they have no plans to terminate coverage in 2014 or after for full-time employees, while 11 percent were not sure. Just 1 percent said they planned to terminate coverage for some employees.
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The Long Arm of the Employer Mandate
The state's Fair Share Law is alive and well, and companies with any employees in Massachusetts may be required to follow it.
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Michigan Teacher Funding of Retiree Health Benefits Violates Employment Rights: Court
The law ran afoul of protections against impairment of government contracts because teachers received three percent less in pay by paying into a fund than the amount the teachers and their employers agreed upon as part of teachers' contracts.
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Mid-Market Companies Face Health Benefits Enrollment Challenges
One challenge for middle-market companies is the U.S. Department of Labor has yet to finalize the regulations implementing the mandate in Section 1511 of the Patient Protection and Affordable Care Act.
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Analysis: Transforming the Mobile Workplace While Keeping an Eye on Ergonomics and Underlying Health Risks
While mobile device use in and outside of the office is still too new to know the long-term impact on employees, this reality holds true: Workplace injuries can leave your company at a competitive disadvantage.
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Direct Primary Care: Medicine for the Masses or an Unused Gym Membership?
For less than $100 a month, direct primary care provides patients with unlimited doctor's visits for routine services. Critics question the plan's economic viability for healthy patients paying a monthly fee for services they don't always use.
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Audit Causes Some Family Members of Minnesota State Workers to Lose Health Benefits
Approximately 3,100 people were deemed ineligible for state-sponsored health care in a recent audit of Minnesota's employee benefits program.
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Memphis Opens Health Clinic for City Employees, Retirees, Dependents
The clinic offers diagnostic services and non-emergency care for a range of conditions, including sinus, urinary tract and upper respiratory infections, cold and flu symptoms, muscle sprains and minor cuts and burns.
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Paul Ryan a Longtime Supporter of Health Savings Accounts
In 2006, Rep. Ryan, along with Rep. Eric Cantor, R-Virginia, now the House Majority Leader, introduced legislation that boosted the appeal of health savings accounts.
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Opinion: Business Leaders Have a Chance to Step Up and Fix Health Care
In the marketplace, employers' relationship with health care must be guided not only by the compassion of human resources but by the hard-headedness of finance and risk management.
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Willis Makes Additions to Health Care Reform Impact Analysis Calculator
The proprietary tool allows companies to examine health plan possibilities within the Patient Protection and Affordable Care Act of 2010.
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Cisco Systems Takes Telemedicine From Coast to Coast
Using its own system, the California technology company takes care of employees at its headquarters and in North Carolina. In India, employees at four locations can access care through the Bangalore office.
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Hello, Doc? With Telemedicine, Medical Help Is Just a Phone Call Away
Companies and employees are finding that the service offers benefits: Employers can cut health care costs, and workers can get issues addressed quicker. But telemedicine isn't a substitute for a face-to-face doctor visit.
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Retailers and Hospitality Industry Employers Face Big Health Care Reform Law Related Cost Increases in 2014
Forty-six percent of employers in the retail and hospitality industries and 40 percent of employers in the health care services industry expect health care cost increases of at least 3 percent due to health care reform law requirements.
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Doctor-Owned Group Launches Medical Home in NYC
The goal of the program is to reduce readmissions and improve health outcomes for its patients.
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Is Patient Health Taking a Hit Under High-Deductible Plans?
High-deductible health plans have been touted as a savvy behavioral tool to motivate enrollees to more closely scrutinize the price tag of imaging tests, brand-name drugs and more.
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Employers Play Key Role in Educating Workers on Health Plan Choices
'People who were confused about what was covered [outside of the deductible] were more likely to cut back on care,' one researcher says.
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N.Y. Universities to Test Self-Funding of Student Health Insurance
Allowing schools to self-insure their student plans, officials said, should reduce the expenses incurred by students while allowing schools to maintain adequate coverage.
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Supreme Court Medicaid Ruling to Leave 36 Million Uninsured in 2016: CBO
A smaller reduction in the number of uninsured could negatively affect employers as the amount of uncompensated care—a cost that health care providers now try to shift in the form of higher charges to patients with health insurance—will not decline as much as providers had initially...
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Most Employers to Offer Health Plans to Employees in Near Future
The findings are similar to those last month from the International Foundation of Employee Benefit Plans, which found that 85 percent of respondents said they definitely would or were very likely to continue coverage.
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Prudential Group Insurance to Wind Down Group Long-Term Care Business
Existing policies will remain in effect and renewable, provided an employer's premiums are paid on time and its policy limits are not exhausted.
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Seasonal Firefighters to Become Eligible for Federal Employee Health Benefits Program
President Barack Obama was motivated to order several federal agencies to change those policies by a recent visit to Colorado, where wildfires have burned hundreds of thousands of acres and destroyed dozens of homes.
