Health Care Costs
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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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It’s All in the Wrist—and in the Back
Emphasizing ergonomic workspaces can lead to a healthier workforce, lower costs and a stronger business overall.
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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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HHS Proposes Rules to Verify Health Care Premium Subsidy Eligibility
Under the proposed rule, administrators of state and federal insurance exchanges must verify whether applicants seeking tax credits to buy health care coverage through an exchange are enrolled or eligible for qualifying coverage in an employer-sponsored health care plan.
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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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Massachusetts Bill Would End Employer Penalty for Not Offering Health Plan
Under the governor's plan, the current annual assessment—known as the Fair Share contribution—of $295 per employee on employers not offering coverage would end on June 30.
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Wellness Programs Can Reduce Worker Medical Costs by 18 Percent: Study
The report said wellness programs could reduce costs for risks such as physical inactivity, smoking, high blood pressure and obesity. If the risk factors were lowered to “theoretical minimums,” health care expenses could be lowered by an average of $650, or 18.
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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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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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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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Pennsylvania Will Not Set Up Health Insurance Exchange
Pennsylvania is the latest state to declare it will not set up a state health exchange. States have until Dec. 14 to inform federal regulators whether they intend to establish exchanges.
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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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HHS Gives Tentative Approval to Six State Health Insurance Exchanges
Those six states are Colorado, Connecticut, Maryland, Massachusetts, Oregon and Washington.
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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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Fixing Patients the First Time Holding Health Care Costs Down
New York hospitals face steep revenue cuts for readmissions that are preventable.
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Corporate Weight-Loss Initiatives: Motivational or Stigmatizing?
Amid the proliferation of corporate weight-loss efforts, some researchers worry that well-intentioned initiatives can risk employee backlash. Sprint Nextel and O'Neal Steel leaders describe how they strive to marry motivation and results.
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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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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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How Whirlpool Boosted Employee Productivity
One organization's data shows that health-related productivity losses cost U.S. employers $227 billion annually. Whirlpool officials are striving to reduce one component, called presenteeism, by providing employees with better mental and physical support at the work site.
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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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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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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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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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Medicare Heats Up Biden-Ryan Debate
The Medicare segment of the debate included some of the most frequent interruptions by both Vice President Joe Biden and Republican vice presidential candidate Rep. Paul Ryan (R-Wisconsin) in a testy debate as each took turns bashing the other side's impacts on the program.
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Illinois Politicians Back Health Insurance Co-Op Applicant
Gov. Pat Quinn, fellow Democrat Richard Durbin and Republican Mark Kirk have written letters of support on behalf of SimpleHx, a co-op proposed by a group of people who met last year while pursuing their MBAs at Northwestern University.
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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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Most Risky Day of Week to Drive to Work? TGIF
A Columbus, Ohio-based insurance company determined its members have the highest average number of claims per day on Fridays—at 4,664. Wednesday came in second with an average of 4,197 claims, followed closely by Thursday, Monday and Tuesday.
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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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Specialty Drugs Appearing as the Next Wave of Health Care Costs
The Midwest Business Group on Health and other organizations aim to educate employers about the cost of biologics, which treat serious illnesses such as cancer. Their cost is expected to rise to 40 percent of employers' total drug costs by 2017.
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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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South Dakota Declines to Set Up Health Insurance Exchange
South Dakota joins several other states, including Texas, whose governors said they will not set up the exchanges.
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Group Health Care Spending Up in 2011: Analysis
For those covered by employer plans, spending on health care services increased by 4.6 percent to $4,547 per plan enrollee. By contrast, in 2010, costs rose an average of 3.8 percent, according to the Health Care Cost Institute, an independent Washington-based health research organization.
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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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Obesity-Related Conditions Could Add $66 Billion Annually to Medical Costs by 2030: Study
The state-by-state analysis of obesity-linked disease rates and associated medical spending projects that obese individuals could account for 44 percent of all American adults by 2030 if obesity rates nationwide continue to grow at their current pace.
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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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Group Health Insurance Premiums See Moderate Increase in 2012: Survey
The survey of more than 2,000 employers found that the premium for family coverage rose an average of 4 percent, increasing to $15,745 this year.
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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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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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Reform Law is Biggest Threat to Medicare: Paul Ryan
As chairman of the House Budget Committee, Ryan drafted budgets for fiscal years 2012 and 2013 that include plans to overhaul the nation's federal healthcare entitlement programs through a premium-support model for Medicare and block grant payments to states for Medicaid.
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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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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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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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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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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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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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Large Employers Expect Group Health Care Plan Costs to Rise 7% in 2013
Amid rising costs, employers say adopting consumer-driven health plans is the most effective step they have or plan to take to combat rising costs.
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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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On-Site Wellness Programs See Growth, Gain Support of Senior Executives
For a majority of employers, the lack of ROI data has not stemmed incremental expansions in the types of services offered at the on-site centers.
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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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Employers Are Caught Up in the Five Stages of Health Care Reform Ruling
While many employers have achieved acceptance, a new survey shows they do not have a strategy for complying with the law's 2014 provisions. One 'sleeper' issue: Medicaid expansion.
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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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Will Walgreen Suffer Side Effects Even After New Express Scripts Deal?
Express Scripts, like other PBMs, are third-party middlemen that negotiate prices with pharmacies and drugmakers on behalf of corporate clients and processes their claims.
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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.
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Arizona Officials Look to Repeal Domestic Partnership Benefits
The law in question, enacted in August 2009, sought to eliminate health care, dental, life, disability and retirement benefits for couples in domestic partnerships, including same-sex couples, by actively applying the state's definition of marriage—which it treats as a union only between a...
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House of Representatives Votes to Repeal Health Care Reform Law
With Democrats controlling the Senate, the bill is unlikely to advance further. In addition, if a repeal measure cleared Congress, President Barack Obama would veto it, the White House said this week.
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House to Vote on Bill to Repeal Health Care Reform Law
The Senate did not take up the repeal bill and it is unlikely that the Senate, where Democrats are in the majority, would do so this time.
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Supreme Court Upholds Health Care Reform Law
The U.S. Supreme Court ruled that the Patient Protection and Affordable Care Act is constitutional, handing President Barack Obama a major election-year victory and shunning 26 states that had sought to overturn the reform law.
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Lack of Supreme Court Ruling on Health Care Reform Keeps Experts Guessing
Speakers at overflow sessions of the Society for Human Resource Management's 64th annual conference detail the likely scenarios that could occur when the justices rule late this week.
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Consultancies and Companies Say They're Ready for Health Care Reform
With tools such as webinars and training videos, companies say they've taken the time to put internal battle plans in place.
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A New Remedy Emerges for Spiraling Health Costs
Accountable care organizations require payers—i.e., insurers—and health care providers to better coordinate care for members, especially those with the most medical needs, with the goal of improving cost trends and patient outcomes.
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U.S. Awaits Supreme Court's Ruling on Health Care Reform Law
Three months after the justices heard oral arguments on a challenge to the Patient Protection and Affordable Care Act by 26 Republican state attorneys general, the high court will rule sometime next week as its 2011-2012 term comes to a close.
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3.1 Million Young Adults Gained Coverage Through Health Care Reform: HHS
The increase is directly attributable to the young adult coverage provision in the health care reform law, federal researchers say.
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U.S. Health Care Spending Sees Modest Increases
The recent modest increases contrast sharply with the explosive growth in health care expenditures of just a few years ago. From 2001 through 2003, increases in health care spending averaged nearly 9 percent. And as recently as 2007, costs leaped 6.2 percent.
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Most Employers Plan to Continue Offering Health Care Coverage
Just over 9 percent cited retention of tax advantages as a reason for keeping coverage and just over 7 percent said a top reason for keeping coverage was to avoid tax penalties.
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Health Care Reform Takes Center Stage at SHRM Event
Typically, SHRM's conference agenda reflects the economic, political and other realities of the workplace, and this year is no different. Several sessions are scheduled on the topics of health care reform, social media, aging workers and domestic partner benefits.
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House OKs Changes to Flexible Spending Account Use It or Lose It Rule
Employers could amend their FSAs to allow employees to withdraw as taxable cash up to $500 in unused balances remaining at the end of the plan year or at the end of an FSA grace period, if an employer has that feature.
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Q&A With Jay Krueger: Evaluating Medical Marijuana Policies
Jay Krueger is chief strategy and client services officer at PMSI Inc., providing overall strategic direction for the Tampa, Florida-based provider of pharmacy benefit management services, medical equipment, home health care and case settlement services.
