A Holiday Package of IRS Guidance on 162(m)(6)
Just in time for the holidays, the IRS published guidance last week regarding 162(m)(6). The guidance was eagerly awaited by companies that sell or have any affiliate that sells health insurance...
View ArticleLooking Ahead to 2014: Individual Mandate
Now that the new year has started and several of the early provisions of health care reform are in place, the focus is shifting to long-term health care strategy. Employers are struggling to understand...
View ArticleEmployers With Insured Plans Should Take Note of New Medical Loss Ratio Rebates
Insurers who do not meet the new medical loss ratio requirements under health reform will begin issuing rebates in August, 2012. Last month, HHS issued regulations regarding these medical loss ratio...
View ArticleConsiderations for Medical Loss Ratio Rebates
Next month marks the deadline for the first round of rebates that must be paid by health-insurance issuers who failed to meet medical loss ratio (MLR) standards. Issuers must provide rebates to...
View ArticleAdditional Guidance on Transitional Reinsurance Program Payments
The Department of Health and Human Services (HHS) has provided additional guidance regarding the calculation and payment of the contributions that will be due from employer-sponsored plans under the...
View ArticleMinnesota Health Insurance Exchange Coming Soon
Minnesota is on the brink of passing a law that would establish a Minnesota health insurance exchange. The “Minnesota Insurance Marketplace Act” passed the Minnesota legislature and is on its way to...
View ArticleIRS Issues Proposed Regulations on Compensation Deduction Limit for Health...
The health care reform provision affecting health insurance providers limits deductions these providers may take for compensation paid for tax years beginning in 2013. The provision limits deductions...
View ArticleTop Five Issues for Multiemployer Plans and Health Care Reform
In the context of multiemployer plans, the application of various provisions of health care reform is murky. Below are five issues that are top of mind for multiemployer plans: 1. Pay or Play...
View ArticleFinal Regulations on Transitional Reinsurance Program Fees
Starting in 2014, the new transitional reinsurance program will require self-insured group health plans and health insurance issuers to pay per-enrollee fees each year for three years. In March, the...
View ArticleMore Details Emerge on Transitional Reinsurance Fee
The latest final regulations on the transitional reinsurance fee provide some clarity for plan sponsors. As a reminder, the transitional reinsurance program requires self-insured group health plans...
View ArticleFEDS WIDEN HEALTH COVERAGE FOR OBESITY
Advocacy groups for the obese are applauding a recent directive by the federal Office of Personnel Management (OPM) on obesity treatment coverage. In a March 20 directive to health plans covering...
View ArticleWill Oregon’s Health Exchange Woes Spread?
As Congress returns to Washington, keep an eye on the fallout from the news late last week that the fairly dark blue state of Oregon will be shifting from a state to a federally run health exchange to...
View ArticleHEALTH SYSTEMS CONTINUE TO ACQUIRE INSURERS
The wall between health care providers and health insurers continues to erode, as Ascension Health’s CEO acknowledges Ascension is in talks to acquire WellCare Health Plans. Ascension is the nation’s...
View ArticleCHI Takes the Plunge into the Insurance Business
For several years now hospital systems have been tip-toeing around the business of health insurance. They’ve been signing up for Medicare Advantage plans, taking on more and more risk, managing care...
View ArticleIllinois Blues Won’t Let Hospitals Jointly Negotiate Unless They’re Married
Remember when Hollywood wouldn’t show an unmarried couple in bed together? Blue Cross-Blue Shield of Illinois is taking that approach to contract negotiations. If hospitals want to negotiate jointly...
View ArticleHospitals and Health Insurers Prodded on Same-Sex and Transgender Issues
In separate actions yesterday, CMS and the New York State insurance regulatory authority took steps to (a) assure equal treatment of same-sex spouses by hospitals and (b) insurance coverage of...
View ArticleQNHII Regs Due Thursday—After Only Five Years
When the Affordable Care Act (ACA) was signed into law back in 2010, it directed the Centers for Medicare & Medicaid Services (CMS) to establish the Consumer Operated & Oriented Program...
View ArticleIt Was the Economy, Stupid!
Remember Bill Clinton’s 1992 campaign mantra, “It’s the economy, stupid!” A study released today by the Robert Wood Johnson Foundation indicates those four words are the best answer to the question,...
View ArticleInsurer’s Agreements with Providers Are Not Per Se Antitrust Violations
The Iowa Supreme Court refused to categorize a health insurer’s agreements with providers in Iowa and its participation in the national Blue Cross and Blue Shield (BCBS) network as per se violations of...
View ArticleOIG Advises that Exclusive Lab Referral Arrangement May be a Kickback
The Department of Health and Human Services Office of Inspector General (OIG) released an advisory opinion (No. 15-04) today that states a proposed arrangement to provide free laboratory tests for...
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