Massive Medicare Fraud by UnitedHealth Uncovered

“The Justice Department has joined a California whistleblower’s lawsuit that accuses insurance giant UnitedHealth Group of fraud in its popular Medicare Advantage health plans …. The whistleblower has accused the insurer of ‘gaming’ the Medicare Advantage payment system by ‘making patients look sicker than they are’ said his attorney … The attorney said the combined […]

By | 2017-06-08T13:21:49+00:00 April 2nd, 2017|2017 News, News|

IRS Revises Enforcement Policy on ACA Individual Mandate Compliance

The IRS has announced that it will not reject 2016 tax returns that do not provide information on whether the individual taxpayer and his family members had qualifying health coverage for 2016. The IRS uses this information to enforce compliance with the Affordable Care Act’s (“ACA’s”) individual mandate provisions. This enforcement policy change comes in […]

By | 2017-06-08T13:03:19+00:00 March 23rd, 2017|2017 News, News|

Opioid Addiction: Implications for Employers

“Employers can contribute toward curbing the opioid addiction epidemic in a number of ways and should play an instrumental role in facilitating increased awareness of and access to needed programming…. This article will explore the size and prevalence of the opioid epidemic, reflect on its implications for employers — including public policy initiatives — and […]

By | 2017-06-08T13:04:51+00:00 March 16th, 2017|2017 News, News|

The next 401(k)? Why Student Loan Repayment May Soon Be a Standard Benefit

“The average tenure of Millennials is around 16 months, and the bulk of these workers are saddled with a tremendous amount of student loan debt ($30,000 on average). That revolving door mentality among younger workers hurts employers’ retention rates and costs a fortune in extra recruiting and training costs. Plus, because student loan debt makes […]

By | 2017-06-08T13:08:15+00:00 March 2nd, 2017|2017 News, News|

Documents Updates

Dear Valued Client/Partner,

Effective February 27, 2017, we have incorporated the following revisions into our templates:

Plan Document and SPD:

  1. Updated definition of HIPAA-excepted benefit to incorporate DOL, HHS and Treasury Department final regulations
  2. Added MLR Premium Holiday language
  3. Enhanced subrogation language
  4. Enhanced general claims procedure, special rules for group health plan claims, and disability claims language
  5. […]

By | 2017-06-08T12:45:29+00:00 February 27th, 2017|2017 News, News|

Time to Revisit Electronic Distribution Rules for SPDs

“Employers interested in using electronic distribution methods must solicit consent, track responses, store e-mail addresses and monitor delivery — an administrative headache few want to take on…. In the almost 15 years since the regulations were last updated, Internet access has skyrocketed — 84 percent of adults now use the Internet (up from 60 percent […]

By | 2017-06-08T11:33:21+00:00 February 14th, 2017|2017 News, News|

DOL Highlights Growth in MHPAEA Enforcement

“Of the 330 health plan investigations closed in the 2016 fiscal year by the EBSA, 191 included Mental Health Parity and Addiction Equity Act (MHPAEA) compliance audits because they involved plans subject to the MHPAEA … EBSA conducts compliance reviews in all open cases where MHPAEA applies. Many of these stem from individual plan participants’ […]

By | 2017-06-08T11:31:08+00:00 February 7th, 2017|2017 News, News|

Lawmakers Interested in Student Loan Repayment as Employee Benefit

“The average debt per borrower has nearly doubled since 2004, increasing from roughly $18,000 to more than $35,000 for a 2015 graduate. As millennials become a larger share of the workforce, the student loan debt dilemma is attracting more attention from employers. Legislative proposals would allow employers to establish a variety of tax-preferred student loan […]

By | 2017-01-19T10:22:12+00:00 January 13th, 2017|2017 News, News|