DOL Releases Final Regulations for Disability Benefit Claims Procedures

The DOL has issued final regulations governing the claims procedures requirement for ERISA-covered plans that provide disability benefits.  In particular, the final regulations require applicable plans to satisfy additional procedural and notice requirements for disability claims.  The regulations apply to disability claims filed on or after January 1, 2018.  [The Wagner Law Group]

By | 2017-01-19T10:22:23+00:00 January 11th, 2017|2017 News, News|

DOL Ramps Up Mental Health Parity Investigations

“MHPAEA violations can result in a breach of fiduciary duty under [ERISA] and an IRS excise tax of $100 per covered individual per day…. The final regulations specify that parity analysis should be performed within each of six classifications of benefits: [1] Inpatient, in-network. [2] Inpatient, out-of-network. [3] Outpatient, in-network. [4] Outpatient, out-of-network. [5] Emergency […]

By | 2017-01-19T10:22:33+00:00 January 9th, 2017|2017 News, News|

Narrow Provider Networks for Employer Plans

“In 2016, only 7 percent of employers with health plans offered a narrow network. Also, in 2014, employers ranked narrow networks the least effective among several strategies to manage health insurance costs…. More than one-third of employers with health plans that have 5,000 or more workers now offer some type of alternative network, including tiered […]

By | 2017-01-19T10:22:41+00:00 January 7th, 2017|2017 News, News|

HSA vs FSA: Which is Better?

“The Health Savings Account is like an IRA. You get to fund it with pre-tax dollars and it’s typically administered by a financial institution. But unlike an IRA, you get to use the funds when you need them (not just in retirement) towards qualifying medical costs…. The Flexible Spending Account is a pre-tax-dollars savings account […]

By | 2017-01-19T10:22:53+00:00 January 5th, 2017|2017 News, News|

Reference-Based Pricing: The New Frontier of Cost Control?

“The largest entity using [reference-based pricing (RBP)] is Medicare, which uses bottom-up pricing based on providers’ costs of doing business … Medicare determines a base rate for each service and then makes adjustments based on patient complications, geographic cost differences, and other factors. Employers who use RBP often pay providers the Medicare rate plus 20-50%. […]

By | 2017-01-19T10:23:05+00:00 January 3rd, 2017|2017 News, News|

Small Employer Healthcare Relief Act Soon a Reality

“Starting January 1, 2017, small employers that do not offer group health insurance to their employees will have a tool to provide a tax-favored reimbursement to their employees. And more good news: there’s transition relief retroactive for all plan years beginning on or before December 31, 2016 that the onerous penalties announced by the IRS […]

By | 2017-01-19T10:23:16+00:00 January 1st, 2017|2017 News, News|