News 2017-08-20T09:17:05+00:00

ERISAPros News

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 … […]

By | April 2nd, 2017|

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 […]

By | March 23rd, 2017|

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 […]

By | March 16th, 2017|

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 […]
By | February 27th, 2017|

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 […]

By | February 14th, 2017|

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 […]

By | February 7th, 2017|

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 […]

By | January 13th, 2017|
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