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

ERISAPros News

Telemedicine Expanding Rapidly

“According to one recent survey, telemedicine services (i.e., remote delivery of healthcare services using telecommunications technology) among large employers (500 or more employees) grew from 18% in 2014 to 59% in 2016. Common selling points touted by telemedicine vendors include reduced health care costs and employee convenience. However, state licensure […]

By | October 17th, 2017|

DOL Opposes UnitedHealth’s Cross-Plan Offsetting Practice

“The Labor Department opposes a health insurance practice called ‘cross-plan offsetting,’ in which insurers like UnitedHealth reduce payments owed to medical providers for services rendered to specific patients. The reductions are meant to offset overpayments the providers previously received on account of different patients who participate in other plans insured […]

By | October 9th, 2017|

Pregnancy is Not a Pre-existing Condition for Disability Insurance

The U.S. Court of Appeals for the Eleventh Circuit, in Bradshaw v. Reliance Standard Life Insurance Co., has rejected a disability insurer’s decision to deny disability benefits to an insured who suffered a stroke days after giving birth on the basis that her pregnancy was a pre-existing condition.

…While the Affordable […]

By | October 2nd, 2017|

Well Drafted Plan Document Saves Self-Insured Medical Plan Over $350,000

“A self-insured medical plan included an anti-assignment provision that prohibited a health care provider from suing on behalf of a participant. The court found the anti-assignment clause to be valid and enforceable. This case highlights the value of a well drafted plan document. Employers sponsoring self-insured plans are encouraged to […]

By | September 19th, 2017|

COBRA and Severance Agreements: A Gift or a Curse?

COBRA“If the individual is left enrolled as an active employee, fully-insured employers may risk violating the medical plan eligibility requirements in their insurance contract. Similarly, self-funded employers may violate the coverage provisions of their stop-loss agreement. Consequently, failure to offer COBRA can […]

By | September 2nd, 2017|

Updated SBC Templates Apply for 2018 Open Enrollment

“Given the current House and Senate ‘repeal and replace’ ACA legislation, many employers are wondering if they need to take the time to revise their SBCs to comply with the new template and requirements. The short answer is use of the new SBC templates is still required. Both the House-passed […]

By | August 14th, 2017|

Premiums the Big Factor in Health Plan Enrollment

“After eliminating employee premiums for all coverage tiers, HSA-eligible health plan enrollment increased from 4 percent to 25 percent among individuals with employee-only coverage and from 2 percent to 31 percent among individuals with family coverage…. Offering coverage with no payroll deduction attracted individual enrollees who were marginally healthier than […]

By | August 8th, 2017|
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