Employers are often surprised to learn they are liable for ERISA statutory penalties associated with participant document requests even though they have retained an insurance company or TPA to administer their ERISA welfare benefits plans. Generally, only the Plan Administrator, as defined by ERISA, can be penalized for failure to respond […]
In 2017 Congress enacted the Tax Cuts and Jobs Act, which reduced the individual mandate penalty to zero, effective January 1, 2019. Recently a federal district court in Texas ruledthat the Affordable Care Act’s individual mandate is no longer permissible under Congress’s taxing power and that the entire Affordable Care Act (ACA) is invalid because the […]
The ACA requires large employers to report the total cost of employer-sponsored group health coverage on employees’ W-2s, which are due to employees by January 31, 2019. Reporting the cost of health care coverage on the Form W-2 does not mean that the coverage is taxable. It is for informational purposes only and will provide employees useful […]
Lawsuits from non-network providers have been on the rise recently due to the sharp rise in their billing rates, more providers moving out-of-network, and self-insured health plans reducing reimbursement rates. One of the ways that health plans have curtailed out-of-network reimbursement rates is through reasonable and customary reductions. A health plan is required to disclose the […]
According to a 2013 study published in JAMA in March, people with Medicare Part D drug insurance unknowingly overpaid for prescriptions by $135 million. Copays in those plans were higher than the cash price for nearly 25% of drugs purchased. Patients overpaid by more than 33% for 12 of the 20 most commonly prescribed drugs.
Concern over surprise medical bills—those from out-of-network physicians that patients had no role in choosing—has grown tremendously in recent years. Some states have taken steps to mitigate this problem. However, these measures do not apply to the roughly half of Americans enrolled in self-insured health plans because ERISA precludes states from regulating these plans.
The term telehealth encompasses clinical diagnosis, education, management, and the monitoring of health via technology. It is not a specific service, but rather an umbrella term for a variety of strategies to enhance medical care delivery.
The greatest advantage of telehealth is ease of access. Patients can quickly and easily speak with doctors making them more likely to […]
Last year the EEOC sued cosmetics and fragrance giant Estée Lauder, claiming its parental leave policies discriminated against men. Estée Lauder provided eligible new mothers with six weeks of paid parental leave for child bonding (in addition to leave for recovery for childbirth), but it only offered new fathers two weeks of paid bonding leave. Estée […]