out of pocket cost

How to Get the Benefits of Self-Funding without the Risks

How to Get the Benefits of Self-Funding without the Risks

There are typically two approaches to securing health coverage for your staff – group health insurance or self-funding. Self-funding, however, can be costly and risky and is usually only done by larger organizations with thousands of employees. But there is a hybrid...

As Specialty Drug Costs Bite, Employers Have Options

As Specialty Drug Costs Bite, Employers Have Options

A new study has found that while group health plan costs will continue growing at the same rate as in the last few years (about 4% a year), the increases would be far less were it not for the spiraling costs of high-cost specialty prescription drugs.  The 2020...

Trump Administration Decides Not to End PBM Rebates

Trump Administration Decides Not to End PBM Rebates

The Trump administration has decided not to pursue a policy that would have put an end to rebates paid to pharmacy benefit managers, which could put the focus again on how drug companies set their prices. The proposal would have barred drug companies from paying...

Get an Early Start on Open Enrollment

Get an Early Start on Open Enrollment

As open enrollment is right around the corner, now is the time to make a plan to maximize employee enrollment and help your staff select the health plans that best suit them. You’ll also need to make sure that you comply with the Affordable Care Act if it applies to...

Short-term Health Plans Skimp on Medical Payments

Short-term Health Plans Skimp on Medical Payments

A new report by the trade publication Modern Healthcare shows just how little short-term care plans spend on enrollees’ medical claims. The report found that some plans spent as little as 9 cents of every premium dollar they collected on medical care. The...

Small Employers Can Reimburse for Medicare Part B, D Premiums

Small Employers Can Reimburse for Medicare Part B, D Premiums

As the workforce ages and many employers want to keep on baby-boomer staff who have the experience and institutional knowledge that is irreplaceable, one issue that always comes up is how to handle health insurance. Once your older workers reach the age of eligibility...

IRS Eases Access to Chronic Disease Treatment

IRS Eases Access to Chronic Disease Treatment

New guidance from the IRS will help people enrolled in high-deductible health plans get coverage for pharmaceuticals to treat a number of chronic conditions. Under the guidance, medicinal coverage for patients with HDHPs that have certain chronic conditions – like...

Circuit Court Seems Poised to Shoot Down Individual Mandate

Circuit Court Seems Poised to Shoot Down Individual Mandate

It’s looking more and more likely that a federal appeals court will strike down the Affordable Care Act’s individual mandate, which requires Americans to carry health insurance, either through coverage they receive from their employer or buying it themselves. The case...