Lauren Coffey’s Post

Employer-sponsored individual coverage health reimbursement arrangement plans are emerging in health coverage enrollment statistics, four years post the onset of the COVID-19 pandemic that initially delayed their introduction. Curious about the intricate dynamics of ICHRAs or benefit spending accounts? Join satisfied clients benefiting from First American Bank Health Account Services to offer your employees the benefits they deserve. Contact us today at (847) 586-2239. Bradley Huff Russell Johnson #HSAmidyearcheck #healthsavingsaccount #financialplanning #IRS #FSA #HSA #OpenEnrollment #Business #Employeebenefits #FirstAmBank #MemberFDIC #taxsavings

Elevance Health, formerly Anthem, is showing positive signs in their core commercial insurance business. Let's break down the good news: - Renewal Rates Up: Elevance is renewing roughly 25% of their large group health plans this month, and they're happy with the results. - Retention on the Rise: "We're seeing persistency up a bit," indicating customers are sticking with Elevance. - Premiums on the Rise: Premium increases are helping to improve profit margins for the company. - New Business Strong: Sales to new large group clients are also performing well. - Employer Satisfaction: Existing clients are giving Elevance a bigger share of their benefit plan business. Learn more: https://hubs.ly/Q02HDgqR0

New data suggests that employers offering self-funded health plans might have a significant advantage. A recent study found that these plans are more effective in controlling administrative costs compared to traditional insurance models. By managing their own health plans, employers are seeing a potential cost savings of nearly $18 per member per month. Learn more: https://hubs.ly/Q02J5lQ80

Employer Group Calls for Pharmacy Benefit Managers to be Fiduciaries   The word ‘fiduciary’ has popped up recently in financial discussions as well as health care. Fiduciary applies to any situation in which one person justifiably places confidence and trust in someone else…”. In this case, by making them a fiduciary they would be subject to legal action if what they are doing isn’t in the client’s best interest.   There’s an industry group that is asking Congress to make Pharmacy Benefit Managers (PBMs) fiduciaries. The result, "PBMs would be subject to the same fiduciary duties that have applied to employer health plan sponsors for 50 years now, and the same fiduciaries that have protected plan participants and beneficiaries from paying unreasonably high prices for covered benefits and excessive or hidden fees,". This is good as it’s more than a suggestion, but a legal requirement.   This is what I believe people expect, that companies want to do the best job for their clients, including competitive pricing.   What do you think?   #fiduciary #PBM #ERISA https://lnkd.in/edw2Xefk

House Democrats are advocating for adding claim denial statistics to Form 5500 filings for self-funded health plans. This move aims to increase transparency and accountability, ensuring that employees are better informed about the performance and reliability of their health coverage. Why It Matters: - Transparency Boost: Including denial stats will shed light on how often claims are denied, helping employees make more informed decisions about their healthcare. - Accountability: Employers and plan administrators will be held accountable for their claim processing practices, potentially leading to better plan management. - Data-Driven Decisions: Access to this data can help in identifying patterns and issues, driving improvements in the healthcare system overall. For HR Professionals: This is a call to stay ahead of regulatory changes and ensure your self-funded plans are compliant and transparent. #EmployeeBenefits #SelfFundedPlans #HRTech #HealthcareReform https://lnkd.in/g8HA_Zge

A steadfast advocate of the multi-employer association health plan (AHP) concept is working to reinstate the Trump-era AHP rules. Rep. Tim Walberg, R-Mich., has introduced a House joint resolution aimed at reversing the recent U.S. Labor Department decision to eliminate the AHP regulations. In 2018, under President Trump, the Labor Department introduced rules to simplify employers’ access to multi-employer AHPs, allowing them to bypass certain state group health insurance mandates. These regulations aimed to provide more flexibility for employers to offer health coverage through AHPs. In May, the Labor Department overturned these AHP regulations, citing concerns about solvency and care quality safeguards. Learn more: https://hubs.ly/Q02GgVN70

Health care price transparency is an area of healthcare that has a significant impact on patient lives, however there is little consensus around how to approach it. While most health insurance companies provide baseline information, there are varying approaches at government, nonprofit, and for-profit health insurance providers. The debate around increasing health care price transparency is important, however without a widespread understanding of different coverage and insurance options, solutions around transparency may fall short of addressing the root issue. Here is a simplified breakdown of the options: 1. Government health insurance is provided for by the state or federal government. Medicare offers benefits to individuals of all ages who are eligible while Medicaid offers health insurance for those over 65 or those under 65 with Social Security disability benefits. 2. Nonprofit health insurance is regulated by federal standards and state bodies, however unlike for-profit health insurance there are no other shareholders. Due to this, nonprofit insurance might offer lower premiums. 3. For-profit health insurance is found by individuals or employers through the health insurance marketplace. It can be more costly, however it can be tailored to specific needs. Spreading a baseline understanding of these different options and their impact on preventative care, medication, and more, is essential for debating the next steps forward. #HealthInsurance #healthcare #HealthcarePrice #PriceTransparency

"Cash for Coverage" Plans emerge for hard to place business segments. Read more. As an Employee Benefits Consultant with PrimeGroup Insurance, my primary focus is to position my clients, along with their employees, with valuable knowledge and education on ways to protect their greatest asset, their employees, and provide unique and creative ways to attract and retain talent. Please take a moment to read this 3 minute read on ICHRA (Individual Coverage Health Reimbursement Arrangement) plans or, "Cash for Coverage" plans. The Affordable Care Act rules are complex but do not have to be confusing. I offer continuous education, along with new technologies and superb services to my clients and get them back to what they are excellent at achieving. Running and growing their business. If you own a business that has been difficult to offer a group health insurance plan to your employees due to various reasons, give me, Ken Rose a call or connect with me here for a no obligation consult and allow me to help you navigate through solutions to this dilemma. PrimeGroup Insurance #notyouraverageinsuranceageny #ICHRA #Healthinsurance #employeebenefits #primegroupinsurance #yourbeardedbenefitsbroker

Last week AHIP met in Las Vegas. Here's a summary of some of the topics: - A year ago, insurers were expanding Medicare plans. Now, with reduced funding from the Centers for Medicare and Medicaid Services (CMS), they're worried about 2025 plans. - After acquiring Change Healthcare, UnitedHealth is dealing with the aftermath of a ransomware attack that disrupted healthcare providers. - This year's conference focuses on artificial intelligence in healthcare, coverage for obesity medications, and health equity. - There's less focus on employer-sponsored health plans compared to past years. - Despite the Haven project failing, Amazon and JPMorgan Chase are still looking for ways to get involved in health insurance, with representatives attending the conference. Learn more: https://hubs.ly/Q02BxQZm0

Cora Opsahl, director of the 32BJ Health Fund, told lawmakers that providers and plan administrators work together to keep prices high. Here are some of the anti-competitive provisions Opsahl saw: * Requirements that one very expensive hospital be in the fund's provider network, simply because the hospital's contracts with carriers' forced the carriers to include it in all of their provider networks. *Rules against putting providers in different tiers. *Limits on the fund's access to claims data. Restrictions on the fund's ability to conduct backward-looking reviews of claims for care already provided. *Limits that would keep the plan from recouping excess payments. "None of those contract provisions are beneficial for employer-sponsored plans or their membership," Opsahl said. "This is just one example of how difficult it is for employers and self-funded plans, even of our size, to have a highly competitive bid process." https://lnkd.in/gwcbZMh6