Tag Archives: Health plans

Supreme Court Will Resolve Split over ERISA Reimbursement

The U.S. Supreme Court decided to hear a case to resolve whether an ERISA health plan can recover money it spent on a plan participant’s care from his or her personal injury settlement, even if the participant has already spent…

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The ACA After Five Years: Disasters Did Not Materialize, But More Change Is Needed

Five years ago, in March 2010, the Affordable Care Act was signed into law by President Obama to resolve problems in the U.S. health system, including: the high number of uninsured Americans; Americans unable to get coverage due to pre-existing…

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Connecting Members and Data Promises to Reduce Costs

Tremendous cost-cutting and patient care improvements await insurers and plans that can leverage the recent gains of computing to improve patient self-management of care. The challenge is how to tap the big pools of data, and get “actionable” personalized results…

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Sixth Circuit Overturns $2.8M ERISA Award for Unjust Enrichment

Simply paying an aggrieved plan participant for unpaid benefits due was enough to make him whole under ERISA, so no further money damages were warranted as a form of equitable relief, a federal appeals court has ruled. With this conclusion,…

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High Court Sees Problems in King Petitioners’ Arguments

Petitioners in King v. Burwell could run up against the same logic that brought down Medicaid expansion under health care reform: it could be unconstitutional for the federal government to use draconian coercion to force states to set up exchanges. Justice Anthony…

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IRS Rules Further Define Payment of ACA Insurer Fees

New IRS regulations define the way health insurers will pay fees under Section 9010 of the Affordable Care Act. In the rules, the IRS applies Notice 2014-47 and provides further guidance on how covered entities will pay the fees for 2015 and subsequent…

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Employers must cover physician and hospital services to avoid ACA fines

On Feb. 23, the Centers for Medicare and Medicaid Services put on public display final rules that require employer health plans to cover physician and hospital services in order to meet health care reform’s minimum value requirement. The rules also set the…

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IRS Offers Temporary Safe Harbor for Some Premium Reimbursement Arrangements

Small employers and certain other plan sponsors can continue to reimburse individual premiums until July 1, without the threat of extreme penalties for offering coverage that does not comply with Affordable Care Act insurance mandates, under new guidance from the…

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Changes to Forms 5500 Ring in the New, Keep Some of the Old

Preparing employer benefit plans’ annual filings to federal agencies can be detailed and time-consuming. A review of recent changes to the 2014 Form 5500 series indicates this process could become even more laborious for some plans, as the government seeks…

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High Court Opinion Vacates 6th Cir. Ruling on Retiree Health

On Jan. 26, U.S. Supreme Court handed a victory to employers struggling to get retiree health care costs under control. A unanimous ruling in M&G Polymers USA v. Tackett, No. 13-1010 (Sup.Ct., Jan. 26, 2015), vacated the 6th U.S. Circuit…

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