Number of Employers Offering Coverage Grows

The number of companies offering health insurance to their employees has risen for the first time in a decade, according to new research from the Employee Benefit Research Institute.

In 2017, almost 47% of private-sector employers offered health insurance, up from 45.3% in 2016. The percentage had previously been dropping steadily since 2008, when more than half (56.4%) were providing coverage.Read More

A Bit of Good News for Embattled ACA

After announcing that it would stop paying risk-adjustment payments to insurance companies with plans on the individual market on July 7, the Centers for Medicare & Medicaid Services reversed course two weeks later and said it would indeed continue making the payments.

The risk-adjustment program tries to balance the medical risk in the Affordable Care Act’s insurance markets. Health insurers that are found to have healthier customers (according to a federal formula) pay money into the program, and then insurers who have sicker customers receive money out of it.Read More

A New Health Care Model Tackles Costs, Quality Care

As group health insurance costs continue rising every year, more employers are embracing a new plan model that aims to both cut costs and improve outcomes for patients.

This trend, known as value-based primary care, is a bit of an umbrella term for various models that involve direct financial relationships between individuals, employers, their insurers and primary care practitioners. Insurers are experimenting with different model hybrids to find better care delivery methods that reward quality outcomes and reduce costs.Read More

New Rules Issued for Small Group, Individual Plans

The Centers for Medicare and Medicaid Services (CMS) has released its final rules on giving states more power to regulate individual and small group health insurance markets.

The new rules are part of the Trump administration’s effort to dismantle the Affordable Care Act after numerous GOP efforts to repeal the law failed in 2017.Read More

OSHA’s Anti-retaliation Rules for ACA

Do you know that Fed-OSHA has regulations on whistleblowing and employer retaliation under the Affordable Care Act?

The rules set forth procedures and time frames for reporting and processing whistleblower complaints by employees against their employers and expand the instances in which an employee can sue their employer for retaliation under the ACA.Read More

Proposed Regs on Small Business Association Plans Could Invite Fraud

Proposed regulations that would allow small businesses and individuals to band together to purchase group coverage could open up a new era of fraud in U.S. health insurance, according to comments filed by a number of groups.

Former Department of Labor officials, insurance companies and employee advocacy groups sounded the warning in letters to the DOL during the proposed regulations’ comment period, which ended March 6, according to a report by Bloomberg Law.Read More

Individual Mandate Repeal Could Spur Interest in Short-Term Plans

One of the likely consequences of the repeal of the Affordable Care Act individual mandate under the tax overhaul that President Trump signed into law right before Christmas is a migration to short-term health plans.

These plans are essentially low-cost, low-coverage plans that do not comply with the ACA’s protections and benefits. They are not your typical health insurance plans, as they are only really good for catastrophic coverage and do not cover run-of-the-mill medical procedures like doctors’ visits and the cost of medications.Read More

Fallout from GOP Tax Bill on Health Coverage

The GOP’s tax bill, which seems on its way to passage in Congress and eventual enactment, will have a number of spillover effects on the health insurance markets, for commercial and individual policies alike.

To get more Republicans on board, the Senate leadership added a provision that eliminates penalties for individuals who do not secure health coverage either through their employers or on their own on publicly run exchanges.Read More

Legislation Takes Aim at ACA Taxes, Penalties

House Republicans are taking another shot at dismantling the Affordable Care Act, this time taking aim at taxes and penalties related to the divisive health care law.

They have also inserted language into the joint-chamber tax bill that would eliminate ACA penalties for people who fail to secure health insurance if they do not get it from their employers.Read More