PEBA Audit Alliance Alert 2012
Editor’s Note: Since most Texas political subdivisions offer employees managed care plans, i.e, PPO plans, we wonder how receptive PPO networks will be towards this PEBA endorsement? Reading a PPO contract is probably a good idea for those considering this audit offer. They may find they have given up their audit rights.
In a statement released by a high ranking Obama administration official last week, many may find it obvious that the root of our health care crisis in this country lies squarely on the back of greedy, uncaring, profiteeriing insurance companies.
Health and Human Services Secretary Kathleen Sebelius said in a news conference Tuesday, “For too long insurance companies have stacked the deck against women, forcing us to pay more for coverage that didn’t meet our needs.”
The federal government, to protect us from greedy profiteering and uncaring insurance companies have mandated that profits must be shared with the masses. This mandate, better known as the Minimum Loss Ratio requirement, makes it nearly impossible for an insurance company to make a profit off the backs of hard working Americans who otherwise could not pay the exhorbitant fees charged by hospitals and doctors.
“It grates against all moral fiber to see greedy insurance companies make a profit off the pain and suffering of sick Americans whom many would otherwise die an early death due to lack of financial resources that prolong the lifestyles of hospital administrators and other kind and giving health care providers who are also our neighbors” said Don Pedro.
“The government now needs to sanction gas station owners against the high price of oil! The government needs to take over all the gas stations in the United States and dictate lower gas prices!” It’s the new American way of conducting business” said Hugo Chavez in a statement released yesterday from his hospital bed in Havana.
If you are fortunate enough to receive an MLR rebate, follow the road map provided by the DOL in Technical Release 2011-04 to make sure you handle the rebate correctly.
Continue reading How Should Employers Handle Medical Loss Ratio Rebates?
The U.S. Departments of Labor, Health and Human Services and the Treasury have issued a set of frequently asked questions (FAQs) regarding the implementation of the Patient Protection and Affordable Care Act. This recent guidance, the ninth in a series of FAQs that the agencies have published, focuses on the summary of benefits and coverage (SBC). The SBC is a new document that group health plans and insurance issuers will be required to provide to plan participants regarding their benefits. Below is a summary of some of the issues addressed by the recent guidance.
Continue reading Employee Benefits Developments July 2012 – Rulings & Opinions
AHIP’s latest census of HSA-qualifying insurance coverage contains some fascinating information. Keep in mind these numbers are for HSA-qualifying coverage only. It does not include HRA plans or stand-alone high deductibles.
The finding reported in most of the news stories is that enrollment in these plans grew from 11.4 million in January 2011 to 13.5 million in January 2012, an increase on 18% in one year.
This continues the steady growth documented by AHIP’s annual surveys. The trend line is unmistakable –
Two major provisions of the health-overhaul law take effect Wednesday, testing employers’ ability to adapt to changes the measure mandates.
