Health care reform regulations that took effect for the 2011 plan year require non-grandfathered self-insured and insured group health plans to make changes to their internal appeal procedures and offer external reviews of denied claims. As a result, all plans, whether subject to or exempt from ERISA, will have to follow the same general claim-handling rules.
Under one administration suggestion, TPAs could fund the coverage through rebates they receive from drug manufacturers that the TPA is not contractually liable to forward to the affiliates.Read More
Large employers at the annual National Business Group on Health conference held last week grappled with uncertainty around health care, but one thing was clear: Employees will be asked to do more to keep costs down by staying healthy and becoming savvier consumers. Read More
Not only are obese workers comp claimants likely to miss more work days than healthy-weight co-workers with similar injuries, obese workers are likely to have higher medical costs and are more likely to become permanently disabled, research has shown.Read More
The survey indicated that only 27 percent of responding employers have determined what it has cost their company to comply with the health care reform law in the two years since its implementation.
Insurance companies are finally fighting back against exorbitant, seemingly unnecessary billings when a procedure could be done for a lot less.Read More
Six winners of the New England Employee Benefits Council's Best Practice awards for 2011 include Ocean Spray's Moms at Work program and Staples' use of computer games to entice the office supply company's younger workers to save for retirement.