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Top Health Care Statistics

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By: Peter Freska, MPH, CEBS, Benefits Advisor
The LBL Group
A UBA Partner Firm

We field many calls to review, speak, and comment on a variety of topics. Of course, these generally pertain to health care. In preparing for a coming presentation, I came across a recent article in Becker’s Hospital Review titled “100 Healthcare Statistics to Know”. While there are many topics that comprise health care, the article breaks them down into 10 categories:  Hospital and Physician Facts, Hospital and Health System Compensation, Health Coverage, Medicaid, Medicare, Hospital Construction, Accountable Care Organizations, Health IT, Patient Care and Quality, and Miscellaneous Health Care Statistics. While all these topics are important, of particular interest is the section on health coverage:



The Story Behind Minimal Changes in Plan Designs and Premium Rates

CTA 2014 Benchmarking Survey

By Carol Taylor, Employee Benefit Advisor
D&S Agency, a UBA Partner Firm 

The United Benefit Advisors (UBA) annual Health Plan Survey for 2014, which contains validated data on 16,467 plans for 9,950 employers, shows minor average change for plans in the last year. The survey contains information on plans that renewed predominantly between June 2013 and June 2014.


How Wellness Programs Affect Affordability and Minimum Value Calculations

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By Linda Rowings

Deadline Approaching for Larger Self-Funded Health Plans To Obtain a Health Plan Identifier Number

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To meet federal requirements, large health plans must obtain a national health plan identifier number (HPID) by November 5, 2014. For this requirement, a large health plan is one with more than $5 million in annual receipts. The Department of Health and Human Services (HHS) has said that since health plans do not have receipts, insured plans should look at premiums for the prior plan year and self-funded plans should look at claims paid for the prior plan year. Small health plans (those with less than $5 million in claims during the prior plan year) have until November 5, 2015, to obtain an HPID.

Determining If Dental and Vision Plans Are “Excepted Benefits”

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By Linda Rowings
Chief Compliance Officer, UBA 

The U.S. Department of Health and Human Services (HHS), the Internal Revenue Service (IRS), and the Department of Labor (DOL) released final regulations that explain when dental and vision plans and employee assistance plans (EAPs) will be considered “excepted benefits.” Excepted benefits are health benefits that are limited enough in scope to be exempt from many of the requirements of the Patient Protection and Affordable Care Act (PPACA), such as annual dollar limits, reporting on W-2s and various fees.


Navigating Narrow or Focused Provider Networks (Part 2)

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By Elizabeth Kay
Compliance and Retention Analyst
AEIS, a UBA Partner Firm

Health care reform has brought about many changes and growing pains. One of the changes we have seen recently in 2014 is the increased use of focused or ”narrow” provider networks. While these were implemented by the insurance carriers in the individual Marketplace to help control premium costs, we have seen the subscribers of employer sponsored or group plans affected as well, but it’s not in the way you might think.



Skinny Plans and Minimum Value: Do these plans really pass the test?

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By Carol Taylor, Employee Benefit Advisor
D&S Agency, A UBA Partner Firm

There is a lot of buzz in the market right now as employers are implementing their plans for the upcoming year. Many employers are looking at ways to keep their costs for medical coverage low, but still meet the requirements of the Patient Protection and Affordable Care Act (PPACA). These plans, often referred to as ”skinny plans,” may only cover preventive services or may cover everything but inpatient or outpatient hospital services.


A To-Do List for Sponsors of Self-Funded Group Health Plans

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Below are some to-dos for sponsors of self-funded group health plans.  The information is limited generally to the “what” and the “when.”  For a summary of the PPACA provisions that apply to group health plans and whether the provision applies to self-funded plans, request PPACA Decision Guide for Self-funded Plans.   

IRS Allows Additional Section 125 Change in Status Events

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On September 18, 2014, the Internal Revenue Service (IRS) issued Notice 2014-55 which allows employers to amend their Section 125 plans to recognize several new change in status events.

Is it Time to Revisit [or Review?] Your PEO Arrangement?

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By Peter Freska, MPH, CEBS
Benefits Advisor, The LBL Group
A United Benefit Advisors Partner Firm

The Patient Protection and Affordable Care Act (PPACA) is driving companies to look at many aspects of their organization more strategically. With an estimated 2.5 million people in Professional Employer Group (PEO) arrangements totaling $92 billion in annual revenue, the spotlight was cast on them (source: https://www.napeo.org/about/annualreport.pdf). The questions related to the implications of PPACA on PEOs are many, and the law is still out for interpretation.



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