Declaring a National Crisis, Providing Affordable Mental and Behavioral Support Remains a Priority for Employer Sponsored Health Plans

As our nation continues to experience a surge in post-pandemic demand for behavioral health counseling and therapy over residual stress, anxiety and depression, Americans are finding it difficult to access and afford mental and behavioral health services. In fact, President Biden declared a National Behavioral Health Crisis during his 2022 State of the Union address, … Continued

Healthcare Inflation Unusually Trails General Inflation, Squeezing Financially Fragile Employees from Both Sides

Many are questioning how the U.S. healthcare inflation rate compares to the rest of our nation’s economy. The simple answer: it’s significantly lower, which is unusual given that healthcare inflation historically outpaces general inflation. According to McKinsey, inflation is at record highs. Consumer prices have rarely risen faster than healthcare inflation, but that’s the situation … Continued

Annual Enrollment Should Start Now with a Proactive Strategy

The indexed Health Savings Account (HSA) and Health Reimbursement Arrangements (HRA) numbers are out –”triggering” the start of  2024 annual enrollment discussions and planning! It is time for employers with a calendar year plan year to begin to “proactively” prepare for annual enrollment.   As reported by SHRM, annual HSA contribution limits for 2024 are … Continued

Is There Value in a Reference Based Pricing Strategy? YES! Is There an ERISA Fiduciary Duty to Offer? NO!

Reference Based Pricing Provides Great Value, Without ERISA Fiduciary Risk Exposures A recent BenefitsPro article argues that given the federal government’s endorsement of Reference Based Pricing (RBP) and its proven efficacy in reducing employer costs and expanding participant options, it is now virtually impossible for a plan fiduciary to lawfully discharge their duties in accordance with ERISA … Continued

Federal Reserve Report: Economic Well-Being of Households in 2022

A Federal Reserve report released in May evaluated the results from the 2022 Survey of Household Economics and Decisionmaking (SHED). Generally, the report found a decline in peoples’ financial well-being over 2021 and the self-reported financial well-being was among the lowest observed since 2016. With respect to health care expenses, the report found that many … Continued

May is Mental Health Awareness Month

May is Mental Health Awareness Month.  It has been observed since 1949. This year the National Alliance on Mental Illness is celebrating with the More Than Enough campaign: It’s an opportunity for all of us to come together and remember the inherent value we each hold – no matter our diagnosis, appearance, socioeconomic status, background … Continued

‘No Surprises Act’ Website Captures Industry and Litigation Updates, Advances Understanding and Compliance

More than a year ago, the U.S. healthcare system marked a turning point with the passage of  federal legislation that went into law intending to protect Americans from unexpected provider charges, a once common practice known as “balance billing.” Taking effect January 1, 2022, the No Surprises Act (NSA) covers patients and participants in employer-sponsored health … Continued

Reprise: Surprise Does Not Equal Unexpected When It Comes to Medical Bills

Just as Americans were starting to express a sigh of relief following an assumed end to medical balance billing under the provisions of the No Surprises Act, many health plan participants are experiencing the difference between “surprise” and “unexpected.” According to a survey conducted by Morning Consult, many respondents claim to have received surprise medical bills since the No … Continued

Self-Insurance: The Impact of Health Reform

Health Reform accelerated the trend to self-insure health plans, large and small. The Department of Labor’s annual reports have not identified any negative impact on participant benefits or the public marketplace exchanges. Plan sponsors of self-insured plans should ensure that plan document provisions authorizing the use of discretion by the plan administrator are in sync … Continued

A Year in Retrospect: How the No Surprises Act Impacted Medical Billing

The Best Response to the NSA is Still a Strategic and Compliant Approach One year ago, the United States marked a turning point for health care cost transparency with a new law aimed at helping Americans avoid unnecessary, unexpected medical debt. The No Surprises Act (NSA) was signed into federal law after years of negotiation between health … Continued