By Sara Richland
Under the Patient Protection and Affordable Care Act, a “waiting period” is defined as the period that must pass before coverage for an individual who is otherwise eligible to enroll under the terms of a group health plan can become effective.
The ACA prohibits group health plans and group health insurance issuers from imposing a waiting period that exceeds 90 days after an employee is otherwise eligible for health coverage.
Generally, an individual is “eligible” to enroll in a health plan if he or she has met the plan’s substantive eligibility conditions, such as being in an eligible job classification, earning a certain level of commission, or satisfying a reasonable and bona fide employment-based orientation period. Read more…
What’s in a name? When it comes to health plans sold on the individual market, these days it’s often less than people think.
The lines that distinguish HMOs, PPOs, EPOs and POS plans from one another have blurred, making it hard to know what you’re buying by name alone – assuming you’re one of the few people who know what an EPO is in the first place.
“Now, there’s a lot of gray out there,” says Sabrina Corlette, project director at Georgetown University’s Center on Health Insurance Reforms. Read more…
Nearly one company in six in a new survey from a major employer group plans to offer health coverage that doesn’t meet the Affordable Care Act’s requirements for value and affordability.
Many thought such low-benefit “skinny plans” would be history once the health law was fully implemented this year. Instead, 16 percent of large employers in a survey released Aug. 13 by the National Business Group on Health said they will offer in 2015 lower-benefit coverage along with at least one health plan that does qualify under ACA standards.
The results weren’t unexpected by benefits pros, who realized last year that ACA regulations would allow skinny plans and even make them attractive for some employers. But the new survey gives one of the first looks at how many companies will follow through and offer them. Read more…
Newly hired employees who don’t sign up for health insurance on the job could have it done for them under an Affordable Care Act provision that may take effect as early as next year.
But the controversial provision is raising questions:
Does automatic enrollment help employees help themselves, or does it force them into coverage they don’t want and may not need? A group of employers, many of them retail and hospitality businesses, want the provisions repealed, but some experts say the practice has advantages and is consistent with the aims of the health law. Read more…
It’s a wait-and-see year for employers, in part driven by the seemingly endless legal challenges to the Affordable Care Act.
But health care is big this year, like it’s been every other year in recent memory.
Whether or not you believe ACA successfully or unsuccessfully reformed the structure of health insurance in America, you’ll agree costs are still an issue. Cheryl DeMars of The Alliance succinctly said, “The work of bending the cost curve is largely the business of physicians and hospitals, employers and consumers — not regulators.” Read more…
In the last 12 months I’ve been to 73 cities in 19 countries, working with our global clients about the advantages of using online benefit management and employee engagement software.
Along the way, I’ve picked up some interesting facts, figures and anecdotes regarding employee benefits management strategies. These are high-level observations and therefore should be taken with a pinch of salt.
I know how infuriating it can be to have your country or region generalized. For example, you can’t talk about the American economy in high-level terms: Read more…
By Ilyse Wolens Schuman
In response to the recent U.S. Supreme Court holding in Burwell v. Hobby Lobby that closely held, for-profit entities with religious objections to certain aspects of the Affordable Care Act’s (ACA) birth control requirements could avoid the mandate by invoking the Religious Freedom Restoration Act, the U.S. Department of Labor has released guidance to address this eventuality.
In the latest set of Frequently Asked Questions on the ACA’s implementation, the Labor Department explains that group health plans offered by closely held, for-profit businesses that intend to cease providing all or some contraceptive coverage must notify plan participants within 60 days after the adoption of a modification or change to the plan’s coverage. Read more…
Health costs will accelerate next year, but changes in how people buy care will help keep them from attaining the speed of several years ago, PricewaterhouseCoopers says in a new report.
The prediction, based on interviews and modeling, splits the difference between hopes that costs will stay tame and fears that they’re off to the races after having been slow since the 2008 financial crisis.
“This is not an immediate return to double-digit growth rates,” says Ben Isgur, a director in PwC’s Health Research Institute. However, he adds, “what we’re seeing for 2015 will be our first uptick in some time.” Read more…
June is National Employee Wellness Month, so let’s focus on some current workplace health and wellness stats.
We know that a workplace culture based on trust creates happier, engaged and higher performing employees on all levels. And health and well-being should be considered an important factor towards this overall goal, because employees who experience poor health and wellness are likely to (among other things):
- Experience higher levels of stress;
- Miss more days of work; and,
- Experience less productivity.
These are all important determinants in an employee’s overall engagement. Read more…
Employers with 20 or more employees are required to offer COBRA benefits to departing, eligible employees.
Managing these COBRA benefits can be a burden to mid-sized businesses, whether they invest the time to manage the process in-house or invest the money to have a third party manage it.
The Affordable Care Act has added a new wrinkle into this process that both employers and employees should be aware of. The issue boils down to timing. Read more…