According to a report from Omniscient Health, a healthcare data science, research and consulting firm, physicians are paid 33.6% less for treating Medicare patients than a decade ago thanks to…
Large U.S. employers expect median health care costs to rise 10% in 2026. Small employers can typically expect larger increases. The projected increase is attributed to a variety of factors,…
The President has signed the “One Big Beautiful Bill”. The health-related provisions are as follows: The bill: Did not take away the employer tax exclusion, a big win in maintaining…
FICA Social Security Tax is 6.2% on income up to $176,100 Medicare Tax unlimited 1.45% to Unlimited ACA Affordability — The ACA benchmark for determining the affordability of employer-sponsored health…
How can your company reduce pharmacy costs while providing the best care and service to employees? Our PBM model consistently delivers high value and significant savings to clients. While each…
Do you know how specialty medications are impacting your company’s health insurance costs? While specialty medications offer promising treatment options for complex conditions, their high cost can pose challenges for…
When medication costs go up, insurance costs follow suit because insurance companies have to cover those expenses. So, rising pharmaceutical medication prices can lead to higher health insurance premiums for…
FICA Social Security Tax is 6.2% on income up to $168,600 Medicare Tax unlimited 1.45% to Unlimited ACA Affordability — The ACA benchmark for determining the affordability of employer-sponsored health…
Effective July 1, 2023 the Florida legislation reshapes the PBM landscape, requiring that PBMs pass through 100% of all manufacturer rebates to plan sponsors, while prohibiting spread pricing, clawbacks, mail…
The Consolidated Appropriations Act, 2023 (CAA23) was signed into law on December 23, 2022. One of the health provisions contained in the law was the relief on telehealth coverage offered…
FICA Social Security Tax is 6.2% on income up to $160,200 Medicare Tax unlimited 1.45% to Unlimited Individual Mandate’s Affordability Exemption — required contribution percentage is 8.17%. High Deductible Health Plans…
The Affordable Care Act (ACA) benchmark for determining the affordability of employer-sponsored health coverage will significantly decrease to 9.12% of an employee’s household income for the 2023 plan year. This is…
Several years ago, I blogged, Fat People Have Issues, with the disclaimer of posting the politically incorrect title in hopes of getting more people to read. Not being one to…
If you are fortunate enough to have health insurance with a low deductible or low-cost prescription co-pays, the high cost of drugs is driving up the premiums that you or…
Workers are rethinking what work means to them, driving an increase in both resignations and demand for talent. For many employers, the best talent is the talent already on their…
Employee Benefit Advisors would like to share the below information regarding at-home COVID-19testing from some of the carriers. Aetna Over the Counter COVID-19 Testing Update AvMed COVID-19 At-Home OTC Testing FAQ…
The U.S. Department of Health and Human Services (HHS) has increased the following penalty affecting group health plans: Medicare Secondary Payer (MSP): Violating the prohibition of offering Medicare beneficiaries financial or other…
FICA Social Security Tax is 6.2% on income up to $147,000 Medicare Tax unlimited 1.45% to Unlimited High Deductible Health Plans Minimum Annual Deductible (Individual/Family) $1,400 / $2,800 Maximum Out-of-Pocket…
Employers are considering vaccine incentives and potential penalties for workers who remain unvaccinated against COVID-19. Before adding a premium surcharge, employers will want to consider how they may impact the…
People are being charged for preventive health care, health care that should be at no cost to them. That’s the headline from an article in the US News & World…
(Read EBA’s Health Care Transparency December 8, 2020 blog for background.) Centers for Medicare & Medicaid Services has started issuing warning letters to hospitals not in compliance with the hospital…
The American Rescue Plan Act of 2021 (“ARPA”) includes major changes to COBRA administration in 2021. The Act creates an opportunity for free COBRA coverage during a six-month period from…
The No Surprises Act, a ban on surprise medical bills, will take effect beginning in 2022. Surprise Medical Bills Surprise medical bills occur when patients unexpectedly receive care from out-of-network…
Yes, employers can require mandatory vaccinations, as a matter of prior health crises and common law. There will be some industries where it is going to be a mandate, like…
FICA Social Security Tax is 6.2% on income up to $142,800 Medicare Tax unlimited 1.45% to Unlimited High Deductible Health Plans Minimum Annual Deductible (Individual/Family) $1,400 / $2,800 Maximum Out-of-Pocket…
New transparency requirements on group health plans and health insurers in the individual and group markets were issued by the Departments of Labor (DOL), Health and Human Services (HHS) and…
BenefitsPro ran an article saying… Changing lifestyle choices could cut $730B in annual health care spending and that more than a quarter of all health care spending is due to…
Medicare Part D notices are due before October 15,2020. But what does that mean and how do you know if your coverage is creditable? If you have any type of…
Surprise medical bill? – Surprise medical billing applies to fully-insured commercial insurance plans. No federal laws exist to prevent surprise medical bills and of the states that do less…
Several clients have asked questions related to COVID-19 and their group disability insurance. Here’s a compilation of how carriers are administering claims. Question: Is someone automatically disabled if he/she is…