Healthcare Reform

Identify and Evaluate the Impact of Your Wellness Program

January 5 | 2017
By: Mary Delaney, MSPT, CWP
Managing Director for Vital Incite, A UBA Partner-Provided Solution

Measuring program value, or return on investment, is critical and imperative in managing a healthy wellness program. Further, clearly identifying and objectively evaluating the impact helps keep the vendor focused on what is critical for the employer. If these programs are not having the impact intended, then the cost of those services is only adding […]

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Emphasis on Consumerism in Health Care Expected Post 2016 Elections

January 4 | 2017
By: Michael Weiskirch
Principal & Founder, Health Cost Manager, A UBA Certified Solution

I really need to stop spending so much time reading the news. I subscribe to several news aggregators, plus a number of content sources: blogs, industry experts and other publications. I pore through news about politics, world affairs, and information related to HR, benefits, and technology – the field I work in. I sometimes do […]

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FAQs on Tobacco Cessation Coverage and Mental Health/Substance Use Disorder Parity

December 20 | 2016
By: Danielle Capilla
Chief Compliance Officer at United Benefit Advisors

Recently, the Department of the Treasury, Department of Labor (DOL), and Department of Health and Human Services (HHS) (collectively, the Departments) issued FAQs About Affordable Care Act Implementation Part 34 and Mental Health and Substance Use Disorder Parity Implementation. The Departments’ FAQs cover two primary topics: tobacco cessation coverage and mental health / substance use […]

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Can Trump Dump Obamacare His First Day in Office?

December 9 | 2016
President of Fringe Benefit Analysts, LLC.

January 20, 2017 we will have the inauguration of our 45th President of the United States, Donald J. Trump. During his campaign he stated that he would repeal Obamacare (the Affordable Care Act or ACA) his first day in office. So what is the political reality of having the ACA repealed on January 21st? The […]

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VOI vs. ROI: A Business Case for Wellness

December 6 | 2016
By: Heather Mills CWWPM
Wellness Program Manager at VolkBell, a UBA Partner Firm

VolkBell began the exploration into health and wellness about eight years ago. It was something our partners would say, “Just made sense.” At the time, health care costs were skyrocketing across the nation, particularly in our home state of Colorado, and the nation’s obesity rates were at an all-time high. In our research, we observed […]

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The Shift Away from Health Risk Assessments

November 30 | 2016
By: Sierra Sullivan
Assistant Population Health Strategist for Vital Incite, LHD Benefit Advisors, A UBA Partner Firm

Historically, employers have utilized health risk assessments (HRAs) as one measurement tool in wellness programs design. The main goals of an HRA are to assess individual health status and risk and provide feedback to participants on how to manage risk. Employers have traditionally relied on this type of assessment to evaluate the overall health risk […]

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Health Care Sharing Ministries Plans – Pitfalls Individuals Should Consider

November 27 | 2016
President of Fringe Benefit Analysts, LLC.

Christian Health Sharing Ministries Under the Affordable Care Act (ACA), members belonging to a certain number of organizations known as Health Care Sharing Ministries – sometimes called Christian Health Plans or Christian Ministries Plan – were granted an exemption from the personal tax penalty (up to 2.5% of one’s household income in 2016 and beyond) […]

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You Ain’t Seen Nothing Yet

November 25 | 2016
President of Fringe Benefit Analysts, LLC.

In a previous blog, we discussed the exorbitant cost of drugs, even generics and the tactics that the pharmacy industry employs to keep the costs high. Well, as the 1974 Bachman Turner Overdrive hit song goes, “You Ain’t Seen Nothing Yet!” Over the past few months, having participated in over a half-dozen health insurance meetings, […]

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State Guide to COBRA Supplemental Requirements

November 23 | 2016
By: Danielle Capilla
Chief Compliance Officer at United Benefit Advisors

The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal requirement of group health plans to provide COBRA insurance continuation coverage to participants who lose coverage due to a qualifying event, when the employer has 20 or more full time employees. Over the years, many states enacted additional requirements similar to COBRA, either for small employers, […]

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Employers and Employees Teeter on Healthcare Cost and Coverage Tightrope

November 22 | 2016
By: Elizabeth Kay
Compliance & Retention Analyst - AEIS Advisors, A UBA Partner Firm

Over the past few years, we have seen the cost of health care steadily increase – a trend supported by the latest data from the 2016 UBA Health Plan Survey. During the recession, employers implemented health plans with higher copays, higher deductibles, or offered multiple plans with a variety of deductibles and pushed the cost […]

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Ouch, Have You Been to the Pharmacy Lately?

November 19 | 2016
President of Fringe Benefit Analysts, LLC.

A friend recently recounted to me his recent visit to the pharmacy needing to fill his Crestor® prescription to control his cholesterol. He was excited by the prospect of saving some money because Crestor® had recently gone generic and the cost should have dropped dramatically.  He was shocked to find out that a 90-day supply […]

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Frequently Asked Questions about the Transitional Reinsurance Fee (TRF)

November 17 | 2016
By: Danielle Capilla
Chief Compliance Officer at United Benefit Advisors

The transitional reinsurance fee (TRF) applies to fully insured and self-funded major medical plans for 2014, 2015, and 2016. The purpose of the fee is to provide funds to help stabilize premiums in the individual insurance market in view of uncertainty about how the Patient Protection and Affordable Care Act (ACA) would affect claims experience. […]

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2016 Election Results: The Potential Impact on Health and Welfare Benefits

November 15 | 2016
By: Les McPhearson
CEO, United Benefit Advisors

Following the November 2016 election, Donald Trump (R) will be sworn in as the next President of the United States on January 20, 2017. The Republicans will also have the majority in the Senate (51 Republican, 47 Democrat) and in the House of Representatives (238 Republicans, 191 Democrat). As a result, the political atmosphere is […]

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What A Trump Presidency Means For Health Care Reform

November 10 | 2016
Senior Consultant

The news of Donald Trump becoming our nation’s 45th President came as a complete shock to many in this country, yours truly included. Now that the dust has settled and this reality has sunk in, there are many questions to be asked. These relate to foreign policy, immigration reform and at least one Supreme Court […]

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Employer FYI: Individual Mandate Requirements and Proposed Regulations

November 10 | 2016
By: Danielle Capilla
Chief Compliance Officer at United Benefit Advisors

Though employers are not required to educate employees about their individual responsibilities under the Patient Protection and Affordable Care Act (ACA), it is helpful to know about the individual mandate. The individual responsibility requirement (also known as the individual mandate) became effective for most people as of January 1, 2014. Under the individual mandate, most […]

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Going Where Others Fear to Tread: When COBRA and the FMLA Cross Paths

November 9 | 2016
By: Jennifer Stanley
In-house Counsel & Compliance Officer for iaCONSULTING, a UBA Partner Firm

In some of my previous blogs, the foundation of the Consolidated Omnibus Reconciliation Act of 1985 (COBRA) continuation coverage was reviewed. Now that the groundwork has been laid, it is time to tread into the territories (or laws) where employers can lose their footing. The area covered in the following is that of the intersection […]

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Employer Considerations When Offering Health Coverage Under the SCA or DBA

November 3 | 2016
By: Danielle Capilla
Chief Compliance Officer at United Benefit Advisors

Employers that are subject to the McNamara-O’Hara Service Contract Act (SCA), Davis-Bacon Act (DBA), and Davis-Bacon Related Acts (Related Acts), and who are considered an applicable large employer (ALE) under the Patient Protection and Affordable Care Act (ACA) must ensure that they meet the requirements of all three acts, despite the fact that the interplay […]

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Are Opt-Outs on the Way Out?

October 27 | 2016
By: Danielle Capilla
Chief Compliance Officer at United Benefit Advisors

Opt-out payments or cash in lieu of benefits have been a staple in the employee benefits industry for many years. Employers offer individuals who are eligible to enroll in their group health plan a sum of money, typically paid monthly, to those who waive enrollment in the group health plan. Employers who offer group health […]

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Controlled Groups and Affiliated Service Groups: How They Apply to the ACA

October 25 | 2016
By: Danielle Capilla
Chief Compliance Officer at United Benefit Advisors

The Patient Protection and Affordable Care Act (ACA) imposes a penalty on “large” employers that either do not offer “minimum essential” (basic medical) coverage, or who offer coverage that is not affordable (the employee’s cost for single coverage is greater than 9.5 percent of income) or it does not provide minimum value (the plan is […]

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Fully Insured vs Self-Insured vs Level-Funded: What Does It All Mean To The Small Employer?

July 14 | 2020
By: Nathan Shumate
Account Coordinator - Fringe Benefit Analysts

  Small employers looking for ways to control their group health insurance costs are more closely examining what it means to be “fully insured.” These days, employers with as few as ten full-time employees are exploring other funding arrangements which can allow them more control—or at least more accountability—over their annual premium increases. Fully Insured “Fully […]

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