J.P. Farley News and Blog

An article in the February 17, 2013 edition of the New York Times discussed small and mid-sized employers choosing to move from insured plans to self insured plans with stop loss coverage in response to the Accountable Care Act (ACA)  otherwise known as Health Care Reform or Obamacare.  Consultants and experts in the group employee benefit business began predicting the movement from insured plans to self insured plans as soon as the ACA went into effect so the fact that this is actually occurring is no surprise.  According to the article, the employers who were quoted have considered the move to self insurance to be successful.

The American Dietetic Association tells us that a typical workday lunch can really take a toll, especially if you’re trying to watch your weight. Did you have an unhealthy lunch today? Here’s How to Burn It Off:

Time is running out for many of America’s most popular prescription drugs. With patent protections ending, generic versions of these drugs will soon be available to patients. The use of generic equivalents in place of brand name drugs offers self-funded health plans and consumer-directed healthcare programs an important opportunity to significantly reduce medical expenses.

For companies that provide self-funded health plans, the start of the New Year provides a golden opportunity to promote employee wellness programs and encourage employees to take greater personal responsibility for their health. With their New Year’s resolutions fresh in their minds, employees will be coming to work this month highly motivated to drop those extra pounds, improve their eating habits, increase daily exercise or quit smoking.

Do you doubt that your employees would really take an active interest if you were to provide them with consumer directed healthcare as part of their group employee benefits? The American Journal of Health Promotion reported on a study that examined the differences between employees who were enrolled in a traditional workplace wellness program that focused on diet and exercise and one that was an "activated consumer" program that helped study participants evaluate health benefits information and take proper doses of medication while a third group had no intervention at all.

If you were not aware, self-funded health insurance can have a positive impact on your business. Officials in one county in the state of Kansas have decided that they are ready to make the switch to self-funding because they believe the change will help reduce health care costs.

As we move further along the Health Care Reform Law (PPACA) timeline, much attention is being directed at provisions that created Accountable Care Organizations (ACOs). Since Health and Human Services (HHS) has issued final ACO regulations, we thought it might be helpful to consider how they might impact health benefit plans in the future.

In “Making Wellness Work for Small Business,” CNBC.com discusses why workplace wellness programs are worth the effort for small organizations even when it seems as if only a large company can show a sizable ROI on wellness programs because "the end result of fewer sick days, heightened productivity and fewer costly insurance claims has been hard to quantify, especially for cash-strapped small businesses."

The IRS has recently published their preliminary guidelines for the implementation of the Patient Protection and Affordable Care Act’s imposed fees on health plans for funding comparative clinical effectiveness research. Both fully insured and self insured health plans will be required to pay these fees for plan years ending after September 30, 2012. It is therefore important for plan sponsors with plan years beginning November 1, 2011 and after to plan according based on the information available to them at this time.

The advantage of choosing a self-funded health plan is that you can design a plan that works well for your budget and your staff...and then you have to manage it effectively. As we have noted before, administering a self-funded health plan involves more that just processing claims and turning paperwork in a timely fashion. Managing group employee benefits can be a daunting task, especially if your staff has plenty of other responsibilities in addition to that work. As health insurance regulations become increasingly complex, it helps to have expert help to make sure that you are in compliance.