Proposed Rule Would Expand Options for HRAs

Proposed Rule Would Expand Options for HRAs

On Oct. 23, 2018, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) issued a proposed rule that would expand the usability of health reimbursement arrangements (HRAs). Effective in 2020, the proposed rule would:

  • Allow HRAs to be used to reimburse the cost of individual market premiums on a tax-preferred basis, subject to certain conditions; and
  • Allow employers that offer traditional group coverage to provide an HRA of up to $1,800 per year (as adjusted) to reimburse certain qualified medical expenses.

This proposed rule was issued in response to a 2017 executive order directing federal agencies to expand access to HRAs. (more…)

Spousal Coverage Audits Make Sense

Spousal Coverage Audits Make Sense

With spousal exclusions or surcharges gaining popularity as a best practice to help organizations control the cost of benefits for everyone, the growing interest in spousal coverage audits (SCAs) makes sense. (more…)

No Joke: Money Back from the Insurance Company

No Joke: Money Back from the Insurance Company

Individual stop loss insurance is an important way that many employers with self-funded health plans manage the financial risk associated with their large claimants. If you fall into this category, you’re probably no stranger to large stop loss rate increases following years of poor large claim experience. (more…)

Keeping Score: Net Cost per Script

Keeping Score: Net Cost per Script

While it might not appear to be a telling indicator, net cost per script can quickly reveal a great deal about your current prescription drug plan performance.

The number can range substantially based on plan design, drug mix, and your current PBM deal. A high cost in this area could be an indication of excess prescription drug spend or issues with your current PBM arrangement.

How does your plan compare? Let us know if you would like to gain more insight into this spend and ways to manage costs.

(more…)

Final Forms for 2018 ACA Reporting Released

Final Forms for 2018 ACA Reporting Released

In late Sept. 2018, the Internal Revenue Service (IRS) released final 2018 forms and instructions for reporting under Internal Revenue Code (Code) Sections 6055 and 6056.

  • 2018 Forms 1094-C and 1095-C (and related instructions) are used by applicable large employers (ALEs) to report under Section 6056, as well as for combined Section 6055 and 6056 reporting by ALEs who sponsor self-insured plans.
  • 2018 Forms 1094-B and 1095-B (and related instructions) are used by entities reporting under Section 6055, including self-insured plan sponsors that are not ALEs.

The 2018 forms and instructions are substantially similar to the 2017 versions. (more…)