The No Surprises Act took effect this year and employers could see some positive impacts to their self-funded health plans in the form of reduced out-of-network costs and simplified regulatory requirements. The new law was approved by Congress in 2020 and went into effect Jan. 1, 2022.1 The basis of
Employers with self-funded employee health plans have long felt protected from state laws that attempted to regulate ERISA plans, however a U.S. Supreme Court case decided last year may begin to change that, according to benefits attorney Felicia Finston. The 2021 Supreme Court decision in Rutledge v. Pharmaceutical Care Management
Employers aiming to reduce health care plan costs could go back to the dictionary when it comes to their summary plan descriptions. From reviews of self-funded employer health care claims, analysts have found broad, sweeping definitions of “physicians” which resulted in services billed at the higher physician rate even though
Everyone will agree that emergency care is a necessary and important part of the US healthcare system. Timely access to emergency care is undisputed. The role of the ER is undermined, however, when used for non-emergent care that can be safely rendered elsewhere. A recent report by Accenture examined one
The expanding cost and responsibilities associated with employer-sponsored healthcare Businesses across the board, from automakers to tech companies to taxpayer-funded school systems, spend a large portion of their budgets on employees in the form of salary and benefits. A rapidly growing percentage of these costs go to fund employee healthcare