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The Hardening Stop Loss Market

While the year 2020 has softened the medical and dental insurance markets, with COVID-19 suppressing claim costs and continuing to place downward pressure on the entire healthcare economy, stop loss has been a very different story. Over the last 12 to 18 months, the reinsurance market continues to harden, and there seems to be a wide variety of reasons, none of which appear to be slowing down. Viewpoints from Adam Okun For those who are unfamiliar, most employer-sponsored healthcare costs in this country are not paid by insurance carriers, but by the employers directly. This arrangement, known as …

https://www.epicbrokers.com/insights/the-hardening-stop-loss-market/

It’s 2020 and Nothing About Healthcare Is Settled

… President Trump’s executive orders. The two he may find most objectionable are: Presidential Executive Order Promoting Healthcare Choice and Competition Across the United States (which allows association and short-term medical insurance plans) Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal (which orders all executive departments to use best efforts to thwart the Affordable Care Act) Another at-risk executive order Another at-risk executive order is the one allowing Health Reimbursement Arrangements to pay for individual insurance purchased on the exchanges. But there is no doubt the Biden administration will seek to

https://www.epicbrokers.com/insights/its-2020-and-nothing-about-healthcare-is-settled/

Individual Coverage HRAs May Be the Solution You Seek

A little bit of healthcare history. In December 2016, President Obama signed the 21st Century Cures Act, which, among other things, reinstated the ability for small employers (fewer than 50 employees) to reimburse their employees for purchasing health insurance on an individual market as long as those employers met several guidelines. The vehicle for this reimbursement was the Qualified Small Employer Health Reimbursement Arrangement (QSEHRA). These plans gained traction in some markets, and in 2018, the Trump administration issued additional guidance to expand the use of these Health Reimbursement Arrangements (HRAs). In 2019, newly finalized rules created two novel types …

https://www.epicbrokers.com/insights/individual-coverage-hras-may-be-the-solution-you-seek/

Spotlight on The EPL Market 

The Perfect Storm: The COVID Economy and the Movement for Racial Justice The Employment Practices Liability (EPL) market made swift adjustments at the onset of the COVID-19 pandemic. Layoffs, furloughs, pay reductions, and remote work arrangements had EPL underwriters anticipating a significant increase in employment litigation. In anticipation of the increased risk, EPL insurers began increasing rates and retentions, reducing capacity, tightening coverage terms and enhancing the underwriting process. Just as the EPL market was starting to adjust to the COVID economy, a powerful social justice movement, demanding the dismantling of systemic racism, began to gain significant support and …

https://www.epicbrokers.com/insights/spotlight-on-the-epl-market/

Plant and Harvest Your Wellness Budget Tree

… works diligently to ascertain wellness funds for our clients. Beyond improving employees’ health, putting these wellness dollars to work can drive down claim costs and generate savings for your health plan. This year, the EPIC New York financial team surveyed clients to develop a benchmark of their various wellness fund arrangements. We found that wellness funds are available to employers of any size, with every carrier, no matter if that employer is in a fully insured, minimum premium, or self-funded plan. However, the amount of those funds can vary greatly between carriers and depends heavily on the client’s …

https://www.epicbrokers.com/insights/plant-and-harvest-your-wellness-budget-tree/

Cost Modeling Projections

… claim with lifetime medical costs that can easily be in the millions of dollars. Typically, these patients, even when in an employer plan are Medicare-eligible. Employers should consider their obligations to establish a Workers Compensation Medicare Set-Aside Arrangement to indemnify Medicare for the medical costs they pay resulting from workplace diseases or accidents. Summary As of the date of this publication, our model calculates net decrease in healthcare spending of $135B in 2020 and an increase of $36B in 2021 as a result of all impacts of COVID-19. In this context payers include all private health …

https://www.epicbrokers.com/insights/cost-modeling-projections/

Why Now Is the Time to Address Your Employees’ Mental Health

… shortage of providers. Primary care doctors in fee-for-service arrangements are under-reimbursed for treating mental health and often prescribe medications without much follow-up care. Kaiser indicated that 50% of California mental health providers have moved to cash-only practices – so those seeking care in-network will have fewer resources to which they can turn. Kaiser Permanente’s response has been to increase access to providers and to integrate more expansive mental health treatment with primary care and other specialties. They have also increased telepsychiatry and embedded additional online resources and digital tools supported by live counselors …

https://www.epicbrokers.com/insights/now-is-the-time-to-address-your-employees-mental-health/

Survey Highlights Accounting Industry's Response to SBA Paycheck Protection Program

… the firms surveyed reported advising and assisting clients with gathering the documentation necessary to prepare the PPP loan application. Eighty-five (85%) reported assisting clients with the required average monthly payroll calculation required for the application. Less than half (46%) reported assisting clients with preparing the actual loan application. Fee arrangements for PPP-related services vary based on the specific advisory services provided. Time and materials arrangements were common to all firms surveyed. Only 25% of firms reported the use of fixed fee arrangements. Fifteen percent (15%) of the firms indicated that in certain instances, no fees were charged for …

https://www.epicbrokers.com/insights/survey-highlights-accounting-industrys-response-to-sba-paycheck-protection-program/