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In September, a tentative $2.7 billion settlement was reached with BlueCross BlueShield (BCBS) in an antitrust action brought on behalf of over one million individual and corporate policyholders. BCBS plans cover 109 million, or almost one-third of Americans. Under long-standing rules governing BCBS Association members, insurance purchasers could only transact insurance business with the plan located in the state where their headquarters were based – unless the home-state plan granted permission to obtain a proposal from a BCBS plan based in another state. This was true even if the employer had offices or employees in multiple states …

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 …

… ACA). In short, an employer creates an HRA through which they reimburse employees for the cost of the purchase of individual health insurance through an individual exchange. The employer contributions must be set at a level that is compliant with ACA rules to avoid penalties. The employer retains the tax benefits of subsidizing the program and the employee enjoys employer support towards the cost of health and prescription coverage. If employees need to make up any difference between the employer’s monthly reimbursement and the total insurance cost, the employee simply does so through a voluntary contribution. The upside: An …