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Covering Coronavirus: Risk Considerations Volume 1, Issue 23

EPIC Risk Advisory Bulletin Volume 1, Issue 23 In this issue, we take a focused look at: Supply Chain and Business Risks Transportation Deadlines Extended DHS Updates Master Question List for Coronavirus U.S. Outlines Sweeping Vaccine Plan Insurance Products and Coverage Information Business Interruption and the PRIA Presumptive Compensability Legislation News of Note Human Resources and Employee Benefits Return-to-Work Coronavirus Templates HHS Coronavirus Resources for LTC Facilities DOL Regulation Regarding Working Parents and Federal Leave Wage and Overtime Enforcement Suspended for Some Employers The information presented here is intended to provide a high level overview of critical …

https://www.epicbrokers.com/insights/covering-coronavirus-risk-considerations-volume-1-issue-23/

Justice Ginsburg’s Death Makes Healthcare Cloudier Than Before

Viewpoints from Craig Hasday The passing of Justice Ruth Bader Ginsburg throws a giant monkey wrench into the healthcare battle and is yet another unexpected plot twist in 2020. California v. Texas (known as Texas v. U.S. in the lower courts) will be heard by the Supreme Court on November 10 – the week after the presidential election – and it may well be that this case ends up at a 4-4 tie with Justice Ginsburg’s seat vacant. A tie would mean California v. Texas gets sent back to the lower courts and the decision would stand, yet it …

https://www.epicbrokers.com/insights/justice-ginsburgs-death-makes-healthcare-cloudier-than-before/

Data Supports Our Assertion That COVID-19 Has Worsened the Mental Health Crisis

… with the prior year. The Federal Communications Commission (FCC) has approved a new three-digit “988” number for the National Suicide Prevention Lifeline, which will be fully adopted by July 2022, providing more direct access to mental health crisis counselors. The current 10-digit hotline number for suicide prevention is (800) 273-8255. Employers need to be concerned about this trend in their workforce. An assessment of mental health resources should be undertaken by all employers and senior management may want to open a dialogue with employees about the issues. Many organizations offer passive Employee Assistance Programs (EAPs) which are

https://www.epicbrokers.com/insights/data-supports-our-assertion-that-covid-19-has-worsened-the-mental-health-crisis/

Attacking Out-of-Network Again

One of the hallmarks of in-network-only plans is that the provider prices have been pre-negotiated as a precondition for the doctor or hospital to join the network – and the insurer and employer to benefit from the lower costs – in exchange for the volume the provider receives through the insurance network. Preferred Provider Organization (PPO)-style plans, similar to the earlier indemnity-style plans, provide coverage (albeit at greater cost to the member) for non-negotiated, out-of-network providers. Employees get more choice at greater cost, and doctors receive some reimbursement from the plan and the remainder …

https://www.epicbrokers.com/insights/attacking-out-of-network-again/

Covering Coronavirus: Risk Considerations Volume 1, Issue 22

EPIC Risk Advisory Bulletin Volume 1, Issue 22 In this issue, we take a focused look at: Supply Chain and Business Risks Entertainment Industry Update Looming Transportation Deadlines Truckers Keep America Rolling Insurance Products and Coverage Information News of Note Human Resources and Employee Benefits Coronavirus Resources for the Fall CA Workers’ Compensation Law Advanced Workers’ Compensation Webinar October 1 Preparing Office Ventilation Systems for Workers The information presented here is intended to provide a high level overview of critical areas of concern for businesses around coronavirus. Consult your EPIC insurance broker for more in-depth guidance. Supply Chain & Business …

https://www.epicbrokers.com/insights/covering-coronavirus-risk-considerations-volume-1-issue-22/

COVID-19 Makes 2021 Medical Cost Predictions Far More Challenging

Self-insured employers typically establish “premium equivalent rates” in the third quarter of the prior year. These are an estimation of claims based upon the most recent claim data available. While these rates are used to set healthcare cost budgets, the costs that hit an organization’s income statement are based upon actual claim costs paid during the year. Several of the large public brokers predicted significant COVID-19-related costs. The EPIC financial team did not. We believed that the deferral of care would offset any pandemic claim spikes and we were right. As 2020 winds down, it is …

https://www.epicbrokers.com/insights/covid-19-makes-2021-medical-cost-predictions-far-more-challenging/

Pharmacy Update Aug 2020

FDA Rejections The Food and Drug Administration (FDA) recently rejected Gilead’s filing for approval of filgotinib for rheumatoid arthritis. With the FDA asking to see data from an ongoing clinical trial, Gilead is unlikely to be able to refile until mid-2021, pushing it further behind its competitors for the Janus Kinase (JAK) inhibitor market. These drugs suppress the immune system to prevent damage to the joints. The FDA rejected BioMarin’s Roctavian for hemophilia A. This expensive gene therapy was expected to revolutionize the treatment of this disease. However, the manufacturer will be required to complete an ongoing …

https://www.epicbrokers.com/insights/pharmacy-update-aug-2020/

There’s a Lot of Money Going to Healthcare Innovation – Will It Work?

Viewpoints from Craig Hasday Lucrative profit potential, along with political and economic pressure to reduce healthcare costs, has spawned consolidation and vertical integration of traditional insurers and pharmacy benefit managers. But costs continue to escalate, and these traditional markets will no doubt be challenged for solutions. Mergers, consolidation and innovation have combined with political agendas with multiple opinions even within the Democratic and Republican parties. Healthcare is a fragmented and inefficient industry in the United States and nearly 20% of U.S. Gross Domestic Product represents a significant opportunity for the nation’s largest companies to do it better. Walmart …

https://www.epicbrokers.com/insights/theres-a-lot-of-money-going-to-healthcare-innovation-will-it-work/