SEARCH

Showing 793 results found

EPIC Adds Wesley Carson as Senior Vice President

EPIC Insurance Brokers and Consultants, a retail property and casualty insurance brokerage and employee benefits consultant, announced today that Wesley Carson has joined the firm as a Senior Vice President, Employee Benefits in its Sacramento, California office.  Carson will be responsible for employee benefits consulting and the design, placement, and management of custom programs. He will primarily focus on mid to large group plans with EPIC clients. Carson brings over 20 years of experience in health and benefits consulting. His background includes experience in employee benefits, health insurance, professional liability, property & casualty insurance. Prior to joining EPIC, Carson held positions …

https://www.epicbrokers.com/insights/epic-adds-wesley-carson-as-senior-vice-president/

The Road Not (Yet) Taken: Surrogacy Benefits

… many years, mental health found itself in this vortex, then same-sex domestic partner benefits – and now it’s surrogacy expenses. Viewpoints from Adam Okun It is a well-established tax principle that expenses deemed as medical care under the Internal Revenue Code (Section 213) are not included in the employee’s gross wages and therefore not subject to taxation if an employer plan elects to cover those medical services. And while standard infertility services performed on the employee or eligible dependent (e.g. intrauterine insemination [IUI] and in-vitro fertilization [IVF]) are deemed deductible because they affect the body …

https://www.epicbrokers.com/insights/the-road-not-yet-taken-surrogacy-benefits/

Compliance Alert: ACA Affordability Safe Harbors: A Primer

… offer meets the current applicable affordability percentage. BACKGROUND  The ACA requires ALEs to offer full-time employees and their dependent children to age 26 affordable, minimum value health coverage or pay a penalty – the so-called play-or-pay mandate. To avoid potential penalties, an ALE must ensure that the employee’s share of the cost for the lowest-level self-only coverage it offers does not exceed a certain percentage – 9.78% for 2020 – of an employee’s household income. The problem for employers is they generally have no way to know an employee’s household income. The IRS …

https://www.epicbrokers.com/insights/compliance-alert-aca-affordability-safe-harbors-a-primer/

Compliance Alert: Commuter Benefits Legislation Keeps Rolling

… and news where employees work regarding commuter benefit program mandates. Employers may want to consider voluntarily offering such programs to employees nationwide in advance of any municipal or state requirements that may apply in the future. BACKGROUND  Internal Revenue Code (Code) Section 132(f) lets employers offer qualified transportation fringe benefits, or commuter or transit benefits, to their employees. Commuter benefits provide tax incentives for employees to use mass transit and other alternative ways to get to work, with the goal of reducing traffic congestion and improving air quality. In brief, a commuter benefit program allows an employee to set …

https://www.epicbrokers.com/insights/compliance-alert-commuter-benefits-legislation-keeps-rolling/

Compliance Alert: DOL Reveals Higher Health Plan Violation Penalties

QUICK FACTS: The U.S. Department of Labor (DOL) recently issued its annual inflation-adjusted penalty amounts for certain Employee Retirement Income Security Act (ERISA) violations. The adjusted amounts are intended to create greater incentives to comply with certain federal laws applicable to health and welfare benefit plans. Federal agencies, including the DOL, are required to annually adjust by January 15 the penalties that can be assessed for violating laws and regulations they enforce. The 2020 adjustments are effective for penalties assessed after January 15, 2020, with respect to violations occurring after November 2, 2015. BACKGROUND  Legislation enacted in 2015 …

https://www.epicbrokers.com/insights/compliance-alert-dol-reveals-higher-health-plan-violation-penalties/

Put Pharmacy Costs Under the Microscope in 2020

In 2015, prescription drug spending in the United States was reported at $337 billion. It is projected that spending will reach $560 billion in 2020, a 66% increase over 5 years. Optum, the pharmacy benefit manager (PBM) subsidiary of UnitedHealthcare recently reported that there are over 150 drugs in the pipeline currently being evaluated by the FDA with 64 approvals expected in 2020. Eleven of these are “blockbuster” drugs with sales anticipated to be more than $1 billion. 70% of the new drug approvals will target specific genetic cancer mutations. The second leading area of drug development targets neurologic disorders …

https://www.epicbrokers.com/insights/put-pharmacy-costs-under-the-microscope-in-2020/

Know the Risks in Adopting Reference-Based Pricing

Reference-based pricing plans (RBPs) impact costs by paying healthcare facilities – that’s to say hospital outpatient facilities, and ambulatory surgical centers – a percentage over the amount that Medicare would pay for the same service. This practice contrasts the reimbursement methodology the traditional insurers use, which is a discount off of the facilities’ billed charges. The result is that payments to facilities are much lower than traditional insurers pay. Employers realize these savings because the self-funded financing model passes those along directly to them. Viewpoints from Matthew Presutti I spend a lot of time debating the state of affairs …

https://www.epicbrokers.com/insights/know-the-risks-in-adopting-reference-based-pricing/

No Significant Healthcare Legislative Changes Likely in 2020

… longer be available. But that may be it legislatively until 2021. It’s clear that both parties are happy with giving voters universal good news. But the kind of changes that make a real impact will change the equilibrium. With the required pay-for, it will be tough in this election year to address the biggest concern of the average American: worsening benefits resulting in higher out-of-pocket costs. I read a recent report by the Agency for Healthcare Research and Quality (AHRQ) on how higher deductibles are impacting families, with out-of-pocket costs for maternity skyrocketing. While

https://www.epicbrokers.com/insights/no-significant-healthcare-legislative-changes-likely-in-2020/