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Emerging Best Practices in Benefits Communication
June 20, 2018 in MO
Worldwide Employee Benefits Network [WEB] - St. Louis Chapter

FMLA Refresher and Update
August 14, 2018 in MI
Miller Johnson

Hot Issues in Executive Compensation 2018
September 21, 2018 WEBCAST
Practising Law Institute

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HHS Secretary Outlines Priorities to Implement President's 'Blueprint' to Lower Prescription Drug Prices

"[HHS Secretary Alex Azar] outlined regulatory steps that he could take without congressional action such as changing drug rebates or changes to Medicare reimbursement. The Food and Drug Administration released a list of companies believed to be delaying the introduction of generic drugs and [CMS] put health insurers on notice that it would not tolerate so-called 'gag clauses' in contracts that cause many consumers to pay more for drugs at the pharmacy counter. Meanwhile, addressing the nation's opioid epidemic remains the dominant health care issue on Capitol Hill." Medliminal

Deadline Approaching -- Fraud Prevention Institute

Employee benefit plans are packed with personal and sensitive information. The Fraud Prevention Institute will uncover the many areas where fraud can occur, how to detect it and preventive measures to implement. Register by June 11 and save $300 .

Costs for Seniors Jump as Generic Drugs Move to Higher Formulary Tiers in Part D Plans

"Senior citizens with Medicare prescription drug plans ... are paying more for generic prescriptions even as the market price of these drugs stays flat ... because, over time, the generic drugs are being placed on higher formulary tiers where patients pay more out-of-pocket costs. The number of generic prescription drugs placed on the least-costly lowest tier fell 53% between 2011 and 2015. This shift resulted in a 93% increase in total patient cost sharing for these drugs, or a total of $6.2 billion." American Journal of Managed Care

A Wellness Program Is Lacking Without Disease Management

"When a condition is diagnosed, the health insurance carrier works closely with the employee ... The carrier may provide access to counseling, nurse on-call resources and other high-touch services. The goal is to help the employee: [1] Understand the chronic condition and health risks; [2] Understand the doctor's instructions, test results and course of treatment; [3] Stay motivated in the treatment; [4] Maintain compliance with taking prescribed medication." Corporate Synergies

Why More Small and Midsize Employers Are Turning to Level Funding for Health Benefits

"Employers in a level-funded plan get access to detailed claims reporting, which highlights where employees are both overspending and underspending on their health insurance. With this information, employers can customize their health plan to better serve employee needs. As with any self-funded plan, employee education and communication play a large role in cost containment." Employee Benefit News

Insurer Reduces Breast Pump Reimbursements, Could Mean Fewer Mothers Will Breastfeed

"Starting last month, Anthem Inc. slashed the rate it reimburses medical suppliers for breast pumps by 44 percent -- from $169.15 to $95. The move means some breast pumps that used to be free under a provision of the [ACA] will now entail a cost to consumers ... More complex pumps, which have always required an out-of-pocket payment, will now be more expensive. It's unclear how many women will be affected." HealthLeaders Media

Blockchain Could Help Improve Physician Directories, But Trust Among Health Plans Likely Must Come First

"Accurate physician directories can be important to all health care stakeholders... In April, Humana, UnitedHealth Group and a few other organizations announced the development of a pilot program that would test the ability of blockchain to reduce errors in their directories.... For such arrangements to work, health plans will need to share data with each other. In this competitive landscape, health plans often do not trust their competitors. They also tend to treat all information about network physicians as proprietary. This includes even basic and publicly available information, such as a physician's name, specialty, address, and phone number." Deloitte

South Carolina Enacts First Insurance Cybersecurity Act Based on NAIC Model Law

"South Carolina now becomes the second state to address cybersecurity in the insurance industry, and the first to adopt the NAIC model largely unchanged. The Rhode Island General Assembly is studying a similar measure, and the Nevada and Vermont legislatures have enacted provisions similar to the model law targeting their financial services sectors." Bryan Cave Leighton Paisner

Labor Force Participation Rates, and Composition of the Adult Population, by Age and Gender (PDF)

22 pages. "For Americans ages 55 or older, the [labor force participation (LFP)] rate increased from 1991 to 2012 ... The oldest Americans (ages 65 or older) had the largest percentage increases in LFP rates since 1991 ... For those ages 25-54, LFP rates have been steady to slightly declining since 1991.... [T]he increase in the share of individuals ages 55 or older in the population and in the labor force means that employers have been, and will continue to be, challenged to provide benefits that meet the needs of these older workers, while still meeting the needs of younger workers[.]" Employee Benefit Research Institute [EBRI]

Can the Plan Pay for That?

"ERISA tells us that a benefit plan may use plan assets only to pay reasonable administrative expenses. That raises some questions: What is reasonable? Who decides what is reasonable? What are administrative expenses? What are not?" Warner Norcross & Judd LLP

Press Releases

Anthem, Inc. to Acquire Aspire Health Anthem, Inc.

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