Premiums Health Insurance

News & Analysis as of

Manatt on Health Reform: Weekly Highlights - August 2016 #5

A federal report finds that Marketplace premiums are lower in expansion states; Massachusetts and Pennsylvania launch prescription drug monitoring systems; and Kentucky submits a slightly modified Medicaid expansion waiver to...more

Appellate Division Finds c.78 Health Benefits Contributions Requirements Do Not Apply to Public Sector Disability Retirees

Last month, in Brick Twp. PBA Local 230 v. Twp. of Brick, the Appellate Division of the Superior Court of New Jersey confirmed that N.J.S.A. 40A:10-21.1, P.L. 2011, c. 78, § 42, more commonly known as Chapter 78, does not...more

Recent Congressional Hearings

Congressional committees held hearings on a wide variety of on health policy issues this month before going on summer recess. Notable hearings include the following...more

Manatt on Health Reform: Weekly Highlights - June 2016#2

Arkansas’ Governor requests to transition to a “State-based Marketplace on the Federal Platform;” Louisiana launches Medicaid expansion with SNAP fast-track enrollment; and study shows 2016 premium increases are lower for...more

Ohio Prepares Medicaid Waiver Request

Ohio is preparing a Section 1115 Medicaid demonstration waiver application that, if approved, would require most of the members enrolled in Ohio’s Healthy Ohio Program to pay premiums and copayments for their health care...more

Are You Still Reimbursing Premiums For Your Employee's Individual Healthcare Insurance? Then You'd Better Read This!!

In the past, many employers (especially smaller companies) have offered to pay their employees’ premiums for individual healthcare insurance instead of sponsoring their own group health plans. With the advent of the...more

CMS Finalizes 2017 Requirements for ACA Marketplace Plans

CMS has published its annual Notice of Benefit and Payment Parameters, which governs participation in the Affordable Care Act (ACA) Health Insurance Marketplaces for 2017. The sweeping rule addresses protection of consumers...more

Drug Costs, Risk Adjustment Drive Q2 Health Insurance Rate Increases

The Massachusetts Division of Insurance (DOI) recently held a two-day hearing on rate changes proposed by Massachusetts health insurance plans to be effective for the second quarter of 2016 (Q2). Presentations by carriers, in...more

Manatt on Health Reform: Weekly Highlights - December 2015

CMS concludes no QHPs can be certified as comparable to CHIP coverage; California's Marketplace plans to connect consumers to vision coverage issuers; and states react to CMS's proposed HealthCare.gov user fee....more

Automatic Enrollment for Health Plans Has Been Repealed

Budget legislation signed into law by President Barack Obama on November 2, 2015, the Bipartisan Budget Act of 2015, repeals the controversial automatic enrollment provision under the Affordable Care Act (ACA). Section 18A of...more

Manatt on Health Reform: Weekly Highlights - October 2015 #4

HHS announces average premium price increases of 7.5% across HealthCare.gov; Michigan and Illinois launch the country’s first joint cloud-based, real-time Medicaid information management system; and the Marketplace carrier...more

Fenwick Employment Brief

California Legislature Acts to Outlaw Pre-Employment Mandatory Agreements to Arbitrate Labor Code Claims - In late August, the California Senate and Assembly passed AB 465, which, if signed by Governor Jerry Brown, will...more

Manatt on Health Reform: Weekly Highlights - September 2015

CMS permits states to use income information from other means-tested benefit programs for Medicaid eligibility determinations; Alaska’s Medicaid expansion is given the green light to launch today; and Washington State submits...more

Hospitality Businesses Should Consider “Play and Pay” for the ACA

A hospitality industry professional recently asked me if I thought most hotels would stop offering group health insurance coverage to their employees and have them purchase their own policies from Covered California.  My...more

Health Care Update - July 2015

In This Issue: - Medicare Releases Set of Payment Rules, Physician Fee Schedule on Deck - Implementation of the Affordable Care Act - Federal Regulatory Initiatives - Congressional Initiatives - Other...more

Congressional Health Policy Hearings - June 2015 #2

A House Ways and Means Subcommittee on Oversight hearing recently reviewed the effects of the Affordable Care Act (ACA) on health insurance premiums. In addition, a House Energy and Commerce Health Subcommittee hearing...more

Investors Should Be Aware of an Interesting Blue Cross Antitrust Case

It was recently reported that Blue Cross and Blue Shield (BCBS), along with the Blue Cross Blue Shield Association, was sued across all states in a class action brought by two types of plaintiffs. One plaintiff class reflects...more

Quirky Question #247, An Update on Wellness Programs

Question: Our company has been considering implementing financial incentives for employees to participate in biometric screening as part of an employee wellness program. Are there legal issues we should be...more

Employee Benefits Developments - November 2014

Health Care Cost Consideration May Support Age Discrimination Claim. Recently, the U.S. Court of Appeals for the Eighth Circuit overturned a lower court’s summary judgment ruling against a plaintiff’s age discrimination...more

Eighth Circuit Permits Employee to Maintain Age Bias Claim Based on Company's Age-Based Health Care Considerations

With the rising costs of health care benefits for both employers and employees alike, a recent case out of the Eighth Circuit provides an important reminder that even seemingly innocuous cost control measures can have a...more

Employer Reimbursement of Employee’s Individual Medical Insurance May Subject Employer to Penalty

IRS Notice 2013-54 provides that an employer’s reimbursement of healthcare insurance premiums paid by an employee on an individual health insurance contract of the employee on a pre-tax basis (an “employer payment plan”) may...more

Can You Link Insurance Premiums To Smoking?

Rocked by soaring costs, including skyrocketing increases in health insurance premiums, employers are desperate to manage, and hopefully limit, whatever costs they can. Many employers have begun to look to the lifestyle...more

Still Reimbursing Employees For Health Insurance Premiums? You May Be Subject To Significant Penalties!

Until very recently, it was not uncommon for employers to reimburse employees for substantiated premiums paid for individual health insurance coverage. Many small employers saw this as a viable alternative to group...more

Final Regulations Allow Retirement Plan Payments for Accident, Health and Disability Insurance

On May 9, 2014, the Internal Revenue Service finalized regulations that govern the tax treatment of payments made by retirement plans to pay accident or health insurance premiums. Under the final regulations, accident or...more

Delawareans Face Substantial Health Insurance Increases

Health insurance premiums are showing sharp increases across the country, with Delaware leading the way. An April survey by Morgan Stanley of brokers who sell coverage in the individual and small group market shows the...more

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