Our Blog: The New Healthcare Marketplace
The New Definition of Plan Metals
Within health plan design offerings, there are four categories, or metal levels, made available to employers and their employees. These levels are listed by the split of costs between the enrolled individual and the health plan. See chart below: How you and your insurance plan split costs The decision process behind enrollment within these plans
Health Insurance Premium Rebate Checks Aren’t Good News for America
Ever since 2012, Americans have received rebate checks from their health insurers when the Medical Loss Ratio doesn’t “measure up” to the 80/20 Rule. In simple terms, the Rule means that insurers must spend 80 percent of their revenue from premiums to pay for the healthcare of their subscribers. The other 20 percent is theirs to keep. What
An Act of True Bipartisanship: The No Surprises Act
On July 1, 2021, the Biden Administration issued its interim final rule cementing into place the No Surprises Act, which was signed into law by the Trump Administration on December 27, 2020. The Act is one of the most important consumer protection measures regarding healthcare—ever. It takes effect on January 1, 2022. And in these days of so
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Ensuring Compliance with the No Surprises Act and Transparency in Coverage Rule
The Transparency in Coverage Rule and the No Surprises Act: A Millennial’s Perspective
The Transparency in Coverage Rule and the No Surprises Act, set to take effect on January 1, 2022, will have a momentous impact on employer-sponsored health insurance, in terms of cost, as well as consumer knowledge. These rules will impact millennials, in particular, because they speak to one of the key characteristics of this demographic—the
Vincible Ignorance – One of the Problems with ESHI
Employer-sponsored Health Insurance (ESHI) covers just over 55 percent of the U.S. population and accounts for just over a third of the overall health care expenditure for the country. With such significant dollars allotted, expectations for the quality of healthcare and the overall health of individuals would be at the top of every health-related metric
Five Steps to Increasing Employee Engagement with Transparency in Coverage
With the Transparency in Coverage Rule and No Surprises Act taking effect January 1, 2022, TPAs, ASOs, Insurers and employers of every kind should be focusing not just on meeting the requirements of the Rule and Act and avoiding fines of up to $100 per member per day, but also on increasing employee engagement with
Resources
Executive Summary
Download the Executive Summary of Ensuring Compliance with the No Surprises Act and Transparency in Coverage Rule
10 Key Considerations
What you need to consider with Ensuring Compliance with the No Surprises Act and Transparency in Coverage Rule
Planning Guide
Download the Planning Guide Ensuring Compliance with the No Surprises Act and Transparency in Coverage Rule
Transparency in Coverage Final Rule
Learn about how the final rule applies to your group.
No Surprises Act
Learn about how the act applies to your group.
True Price Transparency
True price transparency means no surprises.
