Health benefit managers have called on the CMS to continue a little-known Affordable Care Act provision that allows employers to offer limited, supplemental coverage for individual market plans.
The Idaho Blues' new state-based plans violate federal law and could subject the insurer to steep penalties if HHS chooses to enforce the Affordable Care Act. The plans also threaten to harm consumers who enroll and will likely prompt lawsuits, experts said.
Direct contracting, in which self-funded businesses eschew insurance companies to partner directly with a healthcare provider, can give the employer more control over the employee health benefit design.
Two chambers, two bills: House and Senate measures to fund reinsurance pools for the ACA individual markets vie for inclusion in an upcoming spending bill.
Maestro Health, a Chicago-based, healthcare-benefits company, sold for $155 million to AXA Group, a global insurance giant.
Higher prices—not the use of more healthcare services—drove increased healthcare spending in 2016 among patients covered by employer-sponsored plans.
Health insurers have paid $3.2 billion in rebates to consumers since 2011 under an ACA provision requiring the companies to spend a certain percentage of premium dollars on medical care and quality improvement.
While dealing with the physical and mental trauma of surviving a mass shooting, those who lived also face mounting medical bills.
Healthcare stakeholders are calling on Congress to pass legislation that will help stabilize the ACA insurance markets in the wake of the soon-to-be-repealed individual mandate penalty. But experts say states would be better off taking action on their own.
Health insurer and consumer advocacy groups on Thursday pressed state regulators to protect consumers against the expansion of short-term plans, association health plans and health reimbursement arrangements that the groups said could harm the individual market.
Although the CMS said premiums and deductibles for Medicare Part B beneficiaries will remain flat in 2018, many Medicare beneficiaries will pay higher monthly premiums next year for outpatient coverage
Although insurers asked for a 17.7% increase, New York's Department of Financial Services approved a 14.6% bump as it factored in the potential loss of cost sharing–reduction payments that insurers use to cover out-of-pocket expenses for lower-income consumers.