California employers that offer group medical insurance often ask how they can keep a child on an employee's health insurance plan after turning age 26. This article answers questions like this one: My son turns 26 in May and was diagnosed with Autism several years ago. I received a [...]
Walmart has taken a big step towards fixing the “broken” U.S. health Care system by creating Walmart Health. These are clinics that offer primary medical care, mental health counseling, X-rays, labs, dental services, and vision and hearing services at one location. As of December 2020 Walmart has 14 health clinics. [...]
On Wednesday, I was fortunate to be included in a round table discussion with the senior leadership of Kaiser Permanente's small group sales and account management team. To encourage discussion, Kaiser limited participation to a few key brokers. (2019 Kaiser Key Broker Engagement Luncheon, Pasadena, California. Third from [...]
Many employers want to know why medical insurance rates continue to rise and whether they're paying too much compared to other businesses. Two recently released reports address these questions: Medical Cost Trend: Behind the numbers 2019, is prepared by Price Waterhouse Coopers (PwC)'s Health Research Institute and it projects [...]
NOTE: The answer to this question requires compliance with both the HIPAA Nondiscrimination Requirements and the IRS Section 125 Nondiscrimination Rules. IRS Nondiscrimination Rules apply when employees make pre-tax paycheck contributions for employee benefits using a Section 125 Premium Only Plan (POP). If you are a client of Benefits [...]
Like the W-2 forms that employers give to employees and the IRS that report wages; beginning in 2016 employers with 50 or more employees must give employees and the IRS a completed 1095-C form. The 1095-C reports on an employee's medical insurance coverage.
The good news is that in July, 2013 the IRS issued Notice 2013-45 which gave large employers “transitional relief” from the “shared responsibility” penalties.... Accordingly, neither the reporting requirements nor the employer shared responsibility provisions apply for 2014.
Last week the Los Angeles Times reported that large employers estimate that the cost of group health insurance will increase about 5% in 2015. I was quoted in the last two paragraphs of the article, talking about the 2015 rate increases for California small businesses. We've seen rates increase from a few percent to twenty percent depending on the characteristics of the employees. While there are winners and losers among California employers; we have been able to change our clients to different insurance companies and different plans so that in most cases they won't have any increase and many of our clients will pay less for group health insurance in 2015 than they did in 2014.
For the Third Time DOL & IRS say an Employer Can NOT reimburse employees for individual health insurance plans
Today the U.S. Department of Labor released yet another notice/guidance/ "FAQ" instructing employers that "an employer health care arrangement cannot be integrated with individual market policies to satisfy the market reforms." Obstinate vendors continue to push their high cost TPA services and claim that an employer can cancel a [...]
Right before my eyes I saw the top executives from the top hospitals with the top executive from the top insurance company pledge to offer high quality medical care at lower cost. They described how they have aligned incentives for everyone to provide top patient care. If they can do that cost-effectively, they will share in the savings. If not, they will collectively share in the loss...This is a game-changer for health insurance.