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Agencies Issue Final Rule Amending Summary of Benefits and Coverage Requirements

On June 16, 2015, the Departments of Health and Human Services, Labor and Treasury (the “Agencies”) jointly published a final rule amending current guidance governing the Summary of Benefits and Coverage (“SBCs”) (“Final Rule”). 80 Fed. Reg. 34292. This rule finalizes the guidance issued in the Agencies’ proposed rule dated December 30, 2014 (“Proposed Rule”). 

While the rule primarily codified previous guidance and FAQs related to SBCs, and we expect that the biggest changes related to SBCs will be seen when the Agencies finalize the template and instructions, issuers in particular are subject to new requirements under the rule, including a requirement to post the actual certificates of coverage. Entities that rely upon others to provide the SBC now also have a duty to monitor that performance. Please see the attached memo for further information.

What Actions You Should Take

While the rule primarily codified previous guidance and FAQs related to SBCs, and we expect that the biggest changes related to SBCs will be seen when the Agencies finalize the template and instructions, issuers in particular are subject to new requirements under the rule, including a requirement to post the actual certificates of coverage. Entities that rely upon others to provide the SBC now also have a duty to monitor that performance.

Read the full report here.

Contact Steven G. Cosby, MHSA, Group Health Insurance Broker and Agent with Cosby Insurance Group, with questions or to request more information and to schedule a healthcare plan evaluation, savings analysis or group plan solution for your company.

Cosby Insurance Group Warrenton Health Insurance Broker and Agent

Wellness Takes Spotlight As Employers Attempt to Offset Rising Healthcare Costs

Rising healthcare costs and concerns for employees’ financial wellness and retirement preparedness are nudging employers to re-evaluate their benefit offerings.

Wellness programs have jumped notably since 2011, when 60% of employers said they offered some type of wellness programs, according to the Society for Human Resource Management’s 2015 Employee Benefits Survey. In 2015, 70% of employers said they offer wellness programs, up from 62% last year.

“Wellness benefits provide employers with a preventative approach that can reduce health care expenses for organizations over the long haul,” says Evren Esen, director of SHRM’s survey programs. “Rising health care costs also remained a primary driver for how other benefit costs are allocated, as employers are still evaluating the impact of the Affordable Care Act.”

Wellness programs help employers increase engagement and retention, she noted Monday during SHRM’s annual conference in Las Vegas. “We see organizations tackling wellness on a variety of fronts,” she added.

She noted companies implementing wellness programs targeting chronic conditions would likely see the most bang for their buck in the long run. The SHRM research noted another notable spike over the five-year span, with smoking cessation programs jumping 8% and preventive programs specifically targeting employees with chronic conditions jumping 7%.

“When organizations are smart at strategizing benefits, they look at costs and what benefits employees want,” she says. And while savings won’t be immediate, she says including smart programs will prove effective.

Read the full report here.

Contact Steven G. Cosby, MHSA, Group Health Insurance Broker and Agent with Cosby Insurance Group, with questions or to request more information and to schedule a healthcare plan evaluation, savings analysis or group plan solution for your company.

Cosby Insurance Group Warrenton Health Insurance Broker and Agent

Managing Workforce Health Helps Employers Improve Their Overall Bottom Line

A growing body of evidence suggests that employers’ motivations for improving the overall health of their employees should extend far beyond the need to control the inflation of their medical costs.

Poor workforce health management costs employers an estimated $576 billion a year, only 40% of which is attributable to medical costs, according to the San Francisco-based Integrated Benefits Institute. The remaining 60% of those costs represents lost productivity and wage replacement expenses driven by short- and long-term disability and workers compensation claims resulting from untreated or undertreated chronic conditions.

Read the full report here.

Contact Steven Cosby with questions or to request more information and to schedule a healthcare plan evaluation, savings analysis or group plan solution for your company.

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Employees Choose Jobs Based On Benefits

Benefits packages play a major role in whether the majority of people will accept or reject a job, according to the Employee Benefit Research Institute.

More than three-quarters of employees say that the benefits package an employer offers prospective employees is extremely or very important in their decision to take the job, according to the 2013 Health and Voluntary Workplace Benefits Survey.

Thirty-one percent of respondents said they were only somewhat satisfied with the benefits offered by their current employer and 26 percent said they were not satisfied at all.

Read the full report here.