U.S. Department of Labor’s Post

For 50 years, ERISA has been the cornerstone of employer-sponsored health coverage. But employers’ ability to purchase and provide affordable health insurance for employees has diminished as high costs are increasingly being shifted onto workers. Congress can act now to further empower employers to be prudent purchasers of health care. Current bills before Congress would provide employers with better access to their health-care spending data by expanding transparency rules and giving them the force of law. They would also clarify fiduciary obligations of insurers and other parties, such as pharmacy benefit managers. Next year, the 119th Congress and incoming president will have more opportunities to drive accountability from providers and insurers, take up broader reforms to promote competition in health care, and prompt greater transparency. Read my latest in Bloomberg Law: https://lnkd.in/gt8Hj8Di

Negativity is contagious. Negativity can so easily spread through an organization and spoil the culture. I can remember working at an organization, and approaching my medical benefit eligibility period. I began looking into the medical plans to decide which one would be best for my family. I asked a few colleagues for their thoughts on the medical benefit offerings. They responded by telling me "the benefits suck here". Multiple people told me that the medical benefits were so bad that they decided to purchase their own private plans. People who never even used the benefits would say "I am on my husbands plan because the medical here is terrible". They were basing this off of what they heard from others. Conversations would then branch out in to all of the reasons why the company I was working for was not a good company. Colleagues felt that the organization did not care about it's employees because they offered "poor" medical insurance. This lead to a fractured organizational culture. I began to believe what I was being told. But, I needed medical coverage so I enrolled in the base medical plan. To my surprise, the coverage was excellent. I never had an issue getting a claim processed. All expenses were either exactly what I expected, or lower. I also had FREE virtual care, and was able to earn MONEY for maintaining a heathy life style. In addition to that, the company offered a $500 preloaded card to pay copays and other medical expenses. However, the card had to be requested through the insurance app and most employees didn't know anything about it. What I noticed: A. Remarks were coming mostly from the people who had been with the organization the longest. Once upon a time, all medical benefits used to be completely free for employees. However, eventually with the ever rising cost of healthcare and the organization's growth, the company had to start charging its employees a portion of the benefit costs. C. Employees were NOT educated on how to maximize their health benefits. Education about benefits is necessary. It can reduce misconceptions and show the employee how to save money and maximize their benefits. This will show employees that their employer cares about them. Negativity spreads. By understanding what is causing it, an organization can implement small changes that will significantly reduce the threat.

👉 What is TCC for FEHB (Federal Employee Health Benefits) program? TCC allows certain individuals to temporarily continue their FEHB coverage after regular coverage ends #FEHB #Healthcare #TCC #FederalBenefits

While the allure of high deductible health plans (HDHPs) are obvious (i.e. lower premiums and HSAs), it is important to remember these plans also come with higher deductibles and out-of-pocket maximums. As such, employers looking to bolster their coverages should consider offering ancillary benefits. These can include accident insurance, long term/short term disability, and hospital indemnity plans (just to name a few). In terms of cost-to-benefit, these plans can sometimes deliver more financial relief than bolstering the medical plan itself. Obviously, this approach is group dependent, but for employers with limited resources, a HDHP combined with strong ancillary coverages can be a great way to help protect your employees. https://lnkd.in/g4WyyJuy

Lest everyone thought that the CAA would just go away after the end of the year…….surprise, it hasn’t. The requirements and changes being required because of CAA are becoming more and more apparent to all players in healthcare and employer fiduciaries have big responsibilities requiring big changes in the way that they manage their plans and contract for services. This is a good primer piece that outlines many of the new requirements and issues a few ‘bigs’ of which are described here: “It is the second provision that concerns the National Association of Benefits and Insurance Professionals and its members. Health plan brokers and consultants must provide specific service and compensation disclosures for their contracts or arrangements to be considered “reasonable.” Plan fiduciaries must review those disclosures prior to entering into, extending, or renewing the arrangement and concluding the compensation is reasonable. That part is not new, Berman explained. "The new law is to publicly disclose the amount that is being paid to a provider for certain procedures," she said. The provider codes need to be made publicly available in advance before plan participants get their Explanation Of Benefits. "There's advanced EOB requirements, so that you could see in advance how much you're going to have to pay if you go to the hospital and have an in network or out of network procedure," Berman said. "You need to be able to see what you would end up paying in advance." #employers #fiduicary #employeebenefits #compliance #brokers #disclosure Christine Arnold Steve Schutzer, MD John Rodis, MD Lisa Trumble Karyn Gilbert Moving to Value Alliance Chris Deacon Jamie Greenleaf AIF, CBFA, C(k)P Julie Selesnick Scott Haas Al Lewis 🇺🇦 Jill Hummel Stuart Sutley Kathy McKeon, R.N., M.P.H.CSM A. J. Loiacono Kristin Begley Raju Kattumenu Darren Fogarty Elizabeth Mitchell Peter Hayes Dan Burke Michelle Bowers Tim Denman Josh M. Berlin Wyatt Bosworth Kerry Wood Michael Brouthers Patrick Long Justin Venneri Derek Baird Michael Hennessy Christopher Tucker Geoff Matous Cora Opsahl Christopher Gormley Les Wilkinson John Bass Ann M. Richardson, MBA Stacey Richter Eric Weaver, DHA, MHA

As an employer, providing health insurance to your employees is crucial, but it's not the only responsibility you have. By offering financial literacy education surrounding healthcare, employees can make informed decisions about their coverage and savings options. This education can empower employees to maximize the benefits of their health insurance, and understand more about their choices. For example, knowing whether or not to open a Health Savings Account and understanding how to report contributions and withdrawals to the IRS accurately can help teams make wise choices when it comes to their healthcare. By investing in the financial well-being of your employees, you are not only supporting their health and financial security but also fostering a culture of transparency and trust within your organization. Don't overlook the impact that financial literacy education can have on the overall well-being of your workforce. #FinancialLiteracy #HealthCare #HealthSavingsAccount #EmployeeBenefits

To prepare for open enrollment, employers should be aware of the legal changes affecting the design and administration of their health plans for plan years beginning on or after Jan. 1, 2025. The below Compliance Overview includes an open enrollment checklist for the 2025 plan year. ✅📒 Kelly Insurance & Investments, Inc. | Kelly Financial Advisors, LLC #openenrollment #employeebenefits #medical #healthinsurance

A growing trend sees younger generations favoring high-deductible health plans (HDHPs) often paired with health savings accounts (HSAs). This is due to their lower monthly premiums. Benefitfocus, a benefits administration provider, reports 45% of Gen Z, 43% of millennials, and 30% of Gen X employees participate in HDHPs this year. In response, employers are expanding health insurance options. Benefitfocus' 2024 State of Employee Benefits report reveals 84% of employers now offer both traditional and HDHP plans. This wider range caters to different needs across generations and personal circumstances. Learn more: https://hubs.ly/Q02DYhfg0

Help is on the way. There is a good chance that the various class action suits that resulted in employers doing a better job monitoring the administration of retirement benefits and administrative costs will soon come to health insurance. That change, and also possible regulations by the U.S. Department of Labor, will help ensure that employers actually perform their fiduciary oversight to ensure that health benefits are efficiently and properly administered, something that is NOT occurring at present. https://lnkd.in/gBeWGefk

I've thought for years that we would hit a certain price point for health plans that would hurt enough that is would get employers to move away form "status quo" Big Carrier health plans, but the transition has been very slow. Employers pay more, employees get less, and the Big Health Insurance carriers (BUCAs) get rich. Well this just might be the motivation it takes to get employers to move to plans that are more cost effective for both them and their employees. BTW - employers don't have to sacrifice quality of care, they can probably actually improve it. I believe this was part of the motivation behind the Kraft Heinz vs. Aetna lawsuit, Kraft Heinz wanted to get out ahead of the coming tidal wave. If you think the wave of 401(k) litigation was big, just think about the amount of money that flows through health plans vs. 401(k) plans, big difference.