The Zywave Health Plan Design Benchmark Report is based consistently on data from nearly 50,000 employers and 70,000 plans. The report offers benchmarking information on six key plan design measures:
· Individual out-of-pocket maximum
· Individual deductible
· Emergency room copay
· Office visit copay
· Prescription drug deductible
To help employers compare their plan design offerings against similar organizations and plans, we’ve broken down the data by region, group size, industry and plan type for each plan design measure above.
This is a summary document analyzing the data set as a whole and comparing against previous years’ data. To view a report of how your specific plan design measures up in your region and industry, talk to your broker.
On March 12, 2014, the DOL issued a proposed rule that would require retirement plan service providers to furnish employers and other plan fiduciaries with a guide to assist them in navigating required fee disclosure documents, if the disclosures are contained in multiple or lengthy documents.
The proposal would amend the final rule under section 408(b)(2) of the Employee Retirement Income Security Act (ERISA). The final rule establishes specific disclosure obligations for retirement plan service providers to ensure that plan fiduciaries are provided with the information they need for selecting and monitoring plan service providers. Service providers were required to comply with the fee disclosure requirements by July 1, 2012.
Service providers often provide the required disclosures in multiple documents from different sources, or in single documents that are lengthy. According to the DOL, plan fiduciaries, especially in the case of small plans, need a tool to effectively make use of the required disclosures. The proposed guide is intended to assist plan fiduciaries by ensuring that the location of all information required to be disclosed is clear and easy to find.
On March 28, 2014, the Internal Revenue
Service (IRS) released an Office of Chief Counsel Memorandum to provide information on how health
flexible spending account (FSA) carryovers affect eligibility for health savings accounts (HSAs).
Although the IRS memorandum is not official guidance, it helps clarify the IRS’ position on health
FSA carryovers and HSA eligibility.
In the memorandum, the IRS provides that an individual who carries over unused funds from a prior
year to a current year under a general purpose health FSA will not be eligible for HSA
contributions for the entire current plan year (even for months after the health FSA no longer has
any amounts available to pay or reimburse medical expenses).
However, the memorandum offers some alternative approaches that allow health FSA carryovers while
preserving HSA eligibility. These approaches include carrying over unused amounts to an
HSA-compatible health FSA and allowing individuals participating in a general
purpose FSA to decline or waive the carryover.
On April 1, 2014, President Obama signed the Protecting Access to Medicare Act of 2014 (Act) into law. The Act’s main provisions preserve the pay rate for physicians treating Medicare patients and delay the compliance deadline for converting to the updated International Classification of Diseases codes for at least one year.
The Act also eliminates the Affordable Care Act’s (ACA) annual deductible limit that applied to health plans in the small group market. This change is retroactively effective to when the ACA was enacted in March 2010.
The Act does NOT eliminate the ACA’s out-of-pocket maximum, which applies to all non-grandfathered health plans for plan years beginning on or after Jan. 1, 2014.
With both time and resources at a precious premium, it’s become increasingly difficult to do your job—let alone manage insurance costs and stay informed on legislative developments.
Axial University, our new technology solution, directly responds to this challenge. This online tool acts as a resource for all your HR, benefits, risk management, OSHA and other business needs—with thousands of easily searchable on-demand resources at your fingertips.
Join us for a webinar on Thursday, April 24th at 10am to view all that Axial University has to offer.
Massachusetts health officials are poised to achieve their primary stated goal during the ObamaCare website debacle: keeping the vast majority of people covered by health insurance to avoid backsliding on the success of Massachusetts health reform.
Perhaps after reading too many voluminous, jargon-filled fee disclosure agreements, the Department of Labor became fed up and decided to take action. On March 12, the DOL issued a proposed rule (“the Proposed Rule”) that would amend its final service provider fee disclosure regulation (“the Final Rule”) under ERISA Section 408(b)(2).
The Proposed Rule will require covered service providers to pension plans (including 401(k) plans) to provide a guide to assist plan fiduciaries in reviewing disclosures required by the Final Rule where such disclosures are contained in “multiple or lengthy documents.” The Proposed Rule will not require covered service providers to provide this new guide if they already furnish the required initial disclosures to plan fiduciaries in a “concise, single document.” The guide will have to identify the specific page number, section or specific location of documents containing important information about the service provider’s relationship to the plan, including information about compensation, fees and the services provided.
The Affordable Care Act (ACA) imposes a penalty on large employers that do not offer minimum essential coverage to "substantially all" full-time employees and dependents. Large employers that do offer coverage may still be liable for a penalty if the coverage is unaffordable or does not provide minimum value.
On Feb. 12, 2014, the IRS published final regulations on the ACA’s employer shared responsibility rules. These regulations finalize provisions in proposed regulations released by the IRS on Jan. 2, 2013. Under the final regulations, applicable large employers that have fewer than 100 full-time employees generally will have an additional year, until 2016, to comply with the pay or play rules. Large employers with 100 or more full-time employees must comply with the pay or play rules starting in 2015.
The state's three largest health insurers all saw shrinking net income and operating income in 2013, at least partly due to necessary investments to comply with and succeed under the Affordable Care Act, or Obamacare.
The Affordable Care Act (ACA) requires health insurance issuers, self-insured health plan sponsors, government agencies that administer government-sponsored health insurance programs and any other entity that provides minimum essential coverage (MEC) to report information on that coverage to the IRS and covered individuals. This requirement is found in Internal Revenue Code section 6055.
On March 5, 2014, the IRS released final regulations on the section 6055 reporting requirements. These regulations finalize proposed rules issued on Sept. 5, 2013.
The final regulations apply for calendar years beginning after Dec. 31, 2014. This date reflects the one-year delay provided in IRS Notice 2013-45. However, the IRS is encouraging voluntary compliance for 2014.
These reporting requirements are intended to provide the IRS with information necessary to administer other ACA mandates, such as the large employer shared responsibility penalty and the individual mandate.
This communication is strictly intended for individuals residing in the states of AR, AZ, CA, CO, CT, DC, DE, FL, GA, IL, IN, KS, MA, MD, ME, MI, MN, MO, MS, MT, NC, NE, NH, NJ, NM, NV, NY, OH, OR, PA, RI, SC, TX, UT, VA, VT, WA, WI. No offers may be made or accepted from any resident outside these states due to various state regulations and registration requirements regarding investment products and services. Securities and advisory services offered through Commonwealth Financial Network, Member FINRA (www.finra.org) / SIPC (www.sipc.org), a Registered Investment Adviser. Fixed insurance products and services offered by Axial Benefits Group are separate and unrelated to Commonwealth.
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