The Affordable Care Act (ACA) reporting for employers can be confusing, burdensome, and time-consuming. Most of the reporting requirements have not changed, but every year we see employers rushing to complete the requirements before the deadline. One of our partners, Benefit Advisors Network, has put together a resourceful guide with instructions and forms for the 2020 employer reporting requirements. 

The Medical Loss Ratio obligations under the ACA cap the percentage of premium dollars health insurers may use for administration, marketing, and profits. If a health insurer collects more than the allowed amount for these spending categories, they must provide a rebate to affected groups. A few of the medical carriers have recently sent out Medical Loss Ratio (MLR) rebates, so it’s important to know what can be done with that money. If employees paid any portion of the monthly premiums, employers will likely need to share the rebate with them.

The ever-growing prescription drug industry has long been ripe for innovation and disruption. At the same time, members struggle to manage the many prescriptions they may need to take at the same time.  As the cost of many prescription medications continues to be very high, Americans are increasingly looking outside traditional pharmacies for purchasing alternatives. One of these newer alternatives is PillPack, which was purchased in May 2018 by Amazon, and may actually help members improve their medication compliance, a key metric in improving health.

In mid-April, CO SHRM and the Denver Regional Council of Governments conducted a survey about how employers are handling returning to the workplace and teleworking after COVID. The survey was completed by over 350 human resource professionals from across the state of Colorado. 

Life has become more challenging for most of us as we sift through the various demands COVID-19 has added to our work and personal lives. The financial concerns of individuals and companies is just one area of added stress we’re facing. Since March 4, 2020, there have been four COVID-19 relief acts put in place, with possibly more to come. 

Are you wondering how to start an impactful wellness program? Or maybe you are frustrated that your existing wellness program doesn’t seem to be getting traction? Perhaps you are missing a key ingredient in the recipe for success. Come learn how to shift the wellness paradigm within your organization during our upcoming webinars “The Missing Ingredient in Wellness Programs.” 

At Fall River we’re always keeping our eyes on hot topics in the benefits world. As 2019 closes out, we are bringing you news on three potential developments: legislation preventing surprise hospital bills, the Texas v U.S. court case regarding the validity of the ACA, and the potential for a paid parental leave policy for federal workers. 

Evaluating your current benefit plans with the intent to attract and retain top talent is more crucial than ever. Benefits benchmarking gives employers the chance to compare their current plans and contribution strategy to that of the competitors. Fall River helps our clients understand how they stack up, and we will soon be sharing a new benchmarking document. When was the last time you measured your benefits package against other Colorado employers?

Direct Primary Care (DPC), aka “concierge medicine,” is an alternative provider payment model gaining traction with employers who are tired of high health insurance rates and their employees not receiving the care they need. Instead of billing the insurance carrier for routine care, DPC providers usually charge a monthly flat fee which allows the member access to unlimited routine services such as laboratory services, same-day or next-day appointments, and sometimes even house calls. The savings generated by this model can certainly benefit companies, especially those that are self-funding their plans.

While the legislative session in early 2019 included proposals in civil rights, economic security, and educational programs, there was also a large focus on healthcare initiatives. Coloradans continue to express concern about the affordability and access to quality healthcare coverage, and the state legislators believe they are making important strides toward addressing these challenges.