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Question of the Month

May a Plan Impose a New Waiting Period on a Rehired Employee?

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INSURANCE SPOTLIGHT

June 17, 2016

Carrier News

Premera's New Pay-As-Billed 
Premera Blue Cross is moving to a pay-as-billed approach for all groups fully insured and self-funded groups with 51 or more employees. Groups are asked to pay August invoices in full as billed by Aug. 1, 2016. This change will reduce the time employers and Premera spend reconciling monthly invoices. Read more
 
Regence BlueShield - Open Enrollment Videos
director-items.jpg Regence has put together animated Open Enrollment video capsules designed to help Employers reach out to and educate their employees on a range of topics, from understanding health insurance and HSAs to choosing a plan and understanding plan features.  They are available in both English and Spanish (Spanish videos 5-7 are still in production). Video Capsule

HealthEquity Mobile App
The HealthEquity mobile is available for download in the Apple App Store and Google Pay Store. HealthEquity's mobile app provides easy access to a member's account wherever they are.  Read more.

United Health Care Updated Prescription Drug List
Review the latest PDL Tracker for a recap of changes outside of UHC's January 1 and July 1 pharmacy benefit updates.

Federal & State News

Reminder - 1095 Reporting Due June 30th
The Affordable Care Act (ACA) requires "large employers" to Reminder report to the Internal Revenue Service (IRS) information regarding all full-time employees to whom they offered health coverage, called "Large Employer Reporting." Insurers and self-insured health plans must also submit reports to the IRS regarding individuals who were enrolled in their health coverage at any point during 2015, called "Minimum Essential Coverage (MEC) Reporting."

We assisted many groups with their reporting this year but for the few that elected to handle it themselves the deadline for electronic filing is June 30th. Read more

No Waiting Periods on Pediatric Orthodontia
CMS has issued a single FAQ reversing its position regarding benefit-specific waiting periods for pediatric orthodontia. In a previous FAQ, CMS excepted pediatric orthodontia from the general rule that health insurers are prohibited from imposing benefit-specific waiting periods in plans that must provide coverage of essential health benefits (generally, fully insured individual and small group plans). After further consideration, CMS has removed the exception for pediatric orthodontia. Read more
Health & Wellness
Zika Virus
In May 2015, the Zika virus was confirmed in Brazil. Since then, there's been mosquito-borne and sexual transmission in South and Central America, as well as in Puerto Rico, the U.S. Virgin Islands and American Samoa. The threat of serious illness from the Zika virus is low; however, all people, especially pregnant women and both men and women who are considering having children, should know the facts about Zika. Read more

Rehabbing Our Ideas About Addiction
In 1980, our roads were seven times deadlier than our drugs. But in 2008, drug overdoses surpassed car crashes to become the No. 1 cause of accidental death in the U.S., killing almost 50,000 Americans in 2014, the latest year on record. This epidemic is due almost entirely to the alarming rise of one class of drugs: Opioids, which include prescription painkillers and heroin, killed nearly 30,000 Americans in 2014, up from just under 10,000 in 2001. Read the full article.

June is Men's Health Awareness Month
Check out UnitedHealthcare's June newsletter to learn more about health issues that are important for men.
If you have any questions about the articles contained in this newsletter, please give us a call or e-mail us: