Monthly archives for November, 2014

Why should a Company do a HealthPlan ...

Why should a Company do a HealthPlan ERISA Audit through ARC?
Background: Companies regularly conduct, or bring in outside audits, of their healthplan benefits. If they have done this for years, and always reported a “clean bill of health”, why should they now expend effort and cost to have an external audit by ARC ERISA experts?   Top-3 Reasons: If an insurance intermediary has intentionally ma [...]

Is Self-Funding right for you?

Is Self-Funding right for you?
Is Self-Funding right for you? Self-funding is an effective method for taking control of health care expenditures and creating financial & operational efficiencies that inure to the benefit of both the employer and its employees. These benefits require a long-term commitment, which, like any long-term fiscal decision, requires a sound u [...]

4-year high premium increase projecte...

4-year high premium increase projected
BY KATHRYN MAYER November 13, 2014 • Photo: Getty Images   Employer-paid premiums are increasing yet again with a 5.5 percent rise forecast for 2015, the biggest such increase in the last few years, according to new analysis. Meanwhile, employees’ share of the cost is growing at a much higher rate. Aon Hewitt’s analysis showed [...]

On Nov. 5, 2014, federal Court of App...

On Nov. 5, 2014, federal Court of Appeals ruled for out-of-network provider’s ERISA right to sue UnitedHealth on behalf of patients for out-of-network deductible waiver claim denials.
On Nov. 5, 2014, federal Court of Appeals ruled for out-of-network provider’s ERISA right to sue UnitedHealth on behalf of patients for out-of-network deductible waiver claim denials. In a much anticipated case, the 9th Circuit sided with Spinedex Physical Therapy USA Inc., saying the clinic had standing to sue because the plan beneficiaries [...]

Legal update

Legal update
U.S. high court declines BCBSM’s appeal; $6 million judgment stands over hidden fees Originally Published: October 20, 2014 6:11 PM  Modified: October 21, 2014 3:07 PM Blue Cross Blue Shield of Michigan’s long court battle with an automotive supplier that maintains a design center in Rochester Hills appears to be over, after the U.S. [...]