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Provider agreement gag clauses restricting access to price and quality info prohibited

Provider agreement gag clauses restricting access to price and quality info prohibited

by The Lawyers | Mar 22, 2023 | Compliance, Dept of Labor, Employee Benefits, ERISA, Pharmacy

Compliance Alert: Guidance issued on gag clause prohibitions The new compliance obligations that the Consolidated Appropriations Act of 2021 (CAA, 21) created for employer-sponsored plans can seem endless at times.  One of the lesser-known parts of the CAA, 21 is the...
Don’t be Surprised by 2021 Surprise Billing Protections

Don’t be Surprised by 2021 Surprise Billing Protections

by The Lawyers | Sep 28, 2022 | Compliance, Dept of Labor, ERISA, Labor Law, Plan Design

Compliance Alert: Additional Guidance Issued on Surprise Billing Protections The Consolidated Appropriations Act of 2021 (CAA) introduced numerous protections against surprise billing for plan participants that impact group health plans, health insurance issuers, and...
Tip 23: Skeletons in the Closet

Tip 23: Skeletons in the Closet

by Bret Brummitt | Sep 10, 2022 | 30 for 30, ACA, Compliance, Dept of Labor, Employee Benefits

Now is the time to make sure your Insurance Contracts match your Employment Practices   There are so many one-off agreements and handshake arrangements and special provisions granted to one employee or maybe a certain category of employees. Often when we review...
Tip 24:  Tips for your Census Data

Tip 24: Tips for your Census Data

by Bret Brummitt | Sep 9, 2022 | 30 for 30, Employee Benefits, Health Insurance

Creating a Census for your Renewal isn’t as easy as you’d think   When a broker or insurance company asks for a census, they want to specifically know the important demographic data they use to build a pricing option for you. Different plans require...
Tip 25: Learn about Cost Containment Strategies

Tip 25: Learn about Cost Containment Strategies

by Bret Brummitt | Sep 8, 2022 | 30 for 30, Employee Benefits, Health Insurance, Health Rosetta, Pharmacy, Plan Design, Plan Design

Tip # 25: Become well versed in Cost Containment Strategies   Strategic decisions are not made on a spreadsheet when there are factors in the real world that influence cost, quality, and access to health care. There are a plethora of cost containment vendors in...
Should I Explore Self-Insured or Level-Funded Options?

Should I Explore Self-Insured or Level-Funded Options?

by Bret Brummitt | Sep 7, 2022 | 30 for 30, Data Analytics, Health Insurance, Plan Design, Plan Design

Should you Explore a Self-Insured or Level-Funded option instead of Fully-Insured?   The simple answer is yes.  You owe it to yourself and your company to make sure that you explore all options.  What you may find surprising is that this may actually be a really...
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