Posts Tagged ‘health care’

Two Considerations For The Marketplace Open Enrollment Period

Tuesday, December 20th, 2016

The post below is a guest blog from Jay Lowe who serves as Principal, Health & Welfare Consultant for CAI’s employee benefits partner Hill, Chesson & Woody.

The Affordable Care Act provides the ability for individuals to buy coverage regardless of any underlying medical condition.  This guaranteed issue provision has provided millions of Americans the access to health care that was not there before.  Many who had access to group coverage have also shifted either themselves or dependents to individual plans when their group plans were too expensive or did not provide the coverage they needed.

This year’s annual Open Enrollment Period for the Marketplace has opened and we are seeing, on average, a 25% increase to the cost of individual plans.  This cost increase is forcing many who are enrolled there to re-evaluate if an individual plan is still the best option for them when other group coverage is available through an employer.  When making this decision around where to be covered, there are two important items that should be understood about moving onto or coming off of an employer-sponsored health plan.

First, the annual Open Enrollment Period for the Marketplace is not considered a qualifying event under the IRS guidelines to allow someone to drop their individual policy and enroll in an employer-sponsored group plan.  There seems to be a common misconception around this with both employers and employees.  As the costs for individual plans continue to rise, many are looking for ways to move back to an employer’s plan.  The only instance in which someone could leave their individual plan and move onto their employer’s group plan is if the group plan is in an open enrollment period.

Another thing to consider is that the Marketplace Open Enrollment Period is not a qualifying event that will allow someone to drop a spouse or dependent from their group plan (unless the group plan’s annual open enrollment period coincides.)  So those who may be considering moving a dependent to an individual plan would not have the ability to do so at that time.  However, a special provision in the rules does allow an employee the ability to make a mid-year revocation of their group plan (outside of the group’s open enrollment) and enroll in Marketplace coverage.  In order for an employee to move a spouse or dependent to an individual plan during the Marketplace Open Enrollment Period, the employee must also drop coverage for him or herself too.

Given the rising costs of individual plans it seems unlikely that many will want to shift away from the group coverage.  It is important for employers to know the rules around allowing employees to come on and off of their plans outside of their annual open enrollment period.  Employees should understand the potential pitfalls of shifting away their group plan as that could create the opposite impact of what they are trying to achieve.

Marketplace Premiums Will Continue To Trend Upward In 2017

Tuesday, July 19th, 2016

marketplaceblogThe post below is a guest blog from Jay Lowe who serves as Principal, Health & Welfare Consultant for CAI’s employee benefits partner Hill, Chesson & Woody.

Now is the time when insurance carriers will begin determining premium pricing for their individual plans and filing for approval with state departments of insurance.  Undoubtedly, their goal will be to offer plans that meet the needs of most, maintain competitive pricing, and avoid losses associated with not being able to underwrite or deny coverage during the Annual Enrollment Period (AEP) or Special Enrollment Periods (SEP).  The Kaiser Family Foundation discusses some of the challenges that insurers will continue to face when determining rates for the upcoming calendar year.  One challenge that is of interest continues to be those individuals that remain uninsured.  The Kaiser article indicates that these uninsured individuals are generally healthier and their enrollment would help to offset costs as they are expected to have a fewer health care claims.  The Individual Mandate provision of the ACA requires everyone to have coverage, or else face a penalty.  In 2016, that penalty is $695 or 2.5% of household income, whichever is greater.  In 2017, these penalties will be adjusted upward for inflation.  As these penalties continue to rise it will be interesting to see how many people continue to remain uninsured and if their eventual compliance with the Individual Mandate actually has a positive impact on rates.

In North Carolina, the pricing challenge becomes more difficult in 2017 as one major carrier, United Healthcare, is pulling their individual plans from the Marketplace (where individuals can receive a federal subsidy for insurance premiums) as they have decided to no longer participate in this state. This will leave our state with only 1 major carrier offering subsidy-eligible plans, Blue Cross Blue Shield of North Carolina.   This may put additional pricing pressure on BCBSNC and drive their premiums even higher.  They have already been forced to make dramatic network changes in an effort to keep pricing at acceptable levels with both their members as well as the NC Department of Insurance.  Time will tell if these changes create more stability in premium pricing.

As 2017 approaches, those with individual insurance plans will be anxious to see what their premium increases will be for the next year.  Double-digit increases in the 20-30% range would not be a surprise as insurance carriers may still be trying to offset losses from prior years.  State Departments of Insurance will be responsible for approving any increase requests and plan design changes, as the carriers will most likely adjust benefit levels to maximum premium savings.  Regarding the Marketplace departure of United Healthcare in 2017, small group employers need to understand that UHC will continue to offer group-based plans.  With moving away from the Marketplace, UHC is looking 2-3 years to the future to ensure that they will continue to be competitive with individual plans outside of the Marketplace, as well as with their small group plans.  In North Carolina, will BCBSNC follow suit?  Time will tell.

Can We Control Healthcare Cost By Utilizing Medicare?

Tuesday, March 22nd, 2016

hcwhealthcarepicThe post below is a guest blog from Dax Hill who serves as Principal, Health & Welfare Consultant for CAI’s employee benefits partner Hill, Chesson & Woody.

Did you know Medicare reimbursement rates for healthcare are typically lower than reimbursement rates paid by insurance companies?  Some employers are taking notice and indexing their employer reimbursement rates to the Medicare rates in hopes of trying to control their medical claims spent.

This arrangement is typically called “Reference Based Contracting” or a “Cost Plus” program.

There are many flavors of these types of programs, but here’s how these funding arrangements generally work….

  • An employer self-funds their medical insurance plan utilizing a Third Party Administrator (TPA)
  • The TPA partners with a network of doctors to provide discounts on medical services for “professional” charges. The medical reimbursement rates are based on the negotiated charges agreed upon by the network and doctors….this is similar to most of the current arrangements.
  • For “facility” charges, though, things get interesting. Instead of using the typical insurance carrier’s negotiated rates, reimbursements are based on Medicare reimbursement rates. For example, the TPA agrees to reimburse the medical facility at 120% of the Medicare allowed amount.  Medicare reimbursement rates are generally much lower than the typical insurance carrier negotiated rates.  These lower reimbursements (indexed to Medicare) can lead to claims savings to both the employer and employee.

All of this sounds good so far – who doesn’t want to pay a lower price?  There must be some catch, right?  The main concern for these programs is this: what happens if the hospital or medical facility push back and do not accept the employer/TPA reimbursement rates?  The amounts over the employer’s allowed price gets transferred to the employee.

For example, let’s say an employee receives a $5,000 medical procedure and the employer’s allowed amount is $1,000.  In this scenario, the hospital may decide to “balance bill” the employee for the $4,000 difference.  It is important for the employee to appeal this balance bill.  Most TPAs that focus in this market partner with legal counsel that represent the employee at no additional cost to the employee.  The attorney handles the appeal for the employee.  The attorney will send the medical facility a letter stating the reimbursement is adhering to the employers ERISA plan document and the employee should not be balanced bill.  The attorney explains that the employer and employee are paying above what’s normally acceptable (since most of the facility’s patients are covered by Medicare).

At some point, hospitals and facilities will become more aggressive in trying to 1) collect the balance bill from the employee 2) refuse to provide healthcare to individuals that are enrolled on these types of insurance plans or 3) negotiate on the allowed amount.  In the meantime, these plans are getting attention of employers as they try to best manage their healthcare cost.

Take a look at the pros and cons of Reference Based Pricing and the key considerations employers should look at prior to implementing these plans in this white paper.

Employers Need To Be Prepared For The Cadillac Tax

Tuesday, November 18th, 2014

The post below is a guest blog from Mike Beck who serves as Principal, Health & Welfare Consultant for CAI’s employee benefits partner Hill, Chesson & Woody.

cadillac taxWhile most employers are focused on managing through 2015 and the upcoming employer mandate, the Cadillac Tax will present another significant challenge for many in 2018 and deserves attention.

The Cadillac Tax is an excise tax on health coverage deemed to be high cost.  The tax begins in 2018, and levies a 40 percent excise on the value of health insurance benefits exceeding the threshold of $10,200 for individual coverage and $27,500 for family coverage (indexed to inflation) on an annual basis. The thresholds increase for individuals in high-risk professions e.g. police officers/fireman and for employers that have a disproportionately older population.

While these thresholds seem high for some, when most evaluate their current premium and apply three years of  a trend increase to it, it is easy to see how in  2018 many employers will be  close to hitting or even exceeding the thresholds.  Industry estimates show that nearly 50% of employers will be impacted in 2018.  Making matters worse, it is not just the cost of health insurance that goes into the calculation.  Employer or employee contributions to a health flexible spending accounts must be included as well as employer contributions health savings accounts and health reimbursement accounts (HRAs).

The outcome is that employers will likely have to reduce the value of the plan they are offering, reduce the limit of their Flexible Spending Account, and eliminate any employer contributions to an H.S.A. or a combination of these tactics in an effort to avoid the tax.

The tax will apply to employers regardless of plan funding (fully insured or self insured) and is scheduled to begin in 2018 and go into perpetuity.  The tax is non deductible for employers so many employers may experience an increased tax burden due to the loss of deductibility.  The Congressional Budget Office estimates the tax will raise $80 billion between 2014 and 2023.

Employer reaction has been mixed with many taking a wait and see attitude and delaying a decision as long as possible.  In a recent survey of 333 large employers by the National Business Coalition on Health and the Benz Corp, according to the results, “the Cadillac Tax is currently not driving major benefit change.”  Of the employers surveyed, 30 percent have not made any decisions around their course of action with 46 percent of employers keeping benefit coverage the same.

Since the inception of the Affordable Care Act (ACA) there has been wide talk that the Cadillac Tax would be repealed.  Pundits proclaimed that large employers and unions would not stand for it.  As the ACA marches on, the Cadillac Tax is becoming more and more of a reality.  Congress is counting on the tax to be a major source of revenue so repealing the Tax could be unlikely.  There is a possibility that the Cadillac Tax could be redesigned or some form of compromise reached.  The long term impact to employees will most likely be reduced benefits and higher out of pocket costs which may create morale and retention issues.

Employers need to plan now and estimate what the potential costs of the Cadillac Tax to be for their organization and determine a strategy moving forward.

 

 

Shifting Sands in the Small Group Market Under the Affordable Care Act

Thursday, April 24th, 2014

The post below is a guest blog from Steve Byrd who serves as Principal, Health & Welfare Consultant  for CAI’s employee benefits partner Hill, Chesson & Woody.

 hcw april picMany questions have arisen from the ever changing Affordable Care Act (ACA), specifically amongst the small group employers. Many feel as though they have been left out in the cold with more questions than answers when it comes to the changing regulations.

“Should I renew early and what happens if I do? How do I handle the new small group age rates? How do I communicate the new benefit changes concerning, smoker rates, out-of-pocket maximums, age-rated premium schedules, metallic levels, pharmacy MAC pricing changes, pediatric dental/ vision changes, and deductible limit requirements?”

With new regulations published every week and a variety of health-care related bills moving through Congress every day, it is difficult for a large company much less a small employer, to keep up with the changes.

One bill recently passed through Congress and signed by the President (Protecting Access to Medicare Act of 2014)) is worthy of special attention by small employers. This bill, known as the “doc fix” bill, includes a section that ends the limitations on deductibles for small group employer-sponsored health plans that was previously imposed by the Affordable Care Act.

Prior to passage of this bill, deductible levels of no more than $2,000 for individuals and $4,000 for families were required in the small group market. This deductible cap made it extremely difficult for small group carriers to offer a wide range of plan designs within their small group plan offerings.

Small group carriers struggled to design plans that met the deductible requirements while also meeting the required Actuarial Value (AV) bands. The ACA requires small group carriers to offer plans at four specific AV levels (called Metallic Levels): Platinum (90%), Gold (80%), Silver (70%), and Bronze (60%). Deviations of no more than 2% are allowed. To operate within these Metallic Levels, many small group carriers made changes that resulted in higher per occurrence copays and increased costs for non-generic medications.

The passage of the Protecting Access to Medicare Act of 2014 allows carriers designing plans for the small group market to move beyond the $2,000/$4,000 deductible level and still meet the required Metallic Levels. It also allows small employers to remain creative in their plan designs, especially those that have focused benefits strategies around Consumer Driven Health Plans. To find out more about this recent change to the ACA, continue on to Robb Mandelbaum’s coverage on the “doc fix” bill.

SCOTUS Strikes Down DOMA – What Employer Group Health Plans Can Expect Next

Thursday, July 18th, 2013

The post below is a guest blog from Lindsey Surratt, JD, who serves as Compliance Officer for CAI’s employee benefits partner, HCW Employee Benefit Services.

DOMA ringsThe Supreme Court of the United States has invalidated Section 3 of the federal Defense of Marriage Act (DOMA) – a landmark decision that will result in significant changes to the employee benefits landscape for same-sex couples legally married in a state.  Section 3 of DOMA amends the Dictionary Act in Title I, Section 7 of the United States Code to provide a federal definition of “marriage” and “spouse.”  Section 2 of DOMA, which was not challenged in United States vs. Windsor, allows states to refuse to recognize same-sex marriages performed under the laws of other states. Section 3 of DOMA reads as follows:

“In determining the meaning of any Act of Congress, or of any ruling, regulation, or interpretation of the various administrative bureaus and agencies of the United States, the word ‘marriage’ means only a legal union between one man and one woman as husband and wife, and the word ‘spouse’ refers only to a person of the opposite sex who is a husband or a wife.”

Section 3 of DOMA provided the federal definition of “marriage” and “spouse” for purposes of all federal statutes and regulations that controlled over 1,000 federal laws in which marital or spousal status is addressed as a matter of federal law.  Specifically with regard to employee health and welfare benefits, same-sex spouses legally married within a state will now qualify for the following, among other federal benefits:

  • FMLA leave to care for their same-sex spouse if the spouse experiences a serious health condition
  • Premium contributions* and reimbursements on a federal tax-favored basis
  • No FICA or FUTA tax on employer coverage provided to the same-sex spouse*
  • An independent right to elect COBRA for employer-sponsored group health plans*
  • HIPAA special enrollment rights* when a same-sex spouse loses coverage under another employer sponsored      plan
  • Ability to use pre-tax funds from a DCAP to pay for care of a same-sex spouse’s dependent

*The decision in United States vs. Windsor does not appear to require employers to offer eligibility for the employer’s group health plan to same-sex spouses legally married in another state if the state in which the employer’s insurance contract is written does not recognize same-sex marriages performed in other states.  This issue may remain a matter of state law.  Employers should review the laws of the state(s) in which they operate to determine the impact of this decision on the eligibility provisions in their insurance contracts and plan documents.  Generally, the benefits indicated by an asterisk above would only apply if same-sex spouses are eligible for coverage under the employer’s group health plan.

Individual states still seem to have the ability to define “marriage” and “spouse” for purposes of state law, and to refuse to recognize same-sex marriages performed under the laws of other states.  As a result, employer group health plan sponsors should review the definition of “spouse” contained in their carrier contracts and other plan documents.  Employer plan sponsors may also face administrative challenges, particularly if the employer operates in multiple states which may have different marriage laws or laws defining “marriage” or “spouse” differently from other states.  For example, health insurance benefits may be provided on a tax-favored basis for purposes of federal income tax, but not necessarily for state income tax purposes.

In the coming weeks, it is expected that the IRS will release guidance regarding the elimination of Section 3 of DOMA and the resulting federal tax implications.  The Department of Labor may also release guidance to align FMLA regulations with the Supreme Court decision.  The employee benefits landscape in this area will undoubtedly continue to change as the debate continues on both a state and national level post-United States vs. Windsor. Click here to read the Supreme Court opinion in United States vs. Windsor.  You may visit the Oyez website for more information on the case, including a link to the oral arguments, visit Oyez.  NPR has also published an interesting article on how the end of Section 3 of DOMA may impact coverage under the Patient Protection and Affordable Care Act, including whether insurance companies will be required to offer plans that cover same-sex spouses in states that do not recognize same-sex marriages performed under the laws of other states, and how affordability of health insurance coverage will be determined for same-sex spouses.

There is certainly more to come as the federal and state governments, as well as legal scholars of various specialties, continue to analyze the Supreme Court opinion and its impact on employer group health plans. Your organization may need a specific plan around. Please contact Hill, Chesson & Woody to help you prepare.

 

Image courtesy of Salvatore Vuono / FreeDigitalPhotos.net

7 Takeaways from CAI’s 2012 Compensation and Benefits Conference

Thursday, September 6th, 2012

CAI hosted its annual Compensation and Benefits Conference on Tuesday, Aug. 28 and Wednesday, Aug. 29 at the McKimmon Center in Raleigh. More than 200 HR professionals and company leaders participated in the event that focused on trends and best practices in total rewards.

The conference featured presentations from a variety of professionals responsible for advising companies on their compensation and benefits strategy. Some notable presentations included CAI’s Director of HR Services, Molly Hegeman, detailing marketplace trends for salaries and benefits in North Carolina, and Peter Marathas, Partner in the Employee Benefits & Executive Compensation Group, who imparted the audience with tips to handle the recent changes in health care.

Other topics covered at the conference included flexible scheduling, health care management, mistakes related to wage and hour law, and multi-generational retirement planning. Below are some key takeaways from last week’s conference:

  1. Marketplace trends show an increase in consumer-driven health plan options (CDHP), well-being programs, and companies giving employees financial education and advice. These trends show a decrease in 401K matching, salary budget, promotions, teleworking and recognition programs.
  2. Employee time off costs are virtually equal to health care costs, and time off is one of the highest valued benefits to employees, second only to pay.
  3. Top 5 Wage-Hour mistakes include considering salaried employees exempt, averaging work hours, errors in recording work schedule, believing child labor laws aren’t applicable to your own child, and thinking any person may be an independent contractor.
  4. Chronic diseases make up 75 percent of national medical costs, and 80 percent of chronic conditions are modifiable or preventable. National data supports that effective wellness programs improved employee health and impact overall healthcare costs.
  5. A survey from AonHewitt revealed that health benefits satisfaction is declining, more than half of employees do not know how their pay is determined, most employees don’t understand the value of their pension plans, and 80 percent of respondents fear that they will not have enough money in retirement.
  6. According to CAI’s 2012 Wage & Salary Survey, NC companies project to increase employee salaries by 2.9 to 3.6 percent for 2012. Percentage of companies giving performance-based merit increases is 81.2 percent and those giving general increases in 36.2 percent.
  7. Companies that don’t manage total rewards effectively are missing valuable input from their employees, leading to lower engagement and higher turnover; missing opportunities to manage total rewards as a portfolio, which may lead to higher costs and lower effectiveness; and introducing unnecessary risk into their total rewards approach.

CAI holds four conferences each year. The Triad Employment Law Update is CAI’s next conference and will take place at the Koury Center in Greensboro on Wednesday, Nov. 7, 2012. For more information related to CAI’s conferences, please check out CAI’s conference page.

Is Your Company Prepared for America’s Ageing Workforce?

Thursday, April 12th, 2012

Many labor studies and workforce statistics indicate that the American workforce is ageing. Data from the U.S. Census Bureau shows that 4.6 adults will turn 65 each minute during 2012, and by 2025 that figure will increase to eight adults each minute. Knowing that America is graying rapidly, it is surprising that many employers have not prepared for this demographic change when planning for their future business ventures.

Ignoring reports revealing that baby boomers are interested in working past their retirement age and will stay at companies that offer flexibility will leave your company vulnerable to disorganization and revenue loss. Older workers offer a number of benefits to their employers. They are hardworking, loyal and professional. Older employees also boast vast networks of business contacts and extensive experience in their line of work.

Research shows that many baby boomers have no plans to fully retire and are interested in staying plugged into their career fields. If you’re interested in retaining the company knowledge that your older workers have acquired and the strong work ethics they incorporate into each of their projects, make sure you are keeping their needs in mind when you’re planning for company succession and total rewards packages. Listed below are a few items that older workers would like to see from their employers:

Flexibility

Employees approaching retirement age are not interested in working the typical 40-hour week. An increasing number of companies are receiving requests from their older workers to have more flexible work schedules.  Many workers at this age desire a high-quality of life and would prefer to work part time. To accommodate requests, organizations are implementing a number of measures to achieve productive, part-time schedules. Accommodations include reduced hours, telecommuting and job sharing.

Consulting

Data shows that the US is experiencing a skills gap between available positions and available talent. When older workers retire, they take with them company experience and expertise, which is impossible to replace. For your employees who are contemplating retirement, ask them if they’d be interested in working for the company as a part-time consultant. In this setup, they will be able to reduce their hours and continue to apply their knowledge while your organization still has a valuable and reliable company resource on staff.

Health Plans

A company’s health care plan can be a determining factor on whether an employee decides to retire or stay with his organization. Many older workers may remain in their position longer than they’d like for fear that they’ll lose their health benefits. Feeling trapped in their jobs could result in their disengagement and reduced productivity. Meet with your benefits provider and work to offer a wellness and benefits program that will suit all of your employees, including your older workers.

Don’t lose your high-value talent and the company knowledge they carry with them because of poor workforce planning. If you would like additional information on succession planning or managing an aging workforce, please call a member of CAI’s Advice and Counsel Team at 919-878-9222 or 336-668-7746.

Photo Source: skilledwork_org

Benefits for Part-Time Employees

Thursday, May 12th, 2011

According to the U.S. employment statistics reported by the Bureau of Labor Statistics (BLS), there were 26,560,000 employees working part-time in February 2011.  Approximately 31 percent worked part-time because of economic reasons (unable to find a full-time job, full-time hours cut to part-time or seasonal declines in demand).  The remainder worked part-time out of choice or due to personal reasons such as child care, attending school, limits on social security earnings, etc. Women accounted for 62 percent of the part-time workers.

Because they are not as common for part-time employees as they are for full-time employees, benefits packages can be a huge recruitment and retention advantage for employers with part-time workers.  Although involuntary part-time employees will be moving on to full-time jobs as the economy improves, voluntary part-time employees are likely to seek out part-time jobs that offer the best benefits.

The latest data available from BLS regarding benefits for part-time employees was released in July 2010.  From that data, here’s the percentage of employers who provided specific benefits to part-timers (working 1-34 hours):

Retirement plan         39 percent

Paid vacation             37 percent

Health care                26 percent

Paid sick leave           24 percent

The CAI 2011/2012 Policies & Benefits Survey reports that roughly half of employers provide some benefits to part-time employees, with some on a pro-rata basis.  The majority require a minimum of 30 hours per week to qualify for benefits (although some only require 20).

Approximately 50 percent of employers (total responses) who provide part-time benefits provide 401(k), medical and dental insurance, life insurance, AD&D insurance and bereavement pay.  Sixty percent of non-union employers provide vacation and holiday pay.

Benefits provided may vary by size of employer.  For full data on the local provision of benefits to part-time employees and other benefits data, please see the CAI 2011/2012 Policies & Benefits Survey.

Photo source: Earls37a

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Future Effects of Healthcare Reform

Friday, July 23rd, 2010

We are covered in webinars and seminars about the Patient Protection and Affordable Care Act.  I attended several in recent weeks, and the most common answer to audience questions was “We don’t know yet.”  True  as that may be only months after passage, employers will need to make key decisions soon.  Consider these “big picture” predictions by medical industry observers as you think about the future of your group health plan:

  • Higher healthcare costs for employers and most patients, well beyond the additional risk from new enrollees
  • Better access for the previously uninsured with new access impediments for the insured
  • More employers will convert employees to part time to avoid mandates . . .
  • . . .  but watch for regulations complicating the exclusion of part-time workers from plans (remember, the goal is 100% coverage)
  • Much improved data collection and sharing; better use of evidence-based medicine
  • Higher medical equipment and drug costs
  • A rise in concierge medicine, private pay and direct reimbursement plans
  • Breaches in security of electronic personal health data housed in the “cloud”
  • Increased taxes from value added/national sales taxes and such
  • More outcome-based payment schedules
  • Penalties to hospitals for readmissions and hospital-acquired illnesses
  • Increased financial stress at community hospitals
  • “The end of self-insurance” in small- and medium-sized plans due to blunting or deleting its advantages over time
  • Increased subsidization of Exchanges
  • Eventual domination of Insurance Exchanges and Medicare; impractical to remain a “grandfathered” plan under new rules
  • Application of IRC Section 105(h) to non-grandfathered insured plans (discrimination testing and daily excise taxes) making it difficult to exclude categories of full-time employees
  • Micro-networks of physicians providing deeper discounts and limited choices
  • Fewer viable commercial domestic providers over time; more medical tourism overseas
  • Commoditization of healthcare and diminished professional status/pay for office-based physicians
  • Greater use of mid-level practitioners such as Physician Assistants and Nurse Practitioners

Sure, some of these predictions will turn out wrong and others will come into play.  We are taking today’s loose and complex system of doctors, insurers, pharmaceutical and equipment makers, hospitals, network pricing secrecy, etc. and adding significant central direction, data, light-of-day, penalties, incentives, limitations, minimum plan standards, new taxes and regulations.  Yes, the old loose system became unaffordable, but is the regulated one more efficient?  No one ever lost money betting on unintended consequences from large regulatory programs, so let’s hope some of them are good!

Next week I will share my predictions for healthcare reform and some advice for employers on how to prepare.

Note: I am grateful to all the seminar speakers and area professionals for their help, including Todd Yates of Hill, Chesson & Woody, Joel Daniel of Ogletree Deakins and Dr. David Marcinko.

Photo Source: Oldmaison