Category: Employee Benefits

Pharmacy Trend: The Rising Cost of Diabetes

One hundred million Americans have diabetes or pre-diabetes and newly diagnosed cases have tripled over the past 20 years. As the seventh leading cause of death in the United States, diabetes is characterized by inadequate insulin secretion resulting in high blood sugar and potential long-term heart, kidney, eye or nerve complications. Along with the rise of newly diagnosed cases, there has been a sharp increase in the cost of medication, presenting a challenge for many diabetic patients and their employers.

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Government Funding Bill Impacts Employer-Sponsored Coverage

Yesterday, Congress voted to pass H.R. 195, a bill that will continue to fund the government through February 8, 2018. The bill was signed by the President last night and it includes three items specific to the Affordable Care Act, two of which will impact employer-sponsored coverage directly: 

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Court Vacates EEOC’s Wellness Rules for 2019

On December 20, 2017, the U.S. District Court for the District of Columbia vacated key provisions of the Equal Employment Opportunity Commission’s (EEOC) final rules for employer-sponsored wellness programs. However, to avoid disruption to employers, the court stayed its ruling until Jan. 1, 2019.  

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Employer Wellness Programs Compliance Update Three takeaways from Secretary of Labor v. Macy’s, Inc. et al

The HIPAA nondiscrimination regulations aren’t new to most employers with wellness programs. Employers who offer health-contingent wellness programs are especially familiar with the requirement to provide a reasonable alternative standard as part of their wellness program compliance.

Currently, a pending district court case, Secretary of Labor v. Macy’s, Inc. et al, has placed a greater focus on the reasonable alternative standard portion of the HIPAA nondiscrimination regulations. This focus is specific to health-contingent wellness programs that are outcomes based. These wellness programs require individuals to attain or maintain a certain health outcome (or outcomes) to receive a reward. A tobacco health plan premium surcharge is one example.  Although this is an active case, with no official judgements or rulings, the flag has been raised by the Department of Labor specific to the reasonable alternative standard and outcomes-based programs. 

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Open Enrollment is Over … Now What?

Many companies with calendar-year benefit periods have recently wrapped up their open enrollment, or will be doing so in the near future. Open enrollment can be a productive experience, but it can also cause significant stress for employees and employers alike. As every HR professional knows, once employees have made their benefit selections and completed their forms, there is still work to be done.  

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