Health and Wellness

Large Numbers, Risk Pooling and Adverse Selection

As legislators continue to repeal and replace the ACA, they look for new ways to separate portions the insurance markets into different segments. Some efforts counter actuarial and insurance principles: segmenting the risk pool increases volatility and that creation of different risk pools based on health status and effect premiums

Don’t Confuse Cost Shifting with Cost Savings

As the debate in Washington rages on over the efforts to repeal and replace the Affordable Care Act (ACA) there is a fundamental truth that is being ignored: there are no provisions of the current ACA replacement bills - either from the House (the American Health Care Act, or AHCA) or the Senate (the Better [...]

Medicare and Your Employer Health Coverage: Too Much of a Good Thing?

More Americans are working past 65 and continue to have employer-sponsored health insurance. However, the intersection of Medicare and employer coverage has a number of traps for the unwary and some of these traps come with real financial consequences. This makes it more important than ever that you (and your employer) understand the complex rules [...]

By | August 4th, 2017|Categories: Health and Wellness|Tags: , , , , |

Senate Releases Health Care Bill

On June 22, the Senate Republicans released the Better Care Reconciliation Act of 2017 (“BCRA”), their version of a bill to repeal and replace the Affordable Care Act. The bill repeals some provisions of the ACA. However, in many instances the bill retains the ACA framework, but dramatically reshapes provisions of the ACA. Here are [...]

Retirement Patterns: are Workers Outsmarting the Experts?

An increasing number of workers are choosing to stay in the workforce – many on a part-time basis. In effect, these workers have created their own phased retirement program. This ongoing employment contributes to retirement income adequacy and can be viewed as a key part of solving the challenges posed by past errors (such as low savings and insufficient diversification).

Paid Family Leave: Next Benefits Frontier or New Battleground?

Effective January 1, 2018 New York becomes the latest state to require that employers provide paid family leave, joining California, New Jersey, and Rhode Island. Also, Washington State adopted a paid family leave act in 2007, that has not been implemented due to a lack of funding, and San Francisco has adopted its own ordinance. [...]

By | June 27th, 2017|Categories: Health and Wellness|Tags: , , , , |

Multiple Personalities: The Administration’s Approach to the ACA

While the debate over replacing the Affordable Care Act continues, it is also important to focus on the law that currently controls the American health care system – the ACA. The Trump Administration has been sending conflicting signals about how it will administer the Affordable Care Act. These conflicting signals may prove to be disruptive to insurance markets - and to individuals.

Paid Parental Leave – An Emerging Consensus?

A new report, prepared by economists from the American Enterprise Institute and the Brookings Institution, provides some interesting fodder for the debate over a national paid leave policy for the U.S. The report provides an economic rationale for establishment of a paid leave program and attempts to create a consensus proposal for both the right and the left of the ideological spectrum.

By | June 19th, 2017|Categories: Health and Wellness|Tags: , , , |

How Does New York’s Paid Family Leave Fit in With Other Leaves?

Employees faced with caregiving needs are covered by a number of different rules, including FMLA – and, starting in 2018, New York’s paid family leave law. Employers must deal with the complexities of integrating these overlapping – and, sometimes, conflicting – rules.

Case Study: Properly Administering an Employee Benefits Plan

The case Erwood v. Life Ins. Company of North America, et. al. involved an employee, Dr. Scott Erwood suffering from a cancer. Dr. Erwood was covered by employer sponsored group life insurance. In the transition from FMLA leave to disabled/terminated status, the employer, WellStar Health Systems, failed to inform Dr. Erwood about the plan provisions governing conversion of the group life insurance policy to individual coverage.