Surprise Billing Rule May Benefit Insurers

The much-anticipated Surprise Billing Rule scheduled to take effect on January 1, 2022, has added another rule that could slow the growth of premiums. The rule prevents arbitration settlements at higher rates that insurers have contracted to pay.

The arbitration rule states that the arbitrator should choose the amount “closest to the median in-network rate negotiated by insurers for that type of care.” Other factors, while taken into consideration, are not given equal weight. Read more details here.

Source: Kaiser Health News

Major Insurers Delay Payments and Cause Issues

Major insurers including Anthem and UnitedHealthcare are behind paying insurance claims to hospitals and doctors. This issue is straining hospital finances and often putting patients in the position of advocating for themselves with insurers or risk being stuck with the bill. Read more about this issue.


Designing a Health Plan that Includes DEI

When designing a benefits plan it’s important to include diversity, equity, and inclusion (DEI). Here are four ways you can build DEI into your plans.

  • Flexible subsidization (ex: free or low-cost mental health care)
  • Plain language everyone can understand.
  • Offer a plan without a deductible or one that provides exact costs of treatment before service is provided.
  • Searchable health plans with treatment options and information about physician diversity and specialties (i.e. LGBTQIA+ affirming care). Read more details here.


Higher Premiums for Unvaccinated Spouses

Louisiana Health System is charging employees with unvaccinated spouses a $200 monthly premium. Ochsner Health System in Louisiana is charging employees a $200 per month premium for health care coverage for an unvaccinated spouse or partner.

Oschner is a self-insured organization and carries the cost of Covid treatments for those on its health insurance plan. The move is the latest in a trend for employers and insurers to encourage vaccination and cover extra costs of Covid care for those who remain unvaccinated. Read more about this.

Source: NBC News

Benefits Rollout - 5 Best Practices

Your benefits plan rollout is the best time to share the good news about your plan offerings and inform your team about how to access those benefits. Here are five best practices for a successful rollout.

  1. Make sure your team knows the plan and how to communicate it effectively to the rest of the staff.
  2. All materials should be in the languages spoken by your employees.
  3. Post about the rollout through all communication channels including texts, emails, posters in the breakroom, etc.
  4. Plan to share the news in a teleconference or in-person to create more excitement around what you have to offer.
  5. Give employees personalized recommendations for their individual health journeys. Read more details here.


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