Updated HSA Regulations

Effective April 17, 2008, the Dept of Treasury issued final regulations providing guidance on employer comparable contributions to HSA’s under section 490G in instances where an employee has not established an HSA by 12/31 and in instances where an employer accelerates contributions for an employee who gets sick and needs access to employer HSA funds.


Updated HSA Regulations

Can Health Plan Enrollment be Contingent on Completion of Health Risk Assessment (HRA)?

An Employer can require that its employees complete a HRA or participate in a qualified wellness program as a condition to enroll in the employer’s group health plan.  These employer requirements do not violate HIPAA nondiscrimination provision because enrollment is not conditioned on the employee’s health status or on attaining specific health outcomes.


Programs that comply with HIPAA, such programs are those under which none of the conditions for obtaining a reward is based on an individual satisfying a standard related to a health factor or under which no reward is offered.  These are       

·    A program that encourages preventive care through the wavier of the copayment or deductible requirement under a group health plan

·    A diagnostic testing program that provides a reward for participation and does not base any part of the reward on outcomes

·    A program that reimburses all or part of the costs for membership in a fitness center

·    A program that reimburses employees for the costs of smoking cessation programs without regard to whether the employee quits

·    A program that provides a reward to employees for attending a monthly education seminar

·    a program that reimburses employees for the costs of smoking cessation programs without regard to whether the employee quits smoking; and

·    a program that provides a reward to employees for attending a monthly health education seminar.


IRS Reg. §54.9802-1(f)(1).


Insurance Carriers Will Stop Paying for Medical Errors

The Institute of Medicine had reported in 1999 that up to 98,000 people had died in hospitals as a result of medical errors.  Today the number is estimated to be 200,000+ and costing billions of dollars.  Not to mention the medical errors that occur that don’t result in death but result in increased medical costs, cost of ongoing care and disability.


Medicare, Well Point, and Cigna are taking a stand by announcing plans to stop paying for care that’s triggered by a host of medical mishaps.  Doctors will not be paid for surgical procedures on the wrong side, wrong person, wrong body part and or wrong site.  Cigna is adding a list of “potentially non-reimbursable” mishaps that will mandate quality of care.


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Life Expectancy Falls in Areas of the U.S.

Life expectancy in the U.S. is declining demographically especially for women according to researchers at Harvard University.  The authors of the study say it is likely that more areas, and more men, will see life-expectancy gains slow, stop or backslide as chronic conditions associated with obesity and smoking become more widespread.

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Raising Healthcare Costs no Longer Employers No. 1 Concern

According to a most recent Deloitte & Touche and International Society of Certified Employee Benefits Specialists survey “a shortage of skilled and talented workers has become the most pressing concern among employers, supplanting the perennial leading problem, raising healthcare costs.”


Given this information how are you managing your human capital to maximize the health and productivity of your talented workforce. 


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Fundamental Change Needed to Improve Health Care in the U.S

The Commonwealth Fund/Modern HealthCare Opinion Leaders Survey findings continue to support the need for significant fundamental and systematic changes to the healthcare delivery system.


When polled about specific strategies for improving the system strengthening primary care, encouraging care coordination and the management of care transitions and promoting care management of complex patients.  Reforming the provider reimbursement model from a fee for service to a results based systems is imperative.


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