It’s no wonder small businesses are confused when they are told they need to file Form 5500 with the Internal Revenue Service (IRS) and pay PCORI fees. For instance, if you look up 5500 filing requirements on the Internet, most sites say something like, “Form 5500 is required on behalf of any welfare benefit plan that has 100 or more participants as of the beginning of the plan year or is funded through a trust, regardless of participant count.”

Clear as mud to the average employer, right? WRONG! Let’s break it down.

Since 1949, May has been observed as Mental Health Awareness Month. It was established to increase awareness of the importance of mental health and wellness and to celebrate recovery from mental illness.

Telehealth is now playing a huge role in treating mental health and substance abuse. Telehealth is a covered benefit by many employer-based health plans as well as Medicare and Medicaid plans.

​For many, the end of the year is a time to slow down, relax and reflect on the year behind us while setting resolutions for the year ahead. At Allied National, our employees are busy paying claims, providing agent support, closing new business and booking renewals. But we still have time to look back at what we accomplished in 2021 and share with our readers what’s ahead for Allied National in 2022. And be sure to take our quick survey at the end for a chance to win an Amazon gift card! 

Direct Primary Care (DPC) is capturing the attention of employers who want to offer better health care coverage to their employees. With DPC, a patient can form a one-on-one relationship with their doctor and have 24/7 access to medical care. DPC has been shown to help provide superior healthcare for individuals, lowering their overall healthcare costs and improving outcomes.

The challenge for employers who want to offer DPC – how to ensure employees are covered for both primary care health services and care the DPC doctor can’t provide.

The Affordable Care Act (ACA), also known as Obamacare, is a health care reform law that was enacted in March 2010. Some of the key goals of the ACA were to:
 

• Extend health coverage to millions of uninsured Americans.
• Expand Medicaid eligibility
• Create a Health Insurance Marketplace for individual health insurance, prevent insurance companies from denying coverage due to pre-existing conditions, and requiring plans to cover a list of essential health benefits.
• Allow lower-income families to qualify for subsidies for coverage purchased through the Marketplace.

 
However, even though there are some “pros” to the Affordable Care Act, there are just as many “cons” for an ACA plan, many of which led to significantly higher health insurance premiums for individual and small employer health insurance.

Reference-based pricing (RBP) is touted as the economical alternative to Preferred Provider Organization (PPO) pricing and statistics bolster that claim.

RBP is a reimbursement methodology primarily used by self-funded employers. Instead of carriers negotiating a fee directly with a provider (usually through a PPO network), employers reimburse providers and facilities according to a reference point – such as a percentage above of Medicare rates. For instance, Allied National’s self-insured Funding Advantage Freedom Plans reimburse physicians at 125% of Medicare and facilities at 150%.

The question many people have is whether RBP really can save employers and employees a significant amount of money on group health plan premiums and member out-of-pocket costs.

The answer?

Article reposted with permission from BenefitsPro. Written by Kelly Smith, Senior Vice President at MVP Health Care.

​Brokers are experiencing an increase in demand for level-funded plans, which are an exciting offering providing predictability, funding diversity and innovation to their portfolio.

“Open Enrollment is coming!” – A phrase you’ve most likely heard at least a few times recently.
 
The federal Open Enrollment Period (OEP) happens once a year for individual health plans in the ACA marketplace. For most states, you have from Nov. 1, 2021, to Jan. 15, 2022, to choose a health plan for 2022 and get signed up. In order to get coverage starting Jan. 1, 2022, you would need to be enrolled by Dec. 15, 2021.

Although Preferred Provider Organizations (PPOs) have been a popular group health benefit plan feature since their introduction in the 1980s, their shine is starting to fade.
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PPOs are supposed to be a great way to lower health care costs. Providers agree to a discounted rate in exchange for insurers steering members to their services. The problem is that retail prices charged by hospitals and physicians continue to rise steeply. 

The pandemic has had an enormous impact on every aspect of our lives, including the way employees view employee benefits. Employers are having to rethink what kind of perks, benefits and incentives will keep workers engaged and offer a competitive advantage in a post-pandemic world.