When it comes to healthcare plan administration, ASOs (administrative services only) say they offer a big discount to self-funded plans. If you look closer, however, you’ll see that they actually do come with a cost, both monetarily and in terms of lack of flexibility.... Here are five benefits of working with a TPA... READ MORE
In some cases, plain words supported by facts carry the greatest impact. This was the case with the recent testimony provided by SPBA past Board of Directors member, Mary Smith, of Insurance Management Administrators, before the U.S. Department of Labor’s ERISA Advisory Council. Smith proved the point that... READ MORE
When offering health benefits to employees, employers face the risk of experiencing high-cost claims if plan participants are diagnosed with a serious illness or disease. Self-funding allows the flexibility to plan for these situations … proactively. In this example, Tom Doney of Cypress Benefit Administrators shows how implementing two innovative benefit solutions – organ transplant READ MORE>
SFS News Release: Non-Traditional Health Benefits are the Focus of New Piece in Self-Funding Series - Continuing to expand its collection of educational resources, the Self-Funding Success website has published another piece related to the benefits of self-funding. This latest resource explores the more non-traditional health benefits being implemented today and how they are saving plans READ MORE>
ERISA is very clear that the Plan Administrator is required to administer benefits strictly in accordance with the terms of the applicable plan document. Plan Administrators, though, are often faced with difficult situations – situations where paying a claim that might otherwise be excluded under the plan document would avoid considerable headache, appease a member READ MORE>
The future of the healthcare industry may be uncertain when it comes to Congressional action, or the lack thereof. But one concept that has been widely embraced for the past few years is the commitment of healthcare leaders to a value-based model for care and reimbursement. READ MORE
With the healthcare price tag rising to $10,000 or more a year per person, employers and healthcare providers looking to lower costs and help employees manage their health are turning to big data and analytics to better handle surging costs.... cognitive health systems ... integrate patient-level data from health records and other sources to create READ MORE>
SFS News Release: Newly Published Pieces Summarize How Self-Funded Benefit Plans Are Regulated – Designed to be an informational tool for consumers who are exploring how self-funded health benefits work, the Self-Funding Success website has recently published two new resources... READ FULL RELEASE
SFS Tech Tactics: occasional articles focused on technology’s expanding role in cost-savings and improved health in customized self-funded health plans – Jason Langheier, a physician, knew that poor diet was a major problem in the U.S. But he also knew employers could be — and should be — be part of the solution…. That’s why he READ MORE>
U.S. Congress has voted for a bill that provides protection for small and medium sized firms that choose to self-insure. The Lower House passed the Self-Insurance Protection Act ... which sets legal limits to regulators’ jurisdiction over self-insurance health plans by setting unequivocal parameters to define medical stop loss policies and how they are different READ MORE>