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December 10, 2019

Podcast Episode 64: Health Care Costs: U.S. Versus Other Countries

In this episode, Suzanne Spradley and Chase Cannon dig in to the issue of health care costs in the U.S. as compared to other countries. Suzanne begins the discussion by outlining the Organization for Economic Cooperation and Development (OECD) data that has been tracking the cost of health systems in the world since 1986. Suzanne explains the different factors and variances, and the importance of defining terms when it comes to making such comparisons. Suzanne and Chase discuss the OECD findings that the U.S. spends far more than other countries, and they outline the exact dollar numbers and percentages. Suzanne digs in on the different areas where the U.S. spends more, and the two conclude the episode discussing the relationship between health care spend, health care resources, and health care outcomes.
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November 12, 2019

Podcast 63: DOL Proposes New Electronic Disclosure Safe Harbor

In a welcome turn of events, the DOL has proposed a new rule that would allow for electronic disclosure of many retirement plan documents. Beth Allen and Carol Wood discuss the proposed rule — beginning with how the DOL got to this point, explaining the details of the rule, and highlighting the rule’s limited application. Ultimately, the discussion will give retirement plan sponsors a better idea of how they may be able to distribute documents, should this rule be adopted.
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October 29, 2019

Podcast 62: Open Enrollment Compliance Considerations

In this episode, Chase Cannon and Suzanne highlight four considerations to help avoid compliance issues resulting from open enrollment periods. First, Chase outlines the importance of documenting offers and waivers of coverage, and how that can help employers avoid IRS scrutiny and employee misunderstandings. Second, Chase and Suzanne discuss challenges that can arise during open enrollment on HSA eligibility, and how employees can easily step into excess contribution issues when enrolling in benefits. Third, Chase describes challenges in open enrollment relating to absent and remote employees, including those out on FMLA or state-protected leave, and those that are working from different locations or from home. Chase and Suzanne close with a discussion of important notices that must go out during open enrollment, and how to distribute those notices.
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October 01, 2019

Podcast 61: Reference-Based Pricing

In this episode, Suzanne Spradley and Chase Cannon dig in to a trending topic, particularly for self-insured plans: reference-based pricing (RBP). Suzanne begins with a description of RPB, including an example to help illustrate how it works. Next, Suzanne explains the process and the pros and cons of RBP, which leads to a discussion on pricing and billing, including balance billing to unsuspecting plan participants. Suzanne outlines employer considerations when implementing an RBP design, including several issues with respect to the ACA and out-of-pocket maximums, and lessons learned from litigation relating to RBP strategies (including one case that made it to court with over $300K in claims at stake). The two close by discussing related ERISA fiduciary issues and administrative practicalities for employers to consider when adopting an RBP design.
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September 17, 2019

Episode 60: Q4 Updates on the HIT, the Cadillac Tax, and the Lawsuit Challenging the ACA

In this episode, Chase Cannon and Suzanne Spradley look at a few ACA topics that are a bit up in the air. The first is the health insurance tax (HIT), a tax on health insurance carriers that has been on and off moratorium the past few years, but is coming back into effect for 2020. Chase breaks down the HIT, its impact on health insurance rates and on employers and employees, and whether Congress might add a moratorium for 2020 or repeal the HIT entirely. The second is the Cadillac Tax, a tax on plans that provide richer benefits. Chase and Suzanne discuss the potential issues and burdens associated with the Cadillac tax, why it was enacted, and whether the Senate might follow the House’s lead on repealing it. The third is Texas vs. the U.S., the lawsuit challenging the constitutionality of the ACA’s individual mandate. Chase breaks down the lawsuit, the validity of the arguments on either side, and gives a prognosis on how and when the Fifth Circuit might rule on the case. The two close the podcast by looking to the case’s potential impact on the 2020 elections.
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September 04, 2019

Ep 59: Comparing Administrative Costs Between Single Payer Systems and Private Insurance Markets

In this episode, Suzanne Spradley and Chase Cannon examine one argument that is put forth by proponents of a single payer system — that because Medicare is purportedly more administratively efficient, that a single payer system in the U.S. would reap huge savings and reduce overall health care costs. Suzanne breaks down the estimated administrative costs of Medicare (claimed 2% of total costs) versus private insurance (claimed 12% to 15% of total costs), and the reports upon which they’re based. Suzanne explores whether comparing administrative costs versus total costs is the best method, and how a per-beneficiary comparison might be more meaningful. Suzanne and Chase discuss some of the costs that shouldn’t be included in an administrative costs comparison, including profits and taxes. The two wrap the episode with a discussion on how some administrative costs actually reap huge benefits, and why administrative costs may not impact overall health care costs — ultimately concluding that the current comparison and claims on single payer administrative cost savings may not be all they’re cracked up to be.
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August 20, 2019

Podcast 58: What Would the SECURE Act Mean for You?

In this podcast, Beth Allen and Chase Cannon discuss the Setting Every Community Up for Retirement Enhancement (SECURE) Act. Beth highlights the last major retirement legislation that's passed and briefly discusses what has taken place to bring the SECURE Act to this point. That discussion leads into a conversation about what all the SECURE Act entails, including what the act would mean for retirement plan participants, plan sponsors, and industry organizations. They end with a discussion of where the bill is now and what could happen next.
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August 06, 2019

Podcast Episode 57: Updates and Considerations on State Family and Medical Leave Laws

In this episode, Chase Cannon and Carol Wood, in her podcast debut, discuss updates and considerations regarding state family and medical leave laws. The two discuss leave protections that have been enacted in new states in the past few years, as well as states that previously had such laws and protections in place. Chase outlines, at a high level, some of the differences in duration of leave, benefits, and family members for whom an employee can take leave (including domestic partners, who employers often forget about). Chase and Carol wrap up the discussion by outlining several key points employers should consider when developing their employee leave policies, with a focus on the benefits considerations.
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July 09, 2019

Ep 56: DOL and IRS Enforcement Involving Employee Benefit Plans

In this episode, Suzanne Spradley and Lauren Fischer discuss criminal enforcement actions by the DOL and IRS involving employee benefit plans. Specifically, the two discuss the latest development in the action involving The Total Financial Group, Inc., which promoted the Classic 105 program. Suzanne and Lauren then discuss other enforcement actions involving an HRA administrator, an internal employee benefit administrator and a program that sought to carve-out high claimants from a self-insured plan.
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June 25, 2019

What Are the States and Congress Doing about Surprise Medical Bills?

In this episode, Suzanne Spradley and Jill Brooking discuss surprise medical bills and what laws have been enacted or proposed at the state and federal level. The two address situations in which surprise medical bills occur, the two ways that the individual is financially impacted, polling and claims data concerning the extent of this issue, and which states are taking a comprehensive approach to resolving this issue for fully insured plans in their states. Suzanne and Jill then discuss recent proposals by three bipartisan groups in the Senate.
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NFP Corp. and its subsidiaries do not provide legal or tax advice. Compliance, regulatory and related content is for general informational purposes and is not guaranteed to be accurate or complete. You should consult an attorney or tax professional regarding the application or potential implications of laws, regulations or policies to your specific circumstances.