In the last four months, the New York State Department of Financial Services (NYDFS) has issued three letters relating to coverage issues associated with women’s health. First, on April 25, 2016, NYDFS issued Insurance Circular Letter No. 1 (2016) to remind insurers that federal law “requires group health plans and issuers offering group or individual health insurance coverage to provide, with no copayment, coinsurance or deductible, preventive services that have a rating of ‘A’ or ‘B’ in the current recommendations of the United States Preventive …Continue Reading
In mid-September, it was reported that hackers hit another set of health insurance companies. In this case, the hackers hit The Lifetime Healthcare Companies and its affiliates including Excellus BlueCross BlueShield, Univera Healthcare, and The MedAmerica Companies. A full list of plans affected can be found on the press release outlining the details of the attack.
Hackers took information on approximately 10 millions customers including seven million from Excellus and three million from associated entities. Company IT officials first discovered the intrusion on August 5, …Continue Reading
In recent months, the main event in the challenges against the Affordable Care Act centered on the subsidies provisions in the ACA. The Supreme Court decided this matter in King v. Burwell. In July 2015, there were two additional key developments related to the provision requiring employers to provide contraception coverage.
On July 14, 2015, the 10th Circuit Court of Appeals in Little Sisters of the Poor Home v. Burwell held that the self-certifying procedure in place for religious not-for-profits to take advantage …Continue Reading
On June 25, 2015, in a 6-3 opinion written by Chief Justice John Roberts, the United States Supreme Court held that the subsidies available in the Affordable Care Act apply to participants in both state and federal healthcare exchanges. A key component of the Affordable Care Act (i.e., the part that helps make this insurance affordable) is tax subsidies for those who qualify under the income requirements stated in the Act. Language in this provision, according to the petitioners and the dissent, appeared to limit …Continue Reading
Health insurers have begun submitting their proposals for approval of next year’s health insurance rates. For hundreds of Affordable Care Act (ACA) plans, the proposed rates are up by more than 10 percent with insurers seeking increases of upwards of 49 percent for some products. Insurers have cited to increases in drug costs and the receipt of more accurate data on their insureds in support of the proposed rates. Between now and October 2015, when the final rates are published, federal and state regulators will …Continue Reading
With 2014 wrapping up, attention is quickly turning to the benefits enrollment period for 2015 including enrollment for health insurance. A new survey out by Towers Watson, the National Business Group on Health, and PriceWaterhouseCoopers provides a glimpse into how employers are thinking about these benefits. One conclusion is that, for health insurance, higher deductible plans are the new black.
Since the passage of the Affordable Care Act (ACA), one of the big questions is what, if any, impact its passage would have on employer-provided …Continue Reading
On July 22, 2014, two U.S. Courts of Appeals highlighted both the science and the art of statutory construction and interpretation — and came to very different conclusions. These courts were asked to consider an IRS rule (26 C.F.R. § 1.36B-2(a)(1)) associated with a section of the Affordable Care Act that provides tax credits (subsidies) for those who purchase health insurance under the exchanges. The central issue was whether the relevant provision of the ACA (26 U.S.C. 36B(c)(2)(A)(i)) (the provision), which provides that subsidies would …Continue Reading