The Importance of Performance Guarantees
When constructed properly, performance guarantees serve as an objective means for the plan sponsor and its vendor to ensure the service provider is meeting the contract’s expectations.
Dependent Eligibility Process
Dependent eligibility is a subcomponent of the overall eligibility process within a health plan. Because dependents are generally not plan sponsor employees, obtaining key demographic and other applicable information to support their eligibility status [Read More]
Insurance Companies Hit with Big Fines in 2022
Whether it was ignorance, lack of oversight, or something more nefarious, state agencies in Georgia, Colorado and California are cracking down on insurance companies that are running afoul of the rules.
End-Stage Renal Disease and Medicare Coordination
End-Stage Renal Disease is a life-changing disease for employees and a catastrophic health plan expense for employers, so plan sponsors need their insurance carriers to help employees stay healthy in order to control costs, as well as coordinate with Medicare.
Pharmacy Benefit Managers Under FTC Investigation
Increasing transparency and lowering the cost of prescription drugs has long been a point of discussion in Congress, medical offices, and dining room tables. In November 2021, the Biden-Harris administration increased oversight of prescription [Read More]
Group Health Plans: The Plan Sponsor’s Responsibility
As more technology-driven solutions disrupt the traditional healthcare model, many plan sponsors are moving away from the turn-key approach offered by insurance carriers. Before making such a decision, plan sponsors should determine if they are ready to take on the fiduciary challenges associated with this move.