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New Reform Fees, Self-Funding Advantages Explored At MBU

05/07/13

  08:56:06 pm, by MedBen5   , 306 words,  
Categories: News, Health Plan Management

New Reform Fees, Self-Funding Advantages Explored At MBU

Health care reform and its impact of self-funded group health coverage were among the topics at the latest MedBen University (MBU), held today at the Morrow Conference Center in Newark, Ohio.

Caroline Fraker at MBU

Caroline Fraker, MedBen Vice President of Compliance, has covered a lot of miles this year to help groups navigate the twists and turns of the Affordable Care Act. In this presentation – her 15th of 2013 – she broke down two new fees that businesses will soon face under the law:

  1. PCORI Comparative Effectiveness Fee: For plan years on or after October 1, 2012, all group health plans must pay a fee to cover the costs of the Patient-Centered Outcomes Research Institute. The fee is based on average number of covered lives. For the 2013 plan year, the fee equals $1.00 per covered person (employees and dependents) per year; for 2014, the fee equals $2.00 per covered person per year.
  2. Transitional Reinsurance Fee: From 2014 to 2016, health plans must pay a fee per covered individual (employee and dependent) to state-based programs established to provide reinsurance for health insurance carriers issuing individual policies (for policies both in and out of the Exchanges). For 2014, the fee equals $5.25 per individual per month or $63.00 per individual per year.
Brian Fargus at MBU

Following Fraker was MedBen Vice President of Sales and Marketing Brian Fargus, who explained the mechanics of self-funding. In his presentation, Fargus outlined the employer advantages of partially funding group health coverage, such as plan design flexibility, improved cash flow and lower administrative costs.

Fargus also gave a detailed breakdown of what to look for in a third party administrator. Among the most important qualities in a TPA, he said, is “service capabilities", including the ability to provide custom reporting, an advanced claim processing system, and strong compliance support.

MedBen will continue to offer MBUs throughout 2013. Be sure to check this blog for future opportunities to attend a session!

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