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.
Every other week, NFP's legal experts make the subject of compliance personal for a wide audience. By breaking down the daunting details of emerging policies and bridging the gap between legislation and what it means for the listener, Chase Cannon and Suzanne Spradley make compliance issues relatable and relevant. Visit our Soundcloud page every two weeks for the most up-to-date episode.
NFP's Benefits Compliance team is hosting its next webinar on September 18, 2019, from 2:00 to 3:00 p.m. CT (3:00 to 4:00 p.m. ET). The topic is "Top 10 Compliance Tips for Open Enrollment."
Can't make a live webinar? A recording of each session will be posted to the NFP Client Learning Portal within 48 hours of the live webinar. Those listening to a recorded webinar aren't eligible for recertification credit.
The moderator will answer as many questions as possible during the webinar. If your question isn't answered by the end of the webinar, reach out to your advisor for assistance.
Top 10 Compliance Tips for Open Enrollment
September 18, 2019
Register Now »
All programs are pending approval for 1.0 (general) recertification credit hour toward PHR, SPHR and GPHR recertification through the HR Certification Institute. For more information about certification or recertification, visit the HR Certification Institute website at www.hrci.org.
Plans that are subject to ERISA and Form 5500 filing must distribute the SAR to participants within nine months of the end of the plan year; thus, a calendar year plan is required to distribute the SAR for the 2018 plan year by September 30, 2019. If the plan applied for an extension to the Form 5500 filing, the SAR is then due within two months following that filing.
The SAR is a summary of the plan’s information reported on the Form 5500. If a plan is not subject to Form 5500 filing, then it is exempt from the SAR notice requirement — this would include church plans, governmental plans and unfunded or insured plans with fewer than 100 participants. Also, large, unfunded self-insured plans that are unfunded are exempt from the SAR requirement even though they are subject to the Form 5500 filing requirement.
Model language is available for SAR preparation. Please ask your advisor for assistance. For additional information, see the frequently asked question featured in the August 23, 2016, edition of Compliance Corner.
The ACA requires insurers to submit an annual report to HHS accounting for plan costs. If the insurer does not meet the medical loss ratio standards, they must provide rebates to policyholders. Rebates must be distributed to employer plan sponsors between August 1, 2019, and September 30, 2019. Employers should keep in mind that if they receive a rebate, there are strict guidelines as to how the rebate may be used or distributed.
For more information, please contact your advisor for a copy of "Medical Loss Ratio Rebates: A Guide for Employers" or "Medical Loss Ratio: PPACA’s Rules on Rebates."