Employers Say Pharmacy Benefit Manager Contracts too Complex, Opaque

| posted in Blog

Three in five employers think their contracts with pharmacy benefit managers are overly complex and not transparent, according to a new study. The study, which found that employers would prefer that PBMs are more transparent with their pricing and would like them to focus less on rebates and value-based designs, comes as PBMs are under increased scrutiny for their opaque pricing practices. The survey of 88 very large employers, “Toward Better Value: Employer Perspectives on What’s Wrong with the Management of Prescription Drug Benefits and How to Fix It,” was conducted by Benfield and commission by the National Pharmaceutical Council….
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OSHA Electronic Filing Deadline Extended to December

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OSHA has issued final rules that delay for large employers and those in high-risk industries the electronic filing deadline for 2016 annual injury and illness records until Dec. 1, 2017. The new rule changes an Obama-era federal OSHA regulation that required employers with 250 workers, in addition to firms with 20 or more employees operating in various high-risk industries (such as construction, agriculture, manufacturing, transportation and retail) to file their 2016 Form 300A electronically. The original deadline was July 1. OSHA also said that the delay would give employers more time to prepare their systems for electronic submissions and get…
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Trump Administration Writing Regs to Loosen Rules on Health Plan Tax Credits for Small Employers

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The Trump administration is crafting regulations that will allow small employers to bypass government-run exchanges to purchase coverage and still be eligible for a tax subsidy. Part of the Affordable Care Act provides for small employers to be eligible for a tax credit if they purchase health insurance for their workers on federally operated exchanges for small businesses. However, the Small Business Health Care Tax Credit is only available to employers that bought coverage on the Small Business Health Options Program (SHOP), leaving those who bought plans on the private market out of luck. Now the Centers for Medicare & Medicaid…
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Indoor Workers Can Also Get Heat Illness; Here’s How to Protect Them

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As temperatures soar this summer, it’s not only outdoor workers that toil under the sun who are at risk of heat illness. Workers in warehouses, boiler rooms and factories are also susceptible to heat illness, which can cause severe symptoms – and even death. The temperature inside these facilities can often exceed 80 degrees, the threshold at which employers with outdoor workers are required by Cal/OSHA to take certain steps to protect their workers from heat illness. And on extreme heat days, even the air conditioners can sometimes not keep up with cooling down the building, making workers uncomfortable and…
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Workers’ Comp Referral Ring Busted: How You Can Keep Your Employees from Being Ensnared

| posted in Blog, Newsletter

One of the hidden cost drivers in workers’ comp is fraud and while many employers feel that fraud by “injured workers” is the biggest problem, there are also vendors in the system that do their part to skim money from employers and insurers. Most recently, law enforcement in California busted a fraud ring that required attorneys to pay a monthly referral fee to a company that brought the lawyers new clients and then used the same company for a number of services that were later billed to insurance companies. Prosecutors estimate that the ring encompassed 33,000 injured workers and netted…
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Right Mix of Benefits Crucial to Hiring, Retaining Millennials

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As the millennial generation continues filtering into the workforce amid a tightening job market, nearly one-third of them have turned down a job offer because of poor insurance offerings, a new study has found. Making sure that you have the right mix of benefits, including voluntary benefits, is important considering that other studies have found that millennials are already hard to keep on the payroll. This has been underscored by studies that found that one in four millennials were considering looking for new work in the next year. In addition, they are more cautious than boomers or Gen Xers in…
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Pot’s Legal. What Does It Mean for Your Business’s Anti-drug Policies

| posted in Blog

Now that Californians have overwhelmingly voted to legalize the recreational use of marijuana, many employers may be wondering where they stand if they want a drug-free workplace. Fortunately, Proposition 64 included a number of safeguards for employers, allowing them to have anti-drug workplace rules in place. In fact, these safeguards were built into the initiative to the point that the California Chamber of Commerce took a neutral stance on the measure. Prop. 64 would allow Californians who are 21 and older to possess, transport, buy and use up to an ounce of cannabis for recreational purposes, and allow individuals to…
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Appeal Promptly if You Get Notice of Staff Receiving Exchange Subsidies

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More employers have been receiving notices from their state health insurance exchange, informing them that one of their employees has received subsidies to purchase insurance on the exchange and that the employer may be subject to a penalty for not offering employees a health plan that complies with the law. The notices are not calls to pay a fine – only the IRS can do that – but employers need to respond with documentation to show that they did in fact offer affordable coverage that meets the minimum value requirements of the Affordable Care Act. If you receive a notice,…
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Employers Protest Proposed First Aid Claims Rules

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California employers are protesting a part of the Workers’ Compensation Insurance Rating Bureau’s 2017 rate filing dealing with first aid claims, asking the insurance commissioner to delay adoption. Businesses say the proposed reporting provisions are unclear and inappropriate in light of impending changes that will exempt the first $250 of every claim from the experience rating calculation. Many employers simply do not report first aid claims in order to keep their experience modifier down, even though the Rating Bureau requires them to do so. Beginning in 2017, frequency will become a major part of the formula for calculating X-Mods. Under…
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Countdown to New Overtime Exemption Rules

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If you have not yet done so, now is the time to start preparing all of your accounting and payroll systems for the onset of the Department of Labor’s new overtime exemption rules. The final regulation changes the salary level that must be met before an employee can be exempt from overtime if they satisfy the “duty requirement,” meaning they have to be engaged in certain “white collar” jobs, like management. The White House estimates that some 4 million workers who are currently considered “exempt” from overtime pay of time and a half for working more than 40 hours in…
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