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What You Need to Know Before You Need to Know it

The health insurance and group benefits landscape is complicated. Rather than just trying to keep up on changes ourselves, we pride ourselves on being the ones out there on the forefront educating employers about changing regulations and the latest healthcare cost containment techniques. We typically conduct six webinars a year that are free for employers to attend, and publish at least three educational articles each month right here on this site, bringing you tips and tactics to manage your employee benefit plan more successfully.

We also regularly speak at public seminars sponsored by the Mile High and Boulder Area SHRM chapters, Mountain States Employers Council, the Colorado CO-SHRM conference, the Denver Metro Chamber of Commerce, and more– and all those events will be published here as well.

Check back regularly for update as you navigate your current healthcare challenges.


Recent Blogs

  • The Fate of ACA Depends on a Texas Courtroom

    The partisan battle over the Affordable Care Act (ACA) heated up once again during the first week of September, when Judge Reed O’Connor in Fort Worth, Texas heard arguments from Republican attorneys general stating that the ACA is unconstitutional.  Although it may take a few weeks or even months for the judge to render his decision, the healthcare industry continues to speculate about the potential implications for the market, individuals, and employer group plans.  The crux of the issue is around the individual mandate and the preexisting condition protections that the ACA introduced.

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  • Five More Tips to EMPOWER your employees to be smart consumers of health care!

    We wrote a blog article in April about Consumerism and how to empower your employees to be smart consumers of health care. We know how difficult and confusing benefits can be, so check out these five additional tips to continue this education for your employees to enable them to advocate around their own health care and out-of-pocket expenses! 

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  • Medicare Part D Mandatory Compliance Notice Due October 15th

    The Medicare Part D Notice is just one of the many compliance responsibilities to which most employer health plans are subject. Since this notice is due in just a couple of weeks, continue reading for what you need to do.

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  • Healthcare Claims Get Even More Confusing

    At Fall River we are committed to helping our members understand their health benefits and provider bills. We know that navigating the benefits world can be confusing, and unfortunately, we are seeing more and more claims situations that prove it’s getting ever more complicated. 

    Here are recent examples of some complex and downright outrageous claims issues we want you and your members to be aware of.

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  • The Battle to Cut Pharmacy Costs

    This past May, the Trump administration released its plans to reduce pharmaceutical prices on four fronts. The policy was laid out in a blueprint which describes the various fronts the Center for Medicare and Medicaid Services (CMS) and the department of Health and Human Services (HHS) propose to take to alleviate the problem. The four areas the administration proposes to target for action are increasing competition, better negotiation, creating lower list prices, and reducing patient Out-of-Pocket spending. Since all employer plans are impacted by the rising costs of prescriptions, we are encouraged to see active steps proposed to address the problem.

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