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The Patient Centered Outcomes Research Institute (PCORI) fee is due July 31, 2018 for employers with any type of self-funded plan and/or a Health Reimbursement Arrangement. The fee helps fund unbiased research that evaluates the clinical effectiveness of medical treatments regardless of the profit potential. This fee is also known as the Comparative Effectiveness Research Fee, or CERF.

Published in Compliance

When consumers need to access emergency health care services, they usually do not have the time nor presence of mind to determine whether a provider treating them is in-network or not. When those emergencies expose them to out-of-network providers, the provider or facility may “balance bill” the consumer for amounts beyond what the insurer paid. This out-of-network balance billing can create financial burdens and undermine the consumer’s confidence that health insurance will protect them from financial hardship.

Published in Industry Trends

Reference Based Pricing (RBP) is a cost containment strategy that some larger employers have implemented to help place a cap on the cost of larger medical services.  It’s a savvy strategy that, in the past, has worked best with self-funded large employers but is gaining steam across employers of all sizes.

Published in Industry Trends
Monday, 14 May 2018 09:48

The Latest ACA Regulatory Changes

The final Affordable Care Act provisions for 2019 have been released and they are in line with the regulations proposed on October 27, 2017. The provisions primarily concern the out-of-pocket maximums, Essential Health Benefits (EHBs), and the Marketplace.

Published in Healthcare Reform
Friday, 04 May 2018 10:00

2019 HSA Limits Announced

The IRS has published inflation-adjusted Health Saving Account (HSA) contribution limits for 2019, along with minimum deductible and maximum-out-of-pocket expenses for the high deductible health plans (HDHP) associated with HSAs.

Published in Compliance
Current benefit plans have given more purchasing and decision-making power to the members with higher out-of-pocket responsibilities. Members do not always understand what their benefit plans cover, and the costs associated to that coverage, which can cause a lot of confusion and frustration. 
 
We at Fall River Employee Benefits understand that benefit plans can be an intimidating and confusing subject. We want to empower and educate our client’s employees to be their own best health advocates and make informed decisions regarding their health care. 
 
We love helping our clients create year-round campaigns to teach their employees to be better consumers of health care. There are many topics to cover, so we’ll likely do several articles in this area. 
Published in Best Practices
Monday, 16 April 2018 15:08

HIPAA Compliance Made Easy

HIPAA is an important guideline for employers, health care practitioners, and insurance companies to follow. Since the fines for non-compliance can be in the tens of thousands of dollars, it’s imperative that employers pay attention to their obligations in keeping employees’ information private.

Published in Compliance
Monday, 09 April 2018 14:44

Paying Hospitals to Keep People Out?

For years, hospitals have made money by admitting (and readmitting) people. But what if it were more profitable to reduce readmissions?
 
Both the Medicare Modernization Act and the Affordable Care Act increased the incentives hospitals have to reduce readmissions. But the state of Maryland is taking it even further and reaping large savings as a result. Their success suggests a path forward for managing employee healthcare costs down in the future.
Published in Industry Trends
Fall River has been growing in recent years, and we’re still looking for more awesome clients like you! In your network, we know you are connected to some great people and, so we wanted to roll out the details of our new referral program! 
 
First, thank you to Kyle Covell of Censeares Consulting for referring us to a contact of his who needed health insurance brokerage services, and received a reward for doing so! We’d like to return the favor and share that we’ve known Kyle for many years, and as a fractional CFO he can be a trusted and integrated partner in your business. He can lead your entire finance and accounting needs, freeing you to focus on growing your business. Learn more about Kyle here.

To better understand how to best connect us with potential customers and get rewarded ....
Published in Fall River News
We all know that attracting and keeping the superior employees in your field is a constant challenge. Employers must stay ahead of the curve and anticipate the needs of the future. We all wish we could predict the future, but until that time comes, here’s a nice summary from Paylocity of the MetLife 2018 Trends Study to help to identify those future trends. Click here to learn what is worrying employees, what they are expecting, and how employees want to be educated surrounding their benefits. 
Published in Industry Trends
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