VCG’s VANTAGE
A view into the latest Benefits and HR topics
20Sep 2018

Medical Loss Ratio (MLR)

Authors: |Administration, Benefits, Communications, Compliance, In The Know|0 Comments

The Affordable Care Act (ACA) requires health insurance issuers to spend a minimum percentage of premium dollars on medical care and health care quality improvement, which is intended to lower the cost of care. This percentage is known as "medical loss ratio" (MLR). In the large group insurance market, the required MLR is 85%; the small group and individual markets [...]

28Aug 2018

Medicare Part D Notices – Creditable (or Non-Creditable) Coverage

Authors: |Benefits, Communications, Compliance, In The Know|0 Comments

Plan sponsors of group health plans providing prescription drug coverage to individuals who are eligible for Medicare Part D prescription drug coverage are required to satisfy certain notice requirements. Background Individuals must enroll in Medicare Part D prescription drug coverage when first eligible (generally, at age 65).  If they do not do so, they are subject to a permanently higher [...]

23Aug 2018

When Can SPDs and Participant Notices be Distributed Electronically?

Authors: |Administration, Benefits, Communications, Compliance, In The Know, Technology|0 Comments

Summary Plan Description (SPD) is a document that employers are required to give to employees in retirement plans or health benefit plans covered by ERISA.  The SPD is simply a summary of the plan document required to be written in such a way that the participants of the benefits plan can easily understand it. Employers must distribute SPDs and other [...]

22Aug 2018

U.S. News Best Hospitals Rankings 2018-2019

Authors: |Administration, Benefits, Decision Making, In The Know, Technology, Workplace Wellness|0 Comments

On August 14th, U.S. News and World Report released their annual top hospitals rankings. The top five nationally were: Mayo Clinic, Rochester, MN Cleveland Clinic Johns Hopkins Hospital, Baltimore Massachusetts General Hospital, Boston University of Michigan Hospitals-Michigan Medicine Ann Arbor They also reported regional rankings for 200 metropolitan areas and the top five hospitals in selected specialties such as Cardiology and [...]

30Jul 2018

2017 PCORI Fee Due July 31st

Authors: |Benefits, Communications, Compliance, In The Know|0 Comments

The Affordable Care Act requires health insurers and employers that sponsor self-funded group health plans (including health reimbursement arrangements) to pay a Patient-Centered Outcomes Research Institute (PCORI) fee for each year from 2012 to 2019. The PCORI fee for plan years ending in 2017 is due by July 31, 2018. If the plan is fully insured, the insurance carrier pays [...]