How do mental health parity laws affect employer costs?
At first glance, mental health parity laws like the Mental Health Parity and Addiction Equity Act (MHPAEA) appear to be a straightforward compliance...
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At first glance, mental health parity laws like the Mental Health Parity and Addiction Equity Act (MHPAEA) appear to be a straightforward compliance...
Step therapy is one of the most widely used utilization management tools in employer-sponsored pharmacy benefits, and its impact on employer healthcare...
A few years ago, I sat across from a CFO who couldn't understand why his stop-loss renewal had jumped 32%. His claims experience was flat. No new high-cost...
Prior authorization (PA) is a utilization management tool designed to ensure medical services are clinically appropriate and cost‑effective. For employers,...
The short answer is yes, employer health coalitions can and do negotiate lower healthcare costs -often achieving savings that individual employers,...
Surprise medical bills are not just a headache for employees-they are a direct drain on employer healthcare budgets. When a patient unknowingly receives...
For years, ERISA health plan reporting felt like a dusty annual ritual. Your TPA would drop a Form 5500 on your desk, maybe a Schedule A, and you’d check...
Out-of-network (OON) charges represent one of the most volatile and poorly controlled cost drivers in employer-sponsored health plans. Unlike in-network...
Pharmacy benefit managers (PBMs) are the often-unseen architects behind your employees’ prescription drug coverage. They sit between employers, health...
Every year, a benefits team somewhere sits around a table, opens a thick actuarial report, and tries to divine the future from claims that are already 18...
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