Dependent Coverage's Tax Trap
A mid-sized tech company wrapped up a routine dependent eligibility audit last fall. They weren't expecting fireworks-maybe a stray ex-spouse or a...
Explainer
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A mid-sized tech company wrapped up a routine dependent eligibility audit last fall. They weren't expecting fireworks-maybe a stray ex-spouse or a...
Step therapy is one of the most widely used utilization management tools in employer-sponsored pharmacy benefits, and its impact on employer healthcare...
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...
Tucked inside every employer health plan’s claims warehouse is a damning report nobody runs. Open a folder of last year’s professional claims, lay it beside...
When most employers think about the soaring cost of healthcare, they focus on big-ticket items: hospital stays, specialty drugs, and rising physician fees....
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