Segal Benz Blog

Young Americans can buy health insurance for the daily cost of coffee; final mental health parity rules issued; and experts convene to analyze ERISA at 40: 3 things you need to know this week in employee benefits | Segal Benz

Written by Admin | November 11, 2013

HHS estimates most young Americans could get health coverage for about $3 per day

News this week from Wolters Kluwer reports new statistics from the Health and Human Services Department showing that nearly half of young, healthy applicants to an insurance exchange could purchase a policy for $100 or less per month.

According to an HHS analysis of the 34 federal or state-federal co-op exchanges, among the 2.9 million single adults age 18 to 34 who are eligible to buy a plan through the exchanges, 46% could purchase a plan for $50 or less per month; 70% could get a plan for less than $100 per month. Both statistics account for a Bronze-level plan, after tax subsidies.

As WK notes, that price is about the cost of a daily cup of coffee, likely an acceptable selling point for young Americans who are un- or under-employed and looking for coverage.

Federal agencies release final mental health parity rules

The Departments of Labor, Health and Human Services, and the Treasury this week announced final rules for the Mental Health Parity and Addiction Equity Act, which requires health plans to provide the same level of benefits for major medical and mental health/substance abuse coverage. The rules, issued Nov. 8, are scheduled to be published in the Nov. 13 Federal Register. Among the rule changes the agencies made to the law:

  • Applies parity to “intermediate” levels of care, such as residential or outpatient treatment.
  • Details participants’ disclosure rights and other transparency requirements for health plans.
  • Eliminates the “clinically appropriate” exemption for differences in treatment limitations.

The final rules apply to group health plans for plan years beginning on or after July 1, 2014. Until then, plans must follow the interim final rules.

This week’s hidden gem: Benefits experts discuss ERISA’s enduring legacy

The Employee Retirement Income Security Act turns 40 next fall, and a group of benefits industry experts threw the law a birthday party of sorts at a recent symposium in Philadelphia.

The event, sponsored by the Pension Rights Center and the American College of Employee Benefits Counsel, was attended by an ERISA “who’s who,” according to PRC, including Labor Department and Treasury Department officials, and several individuals who helped draft the original law.

In addition to a valuable oral history of ERISA, the event unearthed some fun tidbits, like that the roles that the Labor and Treasury departments would play in overseeing the law was decided over Chinese food and written on a napkin.

Also, PRC reveals, “ERISA didn’t have support from powerful interests, but it passed anyway because of media attention spurred by congressional hearings and the resulting overwhelming support it received from regular Americans.” Power to the people indeed.