1.5 minute read

Optum Rx, a pharmacy benefit manager (PBM) and subsidiary of UnitedHealth Group, plans to pass all rebate drug discounts to consumers by 2028. This move aims to enhance transparency...

1.5 minute read

Employers with insured group health plans may receive a medical loss ratio (MLR) rebate from their issuers if the applicable percentage for 2023 is not met. Rebates, in the form of...

1.5 minute read

In 2021, prescription drug spending by private health plans nearly reached $152 billion, an 18% increase since 2016. Some researchers and stakeholders are scrutinizing certain...

4 minute read

A pharmacy benefits manager (PBM) acts as a middleman in the pharmacy benefits marketplace, connecting employers, drug wholesalers, plan members, pharmacies, and drug companies. PBMs...

4.5 min read

Pierre Guilfoile, NIS' Director of Health Plan Analytics, gives his take on the renewal and market expectations for the insured and self-insured market for 2020 and 2021.

1.5 minute read

The Internal Revenue Service (IRS) has released the final forms and instructions for 2019 reporting under Sections 6055 and 6056.

Public sector organizations with group health plans should be aware of changes to Affordable Care Act (ACA) requirements that take effect in 2020.

1 minute read

The IRS released an information letter which confirms that the employer shared responsibilities or pay or play penalties continue to apply for applicable large employers (ALEs) that...

Employees with low health insurance literacy frequently utilize more health care services.[1] Often, they do not understand how to choose the appropriate healthcare services and may select an...

The next Affordable Care Act (ACA) compliance hurdle that schools, cities and counties are facing is employee subsidy notifications and appeals. Subsidy notifications will be sent out this summer and...