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Medical Plan Design and Administration



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Improving Treatment for Substance Abuse Disorder (Addiction)
These Virtual Summit slides will increase your knowledge of employer strategies for addressing SUD in the workplace, best practices for identifying and increasing access to evidence-based treatment, and emerging approaches to help connect employees and their dependents who are struggling with SUD to get access to the help they need.
Aug 19, 2019
2020 Large Employers' Health Care Strategy and Plan Design Survey: Executive Summary
This year, the Large Employers' Health Care Strategy and Plan Design Survey included questions a range of topics. The executive summary covers 7 highlights from the full report.
Aug 13, 2019
2020 Large Employers' Health Care Strategy and Plan Design Survey: Full Report
This year, the Large Employers' Health Care Strategy and Plan Design Survey included questions to provide insight into large employers' views on the rapidly changing health care landscape. Large employers were asked about their evolving role in bringing about change in health care, their thoughts about proposed policy changes and the position of virtual solutions in their offerings.
Aug 13, 2019
2020 Large Employers' Health Care Strategy and Plan Design Survey: Health Care Costs and Plan Design
This year, the Large Employers' Health Care Strategy and Plan Design Survey included questions focused on health care trend and costs, top conditions driving health care costs, and adoption of consumer-directed health plans.
Aug 13, 2019
2020 Large Employers' Health Care Strategy and Plan Design Survey: Role of the Employer
This year, the Large Employers' Health Care Strategy and Plan Design Survey included questions focused on the role employers' health care strategies play on their overall workforce strategy as well as a look at how employers' are addressing social determinants of health.
Aug 13, 2019
Results from the 2020 Large Employers' Health Care Strategy and Plan Design Survey: Press Briefing
This year, the Large Employers' Health Care Strategy and Plan Design Survey included questions to provide insight into large employers' views on the rapidly changing health care landscape. The press briefing covered 10 key insights into how large employers are approaching the delivery system, policy, pharmacy, health care cost management and more.
Aug 13, 2019
Gender Reassignment Benefits in 2019
The purpose of this survey was to determine whether other employers cover surgical and/or non-surgical gender reassignment benefits. This survey looks specifically at covered procedures, short-term disability (STD) and long-term disability (LTD) coverage, cost of benefits, and lifetime dollar limits. Seventy-four members of the Business Group responded to this survey, although the number may vary from question to question.
Aug 2, 2019
Evidence-based Fertility Treatments
This benefit manager guide discusses the range of fertility treatments and how to design plans to support evidence-based approaches to fertility treatment. The guide provides recommendations to employers looking to implement changes in their fertility coverage and align current or future benefit offerings with evidence.
Jul 23, 2019
LGBTQ-Friendly Benefits
The purpose of this survey was to determine what lesbian, gay, bisexual, transgender, queer (LGBTQ)- friendly benefits employers offer. The survey looks specifically at domestic partner coverage, gender confirmation benefits and fertility benefits. Sixty-one members of the Business Group responded to this survey, although the number may vary from question to question.
Jun 21, 2019
Key Insights from the 2019 Employers' Summit on Health Care Cost and Solutions
The Employers' Summit on Health Care Costs and Solutions is an annual, employer-only meeting hosted in the Business Group's offices in Washington, DC. The event focused on key trends in health care, policy and actionable steps human resources professionals can take to improve health outcomes and reduce health care costs. The following is a brief look at some of the most compelling insights from the 110 employer-strong summit.
Jun 6, 2019
Navigating the Precision Medicine Landscape: Five Key Considerations
We've all seen television ads for at-home genetic testing kits promising to flag our various health risks and trace our ancestry. These offer only a glimpse into today's world of precision medicine – a field rapidly evolving and expanding due to extraordinary advancements in gene science. The number of genetic tests and gene therapies entering the market is growing at such a fast pace that it's hard to keep up. Nevertheless, developing and maintaining a working knowledge of the field is critical; increasingly, this new world will influence your health benefit strategy. Here are five key considerations to help you size up today's precision medicine landscape.
Apr 3, 2019
Surprise Billing for Out-of-Network Medical Claims Data
The purpose of this survey was to determine how employers handle situations in which employees receive surprise bills from out-of-network (OON) providers for services received at in-network hospitals/facilities. This survey looks specifically at how OON claims are paid, protections that health plans have in place for employees receiving surprise bills, types of providers/services that are driving surprise billing and supports offered to employees. Forty-three members of the Business Group responded to this survey, although the number varied from question to question.
Feb 6, 2019
Employer Perspectives and Health Care Trends Across 10 Industries - October 2018
Key insights from the October 2018 Industry Benchmarking Call Series, covering the following topics: the employer role in health care, provider consolidation, virtual care and artificial intelligence, pharmacy supply chain and health care cost trend.
Jan 29, 2019
Provider Consolidation Issue Brief
Provider consolidation has flown under the radar compared to national health plan and pharmacy benefit mergers, but they're having a large impact on health care costs and network contracting in many markets. Employers can take steps to mitigate cost increases and increase value for their employees.
Jan 10, 2019
New Entrants Create Price Competition & Drive New Formulary Solutions in Hepatitis C Market
The approvals and availability of new drugs for the treatment of Hepatitis C have made national headlines because of their superior efficacy and also because of their extremely high costs. The information included in this Employer Alert is intended to help benefit managers understand and make decisions related to this high-profile issue.
Jan 8, 2019
Rising Healthcare Costs: A National Business Group on Health® Infographic
The information provided in this infographic has been taken from the 2019 Large Employers' Health Care Strategy and Plan Design Survey performed by the Business Group.
Jan 8, 2019
Large Employers' Health Care Strategy in 2019
Learn how large employers are shifting their health care strategy for the coming year to better engage employees, lower health care costs and react to changes within health care industry.
Nov 1, 2018
Key Insights from Business Health Agenda 2018
Business Health Agenda (BHA) is an annual conference hosted by the National Business Group on Health®, highlighting the latest trends, best practices and innovative tactics for employer-sponsored health benefits and health care initiatives. Read more about the main takeaways from the three day event.
Oct 11, 2018
Quick Survey Results: Hearing Aid Benefits
The purpose of this survey was to determine whether other employers offer hearing aid benefits. This survey looks specifically at what restrictions are placed on hearing aid coverage and whether coverage is different in pediatric cases. Sixty members of the Business Group responded to this survey, although the number may vary from question to question.
Sep 19, 2018
2019 Large Employers' Health Care Strategy and Plan Design Survey
This year, the survey was redesigned to provide insight into large employers' views on the rapidly changing health care environment. This new information accompanies tried- and- true elements of the survey: critical benchmarking information on health care costs, plan design trends and employer initiatives.
Sep 11, 2018
Disabled Dependent Eligibility for Health Benefits
The purpose of this survey was to determine whether other employers allow employees' disabled dependents older than age 26 to be enrolled in the company health plan and under what circumstances this is permissible. The survey also looks at any other requirements or restrictions that may be in place. Seventy-two members of the Business Group responded to this survey, although the number may vary from question to question.
Aug 23, 2018
2019 Large Employers' Health Care Strategy and Plan Design Survey Chart Pack
Insight into large employers' views on the rapidly changing health care environment and critical benchmarking information on health care cost, plan design trends and employer initiatives.
Aug 7, 2018
2019 Large Employers' Health Care Strategy and Plan Design Survey Executive Summary
Insight into large employers' views on the rapidly changing health care environment and critical benchmarking information on health care cost, plan design trends and employer initiatives.
Aug 7, 2018
Employer Perspectives on the Changing Health Care System Infographic
This infographic pulls together insights into large employers' views on the rapidly changing health care environment from the 2019 Large Employers' Health Care Strategy and Plan Design Survey.
Aug 7, 2018
Employer Tools for Assessing ACO Programs
This presentation provides an update on ACO resources from NBGH and new tools developed by Catalyst for Payment Reform to help employers standardize ACO contracting and evaluation approaches.
May 24, 2018
The Employer Response to Opioids: A National Business Group on Health Infographic
The information provided in this infographic has been taken from a collection of Quick Surveys performed by the Business Group.
Apr 3, 2018
Applied Behavioral Analysis Therapy for Autism Spectrum Disorder
The purpose of this survey was to learn whether employers cover applied behavioral analysis (ABA) therapy as a treatment option for autism spectrum disorder (ASD). This survey looks specifically at annual limits or maximums in place for ABA and prior authorization requirements for coverage. Additionally, the survey looks at programs and services offered to support parents and caregivers of dependents with ASD. Seventy-two members of the Business Group responded to this survey, although the number may vary from question to question.
Mar 20, 2018
Key Insights from the 2018 Employers' Summit on Health Care Cost and Solutions
The Employers' Summit on Health Care Costs and Solutions is an annual, employer-only meeting hosted by the National Business Group on Health focused on key trends in health care, policy and leadership in human resources. This resource summarizes the key insights and lessons from the meeting on health care costs, employee engagement, delivery system strategies, specialty pharmaceuticals, mental health and more.
Mar 13, 2018
What Your CEO is Reading: Cigna to Acquire Express Scripts
Cigna is nearing a deal to buy Express Scripts in a transaction that is believed to be worth more than $50 billion.
Mar 8, 2018
NBGH/BCBSA: Employer Utilization of Point Solutions
This report presents results from an NBGH fielded large employer survey and insights from a BCBSA survey of their consumer community. The results include information on the most prevalent point solutions, challenges employers have had in implementing point solutions, and other key findings that could impact the future of how employers contract/partner with vendors for various health and welfare services.
Feb 9, 2018
Employer Utilization of Point Solutions Presenting Results from a NBGH/BCBSA Collaboration
This webinar presents results from an NBGH fielded large employer survey and insights from a BCBSA survey of their consumer community. The results include information on the most prevalent point solutions, challenges employers have had in implementing point solutions, and other key findings that could impact the future of how employers contract/partner with vendors for various health and welfare services.
Jan 31, 2018
Not All Doctors are Created Equal: How Comcast Connects Members to High-Quality Care
These slides detail how Comcast NBCUniversal is improving overall physician quality through their partnership with Grand Rounds by avoiding significant unnecessary costs and improved care quality with their initial focus on utilization of second opinion services for their employees with complex medical concerns. Comcast's strategy is evolving to connect all of their employees to high-quality care by matching them to local, in-network, top-quality physicians that are best suited to address their clinical needs.
Jan 29, 2018
Motor Vehicle Accidents - Supporting Employees and Their Families: High Cost Claimants Webinar Series Part IX
This webinar slide presentation features information from the Centers for Disease Control and Prevention (CDC) about the scope and impact of motor vehicle crashes and associated injuries on working age populations, as well as how employers can support employees and their families affected by them.
Jan 11, 2018
Industry Insights from the Large Employers' 2018 Health Care Strategy and Plan Design Survey
This special report looks at industry insights from the National Business Group on Health's Large Employers' 2018 Health Care Strategy and Plan Design Survey.
Jan 5, 2018
Special Report: The Cost of Employer-Sponsored Health Care
This Special Report provides a summary of leading benefits consulting firms and research organizations' surveys around employer-sponsored health care. This report focuses on projections on what the employer health care cost trend will be for 2017 and 2016, and the key trends around employer-sponsored health care.
Dec 13, 2017
What Your CEO is Reading - CVS Health to Acquire Aetna
Open to learn more about the proposed merger and whether and how it may affect your company's health benefits and future health strategy.
Dec 6, 2017
Average Annual Premium for Covered Workers, by Industry
This Numbers You Need chart looks at how health care costs vary across industry sectors.
Nov 1, 2017
Average In-Network Deductible for Single Coverage
This Numbers You Need chart provides information on how deductibles across all plan types have risen over time.
Nov 1, 2017
Percent of Covered Employees Enrolled by Medical Plan Type
This Numbers You Need chart includes the latest breakdown of employee enrollment by plan type.
Nov 1, 2017
Percentage of Premium Paid by Employers
This Numbers You Need chart looks at how employers' percentage contribution to the premium has changed over time.
Nov 1, 2017
Supporting Employees with High-Risk Maternity Conditions: High Cost Claimants Webinar Series Part IV
This webinar slide presentation features information from the March of Dimes Chief Medical Officer about the scope and impact of high-risk conditions associated with maternity care, as well as how employers can support employees and their children living with these conditions.
Oct 17, 2017
Employer Plan Design and Network Strategies for ACO Engagement
As employers increasingly engage with accountable care organizations (ACOs), they must make several strategic decisions about how to steer employees to providers within that ACO using plan design and benefit communications. In this presentation, Aetna explores different options for employers to engage ACOs, and CVS Health details how they implemented two ACO pilots and redesigned benefits to promote employee engagement in their ACOs.
Oct 12, 2017
ACO Physician-Patient Selection and Attribution
How patients are assigned to ACO providers can have a significant impact on the ACO's ability to improve health and reduce costs. Self-insured employers must decide if and how they want to facilitate or require this assignment, commonly referred to as "patient attribution." This resource outlines several strategies for patient attribution employers should consider.
Oct 5, 2017
Eight Employer Plan Design and Engagement Strategies for High-Performing ACOs
If an employer buys into the ability of an ACO partner to improve care coordination, health and reduce costs, they should consider using the tools they have available to keep their employees going to that ACO. This fact sheet explores why an employer may want to use financial and communication levers to steer employees to ACO providers, and several potential implementation strategies.
Oct 5, 2017
High-Cost Claimants: Cardiovascular Conditions
This webinar slide presentation features information from the Centers for Medicare and Medicaid Innovation's Million Hearts about the scope and impact of cardiovascular conditions, as well as how employers can support employees and their dependents living with these impactful, high cost conditions.
Oct 3, 2017
Employers' Confidence in Private Exchanges
This Numbers You Need chart looks at how confident large employers believe the private exchanges will be able to perform various activities better than employers already perform them.
Sep 25, 2017
Employers' Plans for Private Exchanges
This Numbers You Need chart contains the latest information on whether employers have moved to private exchanges or plan to do so in the near future.
Sep 25, 2017
Components of Health Care Spending
This Numbers You Need chart contains information on how health care dollars are spent.
Sep 12, 2017
Cost Per Employee, by Plan Type
This Numbers You Need chart contains the latest information on how health care costs vary by plan design. For more information on this chart, please see Mercer's National Survey of Employer-Sponsored Health Plans report.
Sep 12, 2017
Coverage of Autism Spectrum Disorder Treatments Among Large Employers
This Numbers You Need chart contains data on the coverage of various autism spectrum disorders. For more information on this chart, please see the National Business Group on Health's 2018 Large Employers' Health Care Strategy and Plan Design Survey.
Sep 12, 2017
Coverage of Infertility Treatments Among Large Employers
This Numbers You Need chart details what treatments are typically covered by large employer health plans. For more information on this chart, please see the National Business Group on Health's 2018 Large Employers' Health Care Strategy and Plan Design Survey.
Sep 12, 2017
Large Employers' Trend Generally Exceeds National Health Expenditures Trend
This Numbers You Need chart looks at heath care trend for large employers compared to National Health Expenditures data.
Sep 12, 2017
Total Health Care Costs for Large Employers and Their Employees
The total cost of health care includes both premiums and out-of-pocket costs. These costs vary significantly by industry. For more information on this chart, please see the National Business Group on Health's 2019 Large Employers' Health Care Strategy and Plan Design Survey.
Sep 12, 2017
Cancer Gene Therapy Approved – What does this mean for employers?
On August 30, 2017, the New York Times reported on a landmark decision made by the Food and Drug Administration (FDA) to approve the first-ever gene therapy to be available in the United States, bringing treatment options to a rare form of cancer for pediatric and young adult patients. Read more about what this means for employers and ways to address gene therapy through benefits and programs.
Aug 31, 2017
Supporting People with Rare Diseases: High Cost Claimants Webinar Series Part I
This webinar slide presentation features information from the National Organization For Rare Diseases about the scope and impact of rare diseases, as well as how employers can support employees and their dependents living with these impactful, high cost conditions.
Aug 15, 2017
Executive Summary: Large Employers' 2018 Health Care Strategy and Plan Design Survey
Highlights the key findings from the Large Employers' 2018 Health Care Strategy and Plan Design Survey
Aug 8, 2017
Large Employers' 2018 Health Care Strategy and Plan Design Survey
Results from this survey indicate that employers are looking to new methods of controlling health care costs, improving outcomes and increasing satisfaction for their employees, both through demand-side (e.g., implementing CDHPs, modifying plan design and cost-sharing strategies, adding price transparency tools) and supply-side initiatives (e.g., telehealth, on-site clinics, Centers of Excellence, Accountable Care Organizations, etc.).
Aug 7, 2017
Large Employers' 2018 Health Care Strategy and Plan Design Survey: Chart Pack
Results from this survey indicate that employers are looking to new methods of controlling health care costs, improving outcomes and increasing satisfaction for their employees, both through demand-side (e.g., implementing CDHPs, modifying plan design and cost-sharing strategies, adding price transparency tools) and supply-side initiatives (e.g., telehealth, on-site clinics, Centers of Excellence, Accountable Care Organizations, etc.).
Aug 7, 2017
Wage-based Cost Sharing
The purpose of this survey was to determine how employers differentiate medical plan cost sharing for employees based on wages/salary. This survey looks specifically at types of cost sharing and how these arrangements vary. It also looks at the number of tiers in place for cost- sharing arrangements and the bands of wage/salary levels set for each tier. Fifty-four members of the Business Group responded to this survey, although that number may vary from question to question.
Jun 7, 2017
Latest Details of Private Exchanges
This chart tracks the latest details on the private exchanges, including: names and websites of private exchanges, target market, number of participating employers and total number of covered lives, participating carriers, other products offered and structure.
Feb 17, 2017
Beware of Fraud, Waste and Abuse
This Special Alert highlights key real-time, actionable insights based on information received through the National Business Group on Health's participation with Healthcare Fraud Prevention Partnership that can help you detect possible fraud, waste and abuse in your health care program.
Jan 31, 2017
What Your CEO is Reading - Health Care Growth Accelerates
This newsletter highlights recent news articles about how the U.S. will again start to see a rise in costs--the biggest since the recession--after years of slowed growth in health care spending.
Dec 9, 2016
What Your CEO is Reading - State Exchange Premiums
This newsletter highlights a New York Times article about the cost of state exchange premiums versus that of employer-sponsored coverage.
Oct 27, 2016
Annual Premium Contributions for Family Coverage, by Plan Type
This Numbers You Need chart contains the latest information on how much of the premium is paid by employers for family coverage for each type of plan design.
Sep 21, 2016
Industry Insights from the Large Employers' 2017 Health Plan Design Survey
This report contains industry-specific benchmarks from this year's Large Employers' Health Plan Design Survey.
Sep 19, 2016
Large Employers' 2017 Health Plan Design Survey: Changing Health Care Delivery and Tackling High Cost Specialty Pharmacy
Results from the National Business Group on Health Large Employers' 2017 Health Plan Design Survey indicate that employers remain committed to offering health benefits to their employees. While rising costs remain a challenge, large employers anticipate no major plan design changes or significant contribution increases; employees should expect some incremental increase to their out-of-pocket costs. For many employers, the main focus for 2017 is implementing effective strategies for controlling specialty pharmacy costs and optimizing how health care is delivered.
Aug 8, 2016
Large Employers' 2017 Health Plan Design Survey: Chart Pack
Charts from the National Business Group on Health Large Employers’ 2017 Health Plan Design Survey.
Aug 8, 2016
Quick Survey Findings: Gender Reassignment Benefits in 2017
The purpose of this survey is to determine whether employers cover surgical and/or non-surgical benefits for employees who have been diagnosed with gender dysphoria and are considering gender reassignment/realignment. The survey also looks specifically at the types of procedures that are covered, and whether employers have implemented any programs to help employees find high-performing providers. Forty-four members of the Business Group responded to this survey.
Jul 21, 2016
8 Health Engagement Strategies from the National Leadership Committee on Consumerism and Engagement
One of the biggest challenges facing benefit leaders is employee engagement. This document highlights cutting-edge plan design strategies and emerging practices in benefit communications that improve employee engagement. These solutions have been compiled from the members of the National Business Group on Health’s National Leadership Committee on Consumerism and Engagement.
Jul 7, 2016
Low-Hanging Fruit: Nine Evidence-Based Benefit Design Opportunities
This document identifies top opportunities for benefit managers to align plan design with leading clinical evidence to make sure they're steering consumers toward what works--and paying for it--while discouraging potentially wasteful care.
Jun 10, 2016
Medical Plan Coverage and Dependent Eligibility
The purpose of this survey is to determine whether employers' health plans cover services such as acupuncture, hearing aids and FDA-approved weight management medications. The survey also looks at what types of dependents are eligible to join employer plans, including domestic partners, children of domestic partners and grandchildren. Thirty-two members of the Business Group responded to this survey.
May 16, 2016
New Florida Law Limits Hospital and Other Facility Balance-Billing
Recently, Florida enacted a law that will limit balance-billing at hospitals and other facilities for people in PPO insured plans.
May 2, 2016
Health Expenditures Forecasting
The purpose of this survey is to determine how employers forecast health care expenditures for self-insured medical plans. This survey looked specifically at the process of forecasting health care spend, how the forecast is adjusted during the year, forecasting for high dollar claims, and the forecast accuracy from 2015. Fifty-eight members of the Business Group responded to this survey.
Apr 12, 2016
Key Insights and Learnings from the 2016 Employers' Summits on Health Care Costs and Solutions
This Top Solutions outlines the most compelling insights and learnings from the 2016 Employers' Summits on Health Care Costs and Solutions.
Mar 30, 2016
NBGH/Optum: The Cadillac Tax and the Employer Mindset: A Survey of Employers
The Business Group and Optum surveyed large employers to understand employers’ reaction to the Cadillac tax and how it will impact their health management strategy, the steps they are taking to avoid the tax and how employees will be impacted by the tax.
Jan 26, 2016
Transgender-Inclusive Benefits and Policies
Since the National Business Group on Health® first surveyed its members on transgender-inclusive benefits in 2010, the prevalence of employers covering transition services has grown threefold. This issue brief serves two key functions: 1) to provide a primer on transgender-inclusive benefits, with resources from organizations like HRC and the World Professional Association for Transgender Health (WPATH) and 2) to list “dos” and “don’ts” directly from companies that have created a comprehensive approach for supporting transgender employees and dependents.
Jan 8, 2016
Infographic of Key Findings from the Large Employers' 2016 Health Plan Design Survey
Results from the National Business Group on Health® Large Employers’ 2016 Health Plan Design Survey indicate that employers remain committed to offering comprehensive and affordable health benefits to their employees. As a result, employers are pursuing a number of strategies – promoting consumerism, reevaluating cost-sharing arrangements, and working with the health care system to make positive and sustainable changes.
Dec 7, 2015
CDHP Enrollment
This Numbers You Need chart shows how enrollment in CDHPs has risen over time.
Dec 4, 2015
20th Annual Towers Watson/National Business Group on Health Best Practices in Health Care Employer Survey
The 20th annual Towers Watson/NBGH Best Practices in Health Care Employer Survey tracks employers’ best practices and the results of their efforts to provide and manage health benefits for their workforce. The report identifies the actions of high-performing companies, as well as current trends in the health care benefit programs of U.S. employers with at least 1,000 employees.
Nov 23, 2015
Spike in Lyme Disease Cases Calls for Employer Action
The number of counties in the Northeastern U.S. considered to have a high rate of Lyme disease grew by 320%, from 1993 to 2012, and the areas in which Lyme disease is found are growing. If left untreated, Lyme disease poses significant health threats. This Employer Alert provides recommendations for employers as they seek to help prevent and treat Lyme disease amongst their population.
Oct 22, 2015
Domestic Partner Coverage Update
The purpose of this survey is to learn what changes employers have recently made or are planning to make to their coverage of domestic partners and same-sex spouses since the Supreme Court ruling. The survey looks at whether employers have already or are planning to eliminate same-sex domestic partner coverage in lieu of spousal coverage, and whether employees will have a grace period in which to get married. The survey also looks at changes or anticipated changes for coverage of opposite-sex domestic partners, and what changes employers will make if they were not already offering coverage to same-sex domestic partners/spouses. Fifty-one members of the Business Group responded to this survey.
Oct 2, 2015
ACA Key Plan Effective Dates for 2013-2018
This chart summarizes Affordable Care Act compliance deadlines applicable to group health plans for 2013-2018.
Aug 21, 2015
Large Employers' 2016 Health Plan Design Survey: Chart Pack
This year’s survey looks at the benefit offerings of 140 large employer members of the Business Group, and the changes they are making for 2016. This chart pack compiles the results of the survey into an easy-to-use format.
Aug 12, 2015
Large Employers' 2016 Health Plan Design Survey: Reducing Costs While Looking to the Future
This year’s survey looks at the benefit offerings of 140 large employer members of the Business Group, and the changes they are making for 2016. Much of the survey looks at how employers are controlling costs and mitigating the impact of the excise tax through tactics including: expanding consumerism; changes to cost-sharing; and changing the health care delivery system.
Aug 12, 2015
What Your CEO is Reading - National Health Expenditures
This newsletter highlights CMS's National Health Expenditure (NHE) data projecting an annual average growth of 5.8% in health care spending between 2014 and 2024. The National Business Group on Health's large employers survey reports that large employers will be able to keep health care cost increases down to 5.0% after plan design changes for both 2015 and 2016, which is just under the NHE projections.
Aug 5, 2015
What Your CEO is Reading - Domestic Partner Coverage
This newsletter discusses how the recent Supreme Court ruling legalizing same-sex marriage throughout the U.S. impacts employer-sponsored health care. This newsletter highlights two surveys: a Reuters survey conducted of 60 large- and medium-sized employers, and a Business Group survey of 63 member companies about their coverage of same-sex spouses and domestic partners before and after the Supreme Court ruling.
Jul 20, 2015
Domestic Partner Coverage
The purpose of this survey was to determine what changes employers are planning to make to their coverage of domestic partners and same-sex spouses in light of the recent Supreme Court ruling. The survey also looks at whether employers are planning to eliminate same-sex domestic partner coverage in lieu of spousal coverage, and whether employees will have a grace period in which to get married. Additionally, the survey looks at anticipated changes for coverage of opposite-sex domestic partners, and what changes employers are planning to make if they were not already offering coverage to same-sex domestic partners/spouses. Sixty-three members of the Business Group responded to this survey.
Jul 16, 2015
Spousal Surcharges
The purpose of this survey is to determine how employers implement spousal surcharges. The survey looks specifically at surcharge eligibility and verification process, methodology of verification, the annual surcharge amount and employer experience with spousal surcharges. Seventy-five members of the Business Group responded to this survey.
May 28, 2015
Allocation of Wellness Budget
This Numbers You Need chart includes the latest information we have on how employers are allocating their wellness budget.
Apr 17, 2015
Post-65 Retiree Medical Plan Design
This Numbers You Need chart looks at how employers have structured their post-65 retiree health benefits, and what changes they are considering for the future.
Apr 17, 2015
Risk Factors Driving Medical Claims Globally
This Numbers You Need chart contains data on the health risk factors that are driving medical claims in different regions around the globe.
Apr 17, 2015
Source of Health Insurance Among Retirees Aged 55 to 64 (2012)
This Numbers You Need chart contains information on where early retirees are obtaining health insurance.
Apr 17, 2015
The Cost of Health Benefits Administration, by Country
This Numbers You Need chart looks at the cost of health benefits administration among different countries.
Apr 17, 2015
Annual Premiums for Retiree-Only and Family Coverage
This Numbers You Need chart looks at how much retiree health care costs, and how retirees and employers share the costs.
Apr 16, 2015
Employers Offering Retiree Health Care
This Numbers You Need chart looks at whether employers are offering retiree health benefits to any of their pre-65 or post-65 retirees.
Apr 16, 2015
Health and Productivity Costs as a Percentage of Payroll
This Numbers You Need chart includes the costs of various employer benefits as a percentage of payroll.
Apr 16, 2015
Medical Trend Exceeds Inflation Globally
This Numbers You Need chart contains data on medical and general inflation across all the regions of the world.
Apr 16, 2015
NBGH-Optum VOI Study Infographic
This infographic provides an overview of the key findings from the NBGH-Optum Survey on Value of Investment.
Mar 2, 2015
NBGH-Optum VOI Study Key Highlights
This summary provides an overview of the key findings from the NBGH-Optum Survey on Value of Investment.
Mar 2, 2015
Beyond ROI: Building the value of investment (VOI) story for health & wellness
This webinar reviews what metrics employers use to measure the value of their wellness programs, what importance do they assign to each metrics and how easily they can use these metrics.
Jan 21, 2015
Spousal Coverage Options: Strategies for Communicating Changes to Employees
This issue brief lays out options for employers to alter spousal coverage and tips for communicating those changes to employees.
Jan 5, 2015
What Your CEO is Reading - Site of Care
This article highlights the dramatic rise in costs for cancer treatment when private oncology offices are purchased by hospitals.This article highlights the dramatic rise in costs for cancer treatment when private oncology offices are purchased by hospitals.
Nov 25, 2014
What Your CEO is Reading - National Health Spending Growth
This article highlights news national health spending projections and what leading employers are doing to control costs.
Sep 5, 2014
Large Employers' 2015 Health Plan Design Survey
This year’s survey looks at the benefit offerings of 136 large employer members of the Business Group, and the changes they are making for 2015. Areas of focus include: changes due to ACA provisions, health care costs, consumerism, transparency and health improvement.
Aug 11, 2014
Large Employers' 2015 Health Plan Design Survey Chart Pack
This chart pack provides a summary of the benefit offerings of 136 large employers and the changes they are making for 2015. Areas of focus include: changes due to ACA provisions, health care costs, consumerism, transparency and health improvement.
Aug 11, 2014
The Role of Corporate Medical Directors and Officers Within Companies
The purpose of this survey was to determine what role corporate medical directors and medical officers play in organizations. Of particular interest is where medical directors sit within the organizational structure. Forty-three members of the Business Group responded to this survey.
Jul 29, 2014
Coverage of Residential Treatment Facilities for Behavioral Health/Substance Use Disorders
The purpose of this survey was to determine if employers covered behavioral health/substance abuse disorder treatments provided at residential treatment facilities, and what limitations that coverage might include. Seventeen members of the Business Group responded to this survey.
Jul 22, 2014
What Your CEO is Reading - Health Care Cost Rise Predicted
This article highlights PricewaterhouseCoopers' latest report on the 2015 health care cost trend increases.
Jun 25, 2014
What Your CEO is Reading - Specialty Pharmaceuticals
The article highlights concerns from insurers and employers about the dramatic rise in costs for specialty pharmaceuticals even as inflation in overall health care costs and traditional pharmaceuticals has slowed.
Jun 4, 2014
Just the Facts: Dependent Coverage
This fact sheet provides a brief summary of the latest tactics and strategies that employers use to control the costs of dependent health benefits.
Apr 30, 2014
The New Health Care Imperative: Driving Performance, Connecting to Value - the 19th Annual Employer Survey on Purchasing Value in Health Care
The National Business Group on Health/Towers Watson, Inc. Employer Survey on Purchasing Value in Health Care looks at the rising costs of health care, and tactics that employers are adopting to help improve quality ad reduce costs. The findings also look at the use of incentives, employers' thoughts on health care reform and the latest trends in consumer-directed health plans and health management programs.
Apr 14, 2014
Benefit Manager Guide: Integrating Precision Medicine into Benefits
Precision medicine has the potential to be cost-effective, and even cost-saving, by helping employees or dependents avoid ineffectual or harmful drug therapies. This guide provides employers with the business case for the value of precision medicine and offers recommendations on how to integrate precision medicine into benefits.
Apr 8, 2014
Employers’ Implementation of Narrow Networks in their Health Plans
The purpose of this survey was to determine how many Business Group members currently use narrow networks. The survey also looks at respondents’ reasons for offering the network and how employees have reacted. Forty-six members of the Business Group responded to this survey.
Mar 7, 2014
The New Health Care Imperative: the 19th Annual Employer Survey on Purchasing Value in Health Care Executive Summary
The National Business Group on Health/Towers Watson Employer Survey on Purchasing Value in Health Care looks at how employers are viewing health benefits in an era of transformation. This executive summary provides an overview of key finding from this year's survey.
Mar 5, 2014
Final Mental Health Parity Rules: What's Changed and What's the Same
During this webinar, we provide an overview of the new regulations under the Mental Health Parity and Addiction Equity Act and how they apply to group health plans.
Nov 22, 2013
Health FSA Carryover Option
The focus of this survey was to determine if, and when, employers plan on adding a carryover option to their health FSA. Seventy-three members of the Business Group responded to this survey.
Nov 21, 2013
Comments to IRS on Proposed Regulations Related to Reporting on Minimum Essential Coverage
The National Business Group on Health, in response to proposed regulations under the Affordable Care Act related to reporting on minimum essential coverage, submitted comments recommending flexibility to report in a manner that accommodates plans' current administrative, payroll, and recordkeeping procedures.
Nov 8, 2013
Narrow Networks in Today’s Health Care Climate
Looks at narrow networks in the context of today’s health care environment, and provides examples of companies using them in unique ways as part of their overall health benefits strategy.
Nov 1, 2013
Controlling Health Care Spending in the United States
Looks at the drivers of health care spend and provides solutions that will help control costs and improve quality and effectiveness of care. This material is prepared to be adapted or customized for the unique culture and challenges of your company.
Oct 31, 2013
Precision Medicine 101
Precision medicine has the potential to be cost-effective, and even cost-saving, by helping employees or dependents avoid ineffectual or harmful drug therapies. Describes eight actions employers can take to incorporate precision medicine into a benefit plan.
Oct 4, 2013
Employer Alert: Trends in Spousal and Dependent Coverage
Describes how and why large employers are changing their total rewards strategy, especially their philosophy about coverage for spouses, domestic partners and dependents.
Sep 5, 2013
Employer Mandate Delay, Your Company's Response
The purpose of this survey was to determine how the employer mandate delay would impact employers' plans for 2014, especially whether they would proceed with offering coverage to all employees working an average 30 hours or more per week. Forty-two members of the Business Group responded to this survey
Aug 8, 2013
Employer Checklist for Accountable Care Organizations (ACOs)
To assist our members with selecting and contracting with ACOs, the Business Group and our 2012 - 2013 David Scherb Executive Health Policy Fellow (Greg Marchand, Director, Benefits Policy and Strategy, The Boeing Company) developed a ACO checklist of criteria that employers should consider in negotiations.
May 8, 2013
Employer Request for Proposal (RFP) Questions for Accountable Care Organizations (ACOs)
To assist our members with selecting and contracting with ACOs, the Business Group and our David Scherb 2012 - 2013 Executive Health Policy Fellow (Gregory D. Marchand, Director, Benefits Policy and Strategy, The Boeing Company) developed a detailed list of questions for ACOs that employers should consider when requesting RFPs from potential ACOs as potential partners.
May 8, 2013
Employer Solutions to Escalating Specialty Pharmacy Costs
Provides potential solutions for employers to better manage the costs of specialty medications without limiting access to life-improving therapies.
May 1, 2013
IRS Issues Additional Final Regulations on Premium Tax Credit under Affordable Care Act
The IRS issued final regulations clarifying that for purposes of individuals’ eligibility for premium tax credits, affordability of employer-sponsored coverage is based on whether the portion of the annual premium the employee must pay for self-only coverage exceeds 9.5% of household income.
Feb 6, 2013
U.S. Supreme Court Decision Rules Affordable Care Act Constitutional
The U.S. Supreme Court upholds all provisions of the Affordable Care Act.
Jun 28, 2012
Maternal and Child Health PLAN BENEFIT MODEL: Evidence-Informed Coverage and Assessment
Provides an updated listing of evidence-informed health plan benefits for women, children and adolescents. An assessment section is included in each recommendation to enable you to determine which benefits need to be included or changed to meet the legislative requirements and to improve care.
Apr 30, 2012
More on HHS's Exchange Regulations under the Affordable Care Act
This Public Policy Alert focuses on HHS's final exchange regulations that set forth minimum standards for establishing and participating in Exchanges and basic standards that employers must meet to participate in the Small Business Health Options Program (SHOP).
Mar 22, 2012
Agencies Issue Additional Guidance on Summary of Benefits and Coverage under Affordable Care Act
HHS, DOL, and Treasury have issued additional guidance, in the form of FAQs, on the ACAs Summary of Benefits and Coverage requirements.
Mar 20, 2012
HHS Issues Final Regulations Implementing Exchanges under Affordable Care Act
The Department of Health and Human Services (HHS) recently released final regulations implementing Exchanges under the Patient Protection and Affordable Care Act.
Mar 13, 2012
Federal Agencies Issue Additional Guidance on Employer Free Rider Assessment, 90-Day Waiting Period Limitation, and Automatic Enrollment under Affordable Care Act
HHS, DOL, and Treasury have issued additional guidance on the employer free rider assessment, 90-day waiting period limitation, and automatic enrollment provisions of the Affordable Care Act.
Feb 10, 2012
Federal Agencies Issue Final Regulations on Summary of Benefits and Coverage Required under Affordable Care Act
HHS, DOL, and Treasury have issued final regulations, compliance guidance, and templates implementing the Summary of Benefits and Coverage requirement under the Affordable Care Act.
Feb 10, 2012
HHS Issues Additional Regulations for Retiree Drug Subsidy Program
HHS has issued additional regulations on how employers should report payments to PBMs for purposes of the Retiree Drug Subsidy Program.
Jan 13, 2012
HHS Guidance Proposes to Let Each State Define Essential Health Benefits
The Department of Health and Human Services (HHS) issued a Bulletin outlining a proposed regulatory approach to defining "essential health benefits" under the Affordable Care Act.
Dec 19, 2011
External Review Checklist: Contract and Administration Issues Related to Independent Review Organizations (IROs)
This document provides a checklist of issues for plans to consider when contracting and working with IROs.
Nov 10, 2011
Summary Plan Description (SPD) Checklist: Internal Claims and Appeals and External Review
This document provides a checklist of provisions to include and issues to consider when amending SPDs to include internal claims and appeals and external review requirements under the Affordable Care Act.
Nov 10, 2011
EEOC Regional Office Raises GINA Concerns for Employers Providing Spouse Incentives to Complete Health Assessments
At least one EEOC regional office has interpreted the Genetic Information Nondiscrimination Act (GINA) as prohibiting an employer from providing an incentive for a spouse to complete a health assessment, but the Business Group disagrees with this interpretation.
Oct 18, 2011
CMS Issues Additional Medicare Secondary Payer Guidance on Health Reimbursement Arrangements
Recently, the Centers for Medicare and Medicaid Services issued guidance that eases the Medicare Secondary Payer reporting burden for many health reimbursement arrangements.
Oct 4, 2011
Federal Agencies Release Amended Rules and New Guidance for Internal Claims and Appeals and External Review Processes under PPACA
The Internal Revenue Service (IRS), Department of Labor (DoL) and Health and Human Services (HHS) issued an amendment to the interim final regulations and technical release for internal claims and appeals and external review processes.
Jun 24, 2011
A Guide for Employers: Using Comparative Effectiveness Research - Renal Artery Stenosis Treatments
This guide provides actions suggested by the National Business Group on Health for employers who want to use comparative effectiveness research (CER) in their health plan and program design. It is based on research funded by the Agency for Healthcare Research and Quality (AHRQ).
Jun 20, 2011
A Guide for Employers: Using Comparative Effectiveness Research - Rotator Cuff Tears in Adults
This guide provides actions suggested by the National Business Group on Health for employers who want to use comparative effectiveness research (CER) in their health plan and program design. It is based on research funded by the Agency for Healthcare Research and Quality (AHRQ).
Jun 20, 2011
A Guide for Employers: Using Comparative Effectiveness Research - Choosing to Have Labor Induced: Safety and Harm
Provides actions suggested by the National Business Group on Health for employers who want to use comparative effectiveness research (CER) in their health plan and program design. It is based on research funded by the Agency for Healthcare Research and Quality (AHRQ).
Jun 6, 2011
A Guide for Employers: Using Comparative Effectiveness Research - Treatments for Knee Osteoarthritis
Provides actions suggested by the National Business Group on Health for employers who want to use comparative effectiveness research (CER) in their health plan and program design. It is based on research funded by the Agency for Healthcare Research and Quality (AHRQ).
Jun 1, 2011
Innovations In Plan Design: Better Health at a Lower Cost
An new value-based benefit design product introduced by health plans in the Oregon market is designed to achieve up to 10% reduction in premium while addressing underuse of effective care and overuse of preference and supply-sensitive interventions.
Jul 30, 2010
An Employer's Guide to Behavioral Health Services
Provides an overview of employer-sponsored behavioral health services in the United States, including services offered through Health plans, disability management programs, and employee assistance programs. The guide includes statistics on the costs and consequences of behavioral health conditions and provides a set of recommendations that employers can use to improve the design, implementation, and evaluation of their behavioral health benefits and worksite programs.
Dec 16, 2005
An Employer's Guide to Behavioral Health Services Executive Summary
An executive summary to the guide that includes an overview of employer-sponsored behavioral health services; costs associated with mental illness and substance abuse treatment; and recommendations to improve the design, implementation, and evaluation of behavioral health services.
Dec 16, 2005

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