health plan

In this episode, John gives his insight on recent developments on one of this year’s trending healthcare topics, pharmacy benefit managers (PBM) and pharmaceutical rebates.

• CVS announced that it is launching a new pharmacy benefits plan that returns 100 percent of drug rebates to its clients. In a statement, CVS said its new Guaranteed Net Cost pricing model “more closely aligns PBM incentives with plan sponsors’ objectives” by offering more predictability and transparency.

About Darwin Research Group
Darwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes forward-thinking biopharmaceutical and medical device companies, as well as health care providers, private equity, and venture capital firms. The company was founded in 2010 as Darwin Advisory Partners, LLC and is headquartered in Scottsdale, Ariz. with a satellite office in Princeton, N.J.

John shares our take on what happened in health care at the beginning of August including extended coverage through the Affordable Care Act, as well as a new direct-to-employer contract between Henry Ford Health System and General Motors.

• The Trump administration issued a final rule concerning short-term health plans. Consumers can now extend coverage for up to a year, with the option to renew for up to three years.
• Henry Ford Health System announced that it signed its first direct-to-employer contract with General Motors. Starting in 2019, Henry Ford will provide health care management and wellness services to 24,000 salaried GM employees and their families in southeast Michigan.

About Darwin Research Group
Darwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes forward-thinking biopharmaceutical and medical device companies, as well as health care providers, private equity, and venture capital firms. The company was founded in 2010 as Darwin Advisory Partners, LLC and is headquartered in Scottsdale, Ariz. with a satellite office in Princeton, N.J.

Section 125 plans provide a simple and effective way to add employee benefits, especially for businesses with a number of employees who regularly have medical and childcare expenses. Employees can deduct their insurance premiums pretax and set aside pretax funds to use toward qualified medical and dependent care expenses. Business owners can experience decreased company payroll and tax liabilities for social security, Medicare, and unemployment. But, before you start pre-taxing, be sure to have the right documents in place!

In January 2017, the IRS Office of Chief Counsel issued a memorandum clarifying the tax treatment of certain types of fixed indemnity plans offered by employers. Since the memorandum was released, several fixed indemnity plan insurance carriers have pushed back, stating that the interpretation of the IRS memo was too broad and should not affect the taxation of such plans. Listen in to learn how and if this affects various types of hospital and critical care reimbursement plans, cancer and accident plans, and other similar type lump sum reimbursement arrangements.