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Testimony: Wellness Programs and Nondiscrimination Under Employer-Sponsored Group Health Plans

This testimony by the Foundation’s Karen Pollitz before the Equal Employment Opportunity Commission included background on wellness programs, wellness incentives and nondiscrimination since 1996, and questions and issues related to proposed regulations governing the design and application of wellness programs offered in conjunction with employer-sponsored group health plans.

Comparison of Consumer Protections in Three Health Insurance Markets: Medicare Advantage, Qualified Health Plans and Medicaid Managed Care Organizations

This report examines similarities and differences in federal consumer protection standards for Medicare Advantage (MA) plans, Qualified Health Plans (QHPs), and Medicaid Managed Care Organizations (MCOs). It focuses on rules established at the federal level, though some states have chosen to go above the federal minimums and impose additional requirements for QHPs and Medicaid MCOs.

JAMA Forum: Surprise, Surprise

Larry Levitt’s February 2016 post explains how “surprise medical bills” — unanticipated charges for out-of-network care – can happen. It describes some government approaches to the issue and outlines the challenges to protecting consumers. The post is now available at The JAMA Forum.

Workplace Wellness Programs Characteristics and Requirements

This issue brief summarizes what’s known about workplace wellness programs offered by employers today and the use of financial incentives to encourage workers to participate. Findings are drawn from the KFF/HRET Annual Employer Health Benefits Survey. In addition, the brief reviews proposed changes by the Equal Employment Opportunity Commission (EEOC) in federal standards governing financial incentives by workplace wellness programs and how these changes might balance the use of incentives against other discrimination and privacy protections.

Short-Term Limited Duration Plans and HIV

Given the Trump Administration’s promotion of short-term limited-duration (STLD) health insurance policies, this brief examines what they mean for people with HIV. The analysis assesses whether people with HIV could enroll in STLD plans by applying to 38 plans across five states and getting in each case. It also assesses whether such plans could meet basic HIV care and treatment needs for someone diagnosed once enrolled. This finding takes on new importance in light of the Administration’s decision not to defend the ACA and to argue for eliminating pre-existing condition protections.

Medigap Enrollment and Consumer Protections Vary Across States

A quarter of people in traditional Medicare had private, supplemental health insurance in 2015—also known as Medigap—to help cover their Medicare deductibles and cost-sharing requirements, as well as protect themselves against catastrophic expenses for Medicare-covered services. This issue brief examines implications for older adults with pre-existing medical conditions who may be unable to purchase a Medigap policy or change their supplemental coverage after their initial open enrollment period.

300+ FAQs Help Consumers Understand the ACA Marketplaces as Open Enrollment Begins

Ahead of the annual Affordable Care Act (ACA) open enrollment period, the time during which consumers can shop for health plans or renew existing coverage, KFF has updated and expanded its searchable collection of more than 300 Frequently Asked Questions about open enrollment, the health insurance marketplaces and the ACA.…