Midweek update

Fedweek reminds us that the Federal Benefits Open Season is winding down.

While FEHB and FEDVIP coverage continue unchanged unless the enrollee makes a change during the open season, a new enrollment is required each year for those who want a health care flexible spending account, a dependent care account, or both in the following year.

The dependent care maximum remains $5,000 while the health care maximum is rising to $2,700 (a figure set by the IRS after materials were prepared reflecting the old $2,650 figure). Also, you must have a health care account in the following year to take advantage of the $500 allowable carry-over in that type of account.

The Open Season ends on Monday December 10.

CVS Health today announced a new pricing policy for employer sponsored health plans known as its guaranteed net price model. Healthcare Finance explains that

The guaranteed net cost is calculated using plan utilization and expected rebate value, and applying projected drug price inflation and expected shift in drug mix, such as from brands to generics.

Moreover,

[CVS Health] would be accountable for the impact of drug price inflation and shifts in drug mix [and,]

Clients will continue to have the option to implement point-of-sale rebates to provide plan members visibility into the net costs of their medication. 

Speaking of CVS Health, Fierce Healthcare tells us that CVS Health's Aetna subsidiary closed yesterday on the sale of its Medicare Part D business to Wellmark which was the Justice Department's prerequisite to approving the merger under federal anti-trust laws.

As of Sept. 30, WellCare has 1.1 million Part D members. Aetna's business adds 2.2 million more, pushing the insurer ahead of Blue Cross Blue Shield and Express Scripts in terms of Part D market share 

Forbes columnist Avik Roy explains why all healthcare consumers will benefit if the Senate joins the House in suspending the ACA's onerous health insurer tax for 2020 and 2021. The tax was in effect in effect for 2014-16 , suspended for 2017, and resurrected for 2018. Congress suspended the tax for 2019. Roy explains, and the FEHBlog heartily agrees that

[T]he blue ribbon for the Dumbest Tax in Obamacare goes to its tax on health insurance premiums, which the Joint Committee on Taxation estimates as raising $161 billion in revenue between 2019 and 2028. (The number would be higher, but for the fact that Congress passed a one-year premium tax holiday for 2019.) 

The problem is this: Health insurers aren’t in the business of going broke. So they pass along the cost of the tax in the form of higher premiums for consumers. According to estimates developed by consultants at Oliver Wyman, for every dollar Washington raises in taxes, premiums go up by around $1.27.

That translates to an annual premium increase in 2020 of $196 per person for those buying coverage through Obamacare; $458-479 for individuals obtaining coverage through their employers [including the FEHBP]; $241 for enrollees in Medicare Advantage; and $147 for enrollees in Medicaid managed care plans.

Hopefully the Senate will pass this bill before the lame duck session ends later this month.

HHS's Office for Civil Rights announced a $500,000 plus compliance program settlement with a Florida hospitalist practice which was sharing protected health information with a billing service vendor without first putting a business associate agreement in place.