Patient Protection and Affordable Care Act: implications of status grandfathered plan

What is the perspective of today's employers when facing the decision of whether to retain status as a grandfathered plan under the Patient Protection and Affordable Care Act (PPACA)? This article reviews the mandated benefit and underwriting changes for grandfathered employer group health insurance plans. It then describes the challenges employers face in maintaining grandfathered status and the potential advantages and disadvantages to doing so. Finally, the author demonstrates how the employers' perspective is one where the absence of government information and guidance on complex-related issues prevents employers from making fully informed decisions. In effect, employers are being forced to choose whether to maintain grandfathered status without the benefit of knowing what the final rules are.     

Statistical Implications of the Revenue Transfer Methodology in the Affordable Care Act

The Affordable Care Act (ACA) includes a permanent revenue transfer methodology that provides financial incentives to health insurance plans that have higher than average actuarial risk. In this article, we derive some statistical implications of the revenue transfer methodology in the ACA. We treat as random variables the revenue transfers between individual insurance plans in a given marketplace, where each plan’s revenue transfer amount is measured as a percentage of the plan’s total premium. We analyze the means and variances of those random variables and deduce from the zero-sum nature of the revenue transfers that there is no limit to the magnitude of revenue transfer payments relative to plans’ total premiums. Using data provided by the American Academy of Actuaries and by the Centers for Medicare & Medicaid Services, we obtain an explanation for empirical phenomena that revenue transfers were more variable and can be substantially greater for insurance plans with smaller market shares. We show that it is often the case that an insurer that has decreasing market share will also have increased volatility in its revenue transfers.     

Education and advice under ERISA for employee-directed 401(k) plans

Section 404(c) regulation sets forth the conditions that plan fiduciaries must meet to be relieved of liability for the consequences of employees' control over their accounts. After reviewing applicable laws and regulations, the author concludes that employers desiring to provide employees with education and/or advice services through a third party should be able to do so while still obtaining reliance on the protections of Section 404(c) and without taking on significant additional fiduciary responsibilities.     

The effect of the Senior Citizens' Freedom to Work Act of 2000 on employer-provided pension and medical plans

On April 7, 2000 President Clinton signed the Senior Citizens' Freedom to Work Act. The act reduces the Social Security retirement benefit penalties previously imposed on 65- through 69-year-old workers who earned more than nominal incomes after enrolling in the program. This article analyzes the impact that the act will have on retirement decisions of the affected cohorts of older workers and closes with an analysis of how the act may affect employer-provided pension, medical and paid leave plans.     

Performance Measurement in Health Care: History,Challenges and Prospects

A confluence of forces has resulted in massive changes to the collection and use of performance data in the UK health system over the past 25 years. Performance measurement offers major potential benefits for clinical professionals, managers, regulators, politicians, researchers, patients and citizens. However, uncritical reliance on performance data can lead to a number of unintended and adverse consequences. The National Health Service has pioneered the assembly and dissemination of performance data from the early 1980s. This article summarizes the history of performance measurement in the NHS, assesses its effectiveness to date, discusses the major challenges in deploying performance measures, and highlights priorities for policy-makers.     

Performance Measurement in Health Care: History, Challenges and Prospects

A confluence of forces has resulted in massive changes to the collection and use of performance data in the UK health system over the past 25 years. Performance measurement offers major potential benefits for clinical professionals, managers, regulators, politicians, researchers, patients and citizens. However, uncritical reliance on performance data can lead to a number of unintended and adverse consequences. The National Health Service has pioneered the assembly and dissemination of performance data from the early 1980s. This article summarizes the history of performance measurement in the NHS, assesses its effectiveness to date, discusses the major challenges in deploying performance measures, and highlights priorities for policy-makers.     

长期护理保险的理论研究:进展与前景

随着中国步入老龄化社会、家庭结构小型化和空巢家庭增加,导致了传统家庭养老模式的转变,老年人对专业化护理的需求日益增长。长期护理状态发生的不确定性以及专业护理费用的攀升,使得长期护理风险愈加突出,并将成为一种重要的社会风险。因此,开发长期护理保险产品在我国存在巨大的市场空间。本文从长期护理保险的需求、定价以及运作模式等方面回顾了国内外长期护理保险的理论研究进展,同时提出了需要进一步研究的领域和方向。     

关于加强对保障性住房建设金融支持的建议

保障性住房建设是关系人民群众切身利益和经济社会发展大局的重大民生工程。但当前金融支持保障性住房建设还面临着许多问题和制约因素。有效解决这些实际问题,更好地发挥银行信贷和金融服务在保障性住房建设中的资金融通作用,对于促进保障性安居工程的顺利实施具有极其重要的意义。     

创新我国企业年金监管制度——基于对全球金融危机的反思

在金融混业经营背景下,如何创新我国企业年金监管的制度安排,以便加强对企业年金委托—代理链条上的风险点的监管,克服市场失灵,防止出现多米诺骨牌效应,降低国家社会保障的系统风险?笔者利用制度经济学等理论分析了我国企业年金监管制度,在反思美国金融混业背景下的企业年金监管制度的基础上,从制度框架和监管机制两个方面提出创新中国企业年金监管制度安排的对策建议。     

提供经济适用房准入标准的利弊思考

地方政府为了完成保障房指标,超比例投资建设经济适用房造成经济适用房空置,为盘活空置的经济适用房,拟向中高收入人群提供经济适用房。本文将这二项作为研究对象,发现第一个政策解决了财政资金问题,却遇到意向不到的问题;第二个政策可以解决空置经济适用房占用财政资金问题,但在实施过程中将遇到与国家一些法律法规发生冲突的难题。向中高收入人群提供经济适用房的利弊得失,实际是在考验地方政府的智慧和施政能力。     

中国的崛起与人民币的前景

编者按:中国的发展引起了世界的广泛关注,人民币的未来地位如何一直是国内外经济学家、战略家以及政治家思考的问题.本文是理查德·布尔德克教授提供给本刊的专稿,这是一篇评述性文章,至少我们从中看出国外对这一问题的热切关注.理查德·布尔德克教授是美国加州克莱蒙特麦肯纳大学的乔纳森·洛夫雷斯经济学教授.感谢本刊特约编辑詹姆斯·巴茨(James R. Barth)博士的约稿和推荐.     

GSE Activity,FHA Feedback,and Implications for the Efficacy of the Affordable Housing Goals

There is a seeming paradox regarding the “affordable housing goals”: GSE activities in targeted communities have increased under the goals but there has been little measurable improvement in housing market conditions in these communities. This paper seeks to reconcile this paradox by focusing on linkage between GSE purchases and FHA activities. We present a simple theoretical framework suggesting that GSE activities can have a feedback effect on FHA. More aggressive GSE pursuit of targeted borrowers under the affordable housing goals induces potential FHA borrowers with best credit quality to use the conventional market. Changes to the housing market will depend on the FHA response to the loss of its best credits, with many different possible outcomes for credit supply and homeownership, including scenarios in which they remain effectively unchanged. While market-level benefits might not be forthcoming, the shift from FHA to less costly conventional loans is clearly beneficial for affected borrowers. Two-stage least squares estimates of the relationship between GSE and FHA lending after the affordable housing goals were made more binding are found to be consistent with the theoretical predictions.

Patient Power: The Free-Enterprise Approach to the U.S. Health Care Problem

Giving people choices in health care and instilling cost-consciousness is plain old common sense. In Medical Savings Accounts, authors Goodman and Musgrave have hit upon a bold concept that may revolutionize the way health care is delivered throughout America.     

意大利的银行业与经济前景

欧盟作为一个整体在全球金融体系中处于非常重要的地位,然而欧盟成员国有自己的独立性,需要应对自身金融体系所存在的问题。     

Reducing Strategic Forbearance under the CARES Act: an Experimental Approach Utilizing Recourse Attestation

The Journal of Real Estate Finance and Economics - The Coronavirus Aid, Relief, and Economic Security (CARES) Act was passed in response to both the global pandemic’s immediate negative and...     

2011年国际经济金融形势展望

当前,世界经济发展可谓冰火两重天:发达国家经济复苏前景莫测,新兴市场国家经济发展面临过热;欧美日等发达经济体试图采取更宽松的货币政策,而新兴市场国家已启动加息进程,货币政策趋向从紧。IMF对世界房地产市场的预测颇显悲观,认为以中国为代表的发展中国家的房地产市场泡沫严重。发达国家出于恢复贸易收支平衡的动机要求人民币升值,国际贸易中的磨擦加剧,外贸企业经营风险上升。     

Labor Department regulations for Family and Medical Leave Act

Interim regulations issued by the Department of Labor provide employers with significant guidance on compliance with the Family and Medical Leave Act.