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.     

U.S. Health‐care Reform: The Patient Protection and Affordable Care Act

This short article provides an overview of the Patient Protection and Affordable Care Act, which was approved by the U.S. Congress and signed by President Barack Obama in March 2010, with an emphasis on provisions related to the expansion of health insurance. It highlights key provisions concerning coverage expansion, insurance market reforms, and the projected costs and financing of the legislation.     

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.     

Employers and health plans: purposeful partnerships

This article discusses the advantages of developing a partnership between the employer and the health benefit vendor. The author explains that there are three types of employer/vendor relationships ranging from the minimal transaction based to the value based and finally to a partnership-based arrangement. Success depends upon whether the chosen relationship strategy supports the business objectives, organizational culture and effective plan execution.     

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.     

Managing health and welfare plans instead of letting them manage you

The explosive growth and change in the health care provider industry is presenting a considerable challenge to employers that manage these benefits for their employees. Corporate mergers, supportive federal and state legislation expanding benefit availability and access to new consumer markets are a few of the forces changing the shape of the industry. Furthermore, participants are more knowledgeable about their benefit plans and are more vocal about their needs. The authors discuss these challenges and possible solutions for the employer that is attempting to determine how plan delivery and management needs can be served in a way that supports business environment and strategy.     

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。     

论劳动基准法中用人单位的惩罚性赔偿责任

劳动基准具有公私法交融的社会法品格,其义务主体为用人单位,其权利主体则有国家和劳动者。当用人单位违反劳动基准义务,不仅应承担对国家的公法中的责任,还应承担对劳动者的私法中的责任。为追求实质公平、建立正确的利益导向机制以及构建与劳动基准法相匹配的责任制度,有必要在劳动基准法中引入惩罚性赔偿制度     

A model of the Federal Reserve Act under the international gold standard system

Freeman (Am. Econom. Rev. 86 (1996a) 1126) shows that an elastic money supply enhances the efficiency of monetary equilibrium by clearing default-free debts at par value in the domestic credit market. This research adds a foreign exchange market to Freeman's model and extends his analysis into a two-country model, in which the arrival rates of agents are not equal between the two countries. In this model, an elastic money supply in the foreign exchange market to clear the exchange of fiat monies at gold standard parity, accompanied by an elastic money supply in the domestic credit market, could improve the efficiency of monetary equilibrium.     

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。     

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.