14 September 2018 By

New Jersey Enacts
Statewide Paid Sick Leave

On May 2, 2018, New Jersey Governor Phil Murphy signed the Paid Sick Leave Act (Act) into law. The Act will require virtually all employers to provide paid sick leave to employees, effective Oct. 29, 2018. Under the Act:

  • All New Jersey employers must provide paid sick leave to their employees;
  • Employees will accrue one hour of paid sick leave for every 30 hours worked, up to 40 hours per year; and
  • Employees must be paid for paid sick leave at the same rate (and with the same benefits) they normally earn.

 This Compliance Bulletin provides an overview of the Act.

The attached Compliance Bulletin is information about the NJ Paid Sick Leave law which will take effect on October 29th.  You may have to change your PTO policy to comply with the new law. 

04 September 2018 By
The cost of medical and prescription programs continue to rise at an alarming rate.  If your program is fully insured, you are probably frustrated by the double digit rate increases and the lack of transparency (no claims experience provided) by the insurance carrier.  And if you are self insured, you may have additional claims exposure for stop loss lasers being imposed on certain members and very high increases on your stop loss renewals.
16 August 2018 By

If you currently work with OCA for HRA, FSA and/or COBRA administration, I wanted to let you know that there will be an important announcement next week that OCA will be converting to a new administrative system upon your next renewal.  On or about August 22nd, OCA will be sending out communications to clients announcing the change to a new platform, how it’s a massive upgrade from their current system, the weekly webinars they will be hosting to review the new enhanced platform, the new features that will impact participants, HR and the Finance Department, and the transition timeline to the new system.

What we do know so far is that no new paperwork will need to be completed.  Also, there will be no changes or disruption with regard to manual claims submission/payment processes, but participants will receive new benefit cards for the new plan year and will need to create a new benefit login for their online and mobile app.

Please let me know if you do not receive the email from OCA, and let me know if you have any questions.  We will keep you informed of further developments.

Barry E. Fields
Vice President, Employee Benefits

JGS I N S U R A N C E
Cell: 908-406-7000 | Fax: 732-834-0233
101 Crawfords Corner Road, Suite 1300, Holmdel, NJ 07733


31 July 2018 By

Below is a rather long, but interesting and informative article about new legislation that will help protect your employees from out-of-network billing for services that were received at in-network facilities.  Good examples of this is emergency rooms, anesthesiologists, radiology and lab services who are usually not participating with any carrier, or at least may not be participating with your particular carrier.  It is precisely this mismatch of participation status that leads to the so-called surprise bills. 

The interpretation, implementation and administration of the law is complicated and while it may not actually alleviate claims issues from arising, it’s a big step in the right direction because the intent of the law is clear and its patient protections will potentially improve the outcomes and reduce costs.

I will keep you apprised of any further developments.  Please let me know if you have any questions.

Barry E. Fields
Vice President, Employee Benefits

JGS I N S U R A N C E
Cell: 908-406-7000 | Fax: 732-834-0233
101 Crawfords Corner Road, Suite 1300, Holmdel, NJ 07733


If services are either out-of-network “inadvertently” or are “emergent,” the provider is barred from billing the patient in excess of their deductible, copayment or coinsurance obligation.

On June 1, Assembly Bill 2039 became law, ushering in bold patient protections and blockbuster realignment of claims-handling processes. Effective Aug. 30, extinction of “surprise” out-of-network claims is its goal. Patient protections now secured, the true “surprise” awaits providers and carriers scrambling to meet disclosure requirements and the uncertain fiscal impact upon plans who must comply.

A new claims order

Protection under the act hinges upon two classifications of medical charges.

The first category addresses out-of-network services that are “knowingly, voluntarily and specifically” selected. In these circumstances, aside from brief disclosure obligations of the provider (discussed later), no further protections apply.

The second category really shakes things up. Major patient protection provisions are created. Claims practices between providers and payers are significantly modified. Namely, if services are either out-of-network “inadvertently” or are “emergent,” the provider is barred from billing the patient in excess of their deductible, copayment or coinsurance obligation. This is the hallmark achievement of the act, sparing patients from so called “surprise medical billing.”
Page 1 of 40

Contact us

For questions or more information, please contact us by phone or email.

AWARDS

Connect with us

We're on Social Networks. Follow us & get in touch.