The most-read blogs of 2018 reflect a year of staying the course amid uncertainty over the future of healthcare. Contributions weighing the growing impact of healthcare costs were intertwined with speculation about the future of health and wellness and the ever-elusive quest to get employees to save more for retirement.

The following blogs were among the most popular stories on Employee Benefit Adviser and still hold important information for advisers to revisit going into the new year.
10. The new role of HRAs after Trump’s ACA executive orders
The president wants to allow for health reimbursement arrangements to be used for non-group coverage to employers of all sizes. If this happens, this is as an industry-redefining disruption.

Author: Four8 Insights’ Shandon Fowler

Excerpt: “It’s a huge decline in administration required by employers while taking care of an onerous part of the process for individual. When you compare that to other brokerages’ message of digging in and expending more effort to control your healthcare costs, it would seem that the former would be far more favorable to the latter.”
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Checking sales spreadsheet numbers on a computer screen. Canon 5D Mark II.
9. Still selling products? Your days are numbered
Brokers clinging to ways of doing business in the past, such as insurance spreadsheeting, are headed toward a quick retirement.

Author: Q4intelligence’s Wendy Keneipp

Excerpt: “Those approaching the role from the perspective of a consultant, whose job is to constantly educate themselves and offer advice and counsel around business strategy, are seeing refreshingly new conversations with employers.”
open enrollment
Maryland Health Connection health insurance marketplace pamphlets sit at a Community Clinic Inc. health center in Takoma Park, Maryland, U.S., on Tuesday, Oct. 1, 2013. Government-run health insurance exchanges, the cornerstone of the 2010 Affordable Care Act, opened their doors today for sales of subsidized bronze, silver, gold or platinum policies, with correspondingly higher costs. Coverage begins in January and enrollment lasts through March 2014. Photographer: Andrew Harrer/Bloomberg
8. The basics of health insurance captives for small employers
Long used by larger companies, advisers should be knowledgeable about how these medical stop-loss systems are now benefitting a wide range of businesses.

Author: Axial Benefits Group’s Mick Rodgers

Excerpt: “When an adviser does not have the size or client volume to create their own captive, joining together with other advisers is a seemingly smart way to overcome size-driven limitations.”
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7. How the new AHP rule changes will transform small businesses
The DOL upended the traditional dynamic of company-sponsored benefits and threw a lifeline to millions of small companies and their HR teams.

Author: Decisely’s Kevin Dunn

Excerpt: “The job of the AHP is to aggregate and manage member needs to secure coverage on behalf of its members. The AHP often contracts with a broker specializing in small business and program management to create a benefits portfolio for the members, negotiate with insurers on its behalf, and provide program management.”
6. Stop making 401(k) contributions. Fill up your HSA first
Employers, here’s why you should tell employees contributing to a triple-tax-free health savings account is more valuable and versatile than boosting a retirement plan.

Author: Lawton Retirement Plan Consultants’ Robert Lawton

Excerpt: “HSA accounts are a tax-efficient way of paying for healthcare expenses in retirement, especially if the alternative is taking a taxable 401(k) or IRA distribution.”
5. What advisers should know about the first reference-based pricing lawsuit
Hailed as a more rational way for employers to pay for healthcare, the case highlight’s the strategy’s risks.

Author: BerniePortal’s Alex Tolbert

Excerpt: “The thinking is that that no hospital wants to take on the public relations battle that could result from suing or bankrupting a former patient over a balance bill.”
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Close up photo of a stethoscope on top of a stack of United States cash.
4. The rise of reference-based pricing
How brokers can benefit from this trend driving big changes, such as the CVS/Aetna merger.

Author: BerniePortal’s Alex Tolbert

Excerpt: “This option for self-funded employers limits costs by providing a fixed amount for certain healthcare services and negotiating directly with providers, usually through a third-party administrator.”
3. IRS retroactively reduces HSA contribution limit
Employees with family coverage in a health savings account may feel the effects in their tax bills for 2018.

Author: Seyfarth Shaw’s Nicol Bogard, Diane Dygert, Peter Varney and Joy Sellstrom

Excerpt: “Unless they have already implemented modifications to accommodate the new limit for the present, sponsors and administrators may prefer to hold off on HSA program changes to see whether relief is forthcoming.”
A blood pressure monitor stands in the diagnostic imaging area at the Hong Kong Integrated Oncology Centre in Hong Kong, China, on Tuesday, Nov. 3, 2015. Equipped with biopsy facilities, body scanners, and quiet 'VIP' chemotherapy rooms, the Hong Kong Integrated Oncology Centre is the first of a string of such facilities that TE Asia Healthcare Partners, a portfolio company funded by TPG Capital, is planning in Asia. Photographer: Xaume Olleros/Bloomberg
2. The end of the health insurance carrier
What does the future hold? At the very least, it’s the beginning of the end for some of these dinosaurs.

Author: Bottom Line Solutions’ Nelson Griswold

Excerpt: “With control of the health plan thanks to self-funding, the employer can work with a NextGen benefits adviser who knows how to manage the supply chain to both improve the quality and lower the cost of healthcare for the employer and employees.”
1. 9 myths about Section 125 plans
Many employers wrongly believe they don’t need a plan document in place and think that health insurers are experts on regulations.

Author: CBIZ’s Zack Pace

Excerpt: “Employers are not required to include all permissible events in the plan document. Now is a good time to double-check if your plan excludes any of these and if there continues to be a solid rationale for doing so.”