Employer sponsored health plans have evolved significantly over the past few years, and employers have access to a myriad of tools and resources to assist them in managing risk, performance, and efficient utilization within their health plan.
Basic services such as claims payment, disease management, data analytics, etc. have become so complex and use terms that have become so nebulous in their meaning, that employers need to have a better grasp of the capabilities of each aspect of their plan. Additionally, they require a deeper understanding of the roles and responsibilities of each piece of their plan, and how those pieces come together to form a complete program.
With Health Care Reform as the catalyst, we will deeply explore each aspect of both a fully-insured and self-funded health plan. We will also discuss what high performing companies, vendors, and employers are doing, and what you should be asking of your partners.
In this presentation, Jason Rothman, an employee benefits attorney with the international labor and employment law firm of Ogletree, Deakins, Nash, Smoak and Stewart, P.C. will cover two key employee benefit plan issues that all employers must understand: (1) the Affordable Care Act employer mandate, including guidance issued this summer delaying employer mandate assessments until 2015; and (2) the U.S. Supreme Court’s recent decision in the case of United States v. Windsor ruling that Section 3 of the Defense of Marriage Act (DOMA) is unconstitutional. These two developments significantly impact employee benefit plans and require employers to take strategic action in the near future to comply with the requirements thereunder.
Employers and HR departments who are ahead of the game concerning Healthcare Reform are will excel above those who aren't. This presentation will be a good resource from a planning and execution phase this year as we work through this ever-important navigational transition happening now. You'll learn about the entire delivery system from the time you sign the expensive group insurance rates to the time your employee walks in the door at the doctors office and how it all ties in. Stay up to speed on the newest trends, technology, and tolls available to you and your staff as well.
Dependent Eligibility Verification Audits are an increasingly integral part of health care cost containment, ERISA compliance, and PPACA "Pay or Play" analysis. On average, 4-8% of Dependents enrolled in company benefits are NOT eligible. This costs employers 10's of thousands, 100's of thousands - even millions of dollars annually. Time and Money are the most common objections to conducting an audit, along with fear of adverse employee reaction. This webinar explores Best Practices, mistakes to avoid, and the substantial ROI achieved from a comprehensive dependent audit.
Participants will learn what fraud in a benefits plan looks like, how prevalent fraud really is, and what type of savings they can generate for their company with an audit.
Nobody- not Congress, the US Supreme Court, the President or any Wellness Initiative- can immediately impact the cost of health care better than a Dependent Eligibility Audit. Dependents are responsible for over 70% of most company’s health care costs, but on average, 4-8% of those dependents are ineligible for coverage and cost individual employers a FORTUNE annually. Whether your company has 50 employees or 5,000, this session will de-bunk universal myths surrounding Dependent Audits like “We don’t have fraud” (yeah, right!) and share best practices and worst mistakes. Attendees also receive an ROI calculator tool to determine expected savings in their own company.
With the Form 5500 season upon us, this presentation will address basic reporting requirements, provide practice tips, highlight areas the DOL and IRS are focusing on, and walk through how to avoid the top five Red Flags your filings may have.
This presentation will guide HR professionals through the Form 5500 filing to help them gain a better understanding of the information required to be reported and Find out what is new for 2012, how to simplify indirect (Schedule C) service provider compensation reporting, what is and how to report ‘nonmonetary compensation’ and how to perform an effective manager review of each filing before submission.
This course reviews the Affordable Care Act. The first part of the course discusses the general requirements of the Affordable Care Act, including those requirements that apply to companies today. Specifically, the course discusses the extension of dependent coverage to age 26, limits on pre-existing conditions and essential health benefits, coverage of emergency services, cost-sharing restrictions on certain preventive care coverages, the new appeals process, initial authorization by primary care physician restrictions, limits on reimbursements of certain medications, automatic health plan enrollment, additional preventive services, non-discrimination requirements, and more.
The second part of the course discusses requirements that take effect in 2012 and beyond. Specific topics include health FSA salary reduction contribution limits, Medicare Part D subsidy elimination, changes to waiting periods, limitations on pre-existing conditions and essential health benefits, restrictions on cost-sharing, clinical trial requirements, wellness programs, new Summary of Benefits and Coverage regulations, new HIPAA certification requirements, state Exchanges, the individual mandate, and more.
Penalties and taxes associated with non-compliance are also reviewed. Among the penalties and taxes that are reviewed are: the Code section 4980D health plan non-compliance excise tax, the excise tax on HSA distributions for non-medical purposes, the annual fee assessed on plan sponsors, medical loss ratio rebates, medical expenses deduction limit, additional FICA and SECA payroll tax, new investment income tax, $2,000 penalty for each full-time employee who seeks coverage through Exchanges, $3,000/$2,000 penalty for each full-time employee who receives a subsidy because employer’s coverage is unaffordable, annual fee on certain entities that provide health insurance, reinsurance fee, 40% excise tax on “cadillac” insurance plans, and more.
This session will address the new fee disclosure documents and offer plan sponsors the keys to deciphering the information provided therein. We will also map out the next steps required of plan sponsors: 1) benchmark the services provided and the fees received to determine reasonableness, 2) provide participant-level fee disclosure. Like the game Where’s Waldo??, this session will give you the maps and guidance to find the character – but more importantly, find answers and practical action steps. Simply filing the disclosures away will only lead to problems when the next disclosure requirement hits in August 30th. The DOL is offering plan sponsors an opportunity to fix their plans and we can help show the way. Don’t miss this session!
The purpose of this webinar session would be to discuss in detail the fees that must be disclosed beginning August 30, 2012
How often thereafter these fees must be disclosed
To whom must these fees be disclosed and in what formats
Exactly what fees must be disclosed
What are some strategic courses of action you might consider in preparing for fee disclosure
And what proactive preparations might you consider for the inevitable day when participants coming knocking on your door with questions about these fees?
You will learn:
a. how to prepare for August 30
b. how to prepare for after the first disclosure reactions
c. who can help you prepare for those two events
A variety of factors have contributed to the stunning rise in litigation against retirement plan fiduciaries. This problem for employer/plan sponsors is compounded by two other facts. First, ERISA imposes personal liability on plan fiduciaries. Second, many corporate officers, employees and even board members serve as ERISA fiduciaries. Some knowingly. Some not.
As in many other areas of the law (and American society) the courts have rapidly expanded the remedies available to sympathetic plaintiffs and the possible claims against “deep pocket” defendants. For a fiduciary accused of breaching his or her duties under ERISA, the stakes are high. The federal courts have uniformly held that ERISA's fiduciary duty is "the highest duty known to the law." ERISA authorizes lawsuits against a plan fiduciary by plan participants, beneficiaries, the plan administrator, other plan fiduciaries, and the U.S. Department of Labor. Both civil and criminal penalties can apply.
However, there are strategies to protect plan fiduciaries from potential liability. The surprising thing is how many employers/plan sponsors fail to take full advantage of these strategies. Human resources professionals should act to protect their officers, employees, board members and others who serve as ERISA fiduciaries.