Benefit plans are subject to a seemingly never-ending procession of compliance requirements, and even minor problems can lead to significant consequences for employers, fiduciaries, and participants. Fortunately, there are a number of ways you can deploy plan documents and summary plan descriptions to minimize the likelihood of problems, and when Murphy’s law inevitably rears its head, the IRS and DOL offer a number of correction programs that can be used to cure the most common benefit plan ailments. In this session, you will learn practical plan drafting techniques to help you avoid compliance problems along with the (relatively) painless ways that common problems can be corrected under IRS and DOL guidance.
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.
New U.S. regulations in the health privacy field present a number of compliance challenges for employer plans during 2013 and 2014. This session will summarize the basic rules under the Health Insurance Portability and Accountability Act (HIPAA), describe the new final regulations and their changes, and provide practical compliance assistance in areas of particular concern to employers. Among other topics, the session will cover: the changing status of business associates under HIPAA business associate agreements; the new standards for evaluating breaches of security, including risk assessment, notification, and reporting obligations; restrictions on the use of genetic information for health plan underwriting and related notice obligations; new participant rights; and enhancements to the HIPAA enforcement regime and civil penalties. Attendees will have an opportunity to raise questions about the new regulations during the session and will leave with a road map for addressing their HIPAA compliance gaps.
Wellness Analytics have evolved dramatically in the past few years with the growth of Big Data in health care and the capability of new wellness tools to create and execute on strategy. While analytics have traditionally been very expensive and used mainly for Benefit Plan Design, they are now more cost-effective and being applied to Wellness Plan Design, the next frontier of human resources productivity gains and cost savings. Modern analytics can help you generate return-on-investment through a better understanding of the health status of your entire population, alignment with wellness tools, and effective implementation and evaluation of wellness programs.
This webinar will explain the value of wellness analytics, how the field is evolving, and how they can be applied to help you achieve your population health improvement goals.
Come learn about Reward Based Wellness Programs and how they can help reduce costs. Find out what others are doing to incent behavioral change in employees and how these changes benefit not only the individual employee but the organization as a whole. Learn tactics and strategies you can employ quickly to launch a program within in your organization.
This program will be of help to the Human Resource Executive currently struggling with how to justify the implementation of a Reward Based Wellness Program to management . It will be of particular help to SMB owners or executives of companies with fewer than 100 employees who are in the thinking stages of implementation and need resources and data to move their thinking along. Lastly, it will be of help to those executives currently administering Reward Based Wellness Programs who need up to date data and against which to compare their own results.
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.
There are three developments that have made communicating benefits harder than ever:
The increasing complexity of benefits, especially health benefits
The general difficulty in getting anyone's attention
The need to master multiple communications channels
Fortunately, there are new ideas and methods for communicating during the open enrollment period that will help you battle past these challenges.
This webinar will look at the thinking that lies behind successful open enrollment communication programs and shares some specific tips and techniques. Among the techniques we will explore are the use of video, social media, and “federated” creation of content. We can do better communication than ever, but we have to embrace the right tools and right mindset.
This session will address the outsourcing of various health plan administrative functions to third party administrators (TPAs) and Independent Review Organizations (IROs). It will explain what it means to be a Plan Fiduciary; and will address the obligations and plan administrative functions that are automatically imposed on the person or entity that is designated as the Plan Administrator. This session will also address the reasons for outsourcing, the types of administrative functions that are typically outsourced, the impact of such outsourcing on the Plan Administrator from a liability standpoint, and ways in which the Plan Administrator may limit its liability.