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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 under the Employee Retirement Income Security Act (ERISA), the federal law that governs most employer-sponsored plans; 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 (such as government filing obligations, disclosure obligations, COBRA administrative obligations, HIPAA compliance, and recordkeeping). 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. Finally, the recent healthcare legislation, the Patient Protection and Affordable Care Act, introduced the involvement of IROs in making determinations of whether the denial of certain types of appealed benefit claims should be upheld. With respect to IROs, this session will address the mandatory nature of the outsourcing and the significance, from a fiduciary and liability standpoint, of the determinations made by the IROs.
As an attorney in the employee benefits arena, I frequently encounter, in reading cases and in "real life," instances in which the Plan Administrator is unaware of the extent of its obligations to the plan and its participants. The laws in this area are very complex. Oftentimes, Plan Administrators believe that if they have delegated plan administrative functions to other professionals, they are "off the hook" in terms of liability for errors made in administering the plan. Inexperienced Plan Administrators tend to rely too heavily on TPAs, and are later surprised when penalties are imposed on them or claims are made against them. This session will benefit employers and HR personnel involved in health plan administration by identifying the obligations of the Plan Administrator (which is often the employer sponsoring the plan), identifying instances in which the Plan Administrator remains liable under the law despite having delegated administrative functions, and identifying ways in which the Plan Administrator may protect itself from exposure.
Who Should Participate
This session will benefit employers and HR personnel involved in the administration of self-funded health plans by identifying the obligations of the Plan Administrator (which is often the employer sponsoring the plan), identifying instances in which the Plan Administrator remains liable under the law despite having delegated administrative functions, and identifying ways in which the Plan Administrator may protect itself from exposure.
Extra Learning Material
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For more information, please feel free to contact me at 740.917.5155; 614.425.2013; or email@example.com.
Staffing and Recruitment
Workforce Planning and Analytics
Healthcare Legislation and Compliance
Benefits - Cost Containment, Audits and Legal Risks
What You Will Learn
1. The role of the Plan Administrator as a plan fiduciary. 2. Limitations on the Plan Administrator's ability to outsource liability. 3. Ways in which the Plan Administrator may protect itself from liability.
Who is Eligible
This webcast is available to all registered HR.com members for free. You are currently subscribed to HR.com as a Free Member.
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