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Outsourcing Health Plan Administration: Can you "pass the buck" on liability?

Topic:
Outsourcing Health Plan Administration: Can you "pass the buck" on liability?
Date:
April 24, 2012 at 11:00 - 12:00 PM ET
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Description
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

All Registered HR.com members are also eligible for:

  1. A copy of the slides presented in this presentation. These are available before and after the presentation.
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  3. Access to more than 400 podcasts with HR Gurus and Industry Leaders (downloadable files available 24 hours after the live broadcast) as well as access to our blogs, polls, surveys, 25,000+ article library, Business Book Reviews and so much more!
Recommended Resources
For more information, please feel free to contact me at 740.917.5155; 614.425.2013; or sdcohen@columbus.rr.com.
Categories
Benefits
Compensation
Staffing and Recruitment
Workforce Planning and Analytics
Outsourcing Benefits
Medical Benefits
Healthcare Legislation and Compliance
ERISA
HIPAA
COBRA
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.
Sponsored by
Sheila Deselich Cohen, Attorney at Law
Sheila Deselich Cohen, Attorney at Law
Providing independent legal counsel to several leaders in the medical care cost containment community.
Presented by
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Sheila Cohen
The Law Offices of Sheila Deselich Cohen

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Documents

Feedback
Name Comment Rating
Image of Shondra Leary Shondra Leary
DEERFIELD ADVISORS
4 / 5
Very Good Presentation
Image of Charlotte Oliver Charlotte Oliver
HRsmart, Inc
4 / 5
Very Good Presentation
Image of Kendra Taylor Kendra Taylor
Prestwick House
3 / 5
Good Presentation
Image of Sandra McKelley Sandra McKelley
Hess Print Solutions
4 / 5
Very Good Presentation
Image of Lynn Nevin Lynn Nevin
Vertex Innovations Inc.
3 / 5
Good Presentation
3 / 5
Good Presentation
Image of Carol Wilson Carol Wilson
Scouts Canada, Ottawa, Ontario0
5 / 5
Excellent Presentation
Image of Mandy Campbell Mandy Campbell
The Nebraskamedical Center
3 / 5
Good Presentation
Image of Amanda Smith Amanda Smith
Halifax Media Group
4 / 5
Very Good Presentation
Image of Jerlaunda Wilson Jerlaunda Wilson
Sentara Healthcare
4 / 5
Very Good Presentation
Image of Kristal Morales Kristal Morales
CFE Management Group, LLC
5 / 5
Excellent Presentation
Image of Elise Parma Elise Parma
Weaver and Tidwell, LLP
3 / 5
Good Presentation
Image of Shirley Hines Shirley Hines
Beaver Dam Nursing & Rehab Center, Inc.
4 / 5
Very Good Presentation
3 / 5
Good Presentation
Image of Sandra Kronner Sandra Kronner
Marquette General Health System
5 / 5
Excellent Presentation
Image of Melanie Zoeller Melanie Zoeller
Kerr Center for Sustainable Ag
5 / 5
Excellent Presentation
Image of Kathy Herman Kathy Herman
Cb Richard Ellis Inc
4 / 5
Very Good Presentation
Image of Nancy Siu Har Li Nancy Siu Har Li
Bank Of Communications
5 / 5
Excellent Presentation
Image of Debbie Crawford Debbie Crawford
Goodwill Industries (Richmond, VA)
4 / 5
Very Good Presentation
Image of Johanna Koehler Johanna Koehler
ATI Physical Therapy
4 / 5
Very Good Presentation
Image of nora newhouse nora newhouse
Prosser Memorial Hospital
I am sorry to say i missed a portion of the webcast but what i heard was very imformative. thanks 4 / 5
Very Good Presentation
Image of LISA MAXAM LISA MAXAM
The Staff Room
I wish I had known that this fir for US laws and not for Canada. Maybe going forward advise or state that this webinar will be geared to the US laws then if we want to know about or deal with the US we have a choice. I do think it was informative. 3 / 5
Good Presentation
Image of Valerie Krager Valerie Krager
Midwest Industries, Inc
The information was really good but there was so much information that is was hard to write down items not listed on the slides. 4 / 5
Very Good Presentation
Image of Sarah Gillham Sarah Gillham
Total Call International
The pace was a little too quick to be able to take everything in. 4 / 5
Very Good Presentation

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