Employer's Guide to Health Care Reform

Employer's Guide to Health Care Reform
Wolters Kluwer Law & Business; Aspen Health & Administration Development Group; Brian M. Pinheiro, Jean C. Hemphill, Clifford J. Schoner, Jonathan M. Calpas

Soft bound book: 320+ pages
Size: 8.5" x 11"
ISBN 0735598940
9780735598942
Aspen Publishers
August 2010
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The new health care reform law imposes a whole new regime of requirements as well as new opportunities for employers.

Aspen Publishers' Employer's Guide to Health Care Reform clarifies the changes, identifies opportunities for cost savings, and provides practical, hands-on guidance to help employers set health plan strategy - including how to postpone the need to make plan changes and/or focus only on certain parts. Employer's Guide to Health Care Reform helps you:

Grasp every implication of Health Care Reform from the employer's perspective
Meet all deadlines
Achieve significant cost-savings
Fully understand even the most complex new rules

Employer's Guide to Health Care Reform will immediately help you handle these hot-button issues:

When do we have to add adult children to our plan?
How do we obtain reimbursement from the federal government for providing early retiree health coverage?
Should a plan be grandfathered in? If yes, how do we do it? If no, what do we do instead?
What are the new reporting requirements and dates when they apply?
What changes are mandatory in our next open enrollment? And what can we do to delay making costly plan changes?
How can we take advantage of the small-employer tax credits available beginning in 2010?
What are the effects of the law on large and small employers; part-time and full-time employees; union and non-union employees?
And much more!

The table of contents includes these sections:

1. INTRODUCTION
2. EVOLUTION OF HEALTH CARE REFORM
- Reasons for Health Care Reform
- The Employer-Based Health Care Coverage Landscape Prior to Health Care Reform
- The Legislative Process: Making Sausage
- Enforcement Responsibility
3. HEALTH CARE COVERAGE KEY TERMS
4. GRANDFATHERED AND COLLECTIVELY BARGAINED PLANS
- Grandfathered Health Plans: "If You Like Your Current Insurance, You Will Keep Your Current Insurance"
- Collectively Bargained Insured Plans
- Exemption for Excepted Benefits
- Collectively Bargained Insured Plans
5. QUALITY, AFFORDABILITY & ACCESSIBILITY
- Immediate Steps to Expand and Preserve Coverage
- Transition Period Coverage Improvements Applicable to Group Health Plans
- Coverage Improvements Applicable to Employment-Based Coverage Effective January 1, 2014
- New Reporting Obligations
- Additional Electronic Transaction Standards
6. PRESERVING AND EXPANDING IMMEDIATE ACCESS TO COVERAGE
- Temporary Reinsurance Program for Early Retirees
- Temporary High-Risk Pools
- Small-Employer Incentives
7. COVERAGE IMPROVEMENTS DURING THE TRANSITION PERIOD
- Prohibitions on Lifetime and Annual Dollar Limits on Benefits
- Prohibition on Pre-Existing Condition Exclusion Provisions for Children Under Age 19
- Coverage of Preventive Health Services
- Extension of Coverage for Children Up to Age 26
- Mandated Appeals Process
- Prohibitions on Rescissions
- Patient Protections
8. IMPROVEMENTS EFFECTIVE JANUARY 1, 2014
- Prohibitions on Pre-Existing Coverage Exclusions and Other Health Status Discrimination
- Fair Health Insurance Premiums
- Guaranteed Issue and Renewability
- Prohibiting Discrimination Against Health Care Providers
- Quality Coverage Provisions
- Limits on Waiting Periods
- Coverage for Individuals Participating in Approved Clinical Trials
9. TRANSPARENCY AND ACCOUNTABILITY
- Uniform Summary of Benefits and Coverage
- Reporting on Claims Practices and Plan Financing
- Quality-of-Care Reporting
- The Cost of Care
- Ensuring That Consumers Get Value for Their Dollars
- Empowering Consumers With Information
- State Health Insurance Consumer Information
10. MANDATES AND EXCHANGES
- Individual Enroll-or-Pay
- Employer Pay-or-Play
- Free Choice Vouchers
- Health Care Exchanges
11. OPERATIONAL CHANGES FOR HEALTH PLANS
- Medicare Part D
- Nondiscrimination Rules Applicable to Insured Health Benefits
- Auto-Enrollment
- Employer Notice of Coverage Options
- Nursing Mothers
- Reporting Cost of Coverage on Form W-2
- Simple Cafeteria Plans for Small Businesses
12. NEW TAXES AND OTHER REVENUE-RAISERS
- "Cadillac" Tax
- Health FSAs
- HSAs
- Administrative Fees for Self-Funded and Insured Plans
- Additional Taxes on High Earners
- Other Taxes
13. ANALYZING THE IMPACT OF HEALTH CARE REFORM
- Difference Based on Employer Size
- Differences Based on Full-Time vs. Part-Time Employees
- Differences Based on Union vs. Non-Union Workforces
- Looking Ahead
APPENDICES
- 2010 Health Care Reform Act Provisions Applicable to Grandfathered Health Plans
- HHS Regulations on Grandfathered Health Plans
- HHS Regulations on Web Portal Requirements
- HHS Regulations on Early Retiree Reinsurance Program
- Application and Instructions for Early Retiree Insurance Program
- IRS Notice 2010-22 (Small-Employer Tax Credit)
- Recommended Immunization Schedules
- Tri-Agency Regulations on Extended Coverage for Adult Children
- IRS Notice 2010-38 (Exclusions from Income for Adult Children Coverage)
- Information To Be Posted on A Web Site by HHS

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