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An employer is thinking about bringing an MD-DO-PA-LPN one day a week for employees to go to as an alternative to making GP type doctor's office visits.

Would this be providing major medical coverage, deficient per ObamaCare?

What concerns are there if it were provided as part of one of two major medical packages provided by the employer to its employees? One package includes access tp the visiting health practitioner at no co-pay charge to the employee, at one price to employees for coverage, and the other package not including access to the health practitioner, coverage that costs the employee more and visits to doctor's offices carry a co-pay obligation for the employee?

Is the employer exposed to liability for malpractice of the visiting health care practitioner?

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Pre-reform, on-site medical clinics were entirely outside of the group health plan (we had one at the major oil refining company I worked at for 8 years in benefits admin). I'm not aware of the reform bringing them under group health plans but I honestly haven't done indepth study of the reform.

The best people to answer your liability question is your current general liability provider. They'll know what they cover and whether you'd have a hole.

Kurt Vonnegut: 'To be is to do'-Socrates 'To do is to be'-Jean-Paul Sartre 'Do be do be do'-Frank Sinatra

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Masteff

Are you sure? I though that generally an on-site medical facility would be an ERISA welfare plan. The one exception is a clinic that provides treatment only for minor illnesses or injuries or first aid for on-the-job injuries (See, ERISA Reg. § 2510.3-1©(2)). I thought that if you provided things such as annual physical examinations, wellness visits, primary care etc. you could not fit under this exemption and be an ERISA goverend plan (or part of an ERISA governed plan).

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As I stated, answer was mainly based on my one experience. Apparently we fell under ERISA Reg. § 2510.3-1©(2)). Thanks for providing the cite.

Kurt Vonnegut: 'To be is to do'-Socrates 'To do is to be'-Jean-Paul Sartre 'Do be do be do'-Frank Sinatra

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Masteff

Are you sure? I though that generally an on-site medical facility would be an ERISA welfare plan. The one exception is a clinic that provides treatment only for minor illnesses or injuries or first aid for on-the-job injuries (See, ERISA Reg. § 2510.3-1©(2)). I thought that if you provided things such as annual physical examinations, wellness visits, primary care etc. you could not fit under this exemption and be an ERISA goverend plan (or part of an ERISA governed plan).

The employer is not trying to skirt ERISA, just wants to know what the implications under ERISA and other regulations are for providing employees a choice of these two options:

(1) onsite health practitioner/more limited insurance coverage/less employee cost, and

(2) a less limited insurance coverage/more employee cost.

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We've had clients look into these types of arrangements.

One of many implications is that terminated employees must be offered the opportunity to continue "coverage" for the clinics through COBRA. If the clinic is actually physically onsite, this could raise awkward issues in the event of a contentious termination.

Depending on what state you are in, there may be licensing issues for the provider(s).

You will definitely need to speak to counsel before proceeding.

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