The final HIPAA special enrollment regulations took effect in 2005 and require that individuals be allowed to enroll in employer-sponsored health plans outside of open enrollment under certain conditions, referred to as special enrollment. Notices of those rights are also required. The Affordable Care Act (ACA) added to the list of special enrollment rights. But questions still arise about when an employee or an employee’s dependent is entitled to special enrollment and the IRS can impose excise taxes on employers that fail to follow the special enrollment rules. Potentially difficult issues include the content and timing of special enrollment notices, coverage of special enrollment in Summary Plan Descriptions (SPDs), determination of whether an individual qualifies as having lost other coverage because of premium changes, special enrollment when an individual has Medicare, time limits to exercise special enrollment rights, potential damages and penalties, cafeteria plan issues created by special enrollment self-reporting requirements for special enrollment failures.
Please join Christine Williams, founder of Health Plan Plain Talk, as she reviews some of the most problematic special enrollment issues for employer-sponsored health plans and common administrative problems related to special enrollment.
Just a sampling of what this webinar will cover:
- Employers and health plans that must comply with the special enrollment requirements
- The notice requirements and coverage of special enrollment in SPDs
- Who is entitled to special enrollment and is it limited to the employee or does it include dependents
- Who qualifies as a dependent for special enrollment
- COBRA qualified beneficiaries and special enrollment
- How Medicare entitlement affects special enrollment eligibility
- Time limits for special enrollment requests
- Differences between special enrollment in an employer-sponsored health plan and purchase of coverage on the ACA Marketplaces
- Rules regarding premiums and benefits for special enrollees
- Domestic partners and special enrollment
- And much more!
Presenter: Christine Williams, Attorney at Law, Founder, Health Plan Plain Talk
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