HIPAA covered entities, including health plans, health care clearinghouses, and covered health care providers, must comply with the HIPAA Security Rule. This regulation also requires compliance from business associates. Covered entities must create and document compliance with a HIPAA Security manual. This course will outline the security rules, safeguards and what is required for the manual.
Request by Federal Agencies for Comments on New Statutory Requirement for Health Insurers to Provide Reports on Clinical Services (PDF)
Excerpt: "Section 2718 of the PHS Act, among other provisions, requires health insurance issuers offering individual or group coverage to submit annual reports to the Secretary on the percentages of premiums that the coverage spends on reimbursement for clinical services and activities that improve health care quality, and to provide rebates to enrollees if this spending does not meet minimum standards for a given plan year. "
(U.S. Employee Benefits Security Administration; Internal Revenue Service; Department of Health and Human Services)
About the DOL's Model CHIP Notice on State Premium Assistance (Updated April 7, 2010)
Excerpt: "To help inform employees about state Medicaid or children's health insurance programs that offer premium assistance for employer-sponsored coverage, the Labor Department has issued a model notice and guidance. The model describes the assistance program, outlines related special-enrollment rights and lists government resources. Employers may tailor the notice and send it in electronic or paper format with other plan materials."
Health Care Reform Amendments to FLSA Require Break Time and Private Place for Nursing Mothers
Excerpt: "All employers with 50 or more employees should immediately adopt changes to their employee policies that explicitly allow breaks during the work day for nursing mothers to express milk. In addition, such employers should identify one or more areas which may be used by the employee for that purpose. Importantly, the area must be private ('shielded from view,' in the words of the statute) and secure ('free from intrusion'), but it may not be a bathroom. Thus, generally, this will require designating a small office or other room with a lockable door for this purpose."
(Mintz, Levin, Cohn, Ferris, Glovsky and Popeo P.C.)
The Impact of Health Care Reform on Group Health Plans (PDF)
4 pages. Excerpt: "Group health plans in existence at the time Health Care Reform was enacted are 'grand-fathered,' meaning that they are exempt from certain of the Health Care Reform provisions. However, in the final version of Health Care Reform, the benefits of grandfathering were substantially reduced. It is widely believed that adding new employees to a plan does not jeopardize its grandfathered status. However, the extent to which a grandfathered plan may be amended without forfeiting grandfathered status is unclear. Under these circumstances, employers should be cautious about making plan design changes (beyond those required by the legislation) until definitive guidance is issued."
Early Retiree Reinsurance Program Slated to Begin June 23, White House Says
Excerpt: "The early retiree reinsurance program is slated to begin on June 23, 2010, and will use an application process similar to the government's retiree drug subsidy program, according to a fact sheet posted by the White House. The program was enacted as part of the health reform law and will be administered by the Department of Health and Human Services (HHS)."
Forms Ready in June for Employers to Claim Reimbursement of Retiree Health Claims
Excerpt: "The Department of Health and Human Services says application forms will be ready in June for a new, temporary federal program, in which the government will partially repay employers for a portion of their retiree health care claims. Business Insurance reports that under the program, authorized as part of the recently passed health care reform measure, Congress has allocated $5 billion to reimburse employers with health care plans covering early retirees, defined as those between ages 55 and 64. The government will reimburse employers 80% of each claim between $15,000 and $90,000."
Major Employers Announce Costs of Drug Subsidy Deduction Change; Long-Term Impact Is Uncertain
Excerpt: "Some major employers have announced large non-cash charges against their retiree medical liabilities as a result of a provision in the Patient Protection and Affordable Care Act (P.L. 111-148). As of Jan. 1, 2013, the law removes the amount of the Medicare Part D retiree drug subsidy (RDS) these firms receive from the amount of prescription drug costs that they claim as a deduction in their corporate tax returns."
An Insurer's New Approach to Diabetes
Excerpt: "The UnitedHealth Group, one of the nation's largest health insurers, is teaming up with the Y.M.C.A. and retail pharmacies to try a new approach to one of the nation's most serious and expensive medical problems: Type 2 diabetes. Rather than simply continuing to pay ever-higher medical claims to care for its diabetic customers, UnitedHealth is paying the Y.M.C.A. and pharmacists to keep people healthier. The result, they hope, will be lower costs and lower premiums for everyone."
(The New York Times; free registration required)
Executive Compensation; Benefits in General
A Bit of Poetry: Employee Benefits in Extremis?
Excerpt: "Defined Benefits collapsed when the going got tough, Defined Contributions were never enough. What's left? Your House? A very bad bet. Something else instead? (Sigh) Not yet."
(Pension & Benefits Blog)
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