These one-day regional seminars will provide a quick and cost-effective way for jointly-managed plans to know what they need to do now in response to unfolding reform regulations. Included is an afternoon workshop addressing the early retiree subsidy application process. Two additional workshop options are also offered -- Multiemployer Perspectives and Public/Governmental Plan Perspectives.
New Simple Cafeteria Plans (PDF)
4 pages. Excerpt: "The health care reform act, better known as the Patient Protection and Affordable Care Act of 2010 . . ., enacted a new form of cafeteria plan that is available to small employers starting in 2011."
(Kushner & Company)
Insurance Company Denies Long Term Disability Benefits to Woman with Fibromyalgia and CFS
Excerpt: "Based on the conclusions presented by the two doctors . . . hired to review [the medical files], Fort Dearborn denied [the] claim on November 15, 2004. A DRMS [a third party administrator] employee emailed [the] claim handler the same day the letter went out the following message, 'I loved your 9 page denial letter.'"
(Attorneys Dell & Schaefer)
HIPAA Isn't a Shield Against Third-Party Payor Audits
Excerpt: "A frequent question of physicians, medical practices and other providers I represent is whether the HIPAA Privacy Rule prohibits them from providing third-party payors with access to medical records for the purposes of an audit."
(Warner Norcross & Judd LLP)
What Does HIPAA Say About Patients Who Want to Hide Information from Their Health Plan?
Excerpt: "If you are a health care provider, . . . the HITECH amendments to HIPAA include a new right: When a patient receives treatment and pays for that treatment entirely out of his or her own pocket, the patient may request that you not share information about the treatment with the patient's health plan -- and you must honor that request."
(Warner Norcross & Judd LLP)
HHS Issues Interim Final Regs on Pre-Existing Condition Insurance Plan Program (PDF)
3 pages. Excerpt: "The regulations . . . require PCIPs to establish procedures to identify and report to HHS instances where health insurance issuers or group health plans are discouraging high-risk individuals from remaining enrolled in their current coverage, in instances where such individuals subsequently are eligible to enroll in the PCIP."
(Brucker & Morra)
How Local Governments Are Addressing Retiree Health Care Funding (PDF)
15 pages. Excerpt: "The brief follows up on a 2009 survey in which 206 local governments indicated they were likely to adopt a long-term strategy to strengthen their retiree health care funding, including establishing a Section 115 trust (governmental); medical subaccount [401(h)]; or Voluntary Employee Beneficiary Association (VEBA) trust [501(c)(9)];issuing OPEB bonds; increasing the years of service for vesting for RHC; increasing the age at which RHC is available; terminating retiree health care for all new hires."
(Center for State and Local Government Excellence)
DOL Helping Make Sense of Health Care Reform
Excerpt: "[Phyllis Borzi talks about how] new regulations will affect employees and employers. Here, in an edited version, are her comments (supplemented with information from her department's website, www.dol.gov/ebsa)."
(San Francisco Chronicle)
Thousands of 'Subcontractors' May Soon Have to Comply with HIPAA
Excerpt: "Perhaps the biggest surprise in HHS's July 14 proposed rulemaking was a concept that went beyond language contained in the HITECH Act, namely the appearance of the term 'subcontractors' in the list of organizations that would have to comply with the same privacy and security regulations as business associates."
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Benefits in General; Executive Compensation
Will Health Savings Trickle from Your Paycheck to Social Security?
Excerpt: "The theory is that the health law will help the financial viability of Social Security because employers will shift money they now spend on health insurance into higher wages. That, in turn, will mean more taxes collected on fatter payrolls to support Social Security and Medicare."
(National Public Radio)
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