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    Employers Guide to Health Care Reform: 2012-2013 Edition

    ISBN-10: 1454810327
    ISBN-13: 9781454810322
    Author(s): Brian M. Pinheiro, Jean C. Hemphill, Clifford J. Schoner, Jonathan M. Calpas, Kurt R. Anderson
    Description: Employer's Guide to Health Care Reform is the premierstep-by-step practical guide for employers struggling to keep up with therapid pace of changes affecting their health benefit plans. Specifically, itwill help you:Grasp every implication of health  More...
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    Publisher: Aspen Pub
    Binding: Paperback
    Pages: 300
    Size: 8.50" wide x 10.75" long x 1.25" tall
    Weight: 2.530
    Language: English

    Employer's Guide to Health Care Reform is the premierstep-by-step practical guide for employers struggling to keep up with therapid pace of changes affecting their health benefit plans. Specifically, itwill help you:Grasp every implication of health care reform from the employer's perspectiveFully understand even the most complex rulesAchieve significant cost savingsMeet deadlines and take advantage of opportunities to delay implementationAnd much more!Written by experts from Ballard Spahr LLP, the 2012-2013 Edition ofEmployer's Guide to Health Care Reform has been updated to includecoverage of the latest health care reform developments, including:A review of the landmark U.S. Supreme Court decision in National Federation ofIndependent Business v. Sebelius, which upholds the constitutionality of theAffordable Care ActWhen is a plan a "grandfathered" health plan - and how to keep it that wayWhether an employer-sponsored health plan covering solely retirees is subjectto the Affordable Care Act design changes, such as the requirement to coverchildren through age 26What types of subsidies and tax credits are available right now to employersthat provide health coverage to employeesWhich health plans and benefits are currently subject to new prohibitions onannual and lifetime limits, and what exemptions are availableHow and when the Affordable Care Act restricts preexisting-condition exclusionsWhen must an employer-sponsored health plan provide full coverage forpreventive health services without cost-sharingWhat are the consequences of offering health plan coverage to children up toage 26What are the new claims and appeals processes mandated by the Affordable CareAct for health plansWhat additional changes to health plan design are going to be requiredbeginning in 2014 How will employer-sponsored health plans need to changetheir employee communications to address the Affordable Care Act requirementsWhat new types of reporting will be required for health plansWhat is the "individual mandate" to enroll in health coverageWhich employers will have to pay a penalty if they do not provide adequate andaffordable health plan coverageHow employers can determine whether their coverage is adequate and affordableWhat is a health care Exchange, and how will it affect the U.S. health caresystemWhat states will need to do to set up a health care ExchangeHow the Affordable Care Act affects retiree prescription drug coverage underMedicare Part D and how the changes create new opportunities for employersHow and when the new nondiscrimination rules apply to insured health benefits,and what are the consequences of discriminatory coverageWhich employer-sponsored health plans are subject to auto-enrollment and whendo the rules go into effectWhat are the new FormW-2 reporting requirements for employer-sponsored healthplans and when do they go into effectWhen health care flexible spending accounts (Health FSAs) and health savingsaccounts (HSAs) may and may not pay reimbursements for over-the-countermedicines and drugsAnd much more

    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
    Constitutional Challenges To Health Care Reform
    Federal Government's Taxing Power
    Federal Government's Commerce Clause Power
    Health Care Coverage Key Terms
    Health Care Reform Exemptions
    Grandfathered Health Plans: "If You Like Your Current Insurance, You Will Keep
    Your Current Insurance"
    Collectively Bargained Insured Plans
    Exemption for Retiree-Only Plans
    Exemption for Excepted Benefits
    Quality, Affordability, And 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
    Preserving And Expanding Immediate Access To Coverage
    Temporary Reinsurance Program for Early Retirees
    Pre-Existing Condition Insurance Plans
    Small-Employer Incentives
    Coverage Improvements During The Transition Period
    Prohibitions on Lifetime and Annual Dollar Limits on Benefits
    Prohibition on Preexisting-Condition Exclusion Provisions for Children Under Age 19
    Coverage of Preventive Health Services
    Extension of Coverage for Children Up to Age 26
    Mandated Claim and Appeal Process
    Prohibitions on Rescissions
    Patient Protections
    Improvements Effective January 1, 2014
    Prohibitions on Preexisting-Coverage Exclusions or Other Discrimination Based on Health Status
    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
    Transparency And Accountability
    Uniform Summary of Benefits and Coverage
    Reporting on Claims Practices and Plan Financing
    Quality-of-Care Reporting
    Containing the Cost of Health Insurance Coverage
    Ensuring That Consumers Get Value for Their Dollars
    Empowering Consumers With Information
    State Health Insurance Consumer Information
    Mandates And Exchanges
    Individual Enroll-or-Pay
    Employer Pay-or-Play (Shared Responsibility)
    Free Choice Vouchers
    Health Care Exchanges
    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
    New Taxes And Other Revenue-Raisers
    "Cadillac" Tax
    Health FSAs HSAs
    Administrative Feesfor Self-Funded and Insured Plans
    Additional Taxes on High Earners
    Other Taxes
    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
    Employers Providing Retiree Health

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