Employers Guide to Health Care Reform: 2012-2013 Edition

ISBN-10: 1454810327

ISBN-13: 9781454810322

Edition: 2012

Authors: Brian M. Pinheiro, Jean C. Hemphill, Clifford J. Schoner, Jonathan M. Calpas, Kurt R. Anderson

List price: $275.00
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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
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Book details

List price: $275.00
Copyright year: 2012
Publisher: Aspen Pub
Binding: Paperback
Pages: 300
Size: 8.50" wide x 10.75" long x 1.25" tall
Weight: 2.530
Language: English

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
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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