Overview:

This presentation will provide attendees with an introduction to some of the many new regulations relating to employee benefits, with a focus on regulations that have been issued in the past year or so.

Most of the new regulations relate to the Patient Protection and Affordable Care Act (PPACA, also known as health care reform). Other regulations that will be summarized include the ADA (Americans with Disabilities) Amendments Act (ADAAA) and Health Insurance Portability and Accountability Act (HIPAA).

Regulations to be addressed include:

• On November 17, 2010, the Internal Revenue Service (IRS), the Employee Benefits Security Administration (EBSA) and the Office of Consumer Information and Insurance Oversight (OCIIO) jointly issued an amendment to the interim final rules published on June 17, 2010 regarding permissible changes health plans can make in order to maintain their status as a "grandfathered plan".
  
• On November 22, 2010, the Department of Health and Human Services (HHS) issued interim final regulations implementing the “medical loss ratio” (MLR) provisions of PPACA.
  
• On February 9, 2011, HHS announced a proposed rule extending some of the patient protections of PPACA to student health insurance plans.
  
• On March 25, 2011, the Equal Employment Opportunity Commission (EEOC) published final regulations implementing the ADAAA. The ADAAA greatly expands the number of people protected by the ADA.
  
• On May 19, 2011, HHS issued a final regulation intended to ensure that large health insurance premium increases will be thoroughly reviewed and consumers will have access to clear information about those increases.
  
• On May 31, 2011, the Office for Civil Rights (OCR) within HHS published proposed changes to the Privacy Rule under HIPAA pursuant to the Health Information Technology for Economic and Clinical Health (HITECH) Act.
  
• On June 24, 2011, the IRS, EBSA and HHS issued interim final rules and model notices on internal claims and appeals and external review processes. These rules interpret PPACA’s requirement that plans provide notices about appeal rights in a culturally and linguistically appropriate manner.
  
• On June 30, 2011, HHS published interim final rules regarding electronic data interchange (EDI). The rules require compliance by health plans, health care clearinghouses and certain health care providers by January 1, 2013.
  
• On July 11, 2011, HHS proposed regulations to assist states in building Affordable Insurance Exchanges, state-based competitive marketplaces where individuals and small businesses will be able to purchase private health insurance.
  
• On August 12, 2011, HHS along with the Department of the Treasury released three more proposed rules related to developing Affordable Insurance Exchanges (Exchanges).
  
• On August 17, 2011, the Departments of Labor, HHS and Treasury proposed new rules under PPACA that are intended to enable consumers to understand their health coverage more easily and determine the best health insurance options for themselves and their families. PPACA requires all health insurers and group health plans to provide enrollees an accurate Summary of Benefits and Coverage (SBC).
  
• On October 20, 2011, HHS announced final rules regarding Accountable Care Organizations (ACOs). These regulations launch the Medicare Shared Savings Program and the Advance Payment model.

Why you should attend: The employee benefits field is constantly changing. Employee benefits professionals need to keep up with the latest developments, including regulatory changes. Compliance is not optional and what you don't know can hurt you!

Some of the new regulations apply to or will affect all or virtually all employers. Do you know the latest rules governing grandfathered plans?  What about the new requirements regarding claims and appeals? Do you know what an SBC is? It is a Summary of Benefits and Coverage-you will have to provide one if you sponsor a health plan. ACOs may revolutionize health care-do you know what they are? They are Accountable Care Organizations. Similarly, health insurance exchanges will impact all plans, even those that do not participate.

In addition to regulations under the Patient Protection and Affordable Care Act (PPACA, also known as health care reform) there are new regulations under the ADA (Americans with Disabilities Act) Amendments Act and new privacy regulations under the Health Insurance Portability and Accountability Act (HIPAA) that will have broad applicability.

Some of the regulations issued in the past year or so are very specialized and only apply to certain types of plans, like student health plans. Others, like the medical loss ratio regulations or the rules on rate increases apply only to insurers, but not self-funded plans. Some regulations, like those regarding electronic data interchange, apply more generally, but typically employers rely on their insurers and administrators to comply. Of course, if you fall into one of these categories, you need to know about the rules.

Areas Covered in the Session:

• Health Care Reform
  
  • Grandfathered Plans
  • Medical Loss Ratios
  • Student Health Insurance Plans
  • Premium Increases
  • Claims and Appeals
  • Exchanges
  • Summary of Benefits and Coverage
  • Accountable Care Organizations
• HIPAA
  
  • Privacy
  • Electronic Data Interchange
• ADA Amendments Act

Who Will Benefit:

• Vice President of Human Resources
  
• Director of Compensation and Benefits
  
• Benefit Manager
  
• Benefit Specialist
  
• Insurance Agent
  
• Insurance Broker
  
• Employee Benefits Consultant
  
• Group Insurance Representative