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Defined
Contribution Health Plans
A new idea emerging from the health care industry is the “defined
contribution health plan.” Also known as consumer-driven health
care, such plans give employees greater control over their
health care providers while providing some relief to employers
from the spiraling costs of health insurance. Are these “plans”
the wave of the future? Or will they create new problems for
employers? A panel will discuss the pros and cons of this
novel approach to employer-provided health care.
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HIPAA
Privacy Rules
Medical privacy regulations taking effect in April, 2003 will
implement some of the most significant changes in group health
plan operations since COBRA. Plan amendments, revised contracts
with service providers, privacy notices, privacy officers
and in-house privacy policies, medical information “firewalls,”
employee training, participant consent policies - these and
more may be required for your group health plan. Learn what
employers need to do now to get their plans ready.
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New
Claims Regulations
The Department of Labor has changed the rules for how and
when a group health plan must respond to a claim for benefits.
Beginning January 1, 2003, all group health plans will need
to be updated to comply with these new rules. With open enrollment
fast approaching, this is the time to learn what you need
to do to prepare for these new rules.
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The
Supreme Court Weighs In: Rush Prudential HMO, Inc. v. Moran
In an effort to protect patient rights, many states have mandated
independent medical review of an HMO’s decision to deny a
patient’s request for coverage of a medical procedure. In
a close win for patient rights’ advocates, in Rush
Prudential HMO, Inc. v. Moran, the United
States Supreme Court upheld in a 5-4 decision the validity
of an Illinois state law providing for independent medical
reviews. Will this decision increase the cost of your group
health plan? What does it mean if you have employees in states
other than Illinois? Learn how this decision may affect your
group health plan.
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Electronic
Data Interchange
Most group health plans rely heavily on electronic media (such
as e-mail and magnetic data transmissions) to pay claims,
enroll participants, process premiums and the like. For these
and certain other health plan transactions, there’s a new
federal law taking effect soon that will require you to follow
certain standard formats in transmitting data. The bad news?
This law takes effect next month, October 16, 2002. The good
news? An employer may obtain a year-long extension if it files
a compliance plan with the Department of Health and Human
Services by October 15, 2002. Find out what you need to do
to meet this fast approaching deadline.
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