Employer's Guide to Health Care Reform, 2014 Edition

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9781454825494: Employer's Guide to Health Care Reform, 2014 Edition

Employer's Guide to Health Care Reform, 2014 Edition is the premier step-by-step practical guide for employers struggling to keep up with the rapid pace of changes affecting their health benefit plans. Specifically, it will help you:

  • Grasp every implication of health care reform from the employer's perspective
  • Fully understand even the most complex rules
  • Achieve significant cost savings
  • Meet deadlines and take advantage of opportunities to delay implementation
  • And much more!

The 2014 Edition of Employer's Guide to Health Care Reform has been updated to include discussions of the latest health care reform developments and detailed explanations of these important topics:

  • The U.S. Supreme Court's landmark decision in National Federation of Independent Business v. Sebelius, which upholds the constitutionality of the Affordable Care Act
  • Other legal challenges, including claims brought by religious organizations seeking exemptions from the requirement to cover contraceptive services in employer-sponsored group health plans
  • When is a plan a "grandfathered" health plan--and how to keep it that way
  • Whether an employer-sponsored health plan covering solely retirees is subject to the Affordable Care Act design changes, such as the requirement to cover children through age 26
  • What types of subsidies and tax credits are available to employers that provide health coverage to employees
  • Which health plans and benefits are subject to new prohibitions on annual and lifetime limits, and what exemptions are available
  • The extent to which health reimbursement accounts (HRAs) qualify for an exemption from the prohibition on annual limits
  • How and when the Affordable Care Act restricts preexisting-condition exclusions
  • When must an employer-sponsored health plan provide full coverage for preventive health services without cost sharing
  • What are the consequences of offering health plan coverage to children up to age 26
  • What are the new claims and appeals processes mandated by the Affordable Care Act for health plans
  • What additional changes to health plan design will be required beginning in 2014
  • How the Affordable Care Act is encouraging the use of wellness programs to control health benefit costs
  • What are the restrictions on eligibility waiting periods that may be imposed in an employer-sponsored group health plan
  • How will employer-sponsored health plans need to change their employee communications to address the Affordable Care Act requirements
  • What new types of reporting are required for health plans
  • How employers can use premium rebates received from insurance companies under the medical loss ratio (MLR) rebate rules
  • What is the "individual mandate" to enroll in health coverage
  • Which employers must pay a penalty if they do not provide adequate and affordable health plan coverage
  • The impact of the delay in implementation of the employer pay-or-play rules until 2015
  • How employers determine which employees are full-time employees for purposes of applying the pay-or-play penalties
  • How much flexibility employers havein structuring their workforces to avoid the pay-or-play penalties
  • How employers can determine whether their coverage is adequate and affordable
  • What is a health care Exchange, and how will it affect the U.S. health care system

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