Cut Through the Confusion of Health Care Reform! Employers Guide to Health Care Reform, 2012-2013 Edition by Brian M. Pinheiro, Jean C. Hemphill, Clifford J. Schoner, Jonathan M. Calpas, Kurt R. Anderson List Price: $275.00 Eligible for Free Standard Shipping on U.S. Prepaid Orders Imprint: Aspen Publishers ISBN: 9781454810322 Paperback: 484 pages Publication Cycle: Published annually Last Updated: 11/15/2012 Automatic Supplementation More Info.

Description Employer's Guide to Health Care Reform 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! Written by experts from Ballard Spahr LLP, the 2012-2013 Edition of Employer's Guide to Health Care Reform has been updated to include coverage of the latest health care reform developments, including: A review of the landmark U.S. Supreme Court decision in National Federation of Independent Business v. Sebelius, which upholds the constitutionality of the Affordable Care Act 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 right now to employers that provide health coverage to employees Which health plans and benefits are currently subject to new prohibitions on annual and lifetime limits, and what exemptions are available 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 are going to be required beginning in 2014 How will employer-sponsored health plans need to change their employee communications to address the Affordable Care Act requirements What new types of reporting will be required for health plans What is the "individual mandate" to enroll in health coverage Which employers will have to pay a penalty if they do not provide adequate and affordable health plan coverage 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 What states will need to do to set up a health care Exchange How the Affordable Care Act affects retiree prescription drug coverage under Medicare Part D and how the changes create new opportunities for employers How and when the new nondiscrimination rules apply to insured health benefits, and what are the consequences of discriminatory coverage Which employer-sponsored health plans are subject to auto-enrollment and when do the rules go into effect What are the new FormW-2 reporting requirements for employer-sponsored health plans and when do they go into effect When health care flexible spending accounts (Health FSAs) and health savings accounts (HSAs) may and may not pay reimbursements for over-the-counter medicines and drugs And much more View the Highlights for this title. Table of Contents 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 Care Coverage Looking Ahead APPENDICES Affordable Care Act Provisions Applicable to Grandfathered Health Plans Tri-Agency Regulations on Grandfathered Health Plans Amendment to Grandfathered Health Plan Regulations HHS Regulations on Web Portal Requirements IRS Form 8941 and Instructions (Small Employer Tax Credit) Tri-Agency Regulations on Preventive Care Recommended Immunization Schedules Tri-Agency Regulations on Coverage of Contraceptive Services by Religious Employers CMS Temporary Enforcement Safe Harbor for Coverage of Contraceptive Services by Religious Employers Advance Notice of Tri-Agency Proposed Rulemaking on Coverage of Contraceptive Services by Religious Employers Tri-Agency Regulations on Extended Coverage for Adult Children IRS Notice 2010-38 (Exclusions from Income for Adult Children Coverage) Tri-Agency Regulations on Claims and Appeals Process Amendment to Tri-Agency Regulations on Claims and Appeals Process Model Notices for Claims and Appeals Decisions Blank and Completed Template Summaries of Benefits and Coverage DOL Technical Release 2011-04 - Guidance on Rebates for Group Health Plans Paid Pursuant to the Medical Loss Ratio Requirements of the Public Health Service Act HHS Center for Consumer Information and Insurance Oversight - Essential Health Benefits Bulletin and Corresponding Frequently Asked Questions Related Products Complete Guide to Human Resources and the Law, 2013 Edition Dana Shilling The Complete Guide to Human Resources and the Law will help you navigate complex and potentially costly Human Resources issues. 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