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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

Cut Through the Confusion of Health Care Reform!
Employers Guide to Health Care Reform, 2014 Edition
by Brian M. Pinheiro, Jean C. Hemphill, Clifford J. Schoner, Jonathan M. Calpas, Kurt R. Anderson
List Price: $309.00  
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Imprint: Aspen Publishers
ISBN: 9781454825494
Paperback: 460 pages
Publication Cycle: Updated annually
Last Updated: 11/15/2012
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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!


  • 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

Quick Reference to HIPAA Compliance, 2012-2013 Edition by Pamela Sande, Joan Vigliotta

Quick Reference to HIPAA Compliance, 2013-2014 Edition
Pamela Sande, Joan Vigliotta
Quick Reference to HIPAA Compliance is a guide for human resources managers and employee benefits professionals who administer employer-sponsored health plans, health care providers, and anyone who needs to understand and comply with all the regulations under the Health Insurance Portability an more...
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| Price: $399.00 | ISBN: 9781454825739 | Format: Paperback 
Imprint: Aspen Publishers