Recent Federal Laws, Regulations, Guidance and Court Cases Affecting Group Benefits

    /John  /Garnerspeaker of compliance global
    Speaker: John Garner
    Duration: 60 Minutes
    Product Code: 700060
    Level: Intermediate
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overview

Numerous recent developments affect group benefit plans, including new federal law enforcement, regulations, other guidance and court cases.  Many of the new developments relate to health care reform laws. The discussion of health care reform will begin with a review of recent and pending court challenges to health care reform. The webinar will also cover recent guidance related to preventive services, transitional relief from the employer mandate, what constitutes minimum value, measurement periods, employer history reporting, cost-sharing limits, excepted benefits, rules for the Territories, exchanges, waiting periods, flexible spending accounts, summaries of benefits and coverage, reference-based pricing and individual health insurance policies. Other topics covered by this webinar will include cost-of-living adjustments, mental health parity, HITECH compliance, same-sex marriage arguments, cafeteria plan elections, COBRA medical insurance, delay of the requirement to obtain health plan ID numbers, challenges to wellness plans by the Equal Opportunity Employment Commission and the status of the Social Security Disability Insurance trust fund.

why should you attend

The legislative and regulatory environment related to group benefit plans is constantly changing.  The penalties associated with these changes are such that what you don’t know can hurt you. Significant new penalties apply, starting in 2015, for large employers that do not offer all full-time employees minimum essential coverage.  Lesser penalties apply if minimum essential coverage is offered, but it is not affordable or does not meet minimum value standards.  Employers with 50-99 employees may qualify for transitional relief in 2015; however, there are requirements that must be met in order to qualify.  If employers do not meet those requirements, they will be subject to penalties.  Furthermore, the regulators have changed the rules related to minimum essential coverage and some plans that were thought to meet the requirements no longer do so.  It is now clear that all large employers must establish measurement and stability periods, even if they do not have any variable-hour employees.  All large employers must be gathering data now in order to be able to submit accurate reports to the IRS in 2016.  The regulators are cracking down on various schemes that some people have been promoting related to the use of individual health insurance policies and in their efforts to prevent abuse they are requiring many employers to change long-standing practices.

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Areas Covered

This webinar will discuss the latest developments related to health care reform, including the penalties that will apply to large employers, starting in 2015.  The penalties will apply to even more employers in 2016 and this webinar will describe the differences between the rules for 2015 and 2016.  In order to describe the penalties, the webinar will define such terms as applicable large employer, full-time employee, minimum essential coverage, minimum value coverage and affordability.  This webinar will also describe the rules employers with 50-99 employees must follow in order to qualify for transitional relief from the penalties in 2015.  This webinar will also describe the rules related to measurement, administrative and stability periods that apply for new hires who are part-time, seasonal or variable hour employees and the measurement, administrative and stability periods for ongoing employees.  This webinar will also describe the rules related to waiting periods and orientation periods.  This webinar will also describe the new reporting requirements that apply to employers and self-funded health plans. The webinar will also discuss the latest guidance related to employer payments for individual health insurance policies. In accordance with a Supreme Court ruling, certain privately held corporations are exempt from the requirement to cover all oral contraceptives.  This webinar will describe the Administration’s rules for these employers to follow in order to be exempt. This webinar will also describe the cost-of-living adjustments that are effective for 2015 and the ones that have already been proposed for 2016.  This webinar will also discuss new regulations related to the rules for certain benefits, known as excepted benefits, that are not subject to some of the rules under health care reform.  In addition to new final regulations on excepted benefits, there are new proposed regulations, which will also be discussed. New guidance has been issued with regard to health care reform in the Territories and this will be covered, too.  New rules related to exchanges, summaries of benefits and coverage and reference-based pricing will also be discussed.  The new carryover rules for health flexible spending accounts will also be covered.  Other topics covered by this webinar will include cost-of-living adjustments, mental health parity, HITECH Act regulations, same-sex marriage, cafeteria plan elections, COBRA, delay of the requirement to obtain health plan ID numbers, challenges to wellness plans by the Equal Opportunity Employment Commission and the status of the Social Security Disability Insurance trust fund.

Learning Objectives

  • To understand the latest developments under health care reform
  • To understand the latest guidance related to cafeteria plan elections
  • To understand the current challenges to wellness programs
  • To be able to create an action plan for compliance

WHO WILL BENEFIT

Any employer that sponsors a group benefits and any vendor that acts on behalf of health plans.  Some of these titles include: 

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

SPEAKER

Mr. Garner is Chief Compliance Officer at Bolton & Company. John Garner is literally "the guy who wrote the book". As the author of the Health Insurance Answer Book, he is one of the most respected benefit consultants in the country. Mr. Garner began his career in employee benefits in 1971. Before joining Bolton, he was the founding principal of Garner Consulting in Pasadena, California. Prior to founding Garner Consulting, he was a principal in the Los Angeles office of Towers Perrin, where he worked for over ten years. Prior to that he managed a group claim office for Lincoln National Life.

Previously he supervised a claim office for Prudential, where he also served as an underwriter. Mr. Garner serves as the national legislative and government affairs advisor for the Disability Management Employer Coalition. He is a past chair of the CEBS Committee for the International Foundation of Employee Benefit Plans (the committee with academic oversight on the Certified Employee Benefit Specialist program). He is a past member of the Governing Council of the International Society of Certified Employee Benefit Specialists and is a past president of the Los Angeles Chapter. Mr. Garner is also a past president of the Employee Benefit Planning Association of Southern California, the Los Angeles Life and Accident Claim Association and the Western Claim Conference. He is on the Board of Directors of the Western Claim Conference and the Los Angeles Chapter of the International Society of Certified Employee Benefit Specialists.

Mr. Garner is a past member of the Governing Council of the International Society of Certified Employee Benefit Specialists. He is the author of the Health Insurance Answer Book, co-author of the Medical/Disability Claims Handbook and articles that have appeared in numerous publications, including an award-winning article that appeared in the Journal of Financial Service Professionals. His articles have also appeared in Benefits Magazine, Benefits & Compensation Digest, Managed Care Quarterly and many others. He is a frequent speaker; among the groups he has addressed are the International Foundation of Employee Benefit Plans, the International Society of Certified Employee Benefit Specialists and various Bar Associations. Mr. Garner received his B.A. degree from Occidental College in 1971 (where he was a member of Omicron Delta Epsilon, the Honor Society in Economics).

He is a Chartered Life Underwriter, a Certified Employee Benefits Specialist, a Group Benefit Associate, Retirement Plans Associate, a Certified Management Consultant, and a Certified Flexible Compensation Instructor. He is a Fellow of the International Society of Certified Employee Benefit Specialists and a member of the Los Angeles Association of Health Underwriters, the California Association of Health Underwriters, the National Association of Health Underwriters, the Society of Financial Service Professionals and the Institute of Management Consultants. He is past chairman of the community health education committee for the Greater Los Angeles division of the March of Dimes. He is a past member of the Occidental College Alumni Association Board of Governors. He has been quoted in the Wall Street Journal, the New York Times and the Los Angeles Times and many other publications.

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