EBIA's Health Care Reform: Agenda
Covering the latest guidance on health care reform.
8:00 a.m.
Registration/Coffee/Danish
8:30 a.m.
Changing Landscape of Health Care Reform. The individual mandate and constitutional challenges, Exchanges, employer play-or-pay penalty tax, Cadillac plan tax, plus an overview of reforms for insurers (like medical loss ratios and rate increase reviews).
Direct Impacts for Employer-Sponsored Health Plans. Overview of most important reforms for employer plans (including future effective dates and the need for continued HIPAA portability compliance).
Which Plans Must Comply With Which Rules? What “group health plans” are subject to the health reform mandates and HIPAA portability rules, what benefits are excepted (e.g., limited-scope dental/vision, retiree-only plans), noncompliance consequences, and special rules for “grandfathered” plans.
10:15 a.m.
Coffee Break
10:30 a.m.
HIPAA’s Existing Portability Rules. Current limits on preexisting condition exclusions (PCEs). Certificates of creditable coverage. Special enrollment rights. Health status nondiscrimination rules (including wellness and genetic information issues).
Plan Design Reforms. Required coverage for children to age 26 (including the tax rule for children under age 27). Lifetime and restricted annual limit rules. No rescission of coverage and no PCEs for those under age 19. Preventive care and patient coverage protections.
12:00 Noon
Morning program ends (lunch on your own)
1:00 p.m.
Plan Design Reforms (cont’d). Code § 105(h)(2) nondiscrimination testing for insured plans. Limit on OTC reimbursements. Simple cafeteria plans. Increased HSA penalty taxes.
Benefit Administration Reforms. Enhanced claims and external review procedures. Summary of benefits and coverage. W-2 and other reporting of employer-sponsored coverage.
Reforms for 2013. Cap on health FSA salary reductions. Employer notice to employees regarding Exchanges.
2:45 p.m.
Coffee Break
3:00 p.m.
Reforms for 2014 and Later. Prohibition on PCEs and annual limits. Cost-sharing limits. No excessive waiting periods. Required coverage of clinical trials. New information returns. Auto-enrollment rule for certain larger employers.
Tax Incentives and Penalties. Small employer tax credit. Early retiree reinsurance program (closed to new claims). Employer play-or-pay penalty tax. Cadillac plan tax.Will Employers Play? Will employers continue to provide health coverage? Evaluating the value of grandfathered plan status. Wrap-up and next steps.
4:30 p.m.
Health Care Reform program ends
