Are self-funded plans the right option? Find out all you need to know to make the right decision for your organization.
The Patient Protection and Affordable Care Act creates incentives for certain employers to self-insure health care coverage. For example, self-insured plans are not subject to the small-group rating regulations, risk adjustment policies, and essential health benefits provisions newly imposed by PPACA. Self-insured businesses are also exempt from many state insurance regulations. This topic examines the factors that may motivate employers to self-insure, and the ways incentives to self-insure might change after PPACA becomes effective. The topic also will discuss how self-insurance influences benefit design, benefit claims decisions, and financial exposure. Finally, the program will offer practical tips to employers facing this certain uncertainty in the group health care context.
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Why Lorman?
Over 34 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.
Agenda
Self-Insurance Overview
- Dispelling Myths
- PPACA's Large Group Market Study
PPACA's Impact on Self-Funded Plans
- Specific Exceptions
- Reinsurance Requirements
- 2012 DOL Report
Factors Impacting Decisions to Self-Fund
- Regulatory Factors
- Financial Exposure
- Administrative Concerns
- Advantages and Disadvantages
- Stop Loss Issues and Case Studies
- Practical Considerations
Cost Containment Strategies for Self-Funded Plans
- Alternative Risk Arrangements for Small Groups
- Wellness Programs and Incentives
- Paying Instead of Playing
Practical Tips
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Why Lorman?
Over 34 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.
Credits
OnDemand Course
This course was last revised on December 14, 2015.
Call 1-866-352-9540 for further credit information.
This program does NOT qualify, nor meet the National Standard for NASBA accreditation.
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Why Lorman?
Over 34 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.
Faculty
Kristopher R. Alderman
FisherBroyles LLP
- Partner with FisherBroyles, LLP
- Litigates cases in state and federal court; represents health plans, fiduciaries, third-party administrators, individuals, and plan participants and beneficiaries in ERISA and managed care cases
- Has represented clients in cases involving claims for ERISA benefits, allegations of breaches of fiduciary duty, COBRA rights, Section 510 employment discrimination, assignments of benefits, and preemption; he also advises clients on matters related to plan design, ACA compliance, and self-funded plan options
- Extensive experience representing clients in matters involving health care reimbursement; he defends individuals against balance billing by medical providers; well-versed in health care economics and finance; he also represents employers, health plans, plan administrators, fiduciaries, and claims administrators in health care reimbursement matters
- Represents patients across the country in hospital billing disputes at no charge to the patient
- He represents and advocates for his clients’ interests under consumer protection laws, including the Fair Debt Collection Practices Act, the Fair Credit Reporting Act, and deceptive trade practices laws
- Has extensive experience representing and advising clients with respect to hospital liens and subrogation rights
- Also represented clients in a wide variety of employment matters, including claims arising under Title VII, ADA, ADEA, FMLA, and ERISA
- J.D. degree, magna cum laude, Georgia State University College of Law; B.A. degree in English, cum laude, University of Georgia
- •Can be contacted at 404-596-8887 or [email protected]
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Why Lorman?
Over 34 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.
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