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EBIA's Health Care Reform for Employers and Advisors

EBIA's Health Care Reform for Employers and Advisors

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Written and edited by experienced employee benefits attorneys, EBIA Health Care Reform is your essential partner for employer plan compliance, and provides up-to-date expert analysis of the key requirements that affect employers, advisors, and insurers. It features in-depth coverage of legal requirements and information critical to effective decision-making - with examples, tables, implementation timelines, sample documents, and practical tips that will help you comply with the myriad of complex rules. You’ll get guidance on:

  • Which employer plans are subject to health care reform and related mandates, and which benefits are excepted. Special rules for grandfathered health plans, plus noncompliance consequences.
  • Various plan design and administration reforms, plus fees and other tax rules for both employer plans and insurers.
  • Which employers are subject to the employer shared responsibility penalty (also referred to as the “play or pay” penalty). Understanding “eligible employer-sponsored plans” and the “minimum value” and “affordability” conditions for avoiding the penalty.
  • Penalty for individuals who do not have health insurance (also referred to as the “individual mandate”). How Exchanges and the individual mandate impact employers (including required notices, reporting, and the relationship to employer shared responsibility penalty).

And much more.

The online edition is updated monthly to keep pace with evolving ACA rules and requirements.

In addition, subscribers to the online edition will get access to primary source material including:

  • ERISA History
  • Advance Notices of Proposed, Interim & Final DOL Rules
  • DOL Final Regulations and Interim Rules
  • Preambles to DOL Final Regulations and Interim Rules
  • DOL Proposed Regulations & Preambles
  • Selected US Code Provisions
  • Selected US Code Provisions History
  • Selected Final Federal Regulations
  • Preambles to Selected Final Federal Regulations
  • Selected Proposed Federal Regulations & Preambles
  • Other Selected Tax Documents & Releases
  • ERISA Opinion Letters
  • DOL Rulings & Releases
  • Other Miscellaneous Nontax Releases
  • Internal Revenue Code (1990 - present)
  • Code History
  • Final and Temporary Regulations
  • Advanced Notices of Proposed Rulemaking & Treasury Decisions
  • Prior Final and Temporary Regulations (Treasury Decisions)
  • Preambles to Final and Temporary Regulations (Treasury Decisions)
  • Preambles to Proposed Treasury Regulations (Treasury Decisions)
  • Prior Proposed Regulations & Preambles
  • Proposed Regulations and Preambles
  • IRS Publications
  • EBIA Committee Report Excerpts
  • PLRs and TAMs (1977 - present)
  • Revenue Rulings (1954 - present)
  • Revenue Procedures (1955 - present)
  • Announcements (1959 - present)
  • Notices (1980 - present)
  • Internal Revenue Manual

  • Health Care Reform for Employers and Advisors
    • I. Overview of Health Care Reform for Employers and Advisors
    • II. Health Care Reform: Effective Dates, Timeline, and Reference Tools
    • III-IV. [Reserved]
    • V. Which Plans and Insurers Must Comply With the PHSA Mandates?
    • VI. Grandfathered Health Plans
    • VII. PHSA Mandates: Consequences of Noncompliance
    • VIII. [Reserved]
    • IX. Lifetime, Annual, and Cost-Sharing Limits
    • X. Preexisting Condition Exclusions, Waiting Periods, and Rescissions
    • XI. Dependent Coverage for Adult Children
    • XII. Patient Protections, Preventive Health Services, and Clinical Trials
    • XIII. Nondiscrimination in Plan Design
    • XIV. Insurance Mandates
    • XV. Appeals Process and External Review Requirements
    • XVI. Summary of Benefits and Coverage (SBC)
    • XVII-XIX. [Reserved]
    • XX. Mechanisms to Allocate Risk
    • XXI. Exchanges, Qualified Health Plans (QHPs), and CO-OPs
    • XXII. Temporary High Risk Pool: PCIP Program
    • XXIII-XXV. [Reserved]
    • XXVI. Small Business Health Care Tax Credit
    • XXVII. Early Retiree Reinsurance Program (ERRP)
    • XXVIII. Shared Responsibility for Employers (Play or Pay Penalty Tax)
    • XXIX. Shared Responsibility for Individuals (Individual Mandate)
    • XXX. Tax on High-Cost Health Coverage
    • XXXI. Automatic Enrollment (Repealed)
    • XXXII. HIPAA Electronic Transactions and Operating Rules
    • XXXIII. [Reserved]
    • XXXIV. Employee Protections
    • XXXV. Special Issues for FSAs, HRAs, HSAs, and Cafeteria Plans (Including Simple Cafeteria Plans)
    • XXXVI. Reporting, Fees, and Required Payments
    • XXXVII. Participant Notices and Disclosures
    • Index
      • A
      • B
      • C
      • D
      • E
      • F
      • G
      • H
      • I
      • L
      • M
      • N
      • O
      • P
      • Q
      • R
      • S
      • T
      • V
      • W
      • Y
    • Appendix
      • Resources
      • Sample Documents
  • EBIA's Health Care Reform for Employers and Advisors: List of Sample Documents View
  • EBIA's Health Care Reform for Employers and Advisors: Excerpt View
  • EBIA's Health Care Reform for Employers and Advisors: What's New View