This webinar answers the following questions:
• What is a health plan identifer?
• Who has to get one?
• When is it used?
• How do you get it?
• What happens if the health plans do not get one?
2016 Developments in HRA Administration: Reviewing Recent IRS Guidancebenefitexpress
This webinar reviews: the recent IRS guidance in HRA administration, when HRAs are free standing, what requirements must be met to be integrated, and HRA reimbursed Medicare premiums.
How Medicare Affects Employer Health Coveragebenefitexpress
This presentation reviews the topic of Medicare and how it can affect Employers Health Coverage offerings, including: employer secondary rules, COBRA, notice requirements, and reporting requirements.
Keeping Up to Date With Wellness Regulationsbenefitexpress
Learn about the latest developments in wellness programs. A review of EOCC's legal action against wellness programs will be included and steps to avoid legal action will be discussed.
Constructing HRA: Blueprints for Solid Administrationbenefitexpress
Learn the ins and outs of offering a private benefits marketplace for your employees, HRA administration, and various agencies regulating what's included.
This presentation reviews: what information must be protected, what policies and procedures need to be in place, what disclosures have to be given to employees, what agreements have to be in place for business associates, and what breach procedures have to be followed.
2016 Developments in HRA Administration: Reviewing Recent IRS Guidancebenefitexpress
This webinar reviews: the recent IRS guidance in HRA administration, when HRAs are free standing, what requirements must be met to be integrated, and HRA reimbursed Medicare premiums.
How Medicare Affects Employer Health Coveragebenefitexpress
This presentation reviews the topic of Medicare and how it can affect Employers Health Coverage offerings, including: employer secondary rules, COBRA, notice requirements, and reporting requirements.
Keeping Up to Date With Wellness Regulationsbenefitexpress
Learn about the latest developments in wellness programs. A review of EOCC's legal action against wellness programs will be included and steps to avoid legal action will be discussed.
Constructing HRA: Blueprints for Solid Administrationbenefitexpress
Learn the ins and outs of offering a private benefits marketplace for your employees, HRA administration, and various agencies regulating what's included.
This presentation reviews: what information must be protected, what policies and procedures need to be in place, what disclosures have to be given to employees, what agreements have to be in place for business associates, and what breach procedures have to be followed.
Unpacking the SUPPORT for Patients and Communities Act: Trends in Behavioral ...Epstein Becker Green
The SUPPORT Act takes sweeping aim at the opioid crisis, focusing on numerous aspects of opioid prevention, treatment, and recovery and expanding various types of coverage, use of telemedicine, and electronic prescribing, among other things.
This webinar will highlight important parts of the new law as it pertains to SUD treatment providers and how the law will potentially impact profitability and treatment offerings.
Presented by Harry Nelson – Founder & Managing Partner, Nelson Hardiman; Chairman, Behavioral Health Association of Providers - and Paul D. Gilbert – Member of the Firm, Epstein Becker Green.
Part of a "first Thursdays" webinar series hosted by Behavioral Health Association of Providers, Epstein Becker & Green, P.C., and Nelson Hardiman, LLP.
More info: https://www.ebglaw.com/events/unpacking-the-support-for-patients-and-communities-act-trends-in-behavioral-health-webinar-series/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
Offering Wellness Programs After Final Regulationsbenefitexpress
This webinar reviews the requirement that an employer must meet under the new final HIPAA regulations. It will also cover other compliance issues dealing with taxation, ERISA and ADA.
Health Care Reform - list of items for employers as we approach 2013 and 2014. Join us 9/12/12 for our event on the Affordable Care Act/Health Care Reform.
Intertwined Guidelines: Untangling Your Enrollment Notice Requirementbenefitexpress
DOL, PPACA, ERISA, COBRA, and HIPAA all have guidelines for enrollment notices - learn best practices for including the notice in your benefits strategy.
Health Care Reform and the Basics of BenefitsBeyondPay
This webinar will answer questions you have about the insurance you offer employees. It covers all things ACA and benefits administration, including COBRA, ERISSA, and HIPAA. Don't miss the latest ACA updates in 2016 to find out how they will affect you and your company.
[Medi]Caring About Delayed Retirement: A Closer Look at Medicare Strategybenefitexpress
With questions about millennials dominating our conversations about benefits, it’s easy to forget that the work force is growing from both ends. Baby boomers are delaying retirement while millennials (and even Gen Z) start their careers. As boomers become Medicare eligible, many remain on their employer’s coverage, whether or not that’s the best choice for them. Get the tools you need to:
- Navigate paying claims
- Understand how Medicare interacts with COBRA and other healthcare
- Lead eligible employees through their options
- Craft a compliant notification strategy
This presentation covers all the compliance issues with HSA's as well as: which employees are eligible, contribution requirements, distributions requirements, and reporting requirements.
ACA (mis)Management: What Everyone Has Learned & the Game Plan for 2017benefitexpress
After our first ACA reporting season, it’s time to regroup and review what we’ve learned for 2016. The IRS is eliminating extensions and good faith efforts, raising penalties, and strictly limiting transitional relief.
With higher stakes, ERISA attorney Larry Grudzien reviews the changes to ACA reporting for 2016 and common ACA management issues.
The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows individuals to continue their group health plan coverage in certain situations. Specifically, COBRA requires group health plans to offer continuation coverage to covered employees and dependents when coverage would otherwise be lost due to certain specific events...
This presentation covers how Medicare affects employer health coverage in: Providing opt out amounts | Paying for Medicare for active employees | Electing COBRA
Review all of the requirements of the Employee Retirement Income Security Act of 1974. Training will go over which employers have to comply, which benefits are subject to ERISA, what documentation employers must provide, and penalties for noncompliance.
Healthcare check in the latest developments in health and welfare plansbenefitexpress
We work in an exciting industry—which means quick changes are the norm, and adaptability is a necessity.
Keep your compliance plan up-to-date with a download of recent legislative changes.
We'll cover legislation that's passed, what's on the way, and what it means for your organization.
Topics Covered Include:
• IRS Information Letters
• Tax Reform Legislation
• Wellness Regulations - EEOC, AARP
• Comprehensive Guidance on QSEHRAs
• ACA: Elimination of Individual Mandate Penalty
• Employer Tax Credit for Paid Family and Medical Leave
• DOL Annual Adjustments to Employee Benefit Plan Penalties
• “Good Faith” Penalty Relief
• Final Disability Claim Regulations
• Cadillac Tax Updates
• And More!
Presented by Larry Grudzien, Attorney at Law
In today's multi-generational workforce, health and wellness benefits are weighted equally with salary expectations. This is why it's important for small and large businesses alike to embrace health and wellness benefits to recruit top talent as well as retain valued employees.
While offering these benefits has been shown to improve employee engagement and productivity, it comes with some challenges. This webinar reviews common questions human resources professionals confront when offering health and welfare benefits to employees.
Facilitated by ERISA attorney Larry Grudzien, this webinar covers the following:
- Questions Surrounding Tax
- Reporting Disclosures
- ERISA, COBRA & FMLA
- Workers Compensation
- Affordable Care Act (ACA)
Benefits are a critical piece of an employee compensation package, with health care benefits reigning most important. Whether you're already offering these benefits or considering adding them to your benefits offerings, view our webinar to learn more and remain competitive in the talent marketplace.
Unpacking the SUPPORT for Patients and Communities Act: Trends in Behavioral ...Epstein Becker Green
The SUPPORT Act takes sweeping aim at the opioid crisis, focusing on numerous aspects of opioid prevention, treatment, and recovery and expanding various types of coverage, use of telemedicine, and electronic prescribing, among other things.
This webinar will highlight important parts of the new law as it pertains to SUD treatment providers and how the law will potentially impact profitability and treatment offerings.
Presented by Harry Nelson – Founder & Managing Partner, Nelson Hardiman; Chairman, Behavioral Health Association of Providers - and Paul D. Gilbert – Member of the Firm, Epstein Becker Green.
Part of a "first Thursdays" webinar series hosted by Behavioral Health Association of Providers, Epstein Becker & Green, P.C., and Nelson Hardiman, LLP.
More info: https://www.ebglaw.com/events/unpacking-the-support-for-patients-and-communities-act-trends-in-behavioral-health-webinar-series/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
Offering Wellness Programs After Final Regulationsbenefitexpress
This webinar reviews the requirement that an employer must meet under the new final HIPAA regulations. It will also cover other compliance issues dealing with taxation, ERISA and ADA.
Health Care Reform - list of items for employers as we approach 2013 and 2014. Join us 9/12/12 for our event on the Affordable Care Act/Health Care Reform.
Intertwined Guidelines: Untangling Your Enrollment Notice Requirementbenefitexpress
DOL, PPACA, ERISA, COBRA, and HIPAA all have guidelines for enrollment notices - learn best practices for including the notice in your benefits strategy.
Health Care Reform and the Basics of BenefitsBeyondPay
This webinar will answer questions you have about the insurance you offer employees. It covers all things ACA and benefits administration, including COBRA, ERISSA, and HIPAA. Don't miss the latest ACA updates in 2016 to find out how they will affect you and your company.
[Medi]Caring About Delayed Retirement: A Closer Look at Medicare Strategybenefitexpress
With questions about millennials dominating our conversations about benefits, it’s easy to forget that the work force is growing from both ends. Baby boomers are delaying retirement while millennials (and even Gen Z) start their careers. As boomers become Medicare eligible, many remain on their employer’s coverage, whether or not that’s the best choice for them. Get the tools you need to:
- Navigate paying claims
- Understand how Medicare interacts with COBRA and other healthcare
- Lead eligible employees through their options
- Craft a compliant notification strategy
This presentation covers all the compliance issues with HSA's as well as: which employees are eligible, contribution requirements, distributions requirements, and reporting requirements.
ACA (mis)Management: What Everyone Has Learned & the Game Plan for 2017benefitexpress
After our first ACA reporting season, it’s time to regroup and review what we’ve learned for 2016. The IRS is eliminating extensions and good faith efforts, raising penalties, and strictly limiting transitional relief.
With higher stakes, ERISA attorney Larry Grudzien reviews the changes to ACA reporting for 2016 and common ACA management issues.
The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows individuals to continue their group health plan coverage in certain situations. Specifically, COBRA requires group health plans to offer continuation coverage to covered employees and dependents when coverage would otherwise be lost due to certain specific events...
This presentation covers how Medicare affects employer health coverage in: Providing opt out amounts | Paying for Medicare for active employees | Electing COBRA
Review all of the requirements of the Employee Retirement Income Security Act of 1974. Training will go over which employers have to comply, which benefits are subject to ERISA, what documentation employers must provide, and penalties for noncompliance.
Healthcare check in the latest developments in health and welfare plansbenefitexpress
We work in an exciting industry—which means quick changes are the norm, and adaptability is a necessity.
Keep your compliance plan up-to-date with a download of recent legislative changes.
We'll cover legislation that's passed, what's on the way, and what it means for your organization.
Topics Covered Include:
• IRS Information Letters
• Tax Reform Legislation
• Wellness Regulations - EEOC, AARP
• Comprehensive Guidance on QSEHRAs
• ACA: Elimination of Individual Mandate Penalty
• Employer Tax Credit for Paid Family and Medical Leave
• DOL Annual Adjustments to Employee Benefit Plan Penalties
• “Good Faith” Penalty Relief
• Final Disability Claim Regulations
• Cadillac Tax Updates
• And More!
Presented by Larry Grudzien, Attorney at Law
In today's multi-generational workforce, health and wellness benefits are weighted equally with salary expectations. This is why it's important for small and large businesses alike to embrace health and wellness benefits to recruit top talent as well as retain valued employees.
While offering these benefits has been shown to improve employee engagement and productivity, it comes with some challenges. This webinar reviews common questions human resources professionals confront when offering health and welfare benefits to employees.
Facilitated by ERISA attorney Larry Grudzien, this webinar covers the following:
- Questions Surrounding Tax
- Reporting Disclosures
- ERISA, COBRA & FMLA
- Workers Compensation
- Affordable Care Act (ACA)
Benefits are a critical piece of an employee compensation package, with health care benefits reigning most important. Whether you're already offering these benefits or considering adding them to your benefits offerings, view our webinar to learn more and remain competitive in the talent marketplace.
Automated metadata creation - Possibilities and pitfallsNASIG
This program presents an overview of automated indexing and automated metadata creation, and then discuss a project completed last summer at the Florida State University Law Research Center (formerly Law Library) which used computer created metadata to index individual pages of a looseleaf resource. The program will cover an overview of machine created metadata. Internet search engines use this almost exclusively. Some library projects, and some database companies use automated indexing. The program will highlight an index and search designed to retrieve pages from a looseleaf resource as the page appeared on a specific date over a 20 year period. This search is located at www.fsulawrc.com . This project was indexed using scripting to extract most metadata. Staff then completed missing metadata fields and audited for errors. I will present on the cost-effectiveness of automated metadata creation, given error rates and costs for human and machine produced metadata, and an overall assessment of the potentials for digital library projects. The goal is to assist catalogers in knowing what is possible, what is difficult, and what is easy in using techniques for automated metadata creation.
Presenter: Wilhelmina Randtke, Florida State University Libraries - Law Research Center
Antwoord op product informatie management in de GroothandelRogier Hosman
Groothandels zijn gewend vanuit hun traditionele systemen zaken te doen. In de nieuwe tijd verwachten klanten via het online dezelfde informatie als via de traditionele kanalen.
Hoe ga je als groothandel om met dit vraagstuk, en hoe maak je van productinformatie je eigen unieke verkoopmodel?
Sanne Heerink, sr. strateeg bij Social Inc. gaf een presentatie over B2B content tijdens 'Social Stories B2B'. Content is van groot belang voor B2B organisaties. Content helpt je vindbaar en herkenbaar te zijn als autoriteit. Content voegt waarde toe voor nieuwe en bestaande klanten. Content helpt je bij het versterken van relaties en opbouwen van een eigen publiek op social media. Maar waarom is B2B content vaak zo saai, droog en product gedreven? Het kan ook anders! Laat je inspireren door 8 prikkelende content ideeën voor de B2B markt. Cases van o.a. ABN AMRO, Cisco, General Electric en Coolblue. Heb jij aanvullingen? Deel ze in de comments!
https://doi.org/10.6084/m9.figshare.11854758.v1
FRBR as a datamodel for bibliographic metadata focuses too much on traditional library content/publications. The model can be improved for linked data environments by making it a flexible networked model
Royal Opera House: Why we love linked data and the semantic webJamie Tetlow
Ongoing project to rebuild the Royal Opera House website along semantic lines.
The challenges of thoroughly modelling information for a cultural institution.
The potential benefits for arts organisations of exposing their data.
Ellen West and Jamie Tetlow gave this presentation at Culture Geek conference at the Barbican Centre in London on Friday 7th September 2012.
http://www.culturegeek.com
TV newscasts report about the latest event-related facts oc- curring in the world. Relying exclusively on them is, however, insufficient to fully grasp the context of the story being reported. In this paper, we propose an approach that retrieves and analyzes related documents from the Web to automatically generate semantic annotations that provide viewers and experts comprehensive information about the news. Using different Semantic Web and information retrieval techniques, we generate what we call Semantic Snapshot of a Newscast (NSS)
Learn about batch document processing and the technologies used such as barcode recognition, content mining, OCR and more for unattended, automated processing. See how index data can be captured, files can be split, named, routed, cleaned, converted and more with little to no user action to save you money and time.
LinkedTV - an added value enrichment solution for AV content providersLinkedTV
Linked Television is offering a solution for audiovisual content owners to semi-automatically enrich media with links to additional information and content related to objects and topics in the program and build client applications which access this data and provide new added value services to consumers.
Health Reform Bulletin: Certification of Compliance with Electronic Transacti...CBIZ, Inc.
In this health reform bulletin, you will receive information on the proposed regulations relating to certification of compliance with the electronic transaction requirements of the Affordable Care Act (ACA). These rules are particularly significant to self-funded health plans and their sponsors.
This educational webinar reviews all of the requirements that an employer must meet to comply with HIPAA Privacy.
The webinar covers the following topics:
• What health information must be protected by the employer
• What steps an employer must take to comply (forms and procedures)
• What penalties will be imposed by the federal government if an employer does not comply
• What steps an employer must take if any information is disclosed improperly
• What agreements must be in place for an employer's outside vendors to comply
Developments in Health and Welfare Plans in 2016benefitexpress
Kick off enrollment season with a comprehensive review of the legislative changes for 2016. This webinar focuses on what you need to know for successful enrollment and ACA reporting. Learn about new legislation from DOL, HHS, IRS, and EEOC. It’s a webinar you (and your compliance strategy) can’t afford to miss.
This educational webinar will review how to prepare when an employer or a client is notified that its health and welfare plans are being audited by the Department of Labor (DOL).
Latest and Greatest in HRA's and Cafeteria Plansbenefitexpress
This webinar covers:
• New guidance in the Health FSA carryover requirements
• Can individual premiums be reimbursed under HRA's or cafeteria plans?
• New rules on integrated HSA's and standalone HRA's
• When are health FSA's subject to Health Reform?
• New reporting and disclosure requirements
Are you ready for the upcoming 2014 provisions of the new healthcare reform act? Do you know what the implications are to you as a small or midsize company?
Our webinar will help you become familiar with upcoming requirements under the Patient Protection and Affordable Care Act.
Expect to learn the following and more:
What is the Patient Protection and Affordable Care Act
How does an organization determine their 2014 cost to comply?
What should organizations be doing now to prepare?
Federal Benefits Developments - Audits Abound: Are You Ready?CBIZ, Inc.
From Benefits Law Journal, Summer 2014 Issue. This article covers:
- What Triggers a Plan Audit?
- DOL Audits of Health and Pension Plans
- IRS Audits of Pension and Retirement Plans
- HIPAA Privacy and Security Audits
- How Can a Plan Sponsor Best Be Fortified
to Withstand an Audit?
- What Should a Plan Sponsor Do?
There were statutory amendments that HITECH required that were never made, and there was a interim final proposed rule that implements the HITECH Act breach notification requirements. These rules are now amended by the Omnibus rule, because they were confusing and garnered public comment that convinced HHS to make changes.
A HIPAA violation could cost your company up to $50,000 per offense.
HR Workplace and HNI have teamed up to bring you an overview of HIPAA (the Health Insurance Portability and Accountability Act), outlining the main components, and identifying who is covered by the Act to make sure you aren't hit with a noncompliance fee.
We will examine the privacy provisions under HIPAA as they relate to protected health information (PHI) and also give your employees and business associates the tools to recognize the key provisions of HIPAA, how their organizations are affected by HIPAA, and how the privacy rules impact them.
With Department of Labor audits on the rise, this presentation reviews all the requirements under ERISA. This includes the requirements for plan documents, disclosures and reporting.
Chapter 10 Privacy and Security of Health RecordsLearnin.docxcravennichole326
Chapter 10 Privacy and Security of Health Records
Learning Outcomes
After completing this chapter, you should be able to:
♦ List HIPAA transactions and uniform identifiers
♦ Understand HIPAA privacy and security concepts
♦ Apply HIPAA privacy policy in a medical facility
♦ Discuss HIPAA security requirements and safeguards
♦ Follow security policy guidelines in a medical facility
♦ Explain electronic signatures
Understanding HIPAA
In Chapter 11 we will discuss various ways the Internet is being used for healthcare, including various implementations of EHR on the Internet, Internet-based personal health records (PHR), and remote access. In Chapter 12 we will explore the relationship of the EHR data to the determination of codes required for medical billing. Before moving to those topics it is prudent to understand HIPAA. HIPAA is an acronym for the Health Insurance Portability and Accountability Act, passed by Congress in 1996.
The HIPAA law was intended to:
♦ Improve portability and continuity of health insurance coverage.
♦ Combat waste, fraud, and abuse in health insurance and healthcare delivery.
♦ Promote use of medical savings accounts
♦ Improve access to long-term care
♦ Simplify administration of health insurance
HIPAA law regulates many things. However, a portion known as the Administrative Simplification Subsection1 of HIPAA covers entities such as health plans, clearinghouses, and healthcare providers. HIPAA refers to these as covered entities or a covered entity. This means a healthcare facility or health plan and all of its employees. If you work in the healthcare field, these regulations likely govern your job and behavior. Therefore, it is not uncommon for healthcare workers to use the acronym HIPAA when they actually mean only the Administrative Simplification Subsection of HIPAA.
Note Covered Entity
HIPAA documents refer to healthcare providers, plans, and clearing-houses as covered entities. In the context of this chapter, think of a covered entity as a healthcare organization and all of its employees.
As someone who will work with patients’ health records, it is especially important for you to understand the regulations regarding privacy and security. However, let us begin with a quick review of HIPAA, then study the privacy and security portions in more depth.
HIPAA implementation and enforcement is under the jurisdiction of several entities within the U.S. Department of Health and Human Services (HHS). This chapter will make extensive use of documents prepared by HHS.
Administrative Simplification Subsection
The Administrative Simplification Subsection has four distinct components:
1. Transactions and code sets
2. Uniform identifiers
3. Privacy
4. Security
HIPAA Transactions and Code Sets
The first section of the regulations to be implemented governed the electronic transfer of medical information for business purposes such as insurance claims, payme ...
HIPAA in the Public Cloud: The Rules Have Been Set - RightScale Compute 2013RightScale
Speaker: Phil Cox - Director of Security and Compliance, RightScale
On January 25, 2013, the U.S. Department of Health and Human Services (HHS) released the final implementing regulations for many provisions of the HITECH Act (Health Insurance Technology for Economic and Clinical Health Act), often referred to as the Omnibus Rule. Many organizations have based their architectures and implementations on previous proposed and interim regulations, some of which are no longer valid. Anyone falling under HIPAA requirements is required to meet these new definitive compliance requirements by September 23, 2013. This talk will discuss the parts of the Omnibus rule that affect the cloud landscape, and how you can successfully deploy a HIPAA-compliant application in the public cloud.
HIPAA Training: Privacy Review and Audit Survival Guidebenefitexpress
HIPAA Privacy Overview for Employers. Review a helpful checklist of requirements an employer must adopt to stay compliant with HIPAA and to survive an audit by Health and Human Services (HHS).
Similar to Health Plan Identifier! What is it and Why Do You Need It? (20)
Webinar: Mid-Year Election Changes for Cafeteria Plansbenefitexpress
Let's talk about cafeteria plans. When can participants make election changes?
While cafeteria plans can be a great option for employees wishing to pick and choose benefits based on cost, when and how to facilitate election changes outside of open enrollment can be tricky to navigate for employers. As the use of cafeteria plans continue to grow, we take a deeper look at the rules and regulations of these plans, particularly as they pertain to mid-year election changes.
COVID-19 Health & Welfare: Compliance for Employersbenefitexpress
As part of our continuing ERISA Compliance series, we covered such compliance topics and more in our April 9th webinar discussing COVID-19 and updates from the IRS and DOL concerning the Families First Coronavirus Response Act.
Plan Sponsor Webinar: Navigating COVID-19 for Employersbenefitexpress
In this webinar, we take a deeper look into how the novel coronavirus is not only affecting the way we live, but changing the way we work. From remote work environments, FMLA, contract agreements and more, we discuss how to navigate the changing workforce during this time of uncertainty, and answer questions to help you make the best decisions for the health and safety of your employees.
Medicare & Employer Health Coverage - a Coordination Conversationbenefitexpress
Let's talk about Medicare and Employer Health Coverage. The rules on coordinating Medicare and employer coverage can be complex. How it complements other programs (such as COBRA, HSAs and the ACA) are also areas of question for both employees and their employers.
Part of our ERISA Compliance Series, this webinar is hosted by ERISA Attorney Larry Grudzien and moderated by chief marketing officer Julia Goebel. This webinar will discuss the top wage and hour issues that may be unknowingly lurking within your company.
The Affordable Care Act touches the lives of most Americans. In fact, nearly 21 million will be at risk if Obamacare is struck down, and may even lose health insurance completely if the law is ruled unconstitutional. This webinar will discuss what the outcome may be if ACA is repealed.
Watch our free one-hour webinar reviewing the rules for the new Individual Coverage HRA and the new Excepted Benefit HRA (ICHRA and EBHRA).
In June 2019, Treasury, DOL and HHS released final regulations that are effective for plan years beginning on or after January 1, 2020. These regulations created two new HRAs, Individual Coverage HRAs (ICHRA) and Excepted Benefit HRAs (EBHRA).
These new HRAs will be subject to ERISA and COBRA, but will not be subject to the nondiscrimination rules under Code Section 105(h). Any employer can offer these new HRAs to their employees. They can be offered to common law employees, but cannot be offered to self-employed individuals, partners and more than 2% S-Corporation shareholders.
Facilitated by ERISA attorney Larry Grudzien, and moderated by Chief Marketing Officer Julia Goebel, this webinar will cover the following:
-Why are these new HRAs so important?
-Which employees can be included or excluded
-What documentation is needed to be completed by employers to adopt them
-What reporting and disclosure requirements must be met
-What types of expenses can be reimbursed
-The pros and cons of establishing and participating in these new HRAs for employers
How to Administer Wellness Programs in Today's Regulatory Environmentbenefitexpress
Are you struggling to make sense of the recent legislative updates surrounding employer sponsored wellness programs? Perhaps you are trying to decide whether to continue with current wellness plans, modify your plans without guidance from the EEOC, postpone new wellness programs or discontinue them all together.
It’s a complicated landscape ripe with several options for “next steps” for employees and plan sponsors of wellness plans in 2019 — with perhaps the biggest barrier of all being that employers cannot measure the risk of wellness plans at this time.
To help guide you through this maze of options, watch our one-hour webinar on-demand to learn what rules remain after the EEOC’s regulations were found invalid and what rules have to be met in 2019 in order to offer a valid wellness program.
How to administer wellness programs in today's regulatory environment
This webinar covers:
Requirements under HIPAA
Requirements under the Internal Revenue Code
Requirements under ERISA
Requirements under GINA
Requirements under ADA
Requirements under ACA
Webinar | Texas vs. United States - The Repeal of ACA?benefitexpress
Recently a Federal District Court held in Texas, et al. v. United States of America, et al. that the individual mandate in the Patient Protection and Affordable Care Act (ACA) is unconstitutional, and that the other provisions in the ACA are invalid because they are inseverable from the individual mandate.
Our ACA compliance webinar reviews:
- What the Federal District Court decided.
- The basis for the decision.
- The impact of the decision.
- What may happen over the next months or year.
- What Congress may do to address the situation.
Healthcare Check-in: The Latest Developments in Health and Welfare Plansbenefitexpress
We work in an exciting industry – which means quick changes are the norm, and adaptability is a necessity. Keep your compliance plans up to date with a download of all legislative changes since our last update webinar. This webinar covered legislation that's passed in the last six months, what's on the way, and what it means for your organization.
Webinar | From Analysis to Action: How Personalization Can Lower Employer Cos...benefitexpress
Personalization is everywhere – from Amazon to Spotify, and is now the expectation for consumers. Personalization in benefits elections is also the new normal, thanks to decision support tools and data analytics. Modern decision support tools draw on data points including demographics, preferences and medical need, all highly relevant towards personalization ... as opposed to the "one-size fits all" modeler of the past that relied on strict business rules.
Using data to advise clients can be a game changer for a broker. With analytics, you can quantify your benefit plan suggestions based on hard evidence, and advise based on unbiased data versus mere opinion. But where does this data come from? And how do you know which data to use?
This webinar shows how decision support tools can provide data to simplify health benefit decisions, allowing employees to feel more confident in their decisions, leading to lower costs for employers and client retention for brokers as a result.
In this webinar, brokers will learn how decision support analytics can reinforce their role as a trusted adviser by:
• Helping employer clients understand which health plans and programs are being used and which ones are the most cost-effective
• Minimizing the number of employees who are over-insured or under-insured, helping to save on annual and long-term costs for healthcare premiums, leading to better client retention over time
• Supporting healthy employee behaviors, resulting in lower health care expenses overall
FSAs can do some heavy lifting for your benefits plan – they allow employees to save pretax dollars for healthcare costs without the price tag of other financial wellness initiatives.
However, many HR professionals lack a deep understanding of the compliance requirements to offer and administer a well-rounded program for their employees. Engage your employees with a financial wellness benefit that works.
Key webinar takeaways:
- How different types of FSAs interact with benefit plans as a whole
- FSA and reimbursement limits for 2018
- Legal implications of offering an FSA to employees
- Best practices for administering a successful FSA benefit plan
Webinar | COBRA Pitfalls: Common Mistakes and How to Avoid Thembenefitexpress
Leaving the organization isn't the end of the benefits cycle for employees. This webinar focuses on how to avoid one of the most common compliance pitfalls in benefits ... COBRA administration.
Some of the top takeaways were:
• The basics of successful COBRA administration
• Required notices associated with COBRA coverage
• How Medicare interacts with COBRA for employees and dependents
• Penalties for noncompliance
Smooth and successful off-boarding of departing employees is as important as well-planned on-boarding of new hires. Log on to your roadmap for a smooth ride into COBRA compliance.
Webinar | Clients Calling “Mayday”? Design a Benefits Technology Strategy to ...benefitexpress
Benefits administration can be a delicate, and even difficult balancing act for employers. From managing costs and administrative demands, to maintaining compliance, and integrating with workforce wellness plans, it’s not surprising that three in four employers called “mayday” and turned to benefits administration outsourcing in 2017. With the administrative difficulty level rising, and advisory competition increasing, it is now critical to become the partner of choice to relieve this distress. But how?
Join Scott Evans, chief product officer at benefitexpress, this May Day, as he guides benefits advisers through the top considerations for building, buying or borrowing benefits administration technology solutions to offer clients. If you and your clients have benefits technology questions, Scott has answers.
Webinar takeaways include:
• How to assess your readiness: learn and identify the benefits administration business model that is right for you
• Key criteria for evaluating potential benefits technology partners, plus a valuable checklist
• How to create a benefits technology strategy for your business which is seen as an imperative – not a “value-add” – by your clients
• Tips for staying competitive in a changing market, using your solutions portfolio
Webinar | Training the Technique: Advanced ERISA Compliancebenefitexpress
If your organization offers any form of retirement plan, chances are you have questions about ERISA. This advanced compliance training will go beyond the basics of the requirements of the Employee Retirement Income Security Act of 1974.
Attend our one-hour training to learn:
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Factors of Self-Funding: Evaluating the Pros and Consbenefitexpress
In a changing healthcare landscape, employers are increasingly considering taking the funding of their healthcare benefits into their own hands. If you're one of them, this webinar is the one-hour guide you must see.
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CDHP 101: Behind the Wheel of Consumer-Driven Plansbenefitexpress
The most effective benefits are the ones that fully engage employees - which is why employers are increasingly putting their employees in the driver's seat when it comes to choosing their plans.
"Cafeteria Plans" or Consumer-Driven Health Plans help employers efficiently offer tailored benefits to a diverse workforce.These plans can have immense benefits - but only if you don't hit common potholes in administering the plans. This webinar covers:
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CDHP 101: Behind the Wheel of Consumer-Driven Plans
Health Plan Identifier! What is it and Why Do You Need It?
1.
2. Health Plan Identifier (HPID)
Requirements
By
Larry Grudzien
Attorney at Law
2
Copyright 2014 - Not to be reproduced without express permission of Benefit Express Services, LLC
3. Agenda
• Introduction
• HIPAA Standard Transactions Rules
• Health Plan Identifier (HPID)
• Certification of Compliance with Standard Transactions Rules
• Action Plan
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4. Introduction
• Under the original HIPAA administrative simplification statute, which
included privacy and security requirements, covered entities were required
to conduct certain transactions electronically using standards and code
sets designated by the HHS.
• The Affordable Care Act (ACA) added new requirements to these
Transaction Rules, including more detailed operating rules and a new
electronic transaction requirement for electronic funds transfer (EFT).
• The ACA also required HHS to issue rules for a national Health Plan
Identifier number and a new requirement for health plans to certify
compliance with all of these Transaction Rules.
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5. • For the most part, health plans typically look to their business associates
to handle these “standard transactions” responsibilities for them.
• In fact, many TPA agreements and business associate agreements
expressly require the business associate to conduct any applicable
transactions as standard transactions.
• Alternatively, if a health plan does conduct transactions of its own, it
usually hires a clearinghouse to convert the required information into
“standard” format.
5
Introduction
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6. • Some of these new rules, however, place responsibilities directly on the
health plan, even if it normally looks to a third party to conduct its
standard transactions.
• For example, the health plan must register for its own Health Plan Identifier
number to be used in standard transactions.
• And most recently, under proposed rules issued by HHS in January, the
health plan must obtain a certification that its standard transactions are
being conducted under the required Transaction Rules - even for
transactions conducted by its business associates.
6
Introduction
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7. • Under the proposed rules, by December 31, 2015, health plans will be
required to obtain the certification from an outside organization and then
file an attestation with HHS that it has obtained the necessary certification.
• Plans may be penalized $1 per covered life per day (up to a maximum cap)
for failure to file the required certification.
7
Introduction
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8. HIPAA Standard
Transaction Rules
• On August 17, 2000, HHS published final regulations adopting the original
HIPAA standard transactions, which, after a delay, were effective for most
plans as of October 16, 2003.
• The Transaction Rules require that if a health plan covered entity, as
defined under the HIPAA privacy rules, conducts certain “standard
transactions” with another covered entity using electronic media, the two
covered entities must use standards and code sets designated by HHS.
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9. • These standards and code sets establish which data must be provided and
fields that must be used when transmitting electronic information.
• In addition, the Transaction Rules provide that if any entity requests a
health plan covered entity to conduct one of the listed transactions as a
standard transaction, the health plan must do so and may not delay or
reject the transaction because it is standard transaction.
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HIPAA Standard
Transaction Rules
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10. • What is a health plan for these purposes?
Group health plans
Dental and Vision Plans
Health FSAs
Health Reimbursement Arrangements (HRAs)
HSAs subject to ERISA
Individual Policies
Some Employee Assistance Plans (EAPs)
Retiree Health Plans
• Which plans are excluded?
Health Plans With Fewer Than 50 Participants That Are Administered by the
Sponsoring Employer Are Excluded.
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HIPAA Standard
Transaction Rules
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11. • The list of transactions to which these rules apply are:
Claims & Encounter Information – Request from provider to plan to obtain
payment or information.
Eligibility – Transmission from provider to plan, or plan to plan – and their
responses – related to eligibility, coverage, or benefits under the plan.
Authorization & Referrals – Request for authorization for health care or to refer
to another provider – and response.
Claim Status – Inquiry about status.
Enrollment & Disenrollment – Transfer of subscriber information to plan to
establish or terminate coverage.
11
HIPAA Standard
Transaction Rules
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12. • The list of transactions to which these rules apply are:
Payment – Payment or information about fund transfer from plan to provider’s
financial institution; or EOB or remittance advice from plan to provider.
Premium Payments – Information about payment, fund transfer, remittance, or
payment processing from entity arranging provision of care.
Coordination of Benefits – Transfer of claims or payment information to plan for
purpose of determining relative payment responsibility.
12
HIPAA Standard
Transaction Rules
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13. New ACA Requirement: New
EFT/Remittance Advice Transaction
• The ACA mandated that HHS adopt a new transaction to add to the list
above for electronic funds transfers (EFTs).
• HHS issued a final rule adopting the EFT transaction on January 10, 2012.
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14. • The new EFT / Remittance Advice transaction replaces the Payment
transaction in the previous slides and is defined as:
Electronic Funds Transactions – Transmission of any of the following from a
health plan to a health care provider: payment, information about the transfer of
funds, and payment-processing information.
Remittance Advice – Transmission of any of the following from a health plan to
a health care provider: an explanation of benefits or a remittance advice.
• Covered entities were required to comply with the new EFT/ Remittance
Advice transaction by January 1, 2014.
14
New ACA Requirement: New
EFT/Remittance Advice Transaction
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15. • The original HIPAA administrative simplification statute, enacted in 1996,
required HHS to adopt an identifier system for employers, health care
providers, health plans, and individuals.
• The intent was to have the same identifiers on a national basis so that all
electronic transmissions of health information would be uniform.
15
New ACA Requirement:
Health Plan Identifier (HPID)
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16. • HHS has adopted rules for the employer and health care provider identifier
programs, but had not adopted the health plan identifier or individual identifier.
• The ACA again mandated that HHS issue rules adopting the health plan
identifier.
16
New ACA Requirement:
Health Plan Identifier (HPID)
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17. • The HPID rules introduce two new terms for defining health plans, which
also are used in the new certification rules.
Controlling Health Plan (CHP) means a health plan that controls its own
business activities, actions, or policies.
Subhealth Plan (SHP) means a health plan whose business activities, actions,
or policies are directed by a Controlling Health Plan.
17
New ACA Requirement:
Health Plan Identifier (HPID)
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18. • Who Must Obtain an HPID?
Self-funded group health plans must obtain HPIDs. Insured plans are not
required to do so, because they will be identified by the health insurer’s
unique identifier.
All self-funded “controlling health plans” (CHPs) must obtain HPIDs.
Additionally, if a CHP has a subhealth plan (SHP), and exercises sufficient
control over the SHP to direct its business activities, activities or policies,
the CHP can either obtain one HPID for itself and the subhealth plans, or it
can require each of the subhealth plans to obtain their own HPID.
18
New ACA Requirement:
Health Plan Identifier (HPID)
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19. • Who Must Obtain an HPID?
For example, if an employer has one self-funded medical plan for active
employees, a separate self-funded plan for early retirees, and a separate
self-funded dental plan, each plan would have to obtain a separate HPID,
unless one plan is designated as the CHP and it applies for one HPID on
behalf of itself and the other self-funded plans.
Plan sponsors must go on the CMS portal themselves and obtain an HPID.
Third-party administrators (TPAs) cannot obtain an HPID for self-funded
health plans.
19
New ACA Requirement:
Health Plan Identifier (HPID)
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20. • In addition to HPIDs , the final regulations create an other entity identifier
(OEID) for non-health plan entities such as TPAs, repricers, and health
care clearinghouses, that may need to be identified in standard
transactions as the actual recipient of eligibility inquiries or claims on
behalf of a health plan.
• An entity is eligible to obtain an OEID if the entity (1) needs to be identified
in transaction for which a standard has been adopted by HHS; (2) is not
eligible to obtain an HPID or NPI; and (3) is not an individual.
20
New ACA Requirement:
Health Plan Identifier (HPID)
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21. • Large health plans must obtain an HPID by November 5, 2014.
• Small health plans with $5 million or less in annual receipts have an
additional year to obtain an HPID —i.e., their deadline is November 5, 2015.
• All health plans (regardless of size) must use the HPID in standard
transactions beginning November 7, 2016.
• The regulations refer to this last date as the “full implementation date.”
21
New ACA Requirement:
Health Plan Identifier (HPID)
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22. • Where an employer has a “wrap” welfare plan that includes more than one
health benefit option, these rules appear to allow the wrap plan to apply for
one HPID on behalf of all of the Subhealth Plans or to allow each health
plan option (i.e., each Subhealth Plan) to obtain its own HPID.
• This structure is similar to the plan number required on the Form 5500.
• Plans may file separate 5500s with separate plan numbers for each health
benefit option, or may combine into one 5500 with one plan number.
22
New ACA Requirement:
Health Plan Identifier (HPID)
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23. • Once a health plan has an HPID, any covered entity that identifies the
health plan in a standard transaction must use the appropriate HPID
number, rather than another identifier.
• In addition, covered entities must require business associates to use the
appropriate HPID number when they conduct standard transactions on
behalf of a covered entity.
23
New ACA Requirement:
Health Plan Identifier (HPID)
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24. • HHS has established a website where health plans can register and obtain
their HPID.
• There are a series of screens the plan must walk through to provide
information about the plan sponsor and plan.
• See http://www.cms.gov/Regulations-and-Guidance/HIPAA-Administrative-
Simplification/Affordable-Care-Act/Health-Plan-Identifier.html.
24
New ACA Requirement:
Health Plan Identifier (HPID)
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25. • A national enumeration system assigns unique HPIDs to eligible health
plans and OEIDs to eligible other entities, respectively, through an online
application process.
• Access to the enumeration system to obtain HIPDs and OEIDs was made
available on March 29, 2014.
• A new user of the application portal must first register by providing
required identifying information and creating a user ID and password.
• After registering and logging in, the user must accept the terms and
conditions of use of the website, then request application access.
• Further steps are required to gain access to the Health Insurance
Oversight System and the HPID and OEID applications.
25
New ACA Requirement:
Health Plan Identifier (HPID)
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26. • The enumeration system collects and maintains certain identifying and
administrative information about CHPs, SHPs, and other entities.
• The enumeration system also disseminates information through a publicly
available searchable database or through downloadable files.
• Both the HPID and OEID are 10-digit numbers.
• The first digit distinguishes between HPIDs and OEIDs.
• The last digit is a check-digit to identify erroneous or invalid IDs.
26
New ACA Requirement:
Health Plan Identifier (HPID)
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27. • The ACA mandates that health plans must file two one-time certifications
with HHS attesting that the plan is in compliance with the applicable
standard transaction requirements.
• The ACA imposes a penalty on noncompliant plans of $1 per covered life
per day until certification is complete with a maximum penalty of $20 per
covered life.
• The ACA also imposes a penalty of up to $40 per covered life if the plan
knowingly provides inaccurate or incomplete information.
27
New ACA Requirement:
Certification of Compliance with
Standard Transactions Rules
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28. • The ACA breaks down the certification into two parts:
First Certification - The ACA required the First Certification by December 31,
2013, but new proposed rules issued in January 2014 delay the requirement
until December 31, 2015.
This certification requires health plans to file an attestation with HHS to
demonstrate compliance with the following standard transactions:
• Eligibility,
• Claim status, and
• EFT & Remittance Advice.
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New ACA Requirement:
Certification of Compliance with
Standard Transactions Rules
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29. • The ACA breaks down the certification into two parts:
Second Certification – Under the ACA, the Second Certification also is due
12/31/15, but no regulations have been issued yet, so this certification may be
delayed.
This certification requires health plans to file an attestation with HHS to
demonstrate compliance with the following standard transactions:
• Claims & Encounter Information,
• Enrollment and Disenrollment,
• Premium Payments,
• Claims Attachments, and
• Authorization & Referrals.
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New ACA Requirement:
Certification of Compliance with
Standard Transactions Rules
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30. • The First Certification of Compliance would be required for controlling
health plans (CHPs), which would report on their own behalf as well as on
behalf of their subhealth plans (SHPs).
• CHPs would have to provide a single submission that includes:
their number of “covered lives,” as defined in the regulations, as of the date of
submission of the certification; and
documentation demonstrating that the CHP has obtained either of two
permissible certifications of compliance—the HIPAA Credential or the CAQH
CORE Phase III CORE Seal.
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First Certification Requirement
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31. • The submission requirements are a “snap shot” of a CHP’s compliance
with the standards and operating rules.
• HHS stated that it does not intend for the information or documentation to
be updated or resubmitted on a regular basis—suggesting that this will be
a one-time filing requirement.
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First Certification Requirement
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32. • Two different methods (both administered by CAQH CORE, the same
independent organization that developed the operating rules) to document
the First Certification of Compliance—the HIPAA Credential and the Phase
III CORE Seal.
• HHS believes either option is a reasonable approach and there may be
“any number of reasons” why a CHP may elect one alternative over the
other.
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First Certification Requirement
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33. • HIPAA Credential
CAQH CORE is still in the process of developing the HIPAA Credential,
which is expected to be finalized before final regulations are issued.
The key characteristics of the HIPAA Credential are:
Attestation that the CHP has successfully tested the operating rules for each of the
First Certification Transactions with at least 3 (and up to 25) trading partners
accounting for at least 30% of the total number of transactions conducted with trading
partners;
Flexibility of external testing—unlike the Phase III CORE Seal, a specific approach to
external testing is not required;
Provision of contact information, including, but not limited to, name, phone number,
and email address, for each of the listed trading partners; and
Certification, evidenced by the signature of a “senior-level executive,” that the plan
complies with HIPAA's security, privacy, and transaction standards.
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First Certification Requirement
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34. • Phase III CORE Seal
The following four-step process for obtaining a CORE Seal:
conducting a gap analysis by evaluating, planning, and completing necessary system
upgrades;
signing and submitting a pledge to become CORE-certified;
conducting testing through a CORE-authorized testing vendor; and
applying for a CORE Seal by submitting the proper documentation and fee.
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First Certification Requirement
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35. • Phase III CORE Seal
Unlike the HIPAA Credential, the Phase III CORE Seal specifies the testing
process, requiring testing through a CORE-authorized testing vendor using
CORE Certification Master Test Suites.
Test Scripts, which include a description of the requirements for each operating
rule and specific documentation or information necessary to demonstrate
compliance with each of the requirements, are the primary tools for each Test
Suite.
As with the HIPAA Credential, the plan must submit the CAQH CORE HIPAA
Attestation Form, signed by a senior-level executive, indicating, to the best of
the applicant’s knowledge, that the entity is HIPAA-compliant for security,
privacy, and the transaction standards.
35
First Certification Requirement
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36. • Covered lives
HHS states in the preamble to the proposed regulations that it needs to know
the number of covered lives of a CHP (including the number of covered lives of
its SHPs) in case it needs to assess penalties for failure to complete the
certification.
The proposed regulations define “covered lives” to mean all individuals
covered by or enrolled in “major medical policies” of a CHP (which would
include SHPs), including the subscriber and any dependents covered by the
plan.
Individuals who are eligible but not enrolled would not be counted.
The proposed regulations define “major medical policy” to mean “an insurance
policy that covers accident and sickness and provides outpatient, hospital,
medical, and surgical expense coverage.”
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First Certification Requirement
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37. Action Items
• Plan sponsors that conduct standard transactions as part of their
plan's administration functions also must comply with the EDI
Standards.
• Covered entities should monitor new transaction standards and
operating rules—and their effective dates—to ensure continued
compliance.
37
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38. • Health plan sponsors should verify that they have correctly identified
all business associates involved with standard transactions and
review all business associate contracts for EDI requirements.
• A health plan will be out of compliance with HIPAA if its business
associates do not comply with applicable EDI Standards when
conducting covered transactions on behalf of the health plan.
• In some cases, health plans will rely on business associates to
implement the requirements of the rules (e.g., many health plans
contract with TPAs for claims payment and will rely on those TPAs to
implement the EFT/ERA transaction standards and operating rules).
• The obligations of business associates should be carefully
documented and monitored.
38
Action Items
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39. • Health plan sponsors should also determine whether health plan
vendors will continue to accept nonstandard transmissions from an
employer/plan sponsor (e.g., eligibility data feeds and premium
payments), and whether any additional charges will be incurred for
data that are received and processed in nonstandard format.
• If standard format is required and the employer/plan sponsor is not
prepared to comply, arrangements with a health care clearinghouse
may be necessary.
39
Action Items
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40. • Health plans should obtain an HPID by November 5, 2014 or 2015.
• Health plans will need to identify CHPs and SHPs.
• Then, they will need to decide whether the CHP will request a single
HPID for itself and all its SHPs, or whether the SHPs will have their
own HPIDs.
• In addition, since most health plans have business associates that
conduct standard transactions for them, these health plans will need
to communicate their HPIDs to their business associates.
40
Action Items
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41. • Health plans should review the proposed regulations—and watch for
final regulations—regarding the requirements for certifying that the
health plan's data and information systems are in compliance with any
applicable standards and operating rules.
41
Action Items
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42. • Business associates, such as TPAs, should consider whether any of
the EDI Standards have implications for their business operations.
• TPAs should consider whether to obtain OEIDs.
• In some cases, group health plans may require TPAs to use OEIDs.
• Also, TPAs should be ready to implement the operating rules as they
become effective, which requires advance planning and resource
allocation.
42
Action Items
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43. • Larry Grudzien, Attorney at Law
Phone: 708-717-9638
Email: larry@larrygrudzien.com
Website: www.larrygrudzien.com
43
Contact Information
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