Free 8/13 ABA RPTE Study Group Call On Affordable Care Act Claims & Grandfathered Plan Regulations


On August 13, 2010, at  1 PM Eastern, Noon Central, 11 AM Mountain and 10 AM Pacific, the RPTE Employee Benefits Group will host a free one hour “Study Group” conference call led by the Welfare Plan Committee to discuss the interim regulations under the Patient Protection and Affordable Care Act (PPACA) regarding claims adjudication and grandfather plan status.  This timely discussion has immediate impact on practitioners and their clients dealing with group health plans, since the new rules generally apply to plan years beginning on or after September 23, 2010.

Key topics will include:

  • Mandatory Claims Processing and Appeals Process Requirements
  • Impact on 2001 ERISA Claims Regulations
  • Impact on Plan Designs and Plan Administration
  • Determining Grandfather Status
  • Impact of Future Plan Actions on Grandfather Status

In addition, the topics for possible future calls in September and October regarding health care reform, as well as the current ABA projects to provide comments to the DOL, IRS and Department of HHS with respect to guidance under PPACA and opportunities for involvement also will be discussed.

The conference call will be moderated by:

  • Cynthia Marcotte Stamer, Cynthia Marcotte Stamer, PC, Dallas, TX;
  • Elizabeth Leight, Society of Professional Benefit Administrators, Washington, DC; and
  • Scott Douglas Marquardt, Total Plan Services, Inc., Dallas, TX

The phone number and passcode for the call are:

(866) 646-6488

Pass code: 5380700259

Given the scope of the changes wrought by PPACA, and the numerous interpretations being offered in the legal and insurance communities as well as the media, this promises to be a lively discussion.  Multiple views and comments are encouraged.

Other Resources

If you found this information of interest, you also may be interested in reviewing other recent Solutions Law Press updates including:

ü     Small Employers Sponsoring Health Coverage May Qualify For New Tax Credit, Must Act Quickly To Comply With Other New Federal Health Plan Mandates Under Affordable Care Act & Other Laws

ü     Rite Aid Pays $1 Million HIPAA Privacy Settlement As OCR Tightens HIPAA Regulations

ü     New Affordable Care Act Mandated High Risk Pre-Existing Condition Insurance Pool Program Regulations Prohibit Plan Dumping of High Risk Members, Set Other Rules

ü     Register Now For 8/24 2010 Health Plan Update Briefing

ü     Congress & Labor Department Considering Tightening of Retirement Plan Regulations

ü     Testimony Highlights Growing Exposure of Businesses Misclassifying Workers; Businesses Should Act to Minimize Risks

ü     Businesses Employing Children Should Review & Tighten Practices In Light of Tightened Rules & Increased Penalties

ü     New Affordable Care Act Health Plan Appeals Regulations Require Health Plan Updates

ü     Blockbuster & Health Delivery Disability Discrimination Settlements Highlight Need For Tightened Disability Discrimination Risk Management

ü     Agencies Release Regulations Implementing Affordable Care Act Health Plan Preventative Care Mandates

ü     New Retirement Plan Resource To Help Spanish-Speaking Participants With Retirement Planning

ü     Office of Civil Rights Proposes Changes To HIPAA Privacy, Security & Civil Sanctions Rules

ü     St. Louis Employer’s OSHA Violations Trigger Contempt Order and Penalties

ü     Review & Strengthen Defensibility of Existing Worker Classification Practices In Light of Rising Congressional & Regulatory Scrutiny

ü     Key Affordable Care Act Health Plan Coverage Mandates Guidance Issued June 28; Apply ASAP For Early Retirement Reinsurance Program

ü     HHS, DOL & IRS Rules Define “Grandfathered” Group Health Plans & Health Insurance Coverage under the Patient Protection and Affordable Care Act

ü     New Rule Requires Federal Government Contractors To Post New “Employee Rights Under The National Labor” Poster

ü     Defined Contribution Plans Investing In Publically Traded Employer Securities Face New Requirements

ü     CBO Raises Estimated Cost of Health Care Reforms As Employers, Health Plans Brace Costs Of Newly Effective & Impending Mandates

ü     Certain Workforce Reductions Trigger Plant Closing Notice & Other Obligations

ü     Mishandling Employee Benefit Obligations Creates Big Liabilities For Distressed Businesses & Their Business Leaders

ü     DOL Plans To Tighten Employment Protections For Disabled Veterans & Other Disabled Employees Signals Need For Businesses To Tighten Defenses

ü     COBRA, HIPAA, GINA, Mental Health Parity or Other Group Health Plan Rule Violations Trigger New Excise Tax Self-Assessment & Reporting Obligations

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