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Erisa Regulation Of Health Plans
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Book Synopsis ERISA Regulation of Health Plans by : Hinda Ripps Chaikind
Download or read book ERISA Regulation of Health Plans written by Hinda Ripps Chaikind and published by . This book was released on 2001 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The Employee Retirement Income Security Act of 1974 (ERISA, P.L. 93-406) places the regulation of employee benefit plans (including health plans) primarily under federal jurisdiction for about 124 million people. ERISA’s treatment of health plans is both complicated and confusing. ERISA has been interpreted as dividing health plans into two groups regulated differently under the law: about 54 million people are covered by self-insured plans for which the employer, rather than an insurer, assumes the risk for paying for covered services and about 70 million people are covered by purchased insurance (according to 2000 information from the Census Bureau and the Department of Labor).
Book Synopsis Employment and Health Benefits by : Institute of Medicine
Download or read book Employment and Health Benefits written by Institute of Medicine and published by National Academies Press. This book was released on 1993-02-01 with total page 381 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United States is unique among economically advanced nations in its reliance on employers to provide health benefits voluntarily for workers and their families. Although it is well known that this system fails to reach millions of these individuals as well as others who have no connection to the work place, the system has other weaknesses. It also has many advantages. Because most proposals for health care reform assume some continued role for employers, this book makes an important contribution by describing the strength and limitations of the current system of employment-based health benefits. It provides the data and analysis needed to understand the historical, social, and economic dynamics that have shaped present-day arrangements and outlines what might be done to overcome some of the access, value, and equity problems associated with current employer, insurer, and government policies and practices. Health insurance terminology is often perplexing, and this volume defines essential concepts clearly and carefully. Using an array of primary sources, it provides a store of information on who is covered for what services at what costs, on how programs vary by employer size and industry, and on what governments doâ€"and do not doâ€"to oversee employment-based health programs. A case study adapted from real organizations' experiences illustrates some of the practical challenges in designing, managing, and revising benefit programs. The sometimes unintended and unwanted consequences of employer practices for workers and health care providers are explored. Understanding the concepts of risk, biased risk selection, and risk segmentation is fundamental to sound health care reform. This volume thoroughly examines these key concepts and how they complicate efforts to achieve efficiency and equity in health coverage and health care. With health care reform at the forefront of public attention, this volume will be important to policymakers and regulators, employee benefit managers and other executives, trade associations, and decisionmakers in the health insurance industry, as well as analysts, researchers, and students of health policy.
Book Synopsis Employer-based Health Plans by : Mark V. Nadel
Download or read book Employer-based Health Plans written by Mark V. Nadel and published by . This book was released on 1995 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Health Benefits Coverage Under Federal Law--. by :
Download or read book Health Benefits Coverage Under Federal Law--. written by and published by . This book was released on 2010 with total page 108 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Health Coverage Portability written by and published by . This book was released on 2004 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis MEWAs, multiple employer welfare arrangements under the Employee Retirement Income Security Act (ERISA) by :
Download or read book MEWAs, multiple employer welfare arrangements under the Employee Retirement Income Security Act (ERISA) written by and published by . This book was released on 2003 with total page 80 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis ERISA and Health Insurance Subrogation in all 50 States - 5th Edition by : Gary L. Wickert
Download or read book ERISA and Health Insurance Subrogation in all 50 States - 5th Edition written by Gary L. Wickert and published by Juris Publishing, Inc.. This book was released on 2013-01-01 with total page 1300 pages. Available in PDF, EPUB and Kindle. Book excerpt: ERISA and Health Insurance Subrogation In All 50 States is the most complete and thorough treatise covering the complex subject of ERISA and health insurance subrogation ever published. NEW TO THE FIFTH EDITION! • Updated To Include All The Newest Case Law! • Updated To Include Medicaid Subrogation and Preemption of FEHBA ! • New Plan Language Recommendations! • Complete Health Insurance Subrogation Laws In All 50 States • Covers The Application of ERISA In Every Federal Circuit The Fifth Edition of ERISA and Health Insurance Subrogation In All 50 States has been completely revised, edited, and reorganized. This was partly to reflect the new direction recent case decisions have taken regarding health insurance subrogation as well as the crystallization of formerly uncertain and nebulous areas of the law which have now received some clarity. An entirely new chapter entitled, “What Constitutes Other Appropriate Equitable Relief?” has been added and replaces the old Chapter 9, which merely dealt with Knudson and Sereboff. The new edition introduces new state court decisions addressing the issue of causation and whether and when a subrogated Plan seeking reimbursement must prove that the medical benefits it seeks to recover were causally related to the original negligence of the tortfeasor. An entirely new section was added concerning the subrogation and reimbursement rights of Medicare Advantage Plans, a statutorily-authorized Plan which provides the same benefits an individual is entitled to recover under Medicare. This includes recent case law which detrimentally affects the rights of such Plans to subrogate. Also added to the new edition is additional law and explanation regarding Medicaid subrogation, including the differentiation between “cost avoidance” and “pay and chase” when it comes to procedures for paying Medicaid claims. Significant improvements have been made to suggested Plan language which maximizes a Plan’s subrogation and reimbursement rights. The suggested language stems from recent decisions and developments in ERISA and health insurance subrogation from around the country since the last edition. The new edition has been completely reworked both in substance and organization. Recent case law has necessitated consolidation of several portions of the book and elimination or editing of others. A new section entitled “Liability of Plaintiff’s Counsel” has been added, which provides a clearer exposition on the laws applicable and remedies available when plaintiff’s attorneys and Plan beneficiaries settle their third-party cases and fail to reimburse the Plan. Also new to the book are recently-passed anti-subrogation measures such as Louisiana’s Senate Bill 169, § 1881, which states that no health insurer shall seek reimbursement from automobile Med Pay coverage without first obtaining the written consent of the insured. The new edition also goes into much greater detail on the procedures for and law underlying the practice of removal of cases from state court to federal court, and the possibility of remand back to state court. This includes the Federal Courts Jurisdiction and Venue Clarification Act of 2011, effective Jan. 6, 2012, which amended federal removal, venue, and citizenship determination statutes in very significant ways. The new edition also delves into, for the first time, the role which the federal Anti-Injunction Act plays when beneficiaries sue in state court to enforce the terms of an ERISA Plan, while the Plan files suit in federal court seeking an injunction against the state court action. New case law and discussion on preemption of FEHBA subrogation and reimbursement claims have been added to Chapter 10 in the wake of new decisions regarding same.
Book Synopsis Eliminating Health Disparities by : National Research Council
Download or read book Eliminating Health Disparities written by National Research Council and published by National Academies Press. This book was released on 2004-08-09 with total page 310 pages. Available in PDF, EPUB and Kindle. Book excerpt: Disparities in health and health care across racial, ethnic, and socioeconomic backgrounds in the United States are well documented. The reasons for these disparities are, however, not well understood. Current data available on race, ethnicity, SEP, and accumulation and language use are severely limited. The report examines data collection and reporting systems relating to the collection of data on race, ethnicity, and socioeconomic position and offers recommendations.
Book Synopsis An Employee's Guide to Health Benefits Under COBRA by :
Download or read book An Employee's Guide to Health Benefits Under COBRA written by and published by . This book was released on 2010 with total page 36 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis ERISA Pre-emption by : William Pierron
Download or read book ERISA Pre-emption written by William Pierron and published by . This book was released on 2008 with total page 14 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Pension and Employee Benefits: ERISA law and regulations, related laws, proposed regulations by : United States
Download or read book Pension and Employee Benefits: ERISA law and regulations, related laws, proposed regulations written by United States and published by CCH Incorporated. This book was released on 2004 with total page 2224 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Michelle's Law by : United States. Congress. House. Committee on Energy and Commerce
Download or read book Michelle's Law written by United States. Congress. House. Committee on Energy and Commerce and published by . This book was released on 2008 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Older Workers Benefit Protection Act by : United States
Download or read book Older Workers Benefit Protection Act written by United States and published by . This book was released on 1990 with total page 6 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis The Employee Retirement Income Security Act of 1974 by : James Wooten
Download or read book The Employee Retirement Income Security Act of 1974 written by James Wooten and published by Univ of California Press. This book was released on 2005-01-24 with total page 433 pages. Available in PDF, EPUB and Kindle. Book excerpt: This study of the Employee Retirement Income Security Act of 1974 (ERISA) explains in detail how public officials in the executive branch and Congress overcame strong opposition from business and organized labor to pass landmark legislation regulating employer-sponsored retirement and health plans. Before Congress passed ERISA, federal law gave employers and unions great discretion in the design and operation of employee benefit plans. Most importantly, firms and unions could and often did establish pension plans that placed employees at great risk for not receiving any retirement benefits. In the early 1960s, officials in the executive branch proposed a number of regulatory initiatives to protect employees, but business groups and most labor unions objected to the key proposals. Faced with opposition from powerful interest groups, legislative entrepreneurs in Congress, chiefly New York Republican senator Jacob K. Javits, took the case for pension reform directly to voters by publicizing frightening statistics and "horror stories" about pension plans. This deft and successful effort to mobilize the media and public opinion overwhelmed the business community and organized labor and persuaded Javits's colleagues in Congress to support comprehensive pension reform legislation. The enactment of ERISA in September 1974 recast federal policy for private pension plans by making worker security an overriding objective of federal law.
Book Synopsis Federalism and Health Policy by : Alan Weil
Download or read book Federalism and Health Policy written by Alan Weil and published by The Urban Insitute. This book was released on 2003 with total page 448 pages. Available in PDF, EPUB and Kindle. Book excerpt: The balance between state and federal health care financing for low-income people has been a matter of considerable debate for the last 40 years. Some argue for a greater federal role, others for more devolution of responsibility to the states. Medicaid, the backbone of the system, has been plagued by an array of problems that have made it unpopular and difficult to use to extend health care coverage. In recent years, waivers have given the states the flexibility to change many features of their Medicaid programs; moreover, the states have considerable flexibility to in establishing State Children's Health Insurance Programs. This book examines the record on the changing health safety net. How well have states done in providing acute and long-term care services to low-income populations? How have they responded to financial incentives and federal regulatory requirements? How innovative have they been? Contributing authors include Donald J. Boyd, Randall R. Bovbjerg, Teresa A. Coughlin, Ian Hill, Michael Housman, Robert E. Hurley, Marilyn Moon, Mary Beth Pohl, Jane Tilly, and Stephen Zuckerman.
Book Synopsis Section 1557 of the Affordable Care Act by : American Dental Association
Download or read book Section 1557 of the Affordable Care Act written by American Dental Association and published by American Dental Association. This book was released on 2017-05-24 with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt: Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This brief guide explains Section 1557 in more detail and what your practice needs to do to meet the requirements of this federal law. Includes sample notices of nondiscrimination, as well as taglines translated for the top 15 languages by state.
Book Synopsis Regulation of Health Benefits Under ERISA by :
Download or read book Regulation of Health Benefits Under ERISA written by and published by . This book was released on 2007 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: