The final HIPAA special enrollment regulations took effect in 2005 and require that individuals be allowed to enroll in employer-sponsored health plans outside of open enrollment under certain conditions, referred to as special enrollment. Notices of those rights are also required. The Affordable Care Act (ACA) added to the list of special enrollment rights. But questions still arise about when an employee or an employee’s dependent is entitled to special enrollment and the IRS can impose excise taxes on employers that fail to follow the special enrollment rules. Potentially difficult issues include the content and timing of special enrollment notices, coverage of special enrollment in Summary Plan Descriptions (SPDs), determination of whether an individual qualifies as having lost other coverage because of premium changes, special enrollment when an individual has Medicare, time limits to exercise special enrollment rights, potential damages and penalties, cafeteria plan issues created by special enrollment self-reporting requirements for special enrollment failures.
Please join Christine Williams, founder of Health Plan Plain Talk, as she reviews some of the most problematic special enrollment issues for employer-sponsored health plans and common administrative problems related to special enrollment.
WHAT YOU’LL LEARN
Just a sampling of what this webinar will cover:
- Employers and health plans that must comply with the special enrollment requirements
- The notice requirements and coverage of special enrollment in SPDs
- Who is entitled to special enrollment and is it limited to the employee or does it include dependents
- Who qualifies as a dependent for special enrollment
- COBRA qualified beneficiaries and special enrollment
- How Medicare entitlement affects special enrollment eligibility
- Time limits for special enrollment requests
- Differences between special enrollment in an employer-sponsored health plan and purchase of coverage on the ACA Marketplaces
- Rules regarding premiums and benefits for special enrollees
- Domestic partners and special enrollment
- AND MUCH MORE!
YOUR CONFERENCE LEADER
Your conference leader for “Special Enrollment Questions: Help for Employer-Sponsored Health Plans” is Christine Williams. Ms. Williams has worked in the employee benefits field since 1987, both in private practice and as in-house counsel to a Fortune 100 company, and recently founded HealthPlanPlainTalk.com, an online resource for benefit plan sponsors and employee benefit professionals. She has extensive experience with all types of health and welfare plans, and was the editor and a contributing author of HIPAA Portability, Privacy, & Security, published by the Employee Benefits Institute of America (EBIA), a division of Thomson Reuters, and is now a contributor to that publication. She was a contributing author of Health Care Reform for Employers and Advisors, also published by EBIA. She has provided advice on HIPAA, health care reform, and benefit plan compliance to a wide range of health plans, employers that sponsor health plans, and business associates, and she regularly teaches seminars for employee benefit professionals. Before moving into employee benefits, Ms. Williams was a trial attorney at the U.S. Department of Justice and an assistant professor at the University of Maryland School of Law. She earned her J.D. degree from the University of Kentucky College of Law.