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Who should attend Texas Compliance Survival: ERISA, HIPAA And COBRA
This seminar is designed for human resource managers, benefits managers, accountants, controllers, CPAs, plan administrators, enrolled agents, presidents, vice presidents, payroll professionals, financial professionals, business and office managers, financial planners, insurance professionals and attorneys.
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Texas Compliance Survival: ERISA, HIPAA And COBRA  

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This seminar is designed for human resource managers, benefits managers, accountants, controllers, CPAs, plan administrators, enrolled agents, presidents, vice presidents, payroll professionals, financial professionals, business and office managers, financial planners, insurance professionals and attorneys.

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Seminar Summary:

This seminar will cover ERISA, HIPAA, and COBRA compliance communications and their purpose. (see full course description)

 
 

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Training Course Syllabus:


Topics to be discussed include:

  • ERISA

ERISA compliance for Health and Welfare Plans is a complicated process - it requires detailed reporting, disclosure requirements and fiduciary responsibility guidelines. Since ERISA plans preempt most state insurance laws, compliance with Federal guidelines prevail and the legal consequences of non-compliance can be costly. This program will discuss the detailed compliance requirements of ERISA plans. If your plan isn't in ERISA compliance, you have no ERISA protection.

  • HIPAA

The recent HIPAA Privacy laws have finally answered the age old question, 'Whose medical records are they anyway?' If you answered, 'the patient,' you are incorrect. Medical records are the property of the provider. The privacy laws give guidance as to who has access and to whom medical information can be released. And these new provisions will have a major impact on the who can know and receive medical information. We are all about to enter into a vicious circle 'Provider can't release that information - Employer can't know that information - Somebody has to have it' struggle. And, in the name of privacy, you may no longer be able to help your employees through the insurance maze. This session will provide a 'reality check' of the new privacy laws. How will it truly impact you as an employer? How can we balance our 'must know - can't know' world? And, how will insurance rates and accessibility be impacted?

  • COBRA

After 12 years of living under proposed COBRA guidelines, final rules and regulations have been released. And even newer proposed regulations have been released and finalized. Do you know what has changed? Many employers do not. And COBRA is an employer law! This seminar will review the employer COBRA responsibilities and provide attendees an awareness of the revisions and clarifications revealed in the final COBRA regulations. Throughout this seminar, participants will participate in a COBRA test to emphasize the changing areas of the law. Attendees will be provided a COBRA and HIPAA self audit. We will review the provisions of both laws and discuss the 'minor words - major administrative hassles' of COBRA and HIPAA compliance.

  • Four Communications Of Compliance

Pulling all of the compliance communications together, this part of the seminar will review the purpose of the four communications of compliance. Emphasis will be placed on how proper communication protects the employer and their insurance program. 'If you haven't told them the rules, you can't enforce the rules when you need to!'

8:30 a.m. - 10:15 a.m.

I. ERISA

A. Overview

1. ERISA Defined – A Plan, Fund Or Program

2. Why Want An ERISA Plan?

3. Impact On Plan Design And Administration

4. Determining Whether A Fringe Benefit Program Is An ERISA Welfare Benefit Plan

B. Creating And Documenting The Plan

1. Eligibility And Benefits Issues (Included Subrogation, Stop-Loss Insurance, And COB)

2. Creating The Plan Document

3. Plan Modification And Termination

C. The Role Of The Plan Administrator

1. Key Individuals

2. Plan Administration; Outsourcing

3. Fiduciary Duties

D. ERISA Documentation

1. Applicable Legal Requirements

2. Reporting And Disclosure: Effect Of Plan Size And Funding Arrangement

3. New Rules For Summary Plan Descriptions – How Often Must The Document Be Updated And Provided

4. Electronic Disclosure

5. Other Schedules And Items To File

E. Interplay Between State And Federal Laws

1. Preemption Of State Laws

2. Effect On Self-Funded vs. Fully Insured Plans

F. Check Off Lists

G. Questions And Answers

10:15 a.m. - 10:25 a.m.

Break

10:25 a.m. - 12:00 p.m.

II. HIPAA Privacy – The Good, The Not So Bad,

BUT, Still A Little Ugly

A. How Did We Get In The Fix?

1. Clinton Health Care Bill

2. 1996 HIPAA – Portability

3. New HIPAA

a. Administrative Simplification

b. Security And Confidentiality

c. Privacy

4. Final Regulations – Will They Ever Be Final?

B. New HIPAA – Administrative Simplification

1. Standardized Claim And Enrollment

2. Effective Dates

C. New HIPAA – Confidentiality And Security

1. Personal Health Information

2. Who Has Access?

3. Who Is Responsible?

D. New HIPAA – Privacy

1. Whose Medical Records Are They? NOT YOURS

2. But, You Have Control

3. General Release – Health Purposes

4. Specific Release – NON-Health Purposes

E. Are YOU On The 'Blessed' Lists?

1. Health Provider

2. Health Care Clearing House

3. Health Plan

a. Business Associate

b. Self-Insured Employers

F. Accountabilities And Penalties

G. What It Means To YOU

1. As A Patient

2. As An Employer

H. Questions And Answers

12:00 p.m. - 1:00 p.m.

Lunch (On Your Own)

1:00 p.m. - 2:00 p.m.

III. COBRA – Compliance Survival

A. Outline Overview

1. Four Communications Of Compliance

2. How HIPAA And COBRA Work Together

3. Compliance Laws – Responsible Party

4. Policing Responsibilities

B. COBRA – History

1. July 1986 To January 2000

a. Original Law

b. Proposed Changes

c. Amendments

d. Other Laws Impacting COBRA Regulations

e. Supreme Court Ruling

f. Final Regulations

g. New Proposed Regulations

2. Basics Of The Law

a. Continuation

b. Who Can Continue

3. What Employers Must Comply

a. Who Is Exempt And Why

b. Small Employer Test

c. Test – Why And How It Has Changed

2:00 p.m. - 3:30 p.m. (Break 2:30 p.m. - 2:40 p.m.)

III. COBRA – Compliance Survival (Continued)

C. COBRA Test – What Changed – Minor Words – Major Hassles

1. Supreme Court Ruling

2. Election Period

3. Payment Period

4. COBRA Plans

5. Payment Shortage

6. FSAs And COBRA

7. Eligible To Continue What Coverage

8. Changes In Coverage

9. Employee's Responsibility In Certain Situations

10. Employment Status Changes

11. Statute Of Limitations

3:30 p.m. - 3:45 p.m.

III. COBRA – Compliance Survival (Continued)

D. Most Common Employer Mistakes

1. Gross Misconduct

2. Workers' Comp Or Leave Of Absence

3. Being Nosey – Divorce Final Or Just Filed?

3:45 p.m. - 4:30 p.m.

III. COBRA – Compliance Survival (Continued)

E. The Four Communications Of Compliance – WHY

1. Two Types Of Employees – Employer Needs Protection

2. HIPAA Initial Rights Notice

3. COBRA Initial Rights Notice

4. HIPAA Certificate Of Creditable Coverage

5. COBRA Notification

6. Communication Methods

Seminar Summary:

This seminar will cover ERISA, HIPAA, and COBRA compliance communications and their purpose. (see full course description)

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