May 16, 2013

Health Care Plan Design for 2014 – Will Your Hospital/Health System Be Ready?


ASHHRA hosted a webinar titled “Health Care Plan Design for 2014 – Will Your Hospital/Health System Be Ready?” and invited Drinker Biddle lawyers to present.

Health Care Reform imposes a number of new requirements on the benefits that must be covered by certain group health plans. Is your organization prepared for 2014 health care plan requirements? The time has come for employers to decide whether to play or pay under the employer shared responsibility mandate in the Patient Protection and Affordable Care Act (PPACA).

The webinar focused on the steps other hospitals and health systems are taking and summarize the recent regulatory developments and transitional guidance including:

  • An employer may exclude up to five percent of full-time employees and still avoid the no coverage penalty (including per diem, part-time, registry, and other excluded employees)
  • The offer of coverage must include dependent children under age 26, but not spouses
  • Shorter measurement periods are permitted for the 2014 determination of both large employers and full-time employee status
  • Further guidance is provided with respect to hours of service and what it means to offer coverage
  • Rules are provided regarding rehired employees and employees with breaks in service

Learning Objectives:

  • Understand the unique design issues a health care provider will face in implementing the health care reform rules for its own health plan
  • Identify the key health care reform issues your organization needs to address to be ready for 2014
  • Prepare for and avoid the application of the no coverage and unaffordable/insufficient coverage penalties

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