Donnelly, JamesBenefits Quarterly
Health plans subject to the Employee Retirement Income Security Act (ERISA), which cover more than 130 million Americans, are required to submit an annual report known as Form 5500 to the Department of Labor with information about their financial status and operations. Scott and DeSaulnier urge ...
The opt-in plan must provide each primary insured with a health insurance identification card indicating that the plan has elected to be subject to the act. A self-insured plan subject to ERISA that does not want to opt-in needs to take any action. If the plan does not opt-in, ...
The Supreme Court has interpreted ERISA's "savings" and "deemer" clauses to mean that insured plans are subject to regulations directly at the federal level and indirectly at the state level, while self-funded plans are regulated exclusively at the federal level. The ERISA statute and the ...
(the hospital or health care organization) represents or creates the appearance to third persons that the physician is an agent of the principal, subject to the principal's control. This theory focuses on the reasonable expectations and beliefs of the patient, based on the conduct of the ...
HRAs are “group health plans” under the IRC, the Employee Retirement Income Security Act of 1974 (“ERISA”), and the Public Health Service Act (“PHSA”), and thus are subject to the rules applicable to group health plans (which includes, for example, the annual Form 5500 reporting re...
private employment-based group health plans subject to the Employee Retirement Income Security Act of 1974 (ERISA), non-federal government plans (such as plans sponsored by states and local governments) subject to the Public Health Service Act, and church plans subject to the Internal Revenue Code...
Are level funded plans good or bad? It depends on the business's needs. They offer predictability and potential savings but come with some risks. Are level funded plans subject to ACA? Yes, they must comply with ACA regulations. Level funding presents an enticing alternative for employers seeki...
In the six months prior to the time he enrolled in his employer’s health plan, he had no doctor visits and did not take any medication. He was not subject, therefore, to any exclusion period for his pre-existing conditions. Shortly after he started working, his asthma worsened, but he...
QSEHRA plans are also subject to oversight under theEmployee Retirement Income Security Act(ERISA). ERISA regulations require that employers give employees a summary plan description that details their plan benefits.5 Finally, should an employer decide to makegroup health insurance available, it is no...