ERISA Case Analysis

The site offers a comprehensive look at health and benefits regulations. After reviewing this site, employers should have a good understanding of mandatory benefits and benefits regulations. First, this paper described the major features of the website and how each feature can be used to monitor employee benefits. Key features included links to critical benefits information and streamlined functionality that enabled quick access to pertinent information. Second, the paper explained how employers could verify that their employee benefits comply with all federal laws by using this resource. Important benefits regulations that employers can review on the website for compliance include ERISA, COBRA, HIPAA, ACA, and FMLA. Third, the paper described how employees can use this information to ensure their benefits rights are protected. Employees can review the “Consumer Information on Health Plans” subtopic provided by EBSA, review ERISA, and report noncompliance to the DOL hotline in order to protect their benefits rights. Last, the paper provided a detailed outline of the Health Plan and Benefits

After reading the Just The Facts excerpt and the case of McDowell V. Krawchison, I would have to say that I believe this employer violated COBRA. It is stated in the textbook that, “The COBRA requires that employers who have group health insurance plans and at least twenty employees offer continuation coverage to employees (and other beneficiaries if there is family coverage) who experience qualifying events that would otherwise cause the loss of their health insurance.” (Walsh, Pg. 486).

The second way is for employers to utilize the health benefits laws self-compliance tools. There are two major sections listed under this link, HIPPA and other health care-related provisions and the affordable care act provisions. Employers can be used to compare the provisions of their plan to ensure they are compliant with HIPPA, affordable care act, and other health care-related provisions.

The Privacy Rule enacted by the Department of Health and Human Services apply to all HIPAA covered entities such as health plans, health clearinghouses, insurance companies, business associates, and to any healthcare provider who transmits health information in electronic form. (Summary of the HIPPA Security Rule, 2015) Health Plans which are typically group plans that provide and/or pay for the cost of medical services are covered entities that must comply with privacy regulations. Exceptions for Health Plans may include group health plans that contain less than 50 participants and certain types of government funded programs. (Summary of the HIPPA Security Rule, 2015)

The second feature is a list of DOL webpage links that provides more details about COBRA. The topics that are covered in more detail include frequently asked questions, major provisions of COBRA, employer compliance assistance, how the Health Insurance Portability and Accountability Act (HIPAA) is relevant, women and maternal care issues, what to do if an employer has declared bankruptcy, changes in employment status, eligibility, personal life changes, and issues surrounding military deployment.

The purpose of this meeting was to introduce and clarify business health insurance options in the year 2015 and the significance of good health at work. The three main topics that were presented to us were: 1) 2015/16 Affordable Care Act (ACA) overview for small sized businesses with fewer than fifty full time employees; 2) 2015/16 ACA overview for medium to large sized businesses with fifty or more full

To fully understand COBRA, it is necessary to know the meanings of qualifying events, qualified beneficiaries, and continuation coverage. These qualifying events include, death of the covered employee, termination or reduction in hours of employment, divorce or legal separation, dependent child ceasing to meet the health plan’s definition of a dependent child, and covered employee becoming eligible to Medicare benefits under the Social Security Act.

The passing of the AHCA bill will dismantle Obamacare and all of its subdivisions. As a result, the subdivision in which employers, with 50 employees or more, are required to offer affordable health insurance options to both part-time and full-time employees will be eradicated. Therefore, the burden of acquiring affordable health insurance will be lifted off the employer and instead be placed on the employee; leaving many without insurance coverage. In an effort to obtain health insurance part-time employees may be completed to leave their current positions in pursuit of a full-time position with benefits. Consequently, as the repealing of Obamacare is not occurring in a vacuum it will not only have an impact on the health care industry but

For private ventures that might want their workers to have medical coverage however would prefer not to agree to accept a gathering wellbeing design, this plan could be the appropriate response. Beforehand, the Internal Revenue Service ("IRS") and the Department of Labor ("DOL") decided that wellbeing repayment courses of action ("HRAs") abused a few arrangements in the ACA. Bosses with these sorts of game plans confronted paying an extract expense of $100 every day per worker secured under the game plan.

COBRA medicinal insurance, short for the Consolidated Omnibus Budget Reconciliation Act was passed by Congress in 1986, to verify that individuals would not abruptly lose insurance on the off chance that they were terminated from, lost, resigned, quit, or were generally give up from their occupations. It was the first enactment of its kind to shield employees and their families from all of a sudden being without medical insurance and in charge of costly doctor's visit expenses, or more awful needing to go without health care by any means. It is likewise to a great degree imperative to individuals with previous health conditions on the grounds that it offers them constant coverage so they can't be denied later on from another health insurance plan. COBRA medicinal insurance is a program that permits an employer to decide to keep their group health insurance (from their former employer) for up to year and a half. Well known to opposite conviction, it is not an insurance plan on its on, but rather an approach to proceed with the insurance advantages you as of now had. Under the COBRA insurance law people who worked at companies with more than 20 representatives will qualify to choose COBRA medical insurance

Employer based health insurance has received much criticism and its existence is in jeopardy as the Affordable Care Act (ACA) changes the healthcare industry. Penalties enacted by the ACA may cause businesses to reevaluate their standing on providing insurance coverage. However, evidence shown by Klein (2013) and Radnofsy (2012) give way to thinking that large business may not change their policies on providing insurance coverage. Moore (2013) and Pear (2010) show how small to mid-sized businesses may be influenced to drop the benefit, as it may not be in their economic interest. However, this is the area that needs assistance because they are the ones suffering from the insurance gap. The Census Bureau (2013) and Garfield, Damico, Stephens & Rouhani (2014) provide reports of how lower-income families and employees of small businesses very often find themselves without access to healthcare. Discussed are the advantages and disadvantages of employer-based health insurance. Evaluating the current position of employer-base health insurance and the pros and cons to its implementation will help determine how necessary it is for the United States.

“For small businesses, having a single employee with catastrophic expenditures can make insurance unaffordable to all of the workers in the firm. The Obama plan would reimburse employer health plans for a portion of the catastrophic costs they incur above a threshold if they guarantee such savings are used to reduce the costs of workers’ premiums.”

This is something that is usually available to those who have been laid off from a job that provided health care coverage. COBRA is an acronym for Consolidated Omnibus Budget Reconciliation Act and is a law that requires an employer to provide the recently laid off workers with medical insurance. This coverage is limited to a year and a half after you are laid off. When I lost my job years ago, I signed up for this plan. One thing that was shocking was the cost. I hadn't realized how much money my employer was spending to pay for the cost of medial insurance. Under COBRA, I believe I was paying all of it.

All other benefits coverage end on the last day of employment. Upon termination of employment from KMS, an employee has the option to convert or port his or her Company life insurance, and/or to continue medical, dental and vision benefits, at his or her expenses, in accordance with The Consolidated Omnibus Budget Reconciliation Act (COBRA). Information regarding these options is sent directly to the employee’s home after the last day of

The problem with this alternative is the degree of variability within these programs that might limit access, eligibility or benefits to those who need it. Connecticut has legislation underway that sets up a program that is completely employee funded, which puts an increased financial burden on the employee rather than splitting the contributions with their employers, despite the cost saving benefits employers may receive (Report of the Family Medical Leave Insurance Task Force, 2014). The challenges and barriers to federal/state programs are evident, one example of this is Medicaid. Medicaid is dramatically different from state to state which has made oversight difficult and diminished access to quality care (U.S. Government Accountability Office, 2015).