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What to Expect When You’re Expecting a Claim Under Health Care

(And How to Avoid One)

Webinar

June 19, 2012

Since the enactment of the Affordable Care Act of 2010 (the "Act"), employers and other sponsors of group health plans have had to implement a host of reform requirements ranging from the expansion of coverage for children up to age 26 to covering the types of preventive care mandated by the federal government. Because some requirements depend on a plan's "grandfathered status", not all plans are subject to the same mandates. Moreover, the regulations implementing some of the reforms are not as clear as plan sponsors would like. These regulatory "gray areas" and the "gray areas" for those mandates that will take effect in 2014, including the employer mandate to provide "minimum essential coverage", could potentially lead to claims against plans and/or employers for non-compliance. During this teleconference, the panelists will discuss:

  • The Act's reform requirements 
  • The types of claims that plan sponsors can expect to be brought against the plan for non-compliance and the remedies available 
  • How the Act's external review requirement affects the claim process and possibly reduce benefit claim litigation 
  • Best practices for avoiding these potential causes of action and limiting the plan's liability

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