Review & Update Health Plan Notices, Language & Process For New Guidance On COBRA, Other Key Health Plan Rules

June 2, 2014

Add reviewing and updating your plan language, notices and processes for administering the coverage continuation requirements to the ever-growing list of items that employers and other group health plan sponsors, insurers, administrators and fiduciaries need to handle this year.

The most recently emerging guidance published by federal regulators to implement the Patient Protection & Affordability Act (ACA) and other health care reforms is a package of new guidance on COBRA and its interface with COBRA published in early May.  This guidance includes a new HHS Bulletin Allowing COBRA Qualified Beneficiaries to Enroll in the Health Insurance Marketplace,  as well as a series of updated model COBRA and CHIP Notices and related documents.

The HHS Bulletin on COBRA allows individuals who previously elected COBRA rather than enrolling in coverage through one of the new health insurance exchanges created under ACA a special extended enrollment opportunity to enroll in coverage under these exchanges.  Many employers and health plans may want to communicate this new option to help minimize their COBRA exposures.

Beyond  the extended exchange enrollment period for COBRA enrolled or eligible persons, the new guidance also may merit updates and changes to group health plan’s existing COBRA plan language, notices and election forms and procedures.  Labor Department guidance several years ago significantly expanded the number of notifications required under COBRA as well as the required content.  In connection with that guidance, the Labor Department published various model notices and other materials.  As part of new guidance published in May, 2014, the Labor Department has revised and published updated versions of many of these model documents.  The updated materials include:

In addition to the updated COBRA guidance, employers, health plans and their insurers, administrators and fiduciaries also will want to review and update their plan language, processes, budgets, notices and other materials in response to updated guidance in Affordable Care Act Implementation FAQs Part XIX on Department of Labor model notices, limitations on cost-sharing, coverage of preventive services, health flexible spending account (FSA) carryover and excepted benefits, and the Summary of Benefits and Coverage requirements of PHS Act §2715.  Employers and others involved in the design or administration of group health plans  also will want to review this new guidance as part of their continuing health plan compliance, cost forecasting and planning efforts.

Catch Up On Latest, Get Practical Health Plan Insights At June 17  Texas CEO Briefing

Texas CEO Magazine invites Solutions Law Press Readers to catch up on new developments and strategies to help employers prepare for and cope with the ever-evolving stream of health plan developments enacted under the Patient Protection & Affordable Care Act by participating in a practical briefing on:

Tuesday, June 17

7:30 – 9:00 a.m.

Park City Club

5956 Sherry Lane, Dallas

Register: https://texasceomagazine.com/events

Two of Texas CEO’s  “Top 10 Most Read” articles in 2013 were authored by Dallas attorney and benefit specialist Cynthia Stamer who will anchor a panel of benefit experts that will explore new developments and their practical implications on:

  • Benefit Plan Design
  • Workforce Classification
  • Data Collection
  • Cost Projections
  • Private Exchanges
  • New Reporting Requirements (IRC 6055 & 6056)
  • Noncompliance Penalties
  • Avoiding the Tax
  • The New Care Delivery Dynamic

Featured Speakers include Cynthia Stamer, Managing Partner, Solutions Lawyer Publisher and Author, Eric Bassett, Senior Partner & Central Market Leader, Mercer Health & Benefits Consulting, Scott Gibbs, Senior Vice President, McGriff, Seibels & Williams, Inc., and Becky Parker, Health Reform Director, MHBT Inc.

Cynthia is a Dallas-based attorney who has spent more than 25 years helping private and public employers and health and employee benefit planners develop, implement, administer and defend creative, legally compliant and operationally effective health plans and policies.

Cynthia’s Texas CEO Magazine article, “Benefit Plan Triage: 12 STEPS EVERY EMPLOYER WITH A HEALTH PLAN SHOULD DO NOW,” was one of the Top 10 most-read articles of 2012. And in 2013, “Getting Ready for ACA Reform: 13 Steps to Take Now,” and “Affordable Care Act Update,” were both Top 10 most read articles.

Cynthia, among other things,  is:

  • Past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group
  • Immediate Past Chair of the ABA’s RPTE Employee Benefit & Compensation Committee
  • Marketing Committee Chair of the ABA Joint Committee on Employee Benefits
  • Vice Chair of the ABA Tort & Insurance Practice Section Employee Benefits Committee
  • Current Vice-Chair of the Gulf States TEGE Council – Exempt Organizations Group

Eric works with clients in all areas of health care and group benefits with particular emphasis on health care strategies, delivery system capabilities, defined contribution, and consumerism. Eric began his 28-year health care career working for health care vendors. He has led cross-functional teams involved in the development of rural managed care strategies, integration of legacy networks and systems, physician profiling and implementation of open access networks and systems. Eric’s consulting experience includes:

  • Developing and managing health improvement, disease and demand management programs.
  • Chronic PCMH program design and development.
  • Working with management and labor during collective bargaining.
  • Integrating and consolidating benefit plans for mergers and acquisitions.
  • Working closely with corporate committees to facilitate decision-making.
  • Active and retiree exchange strategy and design.

Scott Gibbs works with large employers on long term strategies to make corporate benefit plans consistent with the company’s goals and budgets, working with both fully-insured and self-funded plans.

Scott is a member of:

  • Society for Human Resource Management (SHRM)
  • Texas Public Risk Management Association
  • International Foundation of Employee Benefit Plans
  • State and Local Government Benefit Association
  • Scott has an undergraduate degree from Baylor University and a Master’s in Health Care Administration from Trinity University.

Becky directs all corporate strategy and communication on the Affordable Care Act for MHBT and its clients. She has worked as an employee benefits advisor since 1992 and was one of the first employee benefits professionals to have earned a Certification in Health Care Reform Studies from The American College.

Becky is an active member of the Austin Association of Health Underwriters where she was president in 2003 and also served on the Texas Association of Health Underwriters board as their liaison to the Texas Department of Insurance and was honored nationally for her work.

Becky is an advocate for employee benefits in the legislative arena regularly testifying at the Texas State Capitol and engaging our federal elected officials on insurance related matters. Becky has even advised Texas Congressmen on the employer aspects of the Affordable Care Act.

Becky holds a Bachelor of Arts degree from The University of Texas at Austin.

For Representation, Training & Other Resources

If you need assistance monitoring these and other regulatory policy, enforcement, litigation or other developments, or to review or respond to these or other workforce, benefits and compensation, performance and risk management, compliance, enforcement or management concerns, the author of this update, attorney Cynthia Marcotte Stamer may be able to help.

Board Certified in Labor & Employment Law, Past Chair of the ABA RPTE Employee Benefit & Other Compensation Arrangements Group, Co-Chair and Past Chair of the ABA RPTE Welfare Plan Committee, Vice Chair of the ABA TIPS Employee Benefit Plans Committee, Vice President of the North Texas Health Care Compliance Professionals Association, Past Chair of the ABA Health Law Section Managed Care & Insurance Section and the former Board Compliance Chair of the National Kidney Foundation of North Texas, Ms. Stamer has more than 24 years experience advising health plan and employee benefit, insurance, financial services, employer and health industry clients about these and other matters. Ms. Stamer has extensive experience advising and assisting health care providers, health plans, their business associates and other health industry clients to establish and administer medical privacy and other compliance and risk management policies, to health care industry investigation, enforcement and other compliance, public policy, regulatory, staffing, and other operations and risk management concerns. She regularly designs and presents HIPAA and other risk management, compliance and other training for health plans, employers, health care providers, professional associations and others.

For the past two years, Ms. Stamer has served as the  scribe for the ABA Joint Committee on Employee Benefits agency meeting with OCR.   Ms. Stamer also regularly works with OCR, FTC, USSS, FBI and state and local law enforcement on privacy, data security, health care, benefits and insurance and other matters, publishes and speaks extensively on medical and other privacy and data security, health and managed care industry regulatory, staffing and human resources, compensation and benefits, technology, public policy, reimbursement and other operations and risk management concerns. Her publications and insights appear in the Health Care Compliance Association, Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, the Dallas Morning News, Modern Health Care, Managed Healthcare, Health Leaders, and a many other national and local publications. For instance, Ms. Stamer for the second year will serve as the appointed scribe for the ABA Joint Committee on Employee Benefits Agency meeting with OCR. Her insights on HIPAA risk management and compliance frequently appear in medical privacy related publications of a broad range of health care, health plan and other industry publications Among others, she has conducted privacy training for the Association of State & Territorial Health Plans (ASTHO), the Los Angeles Health Department, the American Bar Association, the Health Care Compliance Association, a multitude of health industry, health plan, insurance and financial services, education, employer employee benefit and other clients, trade and professional associations and others.  You can get more information about her HIPAA and other experience here.

If you need assistance with these or other compliance concerns, wish to inquire about arranging for compliance audit or training, or need legal representation on other matters please contact Ms. Stamer at (469) 767-8872 or via e-mail here.

You can review other recent publications and resources and additional information about the other experience of Ms. Stamer here. Examples of some recent publications that may be of interest include:

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information including your preferred e-mail by creating or updating your profile here. For important information about this communication click here.

©2014 Cynthia Marcotte Stamer.  Non-exclusive right to republish granted to Solutions Law Press, Inc.   All rights reserved.


Assess Your Health Plan Compliance 8/24: Register Now!

August 12, 2010

Get a Health Plan Compliance Checkup

Learn What You Must Do Now To Meet Key 2010/2011
Affordable Care Act & Other Health Plan Compliance Deadlines

2010 Health Plan Update

A Solutions Law Press Live Internet Broadcast Briefing

August 24, 2010 

10:00 A.M.-12:30 P.M. Eastern | 11:00 A.M.-1:30 P.M. Central | 9:00 A.M-11:30 A.M. Pacific

Earn 2 Hours of Texas Insurance Continuing Education Credit,  WorldAtWork or HRCI Credit!

 

Solutions Law Press invites you to catch up on the latest guidance on new group health plan mandates imposed under the Patient Protection and Affordable Care Act (Affordable Care Act) and other federal health plan regulations by participating in the “2010 Health Plan Update” briefing on Tuesday, August 24, 2010. The briefing will be held via a live internet broadcast from 11:00 to 1:30 P.M. Central Time. Registrants can elect to participate in person or watch via the Internet for a registration fee of $150.00. To register click here.

Affordable Care Act Requires Prompt Action By Group Health Plans, Employee Sponsors, Fiduciaries, Administrators, & Insurers

Health benefit costs and legal risks continue to grow for U.S. businesses. The Affordable Care Act and other impending federal health plan regulatory changes will require employment-based group health plans, their employer and other plan sponsors, insurers plan fiduciaries, plan administrators and other service providers and insurers to make quick decisions and to act quickly to meet impending federal compliance deadlines while preserving flexibility. All employer and other group health plan sponsors, fiduciaries, insurers and administrators must act quickly to update their health plan documents, communications, insurance and vendor agreements and practices to comply with new federal requirements that become effective under the Affordable Care Act on the first day of the next plan year beginning after September 22, 2010 and various other changes in federal health plan rules effective or scheduled to take effect during 2010 or 2011 plan years. Many plan sponsors also may need to act quickly to cancel or revise plan design or vendor changes planned or already implemented since March 23, 2010 to position their health plan to qualify for grandfather status. Quick action also may be needed to qualify for small employer tax credits, retiree medical subsidies or other benefits.

August 24 Briefing Provides Key Information

The August 24, 2010 “2010 Health Plan Update” briefing will cover the latest guidance on Affordable Care Act and other federal health plan regulatory changes impacting employment-based group health plans and their sponsors for plan years beginning between September 23, 2010 and September 22, 2011 and other key information to help employers, group health plans, insurers, plan administrators, fiduciaries, broker and others working with these plans to understand and respond to these new requirements including:

  • How to qualify your health plan as a grandfathered plan under the Affordable Care Act
  • How to decide if maintaining grandfathered plan status is worthwhile
  • Claims & appeals requirements for grandfathered & non-grandfathered plans
  • Preventive care coverage & wellness program rules under Affordable Care Act, GINA, ADA & other federal regulations
  • Updated dependent child eligibility, pre-existing condition & other dependent coverage rules for grandfathered & non-grandfathered plans
  • Special enrollment, preexisting condition & other eligibility mandates for grandfathered & non-grandfathered plans under new Affordable Care Act, FMLA, Michelle’s Law, HIPAA & other regulations
  • Mental health & substance abuse, provider choice & other benefit mandates under new Affordable Care Act, Mental Health Parity & other federal rules
  • New HIPAA Privacy Rules
  • Update on other recent & pending Affordable Care Act group health plan rule guidance
  • Cafeteria plan implications
  • Tips to review & update your plans, vendor agreements & processes to meet Affordable Care Act & other federal group health plan dictates
  • Expected future Affordable Care Act & other federal rule changes & tips for preparing
  • Practical strategies for responding to new requirements & changing rules
  • Participant questions

About The Presenter

The program will be conducted by attorney Cynthia Marcotte Stamer.  Ms. Stamer is nationally known for her more than 23 years of work, publications and presentations on health plan and other employee benefit, health care and insurance matters. Current Chair of the American Bar Association (ABA) RPTE Employee Benefit & Other Compensation Group, a Council Member of the ABA Joint Committee on Employee Benefits and Past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group, Ms. Stamer continuously advises group health plans, insurers, employer and other plan sponsors, plan fiduciaries, plan administrators and vendors, and others about health plan design, administration, defense, contracting and related legal compliance, operational, documentation, public policy, enforcement, privacy, technology, litigation and risk management and other concerns. Ms. Stamer also publishes and speaks extensively on these and other health and managed care program concerns and practices. Her insights on these and related topics have appeared in Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, Managed Healthcare, Health Leaders, various ABA publications and a many other national and local publications. To contact Ms. Stamer or for additional information about Ms. Stamer, her experience, involvements, programs or publications, contact Ms. Stamer at (469) 767-8872 or via e-mail here or see here.  Texas Insurance Department Continuing Education Provider Number 3544.

About Solutions Law Press

Solutions Law Press™ provides business risk management, legal compliance, management effectiveness and other updates, consultation, training and education, tools, and other resources for businesses  on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key concerns. If you find this of interest, you also be interested reviewing some of our other Solutions Law Press™ resources available for review here. If you or someone else you know would like to receive future updates and notices about other upcoming Solutions Law Press™ events, please be sure that we have your current contact information – including your preferred e-mail- by creating or updating your profile at here. For important information concerning this communication click here


Solutions Law Press ™ Thanks Our Sponsors

Benefit HR Productions is a producer of enrollment and employee benefit and human resources orientation and on boarding enrollment and other human resources video communications for employers and their service providers.  For more information, contact  Bill at (972) 267-8410.

NFC offers supplemental insurance benefits to individuals and families that pay benefits directly to the insured and offers cafeteria plan administration services at no cost to employers including a Debit Card feature. To learn more about NFC cafeteria plan services or its supplemental insurance products contact Art Mueller at National Family Care Life Insurance Company, 13530 Inwood Rd, Dallas, Tx 75244. 800-527-0996. acmnfc@flash.net

 ©2010 Solutions Law Press. All rights reserved.
  

A limited number of participants on a space available basis will have the opportunity to participate in the briefing as a member of the live studio audio audience in Plano, Texas. Interested persons should e-mail support@solutionslawyer.net.
Discounts available for groups registering three or more participants.  E-mail support@solutionslawyer.net.


Register Now For 8/24 2010 Health Plan Update Briefing

July 30, 2010

Learn If Your Plan Will Be Grandfathered Plan & What You Must Do Now To Meet Key 2010/2011 Affordable Care Act & Other Federal Health Plan Compliance Deadlines

A Solutions Law Press Live Internet Broadcast Briefing

August 24, 2010

10:00 A.M.-12:30 P.M. Eastern

11:00 A.M.- 1:30 P.M. Central

9:00 A.M-11:30 A.M. Pacific

Solutions Law Press invites you to catch up on the latest guidance about the new group health plan mandates imposed under the Patient Protection and Affordable Care Act (Affordable Care Act) and other federal health plan regulations by participating in a live 2010 Health Plan Update” internet[*] broadcast briefing on Tuesday, August 24 2010.  The briefing will be conducted via live video broadcast from 11:00 A.M.-1:30 P.M. Central Time.  Register here for a registration fee of $150.00[†] per participant.   

Affordable Care Act Requires Prompt Action By Group Health Plans, Sponsors, Fiduciaries & Administrators

The Affordable Care Act and other impending federal health plan changes will require employment-based group health plans, their employer and other plan sponsors, plan fiduciaries, plan administrators and other service providers and insurers to make quick decisions and to act quickly to meet impending federal compliance deadlines while preserving flexibility.  All employer and other group health plan sponsors, fiduciaries, insurers and administrators must act quickly to update their health plan documents, communications, insurance and vendor agreements and other practices to comply with new federal requirements that become effective under the Affordable Care Act on the first day of the plan year beginning after September 22, 2010 and various other changes in federal health plan rules effective or scheduled to take effect during 2010 or 2011 plan years.  Many plan sponsors also may need to act quickly to cancel or revise plan design or vendor changes planned or already implemented since March 23, 2010 to position their health plan to qualify for grandfather status.  Quick action also may be needed to claim small employer tax credits, retiree medical subsidies or other benefits. 

Register Now To Get Key Information In August 24 Internet Briefing

The August 24, 2010 “2010 Health Plan Update” briefing will cover the latest guidance on Affordable Care Act and other federal health plan regulatory changes impacting employment-based group health plans and their sponsors for plan years beginning between September 23, 2010 and September 22, 2011 and other key information to help employers, group health plans, insurers, plan administrators, fiduciaries, broker and others working with these plans to understand and respond to these new requirements including:

  •  How to qualify your health plan as a grandfathered plan under Affordable Care act
  • How to decide if maintaining grandfathered plan status is worthwhile
  • Claims & appeals requirements for grandfathered & non-grandfathered plans
  • Preventive care coverage mandates & wellness program requirements & rules under Affordable Care Act & other federal regulations
  • Updated dependent child eligibility, pre-existing condition & other requirements for grandfathered & non-grandfathered plans
  • Special enrollment, preexisting condition & other eligibility mandates for grandfathered & non-grandfathered plans under new Affordable Care Act, new FMLA, COBRA, Michelle’s Law, HIPAA & other federal regulations
  • Mental health & substance abuse, provider choice & other benefit mandates under Affordable Care Act, Mental Health Parity & other federal rules
  • Update on other recent & pending Affordable Care Act group health plan rule guidance
  • Tips to review & update your plans, vendor agreements & processes to meet Affordable Care Act & other federal group health plan dictates
  • Expected future Affordable Care Act & other federal rule changes & tips for preparing
  • Practical strategies for responding to new requirements & changing rules
  • Participant questions

About The Presenter

The program will be conducted by attorney Cynthia Marcotte Stamer. With more than 23 years of experience advising employers, group health plans, plan fiduciaries, plan administrators and vendors, insurers and others about health plan and managed care matters, Ms. Stamer is nationally known for her work, publications and presentations on health plan and other employee benefit, health care and insurance matters. 

Current Chair of the American Bar Association (ABA) RPTE Employee Benefit & Other Compensation Committee, a Council Member of the ABA Joint Committee on Employee Benefits and Past Chair of the ABA Health Law Section Managed Care & Insurance  Interest Group, Ms. Stamer continuously advises employers, health plans, plan sponsors, fiduciaries, plan administrators, plan vendors, insurers and others about health program related legal, operational, documentation, public policy, enforcement, privacy, technology, litigation and risk management and other concerns. Ms. Stamer also publishes and speaks extensively on these and other health and managed care program concerns and practices.  Her insights on these and related topics have appeared in Atlantic Information Service, Bureau of National Affairs, World At Work, The Wall Street Journal, Business Insurance, Managed Healthcare, Health Leaders, various ABA publications and a many other national and local publications.  To contact Ms. Stamer or for additional information about Ms. Stamer, her experience, involvements, programs or publications, contact Ms. Stamer at (469) 767-8872 or via e-mail here, or see here.

About Solutions Law Press

Solutions Law Press™ provides business risk management, legal compliance, management effectiveness and other resources, training and education on human resources, employee benefits, compensation, data security and privacy, health care, insurance, and other key compliance, risk management, internal controls and other key operational concerns. If you find this of interest, you also be interested reviewing some of our other Solutions Law Press resources available for review here. If you or someone else you know would like to receive future updates and notices about other upcoming Solutions Law Press events, please be sure that we have your current contact information – including your preferred e-mail- by creating or updating your profile at here. For important information concerning this communication click here.  If you do not wish to receive these updates in the future, send an e-mail with the word   ©2010 Solutions Law Press.   All rights reserved. 


[*] A limited number of participants on a space available basis will have the opportunity to participate in the briefing as a member of the live studio audio audience in Plano, Texas.  Interested persons should e-mail support@solutionslawyer.net. 

[†] Discounts available for groups registering three or more participants.  Sponsorship opportunities also available.  For information, E-mail support@solutionslawyer.net.


TSHHRAE Provides Health Industry HR & Other Managers Employment Law Update & Other Timely Management Training At April Barnstorm 2010: Creating Effective Leaders Programs

March 23, 2010

Get Details & Registration Information here!

A “Legal Update on Employment Law” presented by Board Certified Labor & Employment Attorney Cynthia Marcotte Stamer is among 5 hours of “Barnstorm 2010: Creating an Effective Leaders-Tools of the Trade” management training that the Texas Society for Healthcare Human Resources Administration and Education (TSHHRAE) will be hosting for health industry human resources and other managers in five Texas cities between April 26 and April 30, 2010. 

Interested health industry human resources and other managers can elect to participate in TSHHRAE’s Barnstorm 2010 management training at the following dates and locations:   

  • April 26 – Weslaco, Knapp Medical Center
  • April 28 – Sweetwater, Rolling Plains Memorial Hospital
  • April 28 – Brenham, Trinity Medical Center
  • April 29 – Lubbock, University Medical Center
  • April 30 – Odessa, Medical Center Hospital

Update on Employment Law Program Highlights

Ms. Stamer’s Legal Update on Employment Law Program will address:

  • Recent changes in FMLA, Military Leave, wage and hour, ADA & other disability, COBRA, GINA, HIPAA and other selected federal & Texas employment laws and regulations;
  • Rising government enforcement of EEOC, HIPAA, wage & hour, worker classification, and other laws and regulations;
  • Recent developments and increases in retaliation claims;
  • Recent cases related to supervision; and
  • Other selected developments impacting health industry human resources management.

Other Barnstorm 2010 Program Highlights and Details

In addition to the Legal Update on Employment Law that Ms. Stamer is scheduled to present, the Barnstorm Program also will feature presentations on:

  • Leadership in 2010
  • Dealing with Poor Performers; and
  • Cultivating a Superstar

For registration and other information about the Barnstorm Program, see here.

About Ms. Stamer

Chair of the Curran Tomko Tarski Labor & Employment & Health Care Practice Groups, Vice President of the North Texas Health Care Compliance Professionals Association, Government Affairs Committee Legislative Chair for the Dallas Human Resources Management Association, Chair of the American Bar Association (ABA) RPTE Employee Benefits & Other Compensation Committee, a Council Representative on the ABA Joint Committee on Employee Benefits and past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group, Ms. Stamer is nationally recognized for more than 22 years of work with health industry and other organizations on labor and employment, staffing and credentialing, employee benefits, performance management and discipline, compliance and internal controls, risk management, and public policy matters.  The publisher of Solutions Law Press HR & Benefits Update, the Solutions Law Press Health Care Update, and Solutions Law Press Health Care Privacy & Technology Update and a former legal columnist for MD News, Ms. Stamer also is nationally and internationally recognized for her publications, industry leadership, workshops and presentations on these and other health industry and human resources concerns. She regularly speaks and conducts training for the ABA, American Health Lawyers Association (AHLA), Health Care Compliance Association, Institute of Internal Auditors, Harris County Medical Society, the Medical Group Management Association, SHRM, Southwest Benefits Association and many other organizations.  Publishers of her many highly regarded writings on health industry and human resources matters include the Bureau of National Affairs, Aspen Publishers, ABA, AHLA, Spencer Publications, World At Work, SHRM, Business Insurance, James Publishing and many others.  You can review other highlights of Ms. Stamer’s health care experience here, and employment experience hereHer insights on these and other matters appear in Managed Care Executive, Modern Health Care, the Wall Street Journal, the Dallas Business Journal, the Houston Business Journal, MDNews, Kentucky Physician, and many other national and local publications.

If you need assistance with health industry human resources or other management, concerns, wish to inquire about compliance, risk management or training, or need legal representation on other matters please contact Cynthia Marcotte Stamer at cstamer@cttlegal.com or 214.270.2402.  

Other Resources

If you found this information of interest, you also may be interested in reviewing other updates and publications by Ms. Stamer including:

If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information here or registering to participate in the distribution of these and other updates on our Solutions Law Press distributions here. For important information concerning this communication click here.    If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject to here.

©2010 Cynthia Marcotte Stamer. All rights reserved.


Stamer To Discuss “Health Care Reform’s Implications For Employers, Health Plans & Employee Benefits Practitioners” At May 5 Dallas Bar Association Meeting

March 22, 2010

Cynthia Marcotte Stamer will discuss “Health Care Reform:  Implications for Employers, Health Plans and Employee Benefits Practitioners” at the May 5, 2010 meeting of Dallas Bar Association Employee Benefits/Executive Compensation Section to be held from 12:00 noon – 1:00 p.m. in the Haynes & Boone Ballroom of Dallas Bar Association Belo Mansion located at 2101 Ross Avenue in Dallas, Texas.

Narrowly passed by Congress in March after a year of contentious debate, the comprehensive health care reform legislation imposes a complex array of reforms impacting employment based health plans, employers, and the insurers and other vendors and administrators of these programs.  Ms. Stamer will explore key elements of these reforms impacting employers and employment based health coverage and their implications for employers, employment based health plans, and employee benefits and other attorneys providing advice about these arrangements.

Chair of the American Bar Association RPTE Employee Benefits & Compensation Committee, an ABA Joint Committee on Employee Benefits Council member, Chair of the Curran Tomko Tarski Labor, Employment & Employee Benefits Practice and former Chair of the ABA Health Law Section Managed Care & Insurance Interest Group and the Dallas Bar Association Employee Benefits & Executive Compensation Section, Ms. Stamer is nationally recognized for more than 22 years of work with employer and other health plan sponsors, fiduciaries, administrative and other service providers, insurers, and other clients on health benefit program and product design, documentation, administration, compliance, risk management, and public policy matters.  The publisher of Solutions Law Press, Ms. Stamer also publishes, conducts training and speaks extensively on these and related concerns for the ABA, the Bureau of National Affairs and many other organizations.  For additional information about Ms. Stamer and her experience or to access other publications by Ms. Stamer see here or contact Ms. Stamer directly.   For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi LLP team, see here.

If you need assistance with evaluating or responding to this new legislation or other employee benefits, employment, compensation or other management concerns, wish to inquire about compliance, risk management or training, or need legal representation on other matters please contact Cynthia Marcotte Stamer at cstamer@cttlegal.com, 214.270.2402; or your other preferred Curran Tomko Tarski LLP attorney.

If you found this information of interest, you also may be interested in reviewing other updates and publications by Ms. Stamer including:

You can review other recent human resources, employee benefits and internal controls publications and resources and additional information about the employment, employee benefits and other experience of Ms. Stamer here and learn more about  other Curran Tomko Tarski LLP attorneys here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information to Cstamer@CTTLegal.com or registering to participate in the distribution of these and other updates on our Solutions Law Press distributions here. For important information concerning this communication click here.    

©2010 Cynthia Marcotte Stamer. All rights reserved.


Extension of Unemployment Benefits Signed Into Law & Immediately Effective As Filibuster Ends

March 3, 2010

By Cynthia Marcotte Stamer

Effective yesterday, the Temporary Extension Act of 2010, H.R. 4691,extended unemployment benefits to April 5, 2010.  It also extended  and expanded the COBRA premium  subsidy requirements originally established under the American Recovery and Reinvestment Act (ARRA) and plan sponsor penalties for noncompliance.

In recent days, H.R. 4691 drew great media attention when its enactment was delayed by a filibuster by Kentucky Senator Jim Bunning.  As media coverage of the Bunning filibuster focused almost exclusively on its unemployment benefit extension provisions, many U.S. employers and others are unaware of its provisions extending and expanding the COBRA premium subsidy mandates and authorizing higher pay for Medicare doctors and funding for federal highway programs. President Obama signed H.R. 4691 into law on March 2, 2010 just hours after Senator Bunning ended his highly publicized filibuster.

Unemployment Benefit Extensions

H.R. 4691’s unemployment insurance benefit provisions became immediately effective when signed by the President.  These provisions:

  • Extend the period during which individuals may file applications for Federal Emergency Unemployment Compensation (EUC) from the current end date of February 28, 2010 to April 5, 2010 and extend  the period during which individuals may claim and be paid EUC from July 31, 2010 to September 4, 2010.
  • Extend from the current end date of February 28, 2010 to April 5, 2010 the period during which individuals may qualify for the Federal Additional Compensation (FAC), the extra $25 weekly benefit amount on state and federal unemployment compensation, while also providing for weekly payment during the phase out period for weeks ending October 5, 2010 instead of August 31, 2010.
  • Extend the period during which 100% federal reimbursement for weeks of regular federal extended benefit payments to April 5, 2010, with the state option to continue the extended period from July 31, 2010 to September 4, 2010.

COBRA Premium Subsidy Extended & New Penalties Added

In addition to extending unemployment benefits, H.R. 4691 also extends and expands the availability of the temporary COBRA subsidy rules originally added to the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) medical coverage continuation requirements by the American Recovery and Reinvestment Act of 2009 (“AARA”) last February.  For details about these COBRA premium subsidy amendments, see here.  To minimize their COBRA rights under the amended COBRA premium subsidy rules, group health plans, their employer or union sponsors, administrators, insurers and service providers will need to act quickly to prepare and provider required updated notifications to assistance eligible individuals of these extended eligibility periods and their resulting rights, and otherwise update their plan documents, procedures, and COBRA notifications in light of these new rules. 

For Added Information or Assistance

If your organization need advice or assistance with these or other labor and employment, employee benefits, compensation or related matters, consider contacting Curran Tomko Tarski LLP Partner Cynthia Marcotte Stamer.

Board Certified in Labor and Employment Law by the Texas Board of Legal Specialization, Ms. Stamer has extensive experience advising and representing management about labor and employment, employee benefits, compensation and other related management matters.  A nationally recognized author and lecturer, Ms. Stamer also speaks and writes extensively on these and other related matters. For additional information about Ms. Stamer and her experience or to access other publications by Ms. Stamer see here or contact Ms. Stamer directly.   For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi LLP team, see here.

Other Information & Resources

We hope that this information is useful to you. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information here or registering to participate in the distribution of our Solutions Law Press HR & Benefits Update distributions here.  Examples of other recent updates that may be of interest include:

For important information concerning this communication click here.   If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject here.

 ©2010 Cynthia Marcotte Stamer. All rights reserved.


COBRA Premium Subsidy Requirements Expanded & Extended Under Newly Signed Unemployment Extension Legislation

March 3, 2010

By Cynthia Marcotte Stamer

Employers, insurers and administrators again must move quickly to deal with newly enacted changes to the premium subsidy requirements temporarily applicable to the medical coverage continuation requirements of the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended (“COBRA”).

The extension and other changes to the COBRA premium subsidy requirements became immediately effective yesterday (March 2, 2010) when President Obama signed the Temporary Extension Act of 2010 (H.R. 4691). H.R. 4691 both extends unemployment benefits through April 5, 2010 and extends and expands the availability of the COBRA subsidy program originally established under the American Recovery and Reinvestment Act (ARRA).

Over the past several days, H.R. 4691 has drawn great media attention when its enactment was delayed by a filibuster by Kentucky Senator Jim Bunning.  As media coverage of the Bunning filibuster focused almost exclusively on its unemployment benefit extension provisions, many U.S. employers and others are unaware of its provisions extending and expanding the COBRA premium subsidy mandates and authorizing higher pay for Medicare doctors and funding for federal highway programs. President Obama signed H.R. 4691 into law just hours after Senator Bunning ended his filibuster.

COBRA Premium Subsidy Extended & New Penalties Added

Group health plans and their sponsoring employers face added responsibilities under the COBRA subsidy amendments adopted under H.R. 4691.

The COBRA subsidy rules originally were added to COBRA’s medical coverage continuation requirements by the American Recovery and Reinvestment Act of 2009 (“AARA”) last February.  Originally, an employee or dependent was required, among other things, to have experienced a loss of coverage as a result of an involuntary termination occurring between September 1, 2008 and December 31, 2009 to qualify for coverage under the COBRA premium subsidy rules as “assistance eligible individual for up to 9 months.  In subsequently enacted legislation, however, Congress extended the involuntary termination period through February 28, 2010 and lengthened the maximum premium COBRA subsidy period to 15 months.  For more details, see here. H.R. 4691 now further extends and expands these COBRA premium subsidy rules.

H.R. 4691’s COBRA provisions both extend the period that an involuntary termination can qualify an employee or dependent for the COBRA premium subsidy, the employment losses that can qualify as an eligible involuntary termination, and the potential liability that can result from noncompliance.  Specifically, H.R. 4691 among other things:

  • Extends through March 31, 2010 the period within which an involuntary employment loss resulting in a loss of health coverage can qualify an employee or his dependent for the 15-month 65 percent COBRA premium subsidy. Before H.R. 4691, the involuntary termination period was scheduled to end February 28, 2010.  Now, the involuntary termination period runs from September 1, 2009 through March 31, 2010;
  • Amends the COBRA subsidy program to clarify that an employee that first experiences a loss of group health plan coverage due to a reduction in hours before subsequently being terminated qualifies as an employee  involuntarily terminated for purposes of determining his eligibility for the COBRA premium subsidy;
  • Details rules and procedures that group health plans and employers or others charged with administration of the COBRA premium subsidy rules must follow to notify affected individuals about and administer the new or expanded COBRA premium subsidy rights added by H.R. 4691;

In addition to these extensions to the COBRA premium subsidy requirements, H.R. 4691 also expands the exposures that plan sponsors and health insurers violating these requirements can face.  H.R. 4691 provides that in addition to civil actions that already authorized for violations of COBRA:

  • “[T]he appropriate Secretary” or an affected individual can bring a civil suit for declaratory or other appropriate relief; and
  • The appropriate Secretary” can assess a penalty against a plan sponsor or health insurance issuer of up to $110 per day for each failure to comply with a determination of the Secretary within 10 days after receipt of the determination.

To minimize their COBRA rights under the amended COBRA premium subsidy rules, group health plans, their employer or union sponsors, administrators, insurers and service providers will need to act quickly to prepare and provider required updated notifications to assistance eligible individuals of these extended eligibility periods and their resulting rights, and otherwise update their plan documents, procedures, and COBRA notifications in light of these new rules. 

Other Health Plan Updates Also Required

The COBRA premium subsidy changes in H.R. 4691 are only part of the ever-growing list of federal mandates that group health plan sponsors, fiduciaries, insurers, administrators and service providers need to be concerned about.  Health plans, their sponsors, administrators, fiduciaries, insurers, business associates and other service providers face a host of other new federal health plan and privacy mandates that have taken effect over the past year, will become subject to additional mandates in upcoming months and face expanded penalty and other liability exposures.  Consequently, beyond the COBRA premium subsidy updates required by yesterday’s amendments, health plans, their employer or other sponsors, insurers, fiduciaries, administrators and service providers also should not overlook the need to review and update their health plans in response to a host of other changes in federal health plan mandates.

In addition to otherwise applicable civil damage awards and civil penalty exposures that can result from violations of these requirements, new Internal Revenue Service regulations that took effect January 1, 2010 also require that employers, health plans or others self-report violations of certain of these requirements and self assess and pay resulting excise taxes arising under the Internal Revenue Code.  See, e.g., COBRA, HIPAA, GINA, Mental Health Parity or Other Group Health Plan Rule Violations Trigger New Excise Tax Self-Assessment & Reporting Obligations

The highly volatile health plan regulatory environment makes it likely that many health plans are not appropriately updated to comply with these and other federal requirements. In recent months, health plans, their employer or other sponsors, administrators and others also have become obligated to comply with a host of other expanded federal health plan rules and requirements. See e.g., New Mental Health Parity Regulations Require Health Plan Review & Updates; New Labor Department Rule Allows Employers 7 Days To Deliver Employee Contributions To Employee Benefit Plans; Newly Extended COBRA Subsidy Rules Require Employers, Administrators Send Required Notices & Update Health Plan Documents & Procedures Quickly;  Employer & Other Health Plans & Other HIPAA-Covered Entities & Their Business Associates Must Comply With New HHS Health Information Data Breach Rules By September 23.

These and other developments make it imperative that health plans, their sponsors, administrators, insurers, fiduciaries and service providers get serious about complying with these and other federal health plan mandates, to tighten their credentialing, selection, oversight and contracts with administrators and vendors, and take other prudent steps to manage health plan related risks.

Unemployment Insurance Extensions

In addition to amending and extending ARRA’s COBRA premium subsidy rules, H.R. 4691’s unemployment insurance benefit provisions:

  • Extend the period during which individuals may file applications for Federal Emergency Unemployment Compensation (EUC) from the current end date of February 28, 2010 to April 5, 2010 and extend  the period during which individuals may claim and be paid EUC from July 31, 2010 to September 4, 2010;
  • Extend from the current end date of February 28, 2010 to April 5, 2010 the period during which individuals may qualify for the Federal Additional Compensation (FAC), the extra $25 weekly benefit amount on state and federal unemployment compensation, while also providing for weekly payment during the phase out period for weeks ending October 5, 2010 instead of August 31, 2010; and.
  • Extend the period during which 100% federal reimbursement for weeks of regular federal extended benefit payments to April 5, 2010, with the state option to continue the extended period from July 31, 2010 to September 4, 2010.

For Added Information or Assistance

If your organization need advice or assistance about COBRA, unemploymenent benefits or other labor and employment, employee benefits, compensation or related matters, consider contacting Curran Tomko Tarski LLP Partner Cynthia Marcotte Stamer. 

Board Certified in Labor and Employment Law by the Texas Board of Legal Specialization,  Ms. Stamer has extensive experience advising and representing management about these and other labor and employment, employee benefits, compensation and other related management matters.  The current Chair of the American Bar Association (ABA) RPTE Employee Benefits & Other Compensation Group, a council member of the ABA Joint Committee on Employee Benefits  and the former Chair of the ABA Health Law Section Managed Care & Insurance Interest Group, Ms. Stamer works extensively with employer and other health plan sponsors and fiduciaries, insurers, third party administrators and others to design, document, administer and defend group and other health plan designs in light of COBRA and other federal and state regulations.  A nationally recognized author and lecturer, Ms. Stamer is the author of the “Health Plan Eligibility Toolkit” and many other highly regarded publications and workshops on COBRA and other health plan mandates.  She speaks and writes extensively on these and other related matters.

To seek the assistance of Ms. Stamer with these or other matters or to make arrangements for her to present a workshop or other training, contact Ms. Stamer directly.   For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi LLP team, see here. To explore other publications by Ms. Stamer, see here or contact Ms. Stamer directly. 

Other Information & Resources

We hope that this information is useful to you. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information here or registering to participate in the distribution of our Solutions Law Press HR & Benefits Update distributions here.  Examples of other recent updates that may be of interest include:

For important information concerning this communication click here.   If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject here.

©2010 Cynthia Marcotte Stamer. All rights reserved.