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- Pub Code: LHRG-11WEB
- ISBN: 1-933801-96-4
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A Guide to Health Insurance Reform: Benefit Design Regulation Under Federal Reform
A user-friendly print/electronic service to help track, understand and comply with dozens of reform-driven federal rules that are revolutionizing health insurance benefit design. The Guide has 30 separate chapters, each of which is devoted to a different change in health insurance (e.g., pre-existing conditions, medical loss ratios), with detailed summaries of the regs that are interwoven with agency guidance and “Commentary and Analysis” by experts. Subscriptions include the comprehensive looseleaf service, a companion CD, and regular print and electronic updates.
A Guide to Health Insurance Reform will help you track, understand and comply with dozens of new federal health insurance regulations
Health reform implementation is now in high gear, and regulations governing various aspects of reform are now being issued with great regularity … each expected to radically alter a different element of health insurance benefit design, access, pricing or distribution.
A Guide to Health Insurance Reform: Benefit Design Regulation Under Federal Reform is a dynamic service that will assist health plans, hospitals and other providers, employers, pharma companies, and others who must survive this tsunami of health insurance regulation.
Subscribers to A Guide to Health Insurance Reform will save valuable time and resources — and minimize risks of costly noncompliance — with easy-to-read summaries of federal regulations that are interwoven with Agency Guidance, and Commentary and Analysis from experts in the field (see Advisory Board).
Published in looseleaf format with a companion CD, A Guide to Health Insurance Reform has separate chapters devoted to each of the 30 regulated areas (see Table of Contents) and a consistent six-point structure for each of the chapters:
- A brief summary of the law,
- A detailed summary of the regulations, updated as each proposed, interim or final rule is issued,
- Agency Guidance from rulemaking preambles and guidance issued separately by HHS, interspersed throughout the reg summaries in (2),
- Commentary and Analysis from experienced health reform attorneys and consultants, integrated into the regulatory summaries in (2) at pertinent discussions,
- Links (in the CD) to all primary documents, and
- Actual regulations to conclude each chapter.
New chapters (along with updated CDs) are issued to subscribers shortly after the issuance of new or revised regulations.
Get an effective way to track, understand and comply with dozens of new federal health insurance regulations. Order your no-risk subscription to A Guide to Health Insurance Reform today!
Table of Contents
Benefit Design
- Coverage of Preventive Services
- Elimination of Lifetime and Annual Limits
- Patient Protections
- Grandfathering Rules
- Essential Health Benefits
- Limits on Cost Sharing
- Wellness Program Incentives
- Changes to Spending Account Rules
- Access to Care Requirements
Eligibility and Guaranteed Issue
- Pre-existing Condition Exclusions
- Dependent Coverage
- Student Health Insurance Coverage
- Nondiscrimination Based on Health Status and Gender
- Waiting Periods
Premium Rate and Profit Regulations
- Medical Loss Ratio and Rebate Requirements
- Rate Increase Regulation
- Ratings Bands
Health Insurance Exchanges
- Risk Adjustment
- Definition of “Qualified Health Plans”
- Enrollment Procedures
- Small Business Health Options Program
Administrative Issues
- Prohibition on Rescissions
- Early Retiree Reinsurance Program
- Appeals and Reviews
- Co-Op Health Plans
- Uniform Explanation of Coverage Documents
- Quality Reporting
- Executive Compensation
- Health Care Choice Compacts
- Multistate Qualified Health Plans
Written By
The Guide is written and managed by Francie Fernald, J.D., who is the managing editor of AIS's diverse line of looseleaf services and has decades of experience covering complex regulatory issues, and Executive Editor Jill Brown, who manages AIS’s health business products and has been covering every beat in the passage and implementation of health reform. Commentary and Analysis is provided by members of the Advisory Board.
Advisory Board
- Angela M. Bohmann, Shareholder, Leonard, Street and Deinard P.A., Minneapolis
- Sander Domaszewicz, Principal and Senior Consultant, Mercer Health & Benefits Services, Newport Beach, Calif.
- Bruce Merlin Fried, Partner, SNR Denton, Washington, D.C.
- Amy Gordon, Partner, McDermott Will & Emery LLP, Chicago
- Mark S. Joffe, Owner, Law Offices of Mark S. Joffe, Washington, D.C.
- Edward A. Kaplan, Senior Vice President and National Health Practice Leader, The Segal Co., New York
- Kurt L. Lawson, Partner, Hogan Lovells US LLP, Washington, D.C.
- Johann Lee, Alston & Bird, Washington, D.C.
- Mark E. Lutes, EpsteinBeckerGreen, Washington, D.C.
- William MacBain, Senior Vice President, Finance, Gorman Health Group, LLC, Washington, D.C.
- Joseph Paduda, Principal, Health Strategy Associates, Madison, Conn.
- Jack Rovner, Founding Principal, The Health Law Consultancy, Chicago
- Chantel Sheaks, Principal, Government Affairs, Buck Consultants, Washington, D.C.
- Dave Tuomala, Director of Actuarial Consulting, Ingenix Consulting, Eden Prairie, Minn.
Written For
Managers at:
- Health plans
- Pharmaceutical companies
- Employers
- Hospitals, health systems and other providers
- Attorneys, consultants and other advisers
AIS Guarantee
When you order A Guide to Health Insurance Reform, you will be happy with it or you will get your money back. If it’s not everything we’ve promised, or for whatever reason you decide not to subscribe, just give us a call within 30 days of receiving the Guide and we’ll have UPS pick it up. We’ll pay the shipping both ways.
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A Guide to Health Insurance Reform: Benefit Design Regulation Under Federal Reform
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