Health Care Reform Hot Buttons for 2015

by Robert on December 11, 2014

Implementation of the employer mandate is just around the corner, along with many other health reform changes in 2015! Be sure to mark your calendars for Thursday, Jan. 22, 2015, where Lockton will provide a complimentary webcast on what to expect from health reform in 2015.

78780375Hot button topics to be discussed include:

  • Incentivizing Employees to Drop Coverage: The feds have issued clear warnings to employers who attempt to induce sick employees to leave their employer plan and find insurance on the public exchanges. The feds have put checks and balances in place, and these will be discussed in the context of 2015 health reform.
  • Reference-Based Pricing (RBP): Many large employers are relying more on reference-based pricing, where the plan pays a specific amount for a particular procedure, incorporating it into their plan design as way to minimize cost increases and improve health outcomes for their employees. But recent agency guidance has made implementation of RBP increasingly difficult, says Lockton Senior Vice President and Director of Compliance Services Mark Holloway. “Guidance from the feds makes it difficult to implement RBP because of the many requirements. If a plan does not meet the new rules, then amounts paid by the employee over the reference price must be applied to the plan’s out-of-pocket limit,” says Holloway.
  • Minimum Value Lite Plans: The IRS has offered guidance on the new generation of pared-down minimum value plans. Employers looking to satisfy the federal requirement for minimum (value) essential coverage must have plans with an actuarial value of at least 60 percent. The ramifications will be discussed, including options for employers who planned on offering plans with no hospitalization coverage next year.
  • Wellness Rules and the EEOC: A spate of recent lawsuits against employers by the Equal Employment Opportunity Commission (EEOC) has put several common features of wellness program design at risk, including biometric screenings, health risk questionnaires and spousal participation. These cases will be discussed, including the Honeywell litigation, which involves an ACA and HIPAA compliant wellness program.
  • New Cafeteria Plan Qualifying Event allows employees to drop coverage mid-year, enroll in plan on the state or federal exchange: “This is good news for employers—if an employee has premature triplets they can now go to the exchange,” says Holloway.
  • The New Congress: Implications for health reform and wellness programs. Holloway concludes: “The ACA is not going to be repealed—but Congress will do some fiddling. For example, the definition of full-time employee may move up from 30 hours—perhaps not to 40 hours, but it could land somewhere in between 30 and 40.”

Other topics to be discussed include:

  • Temporary Staffing Labor: A look at play or pay from both sides.
  • Employer Reporting: Making sense of the havoc, possibility of a delay?
  • Opting Out of the Contraceptive Coverage Mandate: Who’s affected, who isn’t?
  • Expiration of Play-or-Pay Transition Rules after 2015—transition rules that delay the effective date of play-or-pay for non-calendar plans.
  • Feds Hopes That States Will Reign in Small Self-insured Plans: Will they?

Join us for a complimentary webcast: From 3:00 – 4:30 p.m. ET on Thursday, Jan. 22, 2015

Click To Register

Presented By: Lockton Compliance Services Experts: Edward Fensholt, J.D.; Mark Holloway, J.D.; Elizabeth Vollmar, J.D.; Scott Behrens, J.D.

Registration Note: Please register only once for each group of employees who will view and listen to the presentation through a single computer. You are welcome to register multiple groups, but we need to know how many log-in ports to reserve for each session.

CEUs: We now offer Continuing Education Units (CEUs) from the Human Resources Certification Institute (HRCI) for many of the webinars presented by the experts in Lockton Benefit Group. Attendees of the webinars can obtain CEUs for Professional in Human Resources (PHR), Senior Professional in Human Resources (SPHR), and Global Professional in Human Resources (GPHR) certification. To receive CEUs, you will need to log into the presentation individually so that we have a record of your attendance.

Recordings: The webcast will be recorded and available online.

Thanks for reading and feel free to contact me at or 646.572.3962 and enter your email in the opt-in email box at the top of the page to receive future blog updates via email.


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