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Laws Regarding Health Insurance Offered by Employers


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One of the employment benefits employee value most is health insurance, but it's a highly regulated undertaking for employers. Changes to some health insurance laws were made in February 2009 as part of the stimulus package passed by Congress and even more changes to health care benefits are expected in 2009.

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Potential changes to health insurance and how it might affect employers
President Barack Obama has stressed the necessity of health care reform in 2009. The president's eight guiding principles for health care reform outlined in his 2009 budget could have a huge impact on employers. According to the budget, when the president reforms health care he will: (1) protect families’ financial health; (2) make health coverage affordable; (3) aim for universality; (4) provide portability of coverage; (5) guarantee choice; (6) invest in prevention and wellness; (7) improve patient safety and quality care; and (8) maintain long-term fiscal sustainability.

President Obama has previously mentioned several ideas for health care reform including new regulatory requirements, more government involvement, a national public health insurance plan, and a “pay or play” plan for employers.

A public insurance plan would set a standard for quality coverage and compete with private insurance plans. Under a “pay or play” plan, an employer would either have to “play” by offering insurance to employees that meets minimal standards for health coverage or “pay” by contributing to a public fund to help cover uninsured individuals.

Stay up to date on changes to benefits and compensation employment laws with the Benefits and Compensation Law Alert

American Recovery and Reinvestment Act of 2009
On February 17, 2009, President Obama signed a stimulus bill called the American Recovery and Reinvestment Act of 2009 (ARRA), into law. ARRA contains several provisions relating to health care benefits including:

COBRA. The Consolidated Omnibus Budget Reconciliation Act (COBRA) was designed to protect employees and their families from losing health benefits if the employees lost their jobs. Under COBRA, an individual may usually keep health coverage through a previous employer’s health plan for up to 18 months by paying 102% of the cost of coverage. The stimulus package provides for a subsidy in which the government will pay 65% of employees’ COBRA premiums for up to 9 months.

Audio Conference: Effective Immediately: How the Stimulus Package Changes COBRA

HIPAA. The Health Insurance Portability and Accountability Act (HIPAA) was originally passed in part to address another area of employee concern about their health benefits -- whether they could obtain coverage for health conditions they or their families had before they obtained benefits under a new health plan. The ARRA also expands HIPAA’s privacy and security regulations. Under the stimulus package, business associates of covered entities will be directly subject to HIPAA. The stimulus plan also extensively changes HIPAA on other issues, including security breaches and related notification requirements, the rights of individuals regarding their protected health information, and increased enforcement and penalties for violations.

Other laws. The ARRA also includes funding for health information technology (with an emphasis on computerizing health records), health care effectiveness research, disease prevention measures, community health centers, and training for primary care providers.

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Other federal laws regarding health insurance offered by employers
The following is an overview of a few of the major laws affecting health insurance plans offered by employers.

Audit your health benefits policies and practices with the Employment Practices Self-Audit Workbook

Same-sex marriages, civil unions, and domestic partner benefits
This area of the law is rapidly evolving in our nation’s courts and legislatures. Laws prohibiting discrimination based on sexual orientation, including domestic partner benefits, appears to be a very hot issue in a number states in 2009. Some states (and even some cities) have legalized same-sex marriages and/or civil unions, while others have amended their constitutions to forbid them. Some companies, moreover, have chosen to offer benefits to their employees’ same-sex partners, and others cover both same-sex and opposite-sex but unmarried unions. The best course of action is to consult a competent employment benefits attorney to determine which laws apply.

Audio Conference: Same-Sex Marriages: Overcoming Policy, Benefit and Payroll Challenges

State laws on employee benefits
States have continued to weigh in on employment and benefits issues. There’s been a steady trend for states to require that employers or insurance companies cover certain medical conditions, with coverage mandates increasing over the years. States also have a history of regulating workers’ compensation insurance, a parallel health insurance system for work-related injuries and illnesses. Employers should check with competent benefits counsel to learn which state regulations they may need to follow as they implement their benefits program.

State-by-state comparison of 50 employment laws in all 50 states

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