Healthcare Insurance laws & compensation compliance analysis

Healthcare Insurance: What you need to know

What do employers need to consider regarding healthcare benefits? The enactment of the Affordable Care Act (ACA) marks the latest step in a continuing shift from virtually no federal regulation of employer-sponsored health insurance to extensive substantive and administrative requirements. This regulation initially included the reporting, disclosure, and claims procedure requirements enacted in the Employee Retirement Income Security Act (ERISA). Through the years, additional federal requirements were added, including portability and coverage guarantees, minimum maternity stays, mental health parity, required coverage of reconstructive surgery following a covered mastectomy, coverage of adoptees, and pediatric vaccine requirements. During the same period, there was a large increase in state insurance law benefit mandates.
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Employers need to be aware of the many coverage and benefit requirements related to healthcare insurance. There are many laws involved in such requirements, including, but not limited to:
• The ACA;
• The Health Insurance Portability and Accountability Act (HIPAA);
• The Consolidated Omnibus Budget Reconciliation Act (COBRA);
• The Genetic Information Nondiscrimination Act (GINA);
• The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA);
• The Newborns’ and Mothers’ Health Protection Act (NMHPA);
• The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA);
• The Women’s Health and Cancer Rights Act of 1998 (WHCRA);
• The Pregnancy Discrimination Act (PDA);
Michelle’s Law; and
• Various state laws.
HIPAA applies to group health plans established or maintained ...

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