Risk Reduction
RR #1 - HIPAA Training and / or Compliance Consulting for Brokers
Business Associates (Brokers, Consultants) who handle / come in contact with Protected Health Information (PHI) must meet the new HIPAA guidelines that went into effect September 23, 2013 or else face significant fines. Agencies are required to establish formal policies and procedures to actively safeguard all clients’ PHI. This consultancy provides HIPAA training and compliance services. They complete on your behalf all of the required documentation including:
- Review of privacy and security policies
- Preparation of documents containing necessary policies and procedures
- Annual required training and testing of agency employees
- Ongoing compliance support
For more informaion click here
RR #2 - HIPAA Encryption Service to Avoid Privacy Violations and Related Fines and Potential Client Scandals
Note: HR Mining is currentlyi discussions with this vendor
Item# RR3 - Guide for Employers Moving from Fully-Insured to Self-Funded (but Still Insured) Healthcare Benefits
As the costs of fully-insured health insurance programs continue to rise and as the marketplace adjusts to ACA, the need for smaller employers’ (10 to 250 employees) and mid-sized employers (250+) to self-fund group health benefits and realize the advantages is more apparent. This Guide on self-funding identifies the risks involved, shows how to limit and fully-fund the risk and outlines the “newest” technologies, products, regulations and concepts in health care benefit program administration and management so as to reduce and / or avoid healthcare costs. Content examples include TPA vetting, ERISA benefit design flexibility, lowering premium taxes, navigating to self-funding, overviewing IRC Section 105 and 105(h), HRA custom document creation, SPD and stop loss insurance coordination, health care analytics & predictive modeling, solutions for pharmaceutical benefits management, description of wellness programs and more. Results allow the employer to enter into a self-funding arrangement with an understanding of the pros and cons and to have a program that exactly meets the employer’s needs.
RR4 - Mock DOL / EBSA Audit to Prepare for an Actual ACA Group Health Insurance Audit by DOL
DOL is forecasting the collection of over $10 Billion over 10 years in new fines levied against employers for failing to comply with the ACA. Thus, employers need to understand the DOL audit process and take action today to ”audit proof” their benefits as much as possible. This non-law-firm benefits consultancy conducts a due diligence type audit to assess the employer’s ACA mandates compliance requirements and the strengths and weaknesses of current response activities. The end product is identification of a best course of action and a DOL Healthcare Reform Audit Manual. This helps the employer comply with ACA and maintain a state of DOL audit readiness
Item# RR5 – Summary Plan Description (SPD) and Wrap Document Preparation Services for Employers with Fully-Insured Healthcare Plans
The ERISA Plan Administrator (typically the employer) is legally obligated to provide benefit plan participants in writing the most important facts they need to know about their health benefit (and retirement) plans including plan rules, financial information and documents on the operation and management of the plant. Participants must also receive, free-of-charge, a compliant SPD which is most often not part of the Fully Insured insurance company-provided health insurance benefits materials. In addition to the SPD, the plan administrator must automatically provide participants a copy of the plan's Summary Annual Report SAR) each year. This service provider prepares the SPD, SPD Wrap and SAR for each employer client on behalf of the agency so as to help assure compliance with ERISA.