Our Health Plan Compliance Services practice includes members of our Employee Benefits, Healthcare, Privacy & Security practice and industry teams.
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Our Health Plan Compliance Services practice includes members of our Employee Benefits, Healthcare, Privacy & Security practice and industry teams.
Together we provide guidance to health plan sponsors, including employers, associations and boards of trustees. Health plan compliance is becoming increasingly complex, and entities that sponsor health plans need experienced counsel to help guide them through intricate requirements to avoid rising penalties and fines. Our counsel in this area emphasizes:
- Healthcare Reform – from the ACA to new developments
- HIPAA and HITECH Act Compliance – privacy, security and breach notification
- ERISA and Code Compliance
- Health Plan Administration
- Benefits Governance
- Health Plan Contracting
Health Plan Experience
Our Health Plan Compliance Services group has extensive experience with the Affordable Care Act (ACA) and other healthcare reforms, the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Employee Retirement Income Security Act of 1974 (ERISA), the Internal Revenue Code (Code), the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) and other laws that impact health plans.
Our experience encompasses all types of health coverage arrangements, including the following:
- Self-insured group health plans
- Insured plans
- Private exchanges
- Accountable care organizations (ACOs)
- Multiple employer welfare arrangements (MEWAs)
- Account-based plans: health reimbursement arrangements, health savings accounts and cafeteria plans with health flexible spending accounts
- Voluntary Employees Beneficiary Association (VEBA) trusts
We also advise on the compliance, contracting, fiduciary and administrative responsibilities that sponsors of the above plans face. In addition, we take pride in updating our clients on recent legislative and regulatory changes and how those changes could affect them.
Strategies to Reduce Per Capita Costs
Beyond the need for compliance guidance, sponsors of health plans also seek knowledgeable counsel to help them strategize and implement new ways to reduce per capita costs while also improving participant experience and population health. We offer a deep understanding of the design, administration and operation of plans, which informs our advice on cutting-edge developments and how we help clients rethink the status quo.
For example, we have assisted our clients in directly contracting with providers through the establishment of ACOs, participating in health care alliances and private exchanges, and restructuring bundled benefits to eliminate duplicative costs associated with subcontracting arrangements. We have also guided clients in establishing onsite medical clinics to reduce time lost for doctor visits. We listen to our clients and work with them and their advisors to come up with sophisticated, effective and efficient solutions to their specific needs and concerns.
Together we provide guidance to health plan sponsors, including employers, associations and boards of trustees. Health plan compliance is becoming increasingly complex, and entities that sponsor health plans need experienced counsel to help guide them through intricate requirements to avoid rising penalties and fines. Our counsel in this area emphasizes:
- Healthcare Reform – from the ACA to new developments
- HIPAA and HITECH Act Compliance – privacy, security and breach notification
- ERISA and Code Compliance
- Health Plan Administration
- Benefits Governance
- Health Plan Contracting
Health Plan Experience
Our Health Plan Compliance Services group has extensive experience with the Affordable Care Act (ACA) and other healthcare reforms, the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Employee Retirement Income Security Act of 1974 (ERISA), the Internal Revenue Code (Code), the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) and other laws that impact health plans.
Our experience encompasses all types of health coverage arrangements, including the following:
- Self-insured group health plans
- Insured plans
- Private exchanges
- Accountable care organizations (ACOs)
- Multiple employer welfare arrangements (MEWAs)
- Account-based plans: health reimbursement arrangements, health savings accounts and cafeteria plans with health flexible spending accounts
- Voluntary Employees Beneficiary Association (VEBA) trusts
We also advise on the compliance, contracting, fiduciary and administrative responsibilities that sponsors of the above plans face. In addition, we take pride in updating our clients on recent legislative and regulatory changes and how those changes could affect them.
Strategies to Reduce Per Capita Costs
Beyond the need for compliance guidance, sponsors of health plans also seek knowledgeable counsel to help them strategize and implement new ways to reduce per capita costs while also improving participant experience and population health. We offer a deep understanding of the design, administration and operation of plans, which informs our advice on cutting-edge developments and how we help clients rethink the status quo.
For example, we have assisted our clients in directly contracting with providers through the establishment of ACOs, participating in health care alliances and private exchanges, and restructuring bundled benefits to eliminate duplicative costs associated with subcontracting arrangements. We have also guided clients in establishing onsite medical clinics to reduce time lost for doctor visits. We listen to our clients and work with them and their advisors to come up with sophisticated, effective and efficient solutions to their specific needs and concerns.
