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Controlling Health Care Costs With Self-Funded Plan Options

Webinar: ID# 1018035
Recorded CD
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About This Course:
The Patient Protection and Affordable Care Act creates incentives for certain employers to self-insure health care coverage. For example, self-insured plans are not subject to the small-group rating regulations, risk adjustment policies, and essential health benefits provisions newly imposed by PPACA. Self-insured businesses are also exempt from many state insurance regulations.

This topic examines the factors that may motivate employers to self-insure, and the ways incentives to self-insure might change after PPACA becomes effective. The topic also will discuss how self-insurance influences benefit design, benefit claims decisions, and financial exposure.

Finally, the program will offer practical tips to employers facing this certain uncertainty in the group health care context.

Agenda

Self-Insurance Overview
  • Dispelling Myths
  • PPACA's Large Group Market Study
PPACA's Impact on Self-Funded Plans
  • Specific Exceptions
  • Reinsurance Requirements
  • 2012 DOL Report
Factors Impacting Decisions to Self-Fund
  • Regulatory Factors
  • Financial Exposure
  • Administrative Concerns
  • Advantages and Disadvantages
  • Stop Loss Issues and Case Studies
  • Practical Considerations
Cost Containment Strategies for Self-Funded Plans
  • Alternative Risk Arrangements for Small Groups
  • Wellness Programs and Incentives
  • Paying Instead of Playing
About The Presenter

Kristopher R. Alderman
  • Attorney with Lewis Brisbois Bisgaard & Smith LLP
  • Represents group health plans, plan sponsors, participants and beneficiaries, insurers, plan fiduciaries, third-party administrators, and employee benefits consultants in a wide variety of matters related to plan administration
  • Practice focuses on clients engaged in disputes related to health care reimbursement, including claim audits and reinsurance matters, and ERISA litigation
  • J.D. degree, magna cum laude, Georgia State University College of Law; B.A. degree in English, cum laude, University of Georgia
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Controlling Health Care Costs With Self-Funded Plan Options
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