Washington, DC (PRWEB) January 06, 2012
Atlantic Information Services, Inc., publisher of AIS’s Health Reform Week, is pleased to announce its January 12 webinar, ‘Essential Health Benefits’ Under Reform: What HHS’s New Guidance Means for Insurers and Employers. See webinar details at http://aishealth.com/marketplace/c2r04_011212.
HHS’s Dec. 16 guidance on “essential health benefits” under reform provides great flexibility for states and lots of useful insights for health plans and employers. It also, though, is a recipe for wide state-by-state variation in benefits that must be offered. And it leaves undecided — perhaps for longer than plans can wait in their product development cycles — such key aspects as premiums, deductibles and copayments that will enter into the determinations of actuarial value required. Also unresolved is what constitutes medical necessity.
The guidance lets states choose from among four benchmark plans, including both state and federal products, thereby meaning that insurers would have to meet state mandates in some states but not others. Moreover, HHS said it will reassess the benchmarks for 2016 and beyond.
The webinar will provide a thorough analysis of the business strategies health plans and employers now are contemplating for benefit offerings in the post-exchange world ahead. Participants will get reliable strategic information on such key topics as:
- What plans are states likely to choose for their benchmarks under the HHS guidance, and why?
- What will the plan choices mean for benefits that insurers will have to add to comply with the requirements? How costly will this be?
- What does the guidance’s proposed requirement that plans cover one drug per mandated class mean for insurers and pharmaceutical manufacturers?
- To what extent are states likely to modify the benefits within the required categories and replace them with others of comparable worth? What will be the impact?
- What effect will the guidance have on employer decisions on whether to continue offering employee health coverage, as opposed to absorbing penalties under the law and having employees obtain coverage in the exchanges?
- What is HHS likely to decide on the required premium, copayment and deductible aspects of the essential benefits, and when? How will that affect decisions and costs?
- What can insurers expect — and what should they do — regarding the still-coming determinations related to required actuarial value in 2014 and beyond?
- What will be the impact of the guidance on self-insured employers, which are exempt from the essential-benefits requirements but could be affected by insurance-market trends and cannot put annual and lifetime dollar limits on essential benefits?
After a lively 60-minute presentation, a concluding 30-minute question-and-answer session will allow webinar participants to pose individual questions to the speakers. Visit http://aishealth.com/marketplace/c2r04_011212#speakers to learn more about the speakers:
- Chantel Sheaks, a principal in government affairs in Buck Consultants’ National Technical Resources Group in Washington, D.C.
- David Tuomala, Director of Actuarial Consulting for OptumInsight, a unit of UnitedHealth Group, based in the Eden Prairie, Minn., office.
Visit http://aishealth.com/marketplace/c2r04_011212 for more details and registration information.
AIS develops highly targeted news, data and strategies for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. Learn more at http://www.AISHealth.com.
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