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Employee Benefits Answer Book, Sixteenth Edition

Employee Benefits Answer Book, Sixteenth Edition

By Dorinda D. DeScherer


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Employee Benefits Answer Book provides comprehensive guidance for those involved in the design and administration of employee benefit plans.

This convenient Q&A resource provides comprehensive guidance for everyone involved in the design and administration of employee benefit plans. It enables professionals to probe key topics, including current ACA requirements and developments, COBRA continuation coverage, retiree health care coverage, health coverage portability requirements, group long-term care insurance, and much more.

The Q&A format is ideal for probing key topics such as:

  • Health care reform
  • COBRA continuation coverage
  • Retiree health care coverage
  • Health coverage portability requirements
  • Group long-term care insurance
  • Dependent care assistance
  • Adoption assistance
  • Vacation and severance pay plans
  • Death benefits
  • Financing employee benefits
  • Financial accounting for employee benefits
  • And more!

Employee Benefits Answer Book will help you:

  • Set the best Health Care Reform strategy for your company and your clients
  • Keep in compliance with current and coming requirements
  • Find clear answers to hundreds of employee benefits questions
  • Avoid costly errors related to employee benefits administration
  • Resolve employee benefits issues quickly and effectively
  • And much more!

Previous Edition: Employee Benefits Answer Book, Fifteenth Edition, ISBN: 9781454884378

Last Updated 06/14/2018
Update Frequency Updated annually
Product Line Wolters Kluwer Legal & Regulatory U.S.
SKU 10044854-0003
Table of Contents
  • 1. Introduction
    • A Road Map to the Eleventh Edition
    • A Thumbnail Guide to Important Regulatory Goals
    • Practical Plan Administration
  • 2. The Regulatory Scheme: ERISA
    • Basic Concepts and Definitions
    • Covered Employers
    • Covered Employees
    • Covered Plans
    • Requirements for Plan Document
    • Fiduciaries
    • Fiduciary Responsibility
    • Mandated Benefit Provisions
    • Plan Development: Adoption, Amendment, and Termination
    • Plan Assets
    • Trustees and Investment Managers
    • Trust Requirement
    • Prohibited Transactions
    • Fiduciary Liability
    • Nonfiduciary Liability
    • Bonding Requirement
    • Claims Procedure Requirement
    • Reporting and Disclosure Requirements
    • Preemption of State Law
    • Penalties and Enforcement
    • Remedies for Breach of Fiduciary Duties
    • Remedies of Plan Participants and Beneficiaries
  • 3. Group Health Plans: Structure and Administration
    • Impact of the Affordable Care Act
    • Grandfathered Health Plans Under the Affordable Care Act
    • Basic Concepts
    • Employer Responsibility for Health Coverage
    • Health Insurance Exchanges and Group Health Insurance
    • Types of Plans
    • Funding Types and Cost Sharing
    • Plan Administration
    • Health Benefit Claim Processing and Review
    • Coordination of Benefits
    • Subrogation
    • Legal Requirements Affecting Health Plans
    • Tax Treatment of Employers
    • Tax Treatment of Participants
    • Health Reimbursement Arrangements
    • Medical Savings Accounts
    • Health Savings Accounts
    • Employee Assistance Programs
    • Workers’ Compensation
  • 4. Group Health Plans: Mandated Benefits and Standards
    • Basic Rules
    • Nondiscrimination Based on Health Status
    • Prohibition of Discrimination in Favor of Highly Compensated Employees
    • Waiting Periods and Preexisting-Condition Exclusions
    • Certificates of Creditable Coverage
    • Coverage Limits and Cost-Sharing Requirements
    • Dependent Coverage Requirements
    • Special Enrollment Rights
    • Mandated Benefits and Patient Protections
    • Mental Health and Substance Use Disorder Benefits
    • Benefits for Maternity, Newborns, and Mothers
    • Benefits Under the Women’s Health and Cancer Rights Act
    • Qualified Medical Child Support Orders
    • Medicare Secondary-Payer Rules
    • Children’s Health Insurance Program
    • Privacy and Security Requirements
  • 5. Retiree Medical Benefits
    • The Affordable Care Act
    • Obligation to Provide Retiree Medical Benefits
    • Tax Treatment of Retiree Health Benefits
    • Cost Containment Design
    • Plan Cutbacks—Legal Issues
    • Coordination with Medicare
    • Retiree Prescription Drug Benefits
    • Trust Requirement
    • Financial Accounting Rules
    • Funding Options
  • 6. COBRA Requirements for Continuation of Coverage Under Group Health Plans
    • Covered Plans
    • Definition of “Plan” for COBRA Purposes
    • Covered Employers
    • Qualified Beneficiaries
    • Qualifying Events
    • Notice to Participants
    • COBRA Election and Enrollment
    • Type and Extent of Required Coverage
    • Duration of Coverage
    • Premiums
    • Mergers and Acquisitions
    • Preemption of State Continuation Laws
    • COBRA Enforcement and Sanctions
About The Experts
Dorinda D. DeScherer