Group Health Plan Eligibility: Design Decisions and Compliance Audits

CATEGORY: Specialized Knowledge & Applications

COURSE ID: EW143T, VERSION 1.00

Webinar

2 CPE Credits

Group health plans must define which employees—and family members—are eligible for coverage. How has health care reform influenced plan eligibility design decisions? What flexibility remains? And how can employers, administrators, and their advisors be sure that only eligible individuals participate in the plan? Auditing health plan eligibility data and processes can yield cost savings, enhance compliance, and improve overall plan administration—but audits must be conducted without running afoul of health care reform’s prohibition on rescissions of coverage. Our experts will help plan sponsors, service providers, and advisors evaluate the pros and cons, understand the logistics and legal issues, and implement effective eligibility audits for employer health plans.

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Group Health Plan Eligibility: Design Decisions and Compliance Audits

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