ALI-ABA Topical Courses Health Plans: Maximizing Your Flexibility - Is Your Plan Ready for All the Possibilities? February 28, 2012 Video Presentation PROGRAM FACULTY PARTICIPANTS FACULTY BIOGRAPHIES STUDY MATERIALS TABLE OF CONTENTS 1. Exploring the Summary of Benefits Coverage for Group Health Plans Prepared by Greta E. Cowart 2. Update About Reporting Employer-Provided Health Coverage on a Form W-2 - Slides By T. David Cowart Page ix 3. IRS Issues Additional Guidance under the Affordable Care Act on Informational Reporting to Employees of the Cost of Group Health Insurance Coverage - Firm Alert By Alden J. Bianchi 21 4. Department of Labor to the Rescue: Apportioning MLR Rebates Among Group 27 Health Plan Participants and Sponsors - Technical Release 2011-04 By Alden J. Bianchi 5. Treasury Department Proposes Rule Implementing Premium Tax Credits Under the 31 Affordable Care Act - Firm Alert By Alden J. Bianchi 6. Battle of the Comments under Code 36B: Determining Affordability and 39 Minimum Value for Purposes of Access to Premium Assistance Tax Credits under the Affordable Care Act - Firm Alert By Alden J. Bianchi 7. Impact of Federal Health Care Reform on Employers with Contingent Workers - 47 Tax Management Weekly Report ~ Westlaw By Alden J. Bianchi 8. HHS Bulletin Outlining Essential Health Benefits Grants Significant Flexibility to 57 States - Bloomberg BNA Health Insurance Report By Alden J. Bianchi and Gary E. Bacher 9. American Health Insurance Exchanges Under the Patient Protection and Affordable 61 Care Act: An Overview and Primer - Tax Management Compensation Planning Journal By Alden J. Bianchi 10. Agencies Issue Final Rule for Summary of Benefits Requirement - Firm Alert 75 By Douglass A. Farnsworth 11. Weathering the Storm: Can Executory Contracts Have Multiple Personalities? The 79 Fifth Circuit Finds an Asset Purchase Agreement Amended an ERISA Plan - Firm Alert By Greta E. Cowart 12. Through a Glass Darkly: Musings About CIGNA Corp. v. Amara - Slides 83 By T. David Cowart 13. Medical Plan Nondiscrimination Requirements and Related Rules 91 vii xi xiii 1 11
13. Medical Plan Nondiscrimination Requirements and Related Rules 91 By T. David Cowart 14. Claims Procedures Update After the Patient Protection and Affordable Care Act - 121 Claim and Appeal Procedure Guidance Prepared by Greta E. Cowart 15. To Grandfather or Not to Grandfather - What Does It Really Mean? 133 By Greta E. Cowart 16. Executive Reimbursement Accounts or Health Reimbursement Accounts for 193 Executives - Post PPACA and Post 2014 By Greta E. Cowart 17. Various issues of "Capital Checkup" The Segal Newsletter 197 Submitted by Kathryn Bakich ERRP Comes to a Close: Helping Plan Sponsors Keep What They have Received 198 Proposed Rule Implementing the Affordable Care Act s State Exchanges Published 201 Treasury Department Seeks Comments on Comparative Effectiveness Research Fees Included in the Affordable Care Act 206 How to Handle Medical Loss Ratio Rebates: Guidance for Insured Plans Subject to ERISA 209 18. Links Submitted by Kathryn Bakich 213 Submitted by Kathryn Bakich 19. Links Submitted by Roberta Casper Watson 215 Submitted by Roberta Casper Watson 20. Department of Labor to the Rescue Apportioning MLR Rebates Among Group 217 Health Plan Participants and Sponsors By Alden J. Bianchi 21. Affordable Care Act Expands Preventive Services for Women 221 Submitted by Kathryn Bakich 22. Agencies Release Regulations on Preventive Care under the Affordable Care Act 227 Submitted by Kathryn Bakich 23. Departments Expand Guidance and Request Information on Preventive Care 231 Benefits that Non-Grandfathered Group Health Plans Must Provide Submitted by Kathryn Bakich viii
PROGRAM SCHEDULE February 28, 2012 Program Schedule Eastern Central Mountain Pacific Alaska Hawaii National Teleseminar/Webcast 12:30 pm 11:30 am 10:30 am 9:30 am 8:30 am 7:30 am Adjournment 4:00 pm 3:00 pm 2:00 pm 1:00 pm 12:00 pm 11:00 am National speakers, including government attorneys, will help you understand recent developments affecting health plans and their administration. The focus will be on new legislation and regulations, and the trends you can't afford to miss. What You Will Learn Affordable Care Act : Getting Ready for 2014 Essential health benefits: So far, what do we know? Exchanges: What sponsors should know about the proposed regulations Premium tax credit: Understanding the proposed regulations Notice 2011-36 & the employer shared responsibility credit What can we learn from the Summary of Benefits & Coverage guidance & compliance delay? What do the medical loss ratios rules mean to group health plans and their fiduciaries? Annual health plan amendments: Are they needed, & if so, what amendments should have been made by end of 2011 (and what are the consequences of doing them now)? What Amendments Should be made by the end of 2012? How does CIGNA Corp. v. Amara affect the content of group health plans? W-2 Reporting: What do sponsors need to be doing now to be ready to report next year? What are the special rules going to be for reporting in 2013? Claim & review rules: How does an employer manage a claim for benefits under the new rules? Are the rules different if it is a claim for a fiduciary breach? The Constitutionality of the ACA: What do we do while the cases are pending at the U.S. Supreme Court? Additional Topics: Multiple Employer Welfare Arrangements (MEWA): Dealing with the new enforcement guidance New MHPAEA Guidance: How do you apply it? What does it change? Using the New IRS Worker Classification Program: What is the impact on health plan coverage? ix
Halliburton Benefits Committee was not an isolated aberration, according to Evans v. Sterling Chemicals, Inc. (5th Circuit October 17, 2011). What do we do now in our deals? Program Schedule All times eastern 12:30 p.m. Health Plans: Maximizing Your Flexibility - Is your plan really prepared for all the possibilities? -- 20-minute break minute mid-program 4:00 p.m. Adjournment Total 60-minute hours of instruction: 3.16; Total 50-minute hours of instruction: 3.8. Suggested Prerequisite: Significant knowledge of employee benefits law. Educational Objective: Acquisition of knowledge and skills to develop proficiency as a practitioner; maintenance of professional competence as a practitioner; provision of information on recent legal developments. Level of Instruction: Advanced Nothing in this program, the program materials, or communications stemming from the program (including questions and answers) should be considered as the rendering of legal advice. Non-lawyers should seek the advice of a licensed attorney in all legal matters. Registrants/readers should assure themselves that these presentations/materials/communications are still current and applicable at the time they are delivered or read. Neither ALI-ABA nor the speakers/authors can warrant that these presentations/ materials/communications will continue to be accurate, nor do they warrant them to be completely free of errors when delivered/published. Registrants/readers should verify statements before relying on them. These presentations/materials/communications reflect the viewpoints of their speakers/authors and do not necessarily express the opinions of ALI-ABA Continuing Professional Education or its sponsors. The members of this program's faculty are contributing their services to further the continuing legal education of their fellow members of the Bar. x
ALI-ABA Topical Courses Health Plans: Maximizing Your Flexibility - Is Your Plan Ready for all the possibilities? February 28, 2012 Live Video Webcast PLANNERS & SPEAKERS Roberta Casper Watson, Esquire Trenam, Kemker, Scharf, Barkin, Frye, O'Neill & Mullis, P.A. P.O. Box 1102 Tampa, FL 33601 T. David Cowart, Esquire SNR Denton 2000 McKinney Ave Ste 1900 Dallas, TX 75201-1858 FACULTY Kathryn Bakich, Esquire The Segal Company 1920 N St NW Ste 400 Washington, DC 20036-1659 Alden J. Bianchi, Esquire Mintz Levin Cohn Ferris Glovsky and Popeo PC 1 Financial Center, 39th Floor Boston, MA 02111-2641 Greta E. Cowart, Esquire Haynes and Boone, LLP 901 Main Street Suite 3100 Dallas, TX 75202-3789 Stephanie Lewis, Esquire Office of Health Plan Standards and Compliance Assistance U.S. Department of Labor, Employee Benefits Security Administration 200 Constitution Ave NW Room C-5331 Washington, DC 20210-0001 Russell E. Weinheimer, Esquire Senior Counsel Office of the Chief Counsel Internal Revenue Service Room 4034, CC:TEGE:EB:HW 1111 Constitution Avenue, N.W. Washington, DC 20224 Kevin P. Knopf, Esquire Attorney Advisor U.S. Department of the Treasury, Office of Benefits Tax Counsel 1500 Pennsylvania Ave NW Room 4028 Washington, DC 20220-0001 xi
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FACULTY BIOGRAPHIES Planning Co-Chairs Roberta Casper Watson, Tampa, Florida Trenam, Kemker, Scharf, Barkin, Frye, O'Neill & Mullis, P.A. Practice Area(s): ERISA, Employee Benefits and Compensation Additional Practice Areas: Benefits Litigation COBRA Planning Executive Compensation and Deferred Compensation Health and Welfare Plans Qualified Domestic Relations Orders (QDRO) Qualified Plans Roberta Watson joined the firm in 1985 and became a Shareholder in 1988. Her practice involves employee benefits, pension and profit sharing plans, 401k plans, health benefit plans, life and disability insurance plans, other welfare benefit plans, ERISA fiduciary law, employee stock ownership plans, COBRA and HIPAA compliance, deferred compensation, ERISA litigation support, and employee benefit aspects of family law. She graduated from the University of Idaho in 1971 cum laude with a BA in political science. In 1974 she earned her law degree from Harvard Law School. Roberta is a member of and past chair of the Employee Benefits Interest Group of the American Bar Association's Health Law Section and a member and past chair of the ABA Tax Section's Employee Benefits Committee. She is also past chair of the ABA's Joint Committee on Employee Benefits ("JCEB"). She is a charter fellow of the American College of Employee Benefits Counsel. She is also a member of the Hillsborough County Bar Association. Roberta is on the board of and past president of Northside Mental Health Center. She is also on the board of the Harvard Club of the West Coast of Florida. She is a member and past president of the Florida West Coast Employee Benefits Council. She is also a member of the American Law Institute and the Tampa Bay Pension Council. xiii
Education: Harvard Law School (J.D.) University of Idaho (B.A. in Political Science, cum laude) Bar Admissions: Florida Massachusetts Honors & Distinctions: AV Rated by Martindale Hubbell Best Lawyers in America (Employee Benefits Law) 1995-2009 Florida Super Lawyers 2006, 2007, 2009 T. David Cowart, Dallas, Texas SNR Denton US LLP LL.M., New York University; J.D., B.B.A.: University of Mississippi Mr. Cowart is a Charter Fellow, founding member, and former chair of the American College of Employee Benefits Counsel and was a founder and Chair of the IRS Mid-States Key District EP/EO Council and a founder of the Department of Labor EBSA Practitioners Group. A member of the American Law Institute, he has chaired the ABA Joint Committee on Employee Benefits, and the Section of Taxation s Employee Benefits Committee, Health Care Task Force, and Health Plan Design Subcommittee. He also chaired the ABA s ERISA CLE efforts. Mr. Cowart served on the Board of Directors of the SouthWest Benefits Association and has been chair, officer, and council member of the Dallas Bar Association Employee Benefits Section and Executive Compensation Section. He has received numerous Best Lawyer awards. A member of the College of the State Bar of Texas and a Certified Public Accountant, he has authored a lot of articles and study outlines and has been on the editorial boards of multiple publications. Mr. Cowart co-chairs ALI-ABA Video Law Review programs on Health Plans and on ERISA Fiduciary Responsibility Issues, as well as being on the faculty for ALI-ABA courses of study. xiv
Faculty Kathryn Bakich, JD, Washington, D.C. The Segal Company Ms. Bakich joined The Segal Company's Washington, DC office as National Director of Healthcare Compliance in 1998. She became a Vice President in 2000 and a Senior Vice President in 2005. Ms. Bakich has more than 15 years of experience with healthcare compliance. She works with the national staff of the Health and Compliance Practices and is responsible for the dissemination of health compliance information to staff, monitoring federal and state laws and regulations, preparing amendments for health plans and summary plan descriptions based on national models, and collaborating with other health compliance specialists. Ms. Bakich specializes in research and analysis on federal laws and regulations affecting health coverage such as ERISA, Medicare, managed care regulations, HIPAA, COBRA, the Newborns and Mothers Health Protection Act, the Mental Health Parity Act, and the Women s Health and Cancer Rights Act. Prior to joining Segal, Ms. Bakich was an attorney in private practice representing multiemployer health plans, and an appellate administrative law judge. She graduated in 1979 with a BA in Political Science, in 1982 with an MA in Public Policy, and in 1985 with a JD from the University of Missouri. She has been admitted to the Bar in the District of Columbia, United States Supreme Court, and multiple federal district and appellate courts. xv
Alden J. Bianchi, Washington, D.C. Mintz Levin Cohn Ferris Glovsky and Popeo PC Alden J. Bianchi is the Practice Group Leader of the firm s Employee Benefits & Executive Compensation Practice and a Member in the Employment, Labor & Benefits Section. He advises corporate, not-for-profit, governmental, and individual clients on a broad range of executive compensation and employee benefits issues, including qualified and nonqualified retirement plans, stock and stock-based compensation arrangements, ERISA fiduciary and prohibited transaction issues, benefit-related aspects of mergers and acquisitions, and health and welfare plans. Alden represented the Romney administration in connection with the historic 2006 Massachusetts health care reform act, and he has testified before the Senate Finance Committee on the subject of health care reform. He is a member of the BNA Pension & Benefit Publications Advisory Board, a resource to one of the nation s premier tax and legal publishers, Tax Management, Inc./Bureau of National Affairs. Alden is a graduate of Worcester Polytechnic Institute and the Suffolk University and Georgetown University law schools, and he holds an LL.M. in taxation from Boston University School of Law. He is listed in Woodward & White s Best Lawyers in America and Marquis Who s Who in American Law, and was also nationally recognized in the 2011 edition of Chambers USA: America's Leading Lawyers for Business as a leader in his field. Annually since 2006, Alden has been recognized as a Massachusetts Super Lawyer by the publishers of Boston Magazine. He is also a Fellow of the American College of Employee Benefits Counsel. xvi
Greta E. Cowart, Dallas, Texas Haynes and Boone, LLP. Greta E. Cowart is known for her expertise in fixing complex employee benefit plan issues and has secured significant results in Internal Revenue Service employee plans team audits and in U.S. Department of Labor audits of employee benefit plans. During Greta's 24-year career, Greta has also resolved significant employee benefit compliance issues through the various voluntary compliance programs. Through her work on the Employee Benefits Committee of the American Bar Association, Section of Taxation, she has worked with the technical provisions governing retirement plans and executive compensation. Greta has worked extensively with Code section 409A and the regulations under such section governing nonqualified deferred compensation, and other employee benefits issues in depth and provided recommendations to the government for its use in rule making. Greta is a former Chair of the Employee Benefits Committee of the American Bar Association's Section of Taxation. Greta's extensive knowledge of employee benefits and executive compensation provides her with the background to assist corporations quickly with plan design and administration issues, including litigation of benefit disputes. Kevin P. Knopf, Attorney Advisor U.S. Department of the Treasury, Office of Benefits Tax Counsel, Washington, DC Stephanie Lewis, Attorney, Office of Health Plan Standards and Compliance Assistance U.S. Department of Labor, Employee Benefits Security Administration Washington, DC Russell E. Weinheimer, Senior Counsel, Office of the Chief Counsel, U.S. Department of the Treasury, Internal Revenue Service, Washington, D.C. xvii
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