> Exclusive Provider Organization (EPO) EPOs allow subscribers to visit any physician within the contracted network without prior approval or referrals. Services received outside the network may not be covered.
> COBRA Benefits COBRA stands for “Consolidated Omnibus Budget Reconciliation Act of 1985,” which requires companies with 20 or more employees to offer separating employees the option to continue their group health-care coverage at their own expense.
> Workers' compensation Most employers are required by law to provide workers' compensation insurance through a state system operated by the Department of Labor & Industries. Worker comp pays an employee's medical expenses and provides some income replacement when a worker is injured on the job.
HIPAA offers protections for individuals who have preexisting conditions, helping them to keep coverage for those conditions or get coverage in no more than 12 or 18 months through limits on preexisting condition exclusions.
HIPAA includes protections to help ensure individuals are not excluded from coverage under their group health plan or charged a higher premium based on health status.
COBRA generally requires that group health plans of employers with at least 20 employees offer employees and their dependents the opportunity to continue their health plan coverage for limited periods of time when the employee loses his or her job due to retirement.
ERISA Claims Procedures help ensure fair and timely appeals process for covered individuals.
ERISA Disclosure Provisions require that group health plan disclosure material furnished to plan participants and beneficiaries must contain information about specialists in the plan network and the plan’s rules for accessing specialty care.
ERISA Disclosure Provisions also require that plan disclosure material must describe the ability of the employer to reduce plan benefits or terminate the plan.
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Did You Know?
There are several areas of risk that you should consider if you operate a business in your home.
These include: Business-related personal property coverage (computers, furniture, etc.) Inventory Off-premises coverage for business-related personal property Business property of others accounts receivable (up to a specified limit) Liability coverage may include personal injury, products and completed operations, incidental contractual liability, and general commercial liability. Electronic data processing coverage Valuable papers Business interruption and extra expense
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