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Monthly Archives: June 2014

  • ERISA: Basics and In Context

    Posted on June 11, 2014

    Below is the link to the June 10, 2014 UBA Employer Webinar Series: “ERISA: Basics and In Context ”

    Health care reform has created a number of critical issues for group health plans, but employers typically sponsor other benefits for their employees – dental, vision, life, long term disability, severance, and others. ERISA may apply to all of these programs, including health benefits. Because the Employee Retirement Income Security Act of 1974 is so fundamental to a company’s overall employee benefits strategy and implementation, all plan sponsors need to be aware of certain key provisions of ERISA that affect plan design, administration, and compliance. In this webinar we will touch on the following:
    • Overview of ERISA’s regulatory environment
    • Reporting and disclosure provisions, including basic rules for SPDs and wrap documents
    • Which plans are covered by ERISA, including voluntary benefits
    • ERISA preemption

    We also will cover what can sometimes be vexing questions for plan sponsors, such as:
    • Are these “voluntary” benefits subject to ERISA?
    • When do we have to file an annual report/Form 5500?
    • Do we need a fidelity bond?
    • How do we handle benefits while an employee is on leave?

    This webinar will provide an introduction to ERISA and address some of the key concepts that all employers and other plan sponsors should know.

    Joseph J. Lazzarotti, Shareholder – Jackson Lewis P.C.
    Joseph Lazzarotti leads the firm’s Privacy, e-Communication and Data Security Practice. He also is a member of the Employee Benefits Counseling and Litigation Practice Group and is a member of the Firm’s Healthcare Reform Taskforce. Mr. Lazzarotti advises employers and plan sponsors regarding the establishment, administration and operation of fully insured and self-funded health and welfare plans.

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    Please feel free to watch/listen to this whenever it is convenient for you and your staff. It will be available for you to view for the next 11 months. Your name and email are required for registration. There is no cost however this webinar has been approved for one credit hour toward PHR, SPHR and GPHR recertification through the HR Certification Institute. Once you have viewed the webinar, the last page will provide details on receiving the credit hour.

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  • Tips from Paula – Sleep Studies and CPAP Machines

    Posted on June 3, 2014

    With increased technological advances in the diagnosis of sleep apnea, more and more patients are being told by their physicians that they could be candidates for a CPAP (Continuous Positive Airway Pressure) machine. It is important for patients to know what is expected from the doctor when this machine is recommended.

    First, the doctor’s office will need to call the insurance company to obtain authorization for a sleep study. Many insurance carriers contract this authorization process out to a third party.

    Once the sleep study is approved and completed, the doctor may now recommend a CPAP machine. As with the sleep study, this device will need to be approved by either the insurance company, or the third party review company.

    We strongly urge our customers to contact their insurance carrier to see if the authorization has been done before obtaining any sleep study services or medical equipment. Failure to obtain authorization could result in substantial costs for the patient, as well as denial for equipment. For example, a lack of authorization for sleep study could mean an automatic denial for a CPAP machine. The authorization for the sleep study and the CPAP machine itself are a two-part process.
    We advise patients to never assume that their physician has gone through the different phases of authorization required. It is always best to “pick up the phone” and call the number on your health plan ID card to be sure your authorizations are in place for any sleep studies or related equipment. If the patient makes that call and finds out the authorizations are not in place, the next step is to have the patient call their doctor’s office to remind them of their responsibility to obtain the patient’s proper authorizations and to follow up as needed.
    For further assistance after these steps have been followed, Employee Advocate Paula Green may be reached at:, or by calling 207-523-0065.

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