Category: ‘Plan Documents’

March 13th, 2012

SRP Webinar Mar 28, Benefits of Health Plan Documents On-Demand

Webinar: Benefits of Health Plan Documents On-Demand
Featuring PLAN DOC Builder™ by SRP

Wednesday, March 28 | 11:00 A.M. (EST)
Live 30-Minute Online Presentation Includes Interactive Q&A

Employers require Health Plan Documents containing clear language about available benefits that are compliant with the ERISA, PPACA, and other laws. PLAN DOC Builder™ by SRP simplifies the task of generating Plan Documents for Prescription, Dental, Vision, and Cafeteria benefits.

This webinar will demonstrate how this “web-based” tool can replace outdated software and the need for expensive outsourcing.

Webinar topics will include:

  • The state of compliance
  • Features and benefits of PLAN DOC Builder™ by SRP
  • Fixed, affordable subscription pricing tiers
  • Opportunities for TPAs, brokers, and other users

Register: https://www2.gotomeeting.com/register/777063618

 

© 2012 Strategic Recovery Partnership
Healthcare Subrogation Recovery | Plan Document Solutions
Call toll-free 855.557.5777 |  Email info@srpsubro.com

 

Posted in Plan Documents |

December 13th, 2011

NEW Plan Doc Builder™ Automates Health Plan Documents

Generating Health Plan Documents can be a cumbersome and time-consuming task.  In addition to complying with ERISA, PPACA and other government regulations, documents must contain clear language about available benefits, participant rights, and obligations under the health benefit plan.  Now, you can automate this task while producing customized, attorney-approved Health Plan Documents using Strategic Recovery Partnership (SRP)’s Plan Doc Builder. This web-based service allows Third Party Administrators (TPAs) and other users to easily generate Health Plan Documents on-demand by completing an online questionnaire with user-friendly prompts.

Created specifically for the generation of Health Plan Documents including prescription, dental, vision and cafeteria plans, SRP’s Plan Doc Builder gives TPAs the flexibility to:

  • Create or clone Health Plan Documents in an intuitive web interface
  • Easily collaborate with experts to produce customized, attorney-approved Health Plan Documents
  • “See as you go” by continuously reviewing and updating content during document preparation
  • Generate easy-to-read and compliant Health Plan Documents and Summary Plan Descriptions with regulatory and benefit amendment capability

Thoroughly designed and developed, and a natural progression of SRP’s Plan Documents | PERFECTED service, the new Plan Doc Builder fully equips in-house users in both the self funded and fully insured industries and is available at fixed licensing rates with no initial subscription fee. Users of Plan Doc Builder also can access online feedback to technical and legal questions from SRP. With nearly 20 years of experience in the health subrogation and recovery industry, SRP has in-depth expertise with TPA claim and benefit practices, technical writing, plan consulting and ERISA.

Become an SRP Subrogation client and receive your license at no cost

See how we compare!

Schedule  a personal demonstration
Request  a quote for affordable licensing rates
Speak to a Plan Document Specialist: 855 .557.5777
Learn more about SRP’s Plan Doc Builder

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Posted in Plan Documents |

September 23rd, 2011

The approaching Affordable Care Act

Next year, under the Affordable Care Act, insured and self-insured plans with their plan year starting after February will need to distribute a summary of the summary plan document.  The so-called Summary of Benefits Coverage (SBC) is to be no longer than 4 two-sided pages and modeled after a standardized format like the one found at www.dol.gov/ebsa/pdf/SBCtemplate.pdf and www.dol.gov/ebsa/pdf/SBCSampleCompleted.pdf.   Plans and carriers are then also required to update their SBC’s at least 60 days before any subsequent changes become effective.  The SBC is a stand alone document that can be provided by hardcopy or electronically. The goal of this third layer of plan documentation is to allow for easy comparison shopping by individuals.  And to further assist those comparison shoppers, the federal government has developed a standard dictionary of medical and health insurance related terms. (http://www.dol.gov/ebsa/pdf/SBCUniformglossary.pdf. )  This, too, must be provided, even in paper copy if requested.

Posted in Plan Documents |

March 31st, 2011

An SPD by any other name…

Employers know they need a Summary Plan Description (SPD) for their medical and prescription drug benefits, whether self-funded or fully insured. What are the actual requirements of a SPD, and does a “booklet” suffice? And if you are a Third Party Administrator (TPA), is what you are producing for your Plans compliant or not?

It depends.  Even though you may have received, or produced, what looks like an SPD, calling it an SPD doesn’t necessarily mean it is one.

ERISA (and the regulations issued thereunder) describes the information that must be included in welfare plan SPDs.  If a plan is fully insured, an off-the-shelf document produced by a vendor, or the certificate of coverage (COC) provided by a carrier, may not have all of the legally required language. If your plan is fully insured, the booklet you receive is usually the summary created by the insurer for filing with insurance boards of the states in which the benefit is offered.  It is typically written to satisfy a particular state’s licensing requirements.  Often it even includes additional language – and sometimes technical amendments  – that do not even need to be in a SPD.  Booklets are not typically designed for a specific company either, nor are they easily formatted to match a specific company’s communication style and terminology. Some booklets may include applicable “ERISA” language and may technically be used as an SPD (assuming all other required information is included), but in the end that booklet forces members  to sort through insurance information that doesn’t affect them.

A better alternative than a booklet is to create a compliant, user-friendly SPD that is easy to follow and customized for a particular Plan. TPA’s are then left with comprehensive documents upon which to administer, Plans are up to date and compliant with healthcare reform, and employees and their dependents will appreciate the value of Plan benefits clearly conveyed.

Contact SRP for more information.

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Posted in Plan Documents |

March 28th, 2011

Demystifying Plan Documents and Health Care Reform: Effective dates for Plan changes to know

By now, most organizations have faced the inevitable prospect of health care reform.  While several provisions of the Patient Protection and Affordable Care Act (PPACA) do not take effect until future years, others become effective with the first plan year beginning on or after September 23, 2010.

For calendar year plans, this means that important decisions regarding plan changes need to be made before their January 1, 2011 effective date.  Although health care plans may implement required changes sooner, most employers are taking a “wait and see” approach, choosing only to implement changes as of the mandated effective date over the next several years.  Additionally, plan sponsors are faced with the pressing decision of whether to adopt “grandfather status” in order to delay implementation of non-essential benefits under PPACA.  What to do?

Interim rules recently issued by the Departments of Health and Human Services, Labor, and Treasury provide the administrative steps a plan must take to maintain grandfather status.  Plans in existence on the date of PPACA’s enactment on March 23, 2010 may elect to be exempt from certain market reform provisions of the Act, provided they do not make certain plan changes.  But plans are not exempt from other requirements such as annual and lifetime limits, dependent coverage to age 26, waiting periods, and tax provisions, as well as several other provisions.

In addition to the communication requirements included in the Act, all ERISA plans must continue to comply with existing disclosure requirements.  On one hand, communicating upcoming changes may represent a challenge to plan sponsors and create some confusion with plan participants.  On the other, with an appropriate strategy, plan communications ahead of time can be used to deliver a cohesive message that reinforces the value of employees’ overall benefits package.
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Posted in Plan Documents |