COMPLIANCE

As we all know, there is a lot going on in the United States and the Health Insurance industry. The rules are constantly being modified. Some of these include:

    • ACA Compliance- Otherwise known as “ObamaCare”, the Affordable Care Act has many complicated and detailed stipulations. From filing documentation to the IRS to plan regulations, GMR stays ahead of the changes. In order to be compliant, the most cost-effective way we offer Minimal Essential Plans and Minimal Value Plans in addition to a large number of buy up plans.
    • HIPAA Compliance- HIPAA is the acronym for Health Insurance Portability and Accountability Act that was passed in 1996.  HIPAA does the following:

I. Allows employees and their families to transfer and continue health insurance coverage when they change or lose their jobs
II. Minimizes health care fraud and abuse and misuse
III. Regulates standards for health care information on electronic billing and other processes
IV. Requires the protection and confidential handling of protected health information

  • COBRA- The Consolidated Omnibus Budget Reconciliation Act allows workers and their families the ability to choose to continue group health benefits provided by their group health plan. For a limited period of time, under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events the members can continue the coverage that they previously had at a maximum of 102% of the premiums.
  • Mental Health Parity Act The Mental Health Parity Act of 1996 (MHPA) requires large employers to treat Mental Health benefits identical to medical and surgical benefits. They would have the same copays, deductibles and coinsurance as well as the maximums removed.
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