August 18, 2022
Employers have increasing opportunities to engage with vendors who provide specific solutions to improve health conditions. However, these solutions can impose various health and welfare compliance obligations. Join us for a discussion of the compliance implications inherent in offering certain programs.
Agenda
- Overview of Vendor 'Point' Solutions
- ERISA, COBRA, HIPAA, and the ACA
- Practical Solutions for Federal Law Application
- Impact on HSA Eligibility
- Taxation
- Reporting Requirements
Overview: What are vendor 'point' solutions?
Point solution programs - specific vendor solutions that add value to an employer's major medical plan - are a recent popular trend in employee benefit offerings.
- Benefit plan enhancements range from specific condition management to digital solutions and apps to overall benefit program simplification
- Generally provided through third-party vendors
- Premium generally paid by employer (but could be paid by pre-tax by employee through the section 125 plan if benefit constitutes 'medical care')
Examples of Vendor Point Solutions
Point solutions come in all shapes and sizes and address many different health conditions and concerns, including:
- Fertility
- Musculoskeletal
- Developmental disability
- Mental and behavioral health
- And others
Common Themes
Eligibility: All employees versus only medical plan participants?
- Because most point solution benefits are considered medical care, integration with medical plan is key to compliance
- Point solution vendor generally doesn't consider their solution as an insured product (no Schedule A)
- Seek assistance from outside counsel