This course is a comprehensive study of major healthcare reform in the United States. The student will understand the issues that lead to reform and the significant changes mandated in the 2010 healthcare reform legislation. Students will learn the details of grandfathered health plans, state exchanges, medical loss ratios, and revised internal and external review processes under healthcare reform. The course also will explore the CLASS act and the effect of healthcare reform on HIPAA and ERISA legislation. Students who successfully pass this course will be positioned to serve effectively in the new environment created by the historic healthcare reform of 2010.

This course is designed to provide the knowledge and skills for healthcare professionals to operate in the new environment formed by passage of massive healthcare reform legislation in 2010. The course first reviews the effects of healthcare reform at the federal and state levels and the consequences for insurers, employers, and individuals. Next, the course explores the regulatory environments including state regulations and federal agencies such as the Department of Labor, Internal Revenue Service, and the Department of Health and Human Services. With that overview, the subject turns to the evolving role of the healthcare consultant and new opportunities as a fee-based healthcare consultant. The course emphasizes communications, the healthcare planning process, and characteristics of successful consultants. Finally, the course explores group health plans, individual plans, and ethical business practices.

Provides an overview of individual health insurance that is designed to meet the needs of individuals, families and certain business situations. Covers medical expense insurance, disability income insurance and long-term care insurance. Discusses types of policies, contractual provisions, regulation and underwriting. Consumer-directed health plans are also covered.

Analyzes group insurance benefits including the governmental environment, contract provisions, marketing, underwriting, rate making, plan design, cost containment and alternative funding methods. Covers the various private programs related to the economic problems of death, old age and disability. Discusses cafeteria plans, as well as consumerdirected health plans, such as HSAs and HRAs.

Covers various advanced topics in group benefits. Addresses COBRA, ERISA, HIPAA privacy rules, Social Security, Medicare, Medicaid, health plans for federal workers, voluntary benefits, dental benefits, self-funding, international benefits and ethics.

Focuses on selecting the right retirement plan for the business and on individual retirement planning. Covers qualified plans, SEPs, SIMPLEs and 403(b) plans and nonqualified deferred compensation plans. Emphasizes the practical knowledge needed for choosing the best retirement plan, especially for the small business, and designing a plan that will meet a client’s needs. Also covers individual retirement planning including IRAs and Roth IRAs, Social Security benefits, saving for retirement and planning for retirement plan distributions.

Analyzes the many types of programs used to provide benefits for executives of business firms. Discusses plan design and installation and reviews ERISA, tax and other compliance issues that apply to each type of program. The course includes cash-compensation planning, nonqualified deferred-compensation plans, funded deferred compensation and restricted property plans, stock options, split-dollar life insurance plans, disability income benefits, executive fringe benefits, health reimbursement arrangements and limits on golden parachute payments.

Covers the broad area of human resource management, including total compensation planning and the interrelationship of employee benefits with cash compensation. Also discusses employee recruitment, selection, interviewing and orientation, training and management development, performance appraisal, safety and health, labor relations and collective bargaining and equal opportunity and the law.

Analyzes managed health care in detail. Covers such topics as physician and member behavior, provider compensation, authorization systems, member services, specialty managed care services, value, accreditation, information systems, sales, marketing and federal legislation.

Provides a thorough analysis of the alternatives available for senior clients to finance medical and long-term care, including private resources, government programs and private insurance. Emphasizes the need for care, the settings in which health care services are provided, and the types of resources available to finance them.