Health Plans
Reinhart is on the cutting edge of developments in the rapidly changing area of health plans. We assist a wide array of employers across the country in creating innovative health plan solutions.
Our experience and depth of knowledge in working with health plans enables us to efficiently deliver practical, insightful and comprehensive service to our clients. We assist our clients in all phases of establishment and management of health plans including the following:
Plan Design and Documentation
We have developed an extensive library of model documents and forms that we share with our clients to help them efficiently establish the necessary health plan documentation. We help structure both traditional health plans (medical, dental, vision, prescription drug), as well as newer consumer-driven health plan designs including high-deductible health plans (HDHPs), health flexible spending accounts (health FSAs), health reimbursement accounts (HRAs), health savings accounts (HSAs), individual health premium reimbursement programs and wellness initiatives. We help our clients ensure that plan documents, summary plan descriptions (SPDs) and other plan forms and documents are accurate, complete and compliant with applicable legal requirements.
Regulatory Compliance
Today's health plan environment makes maintaining compliance with the wide array of legal requirements more challenging than ever. Through our advice and frequent, comprehensive client alerts, we help our clients stay abreast of continuous developments in the regulations governing health plans. This includes developments in federal law such as ERISA, COBRA, HIPAA, USERRA, ADA, Medicare, the Mental Health Parity Act, the Newborns and Mothers Health Protection Act and the Women's Health and Cancer Rights Act. We also advise our clients on various state and local laws and ordinances impacting health plans such as the unique health plan mandates implemented by the State of Massachusetts and the City of San Francisco.
Contract Review and Negotiation
We help clients create, review and negotiate a wide range of health plan contracts including TPA agreements, insurance policies and contracts, HMO and managed-care agreements, network agreements, agent and consultant agreements and other agreements with health plan service providers. Our extensive experience enables us not only to advise on the specific terms of the agreement, but also to assist clients in understanding agreements in the context of the health plans industry and best practices.
Funding and Trust Issues
We assist our clients with a variety of funding and trust issues associated with health plans. This includes helping clients manage challenges with funding retiree health coverage, as well as assisting with the establishment of other appropriate funding vehicles, including:
We also assist clients with fiduciary and administrative issues associated with managing health plan funds.
Administration and Claims
We assist administrators in working through the many challenges that can arise in the administration of health plans. This includes assistance with claims, discrimination testing, eligibility determinations and other administrative matters.
Mergers and Acquisitions
We assist clients in conducting appropriate due diligence, as well as in integrating health plans and addressing other health coverage challenges that may arise from changes in business organizations.