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Advanced Topics in Group Benefits
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Please verify your state CE approval prior to enrollment by clicking here.
Who should take this course: Licensed Life/Health Agents, Consultants and Brokers
CE Requested in all 50 states: up to 8 hours
Reading Material - Textbook
Viewing Material - Video
Study Method: On-line self-study
OVERVIEW AND OBJECTIVES
This course covers advanced topics related to group benefits, including ERISA, Medicaid, and Social Security. NAHU has created a course to educate professionals about advanced group benefits topics.
ERISA is a major federal legislation which widely affects the employee benefits marketplace. It defines an employee welfare benefit plan and the communication and transparency requirements that must be met in order to be compliant with the law. It also defined a fiduciary and established the fiduciary’s role in an ERISA plan. ERISA also established rules around plan discrimination, benefit plan claims procedures, required plan reporting, and the appropriate handling of plan assets.
Medicaid is a federal and state government program that pays for medical assistance for certain individuals and families with low incomes and resources. Medicaid enrollment has grown significantly due to the Affordable Care Act’s guidelines. Medicaid is a highly visible alternative to medical care that is available through the state health insurance exchanges.
In addition to covering the topics on Medicaid and ERISA, this course will explore Underwriting and the processes of evaluating an insurance applicant, making decisions about the applicant’s acceptability for insurance coverage, and determining the appropriate basis on which to determine the price for the coverage. The agent or broker needs to understand the pricing and underwriting process, as this is the process which determines the competitive status of his/her proposal for the client.
This program will survey Social Insurance programs, including Social Security, that are important in the employee benefits marketplace. Social benefits account for nearly one quarter of the dollars that employers spend on benefits for their employees. For some employees, the social insurance benefits serve as the foundation for the employee’s benefit program; for other employees, the social insurance benefits may be the only benefits they have.
Learning Objectives:
- Understanding the types of welfare benefit plans that are subject to ERISA and the parties involved
- Understanding ERISA plan documents and specifics addressed in the required documents and how ERISA affects claims procedures
- Understand who are ERISA fiduciaries
- Understanding the roles of the federal and state governments in Medicaid programs
- Understanding the eligibility requirements for Medicaid and scope of services
- Understanding the relationship between Medicare and Medicaid
- Understanding the process of underwriting and its importance to group insurance rates and how premium rates are calculated and used to determine group insurance premiums
- Understanding the process of using experience rating to calculate premiums
- Understand the reasons why social insurance exists and what are the basic features
- The extent of Social coverage and how programs are financed
- The types of benefits available under Social Security and benefit eligibility
- Social Security federal tax laws apply and Medicare contributions
CE rules by state
NAHU Course Refund Policy: In order to be eligible for a course refund, the student will have to request a refund within one year of the purchase date. In addition, the course must be intact, meaning the student has not begun the course. If the student is entitled to a refund, NAHU will refund the purchase price using the original method of payment.
If a printed textbook is included in the course purchase and has been mailed to the student, the cost of the textbook is non-refundable. The cost of the textbook will be deducted from the course refund.
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