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Unformatted text preview: can be changed by the employer during negotiations that will allow the employer to create lower the price of coverage for their employees. Most employees have an enrollment period where the employee chooses a set of benefits during the benefit period. Most group health plans have specific rules in order to be eligible to enroll and drop coverage. These rules are based on employment status and conditions on enrolling dependents. The employer decides on which provider networks their employees will choose from. Many of them provide their own provider and others are allowed to choose their provider. Many of the employers are regulated by state laws when it comes to self-funded health plans. Third party administrators are hired do deal with the self-funded plans. The administrator has an administrative assistant who is hired only to perform tasks such as subscriber enrollment and claims processing. These plans are controlled by ERISA law instead of by state law....
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This note was uploaded on 09/19/2011 for the course HEALTH ADM HCR 230 taught by Professor Heathercsanky during the Spring '10 term at University of Phoenix.
- Spring '10