> Long-Term Disability (LTD) Long-term-disability plans provide income for an individual who cannot work because of an illness, disease, or non-occupational injury. Most plans require that the individual be a full-time employee for at least one year before the disability coverage applies.
> Preferred Provider Organization (PPO) PPOs are comparable to indemnity plans, although they require subscribers to choose their health-care providers and health-care facilities from a preferred-provider list. Because the preferred providers have agreed to the plan's requirements, including discounted fees, subscribers have a financial incentive to stay within the network.
ERISA permits a parent to obtain a court order to provide coverage for children under the noncustodial parent’s health plan (called a qualified medical child support order).
ERISA Disclosure Provisions help to ensure that individuals covered by group health plans receive clear information about their rights, benefits, and obligations under the plan, including information about COBRA continuation coverage, access to urgent or specialized care, and composition of physician and other provider networks.
HIPAA includes protections for newborns and adopted children with preexisting conditions. Specifically, HIPAA does not permit a preexisting condition exclusion to be applied to a newborn or adopted child who enrolls within 30 days of birth or adoption.
ERISA Claims Procedures help ensure timely and fair review of plan denials of claims.
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Did You Know?
Payments you receive from qualified long-term care insurance contracts will generally be excluded from income
As reimbursement of medical expenses received for personal injury or sickness under an accident and health insurance contract. Also, certain payments received under a life insurance contract on the life of a terminally or chronically ill individual (accelerated death benefits) can be excluded from income. Refer to Publication 17, Your Federal Income Tax, Chapter 13, Other Income.
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