Author : | Paul Winn, CLU, ChFC |
Course Length : | Pages: 45 ||| Word Count: 18,755 ||| Review Questions: 22 ||| Final Exam Questions: 18 |
CPE Credits : | 3.5 |
IRS Credits : | 0 |
Price : | $31.45 |
Passing Score : | 70% |
Course Type: | NASBA QAS - Text - NASBA Registry |
Technical Designation: | Technical |
Primary Subject-Field Of Study: | Specialized Knowledge - Specialized Knowledge for Course Id 2462 |
Description : | Healthcare Reform: Pre-Existing Conditions, Benefit Limits, Rescission & Patient Protection Rules examines the principal coverage provisions of the Patient Protection and Affordable Care Act (ACA) The requirements of the ACA and the associated regulations addressed in the course are those relating to grandfathered health plans, ensuring patient protections, excluding coverage for pre-existing conditions, imposing annual and lifetime benefit limits for essential health benefits, and rescinding health coverage. |
Usage Rank : | 20030 |
Release : | 2025 |
Version : | 1.0 |
Prerequisites : | Although no specific course prerequisite is necessary for a full understanding of the material presented in this course, students should possess a solid, working knowledge of group and individual health insurance. |
Experience Level : | Overview |
Additional Contents : | Complete, no additional material needed. |
Additional Links : |
Pre Existing Conditions: How They Affect Your Health Insurance
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Advance Preparation : | None. |
Delivery Method : | QAS Self Study |
Intended Participants : | Anyone needing Continuing Professional Education (CPE). |
Revision Date : | 23-Jan-2025 |
NASBA Course Declaration : | Participants must complete the final examination within one year of purchase and with a minimum passing grade of 70% or better to receive CPE credit unless otherwise noted on the Course History page (i.e. California Ethics must score 90% or better). After logging in click on the Course History links on your My Courses page for the Begin date and Expire date for the Final Exam. |
Approved Audience : | NASBA QAS - Text - NASBA Registry - 2462 |
Keywords : | Specialized Knowledge and Applications, Healthcare, Reform, Pre-Existing, Conditions, Benefit, Limits, Rescission, Patient, Protection, Rules, cpe, cpa, online course |
Learning Objectives : |
Course Learning Objectives Upon completion of this course, the student should be able to:
Chapter 1
Chapter 2
Chapter 3
Chapter 4
Chapter 5
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Course Contents : | Course Learning Objectives How You Will Learn Why This Information Is Important and How You Can Use It Chapter 1 - Grandfathered Status Chapter Learning Objectives Patient Protection and Affordable Care Act Grandfathers Certain Coverage Certain Act Provisions Inapplicable to Grandfathered Health Plans Many Act Provisions Apply to Grandfathered Health Plans The Consequences of Grandfathering in Brief Grandfathered Health Plan Status Unaffected by Certain Changes Grandfathered Health Plan Status May Be Lost Maintaining Grandfathered Health Plan Status Special Rules Applicable to Collectively Bargained Plans Losing Grandfathered Health Plan Status Losing Grandfathered Status in Brief Short-Term Health Insurance Plans Limited Plan Duration Lengthened Summary Chapter 1 Review Questions Chapter 2 - Pre-existing Condition Exclusion Chapter Learning Objectives Pre-existing Condition Exclusion Defined Exclusion of Coverage for All Participants Not a Pre-existing Condition Exclusion Pre-existing Condition Exclusions Prohibited Under Act Effect of Grandfathered Health Plan Status Effective Dates for Pre-existing Exclusion Prohibition Summary Chapter 2 Review Questions Chapter 3 - Benefit Limits Chapter Learning Objectives Benefit Limits Essential Health Benefits Condition-Based Exclusions of Coverage Permitted under the Act Annual Benefit Limits Prohibited Lifetime Benefit Limits Prohibited Benefit Limit Rules in Brief Summary Chapter 3 Review Questions Chapter 4 Coverage Rescission Limits Chapter Learning Objectives Contract Rescission Legal Elements of a Contract Post-Claims Insurer Review of Health Coverage Coverage Rescission Limited under Act Rescission Differs from Prospective Cancelation Regulations Apply Broadly Contestable Period End Not a Bar to Rescission Fraud as Basis for Rescission Intentional Misrepresentation of Material Fact as Basis for Rescission Rescission Notice Requirement Examples Rescission Rules in Brief Summary Chapter 4 Review Questions Chapter 5 - Patient Protections Chapter Learning Objectives Choice of Healthcare Providers for In-Network Plans Designation of Primary Care Provider Designation of Pediatrician as Primary Care Provider Patient Access to OB/GYN Care Patient Protection Disclosure Requirements Coverage of Emergency Services Emergency Services Defined Out-of-Network Cost-Sharing Requirements Grandfathered Plans Patient Protection Rules in Brief Summary Chapter 5 Review Questions Appendix I - Grandfathered Status at a Glance Appendix II - PPACA Provisions at a Glance Glossary |