Health Benefit Plan Basics
Today's competitive world places a high value on attracting and retaining global talent, especially in the current economic environment. Prospective and current employees need to look closely at employee compensation strategies and health benefit plans. This course provides the essential framework, knowledge, competencies and tools to evaluate and enhance existing plan designs. Using case studies and classroom interaction with peers, this two-day course presents a systematic way to evaluate how plans can remain robust and become a leading-edge total benefits program. Join your peers and experts to gain insight related to the latest legislative, regulatory and marketplace challenges that accompany health and welfare plan design and administration.
Topics Covered
- History and evolution of health benefit plans
- Plan models
- Managed care definitions and designs
- Plan financing
- The legal environment
- Carve-outs
- Retiree medical coverage
- Resources
- Case study
Course Outline
Day 1
- Introduction
- History and Evolution of Health Benefit Plans
- Health insurance as an employee benefit
- Causes and catalysts of health care inflation
- Relationship between health behavior and cost
- Plan Models
- Major medical terminology
- Coordination of benefits
- Managed Care - Definitions and Design
- HMO, PPO, POS, EPO, QHDHP, FSA, HSA, HRA
- Indemnity
- Consumer-driven health care
- Plan Financing
- Fully insured, self-funded, self-funded plus variations
- Contribution formula
- The Legal Environment
- Federal legislative and compliance agenda
- IRS, DOL, CMS, DHS
- Federal laws: ERISA, COBRA, HIPAA, FMLA, MPHA, MHPAEA, QMCSO, USERRA, PPACA, No Surprises Act
- Legal compliance and tax implications
- Summary of benefits and coverage documents
Day 2
- Carve-Outs
- Pharmacy benefits and Rx drugs
- Worksite wellness and incentives
- Behavioral health management and mental health
- Retiree Medical
- Plan design
- Medicare and Medicaid
- Employer considerations for retirees
- Resources With an Expanded Appendix of Reference and Resource Tools
- Case Study
The case study is a review and analysis of an independent audit performed by the Department of Labor (DOL). Groups will look at the new funding method and managed care for a benefit plan and will redesign the current benefit plan and discuss how and why the new plan provisions are being recommended.
Course Applies To
Pricing
July 14 - 15, 2025
Fairmont Chicago, Millennium Park, Chicago, IL
Through June 2, 2025
US$1,400.00
Member
US$1,620.00
Nonmember
After June 2, 2025
US$1,700.00
Member
US$1,920.00
Nonmember
Pricing
October 8 - 9, 2025
Hilton Austin, Austin, TX
Through August 25, 2025
US$1,400.00
Member
US$1,620.00
Nonmember
After August 25, 2025
US$1,700.00
Member
US$1,920.00
Nonmember
Pricing
April 27 - 28, 2026
Hilton Scottsdale Resort & Villas, Scottsdale, AZ
Through March 16, 2026
US$1,495.00
Member
US$1,715.00
Nonmember
After March 16, 2026
US$1,795.00
Member
US$2,015.00
Nonmember
Pricing
October 2 - 3, 2026
Caribe Royale Orlando, Orlando, FL
Through August 17, 2026
US$1,495.00
Member
US$1,715.00
Nonmember
After August 17, 2026
US$1,795.00
Member
US$2,015.00
Nonmember
Continuing Education
Educational sessions at this program can qualify for CEBS Compliance credit. Visit www.cebs.org/compliance for more information.
Agenda
Monday, July 14 - Tuesday, July 15, 2025
Fairmont Chicago, Millennium Park, Chicago, IL
Handout Dates: July 9 - September 17, 2025
8:00 AM - 5:00 PM
8:00 AM - 3:00 PM
Wednesday, October 8 - Thursday, October 9, 2025
Hilton Austin, Austin, TX
8:00 AM - 5:00 PM
-
Mark Dunlop, CEBS, AEP, AFC, CFP, ChFC, CLU, FLMI, REBC, RHU
8:00 AM - 3:00 PM
-
Mark Dunlop, CEBS, AEP, AFC, CFP, ChFC, CLU, FLMI, REBC, RHU
Monday, April 27 - Tuesday, April 28, 2026
Hilton Scottsdale Resort & Villas, Scottsdale, AZ
The selected event has no sessions.
Friday, October 2 - Saturday, October 3, 2026
Caribe Royale Orlando, Orlando, FL
The selected event has no sessions.