{"id":3001,"date":"2017-07-20T02:18:00","date_gmt":"2017-07-20T07:18:00","guid":{"rendered":"https:\/\/worldcarenew.wpenginepowered.com\/?p=3001"},"modified":"2026-03-08T02:27:26","modified_gmt":"2026-03-08T07:27:26","slug":"deuxieme-avis-medical-et-erisa-ce-que-les-employeurs-doivent-savoir","status":"publish","type":"post","link":"https:\/\/www.worldcare.com\/fr\/medical-second-opinions-and-erisa-what-employers-need-to-know\/","title":{"rendered":"Deuxi\u00e8me avis m\u00e9dical et ERISA\u00a0: ce que les employeurs doivent savoir"},"content":{"rendered":"<p>Chez WorldCare, on nous demande parfois si les services de deuxi\u00e8me avis m\u00e9dical (MSO) propos\u00e9s dans le cadre d&#039;un r\u00e9gime d&#039;avantages sociaux sont soumis \u00e0 l&#039;ERISA. L&#039;application de l&#039;ERISA aux MSO peut \u00eatre complexe et les r\u00e8gles varient selon les contextes.<\/p>\n\n\n\n<p>Voici donc quelques points cl\u00e9s \u00e0 retenir\u00a0:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Les organismes de gestion des services (MSO) sont un atout majeur dans la lutte contre les maladies graves et leurs co\u00fbts, et contribuent \u00e0 am\u00e9liorer la prise en charge des patients. De ce fait, l&#039;int\u00e9gration d&#039;un MSO sp\u00e9cialis\u00e9 dans les maladies graves \u00e0 votre programme d&#039;assurance maladie et\/ou invalidit\u00e9 des employ\u00e9s repr\u00e9sente un service pr\u00e9cieux, au retour sur investissement av\u00e9r\u00e9, et de plus en plus demand\u00e9.<\/li>\n\n\n\n<li>Les programmes de bien-\u00eatre offrant des soins m\u00e9dicaux sont soumis \u00e0 la loi ERISA, et les organismes de gestion de programmes de bien-\u00eatre (MSO) sont parfois concern\u00e9s par la conception et la communication de ces programmes. Les employeurs doivent donc \u00eatre vigilants, car le minist\u00e8re du Travail am\u00e9ricain les contr\u00f4le rigoureusement afin de garantir leur conformit\u00e9 aux r\u00e9glementations autres que celles pr\u00e9vues par la loi HIPAA.<\/li>\n\n\n\n<li>Dans le cadre d&#039;un programme d&#039;avantages sociaux autog\u00e9r\u00e9 ou d&#039;un r\u00e9gime couvrant moins de 50 participants, toutes les dispositions de l&#039;ERISA ne s&#039;appliquent pas. Toutefois, de nombreuses r\u00e8gles doivent \u00eatre respect\u00e9es. En pratique, la plupart des employeurs prendront prudemment en compte les m\u00eames aspects, m\u00eame s&#039;ils consid\u00e8rent l&#039;organisme de gestion des services m\u00e9dicaux (MSO) comme distinct de leur r\u00e9gime d&#039;assurance maladie.<\/li>\n\n\n\n<li>Les r\u00e8gles de non-discrimination de la loi HIPAA ne s&#039;appliquent pas aux r\u00e9gimes compl\u00e9mentaires d&#039;assurance compl\u00e8te (con\u00e7us pour rembourser les franchises et les quotes-parts). Les MSO qui y sont int\u00e9gr\u00e9s sont g\u00e9n\u00e9ralement \u00e9galement hors du champ d&#039;application de l&#039;ERISA.<\/li>\n<\/ul>\n\n\n\n<p>Pour plus de d\u00e9tails, WorldCare vous encourage \u00e0 consulter votre avocat. Si vous souhaitez parler \u00e0 l&#039;un de nos experts en deuxi\u00e8me avis m\u00e9dical, veuillez nous contacter par courriel.&nbsp;<a href=\"mailto:connect@worldcare.com\">info@worldcare.com<\/a>&nbsp;et nous fixerons un rendez-vous pour que vous puissiez discuter.<\/p>","protected":false},"excerpt":{"rendered":"<p>At WorldCare, we are sometimes asked if medical second opinion (MSO) services as part of an employee benefit plan are subject to ERISA. MSOs may or may not fall within ERISA\u2019s reach \u2013 this is complicated stuff and the rules are not all that clear in different contexts. So let\u2019s share a few key points: [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":549,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[16],"tags":[52,46,53,49,48,51,47,50,54],"class_list":["post-3001","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medical-second-opinion","tag-brain-tumor","tag-cancer","tag-health","tag-multiple-sclerosis","tag-ovarian-cancer","tag-pancreatitis","tag-prostate-cancer","tag-rheumatoid-arthritis","tag-skin-cancer"],"_links":{"self":[{"href":"https:\/\/www.worldcare.com\/fr\/wp-json\/wp\/v2\/posts\/3001","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.worldcare.com\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.worldcare.com\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.worldcare.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.worldcare.com\/fr\/wp-json\/wp\/v2\/comments?post=3001"}],"version-history":[{"count":0,"href":"https:\/\/www.worldcare.com\/fr\/wp-json\/wp\/v2\/posts\/3001\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.worldcare.com\/fr\/wp-json\/wp\/v2\/media\/549"}],"wp:attachment":[{"href":"https:\/\/www.worldcare.com\/fr\/wp-json\/wp\/v2\/media?parent=3001"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.worldcare.com\/fr\/wp-json\/wp\/v2\/categories?post=3001"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.worldcare.com\/fr\/wp-json\/wp\/v2\/tags?post=3001"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}