{"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":"druhe-lekarske-posudky-a-eris-co-by-mali-zamestnavatelia-vediet","status":"publish","type":"post","link":"https:\/\/www.worldcare.com\/sk\/medical-second-opinions-and-erisa-what-employers-need-to-know\/","title":{"rendered":"Druh\u00e9 lek\u00e1rske posudky a ERISA: \u010co by mali zamestn\u00e1vatelia vedie\u0165"},"content":{"rendered":"<p>Vo WorldCare sa n\u00e1s niekedy p\u00fdtaj\u00fa, \u010di slu\u017eby druh\u00e9ho lek\u00e1rskeho n\u00e1zoru (MSO) ako s\u00fa\u010das\u0165 zamestnaneck\u00e9ho benefitn\u00e9ho pl\u00e1nu podliehaj\u00fa z\u00e1konu ERISA. MSO m\u00f4\u017eu, ale nemusia spada\u0165 do p\u00f4sobnosti z\u00e1kona ERISA \u2013 je to zlo\u017eit\u00e1 vec a pravidl\u00e1 nie s\u00fa v r\u00f4znych kontextoch \u00faplne jasn\u00e9.<\/p>\n\n\n\n<p>Po\u010fme si teda poveda\u0165 nieko\u013eko k\u013e\u00fa\u010dov\u00fdch bodov:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>MSO s\u00fa poprednou zbra\u0148ou vo vojne o kontrolu n\u00e1kladov na zdravotn\u00fa starostlivos\u0165 a s\u00favisiacich n\u00e1kladov a o zlep\u0161enie v\u00fdsledkov lie\u010dby pacientov. Preto je zahrnutie MSO pre z\u00e1va\u017en\u00e9 ochorenie do v\u00e1\u0161ho programu zdravotn\u00e9ho poistenia a\/alebo poistenia invalidity pre zamestnancov vysoko cenenou slu\u017ebou s preuk\u00e1zanou n\u00e1vratnos\u0165ou invest\u00edci\u00ed, ktor\u00e1 je \u010doraz viac \u017eiadan\u00e1.<\/li>\n\n\n\n<li>Z\u00e1kon ERISA m\u00e1 d\u00f4sledky pre wellness programy, ktor\u00e9 poskytuj\u00fa lek\u00e1rsku starostlivos\u0165, a MSO niekedy spadaj\u00fa pod n\u00e1vrh a komunik\u00e1ciu s\u00fa\u010dasn\u00fdch wellness programov. Zamestn\u00e1vatelia by preto mali by\u0165 ostra\u017eit\u00ed \u2013 ke\u010f\u017ee ministerstvo pr\u00e1ce ich agres\u00edvne kontroluje, \u010di dodr\u017eiavaj\u00fa aj in\u00e9 pravidl\u00e1 ako HIPAA.<\/li>\n\n\n\n<li>V pr\u00edpade programu poistenia so samostatn\u00fdm poisten\u00edm alebo pl\u00e1nu, ktor\u00fd pokr\u00fdva menej ako 50 \u00fa\u010dastn\u00edkov, sa neuplat\u0148uj\u00fa v\u0161etky ustanovenia z\u00e1kona ERISA. St\u00e1le je v\u0161ak potrebn\u00e9 dodr\u017eiava\u0165 mnoho pravidiel. V praxi by v\u00e4\u010d\u0161ina zamestn\u00e1vate\u013eov obozretne zv\u00e1\u017eila rovnak\u00e9 ot\u00e1zky, aj ke\u010f vn\u00edma MSO oddelene od svojho zdravotn\u00e9ho pl\u00e1nu.<\/li>\n\n\n\n<li>Pravidl\u00e1 HIPAA o nediskrimin\u00e1cii sa nevz\u0165ahuj\u00fa na plne poisten\u00e9 doplnkov\u00e9 pl\u00e1ny (ktor\u00e9 s\u00fa ur\u010den\u00e9 na preplatenie spolu\u00fa\u010dasti a spolu\u00fa\u010dasti). MSO zahrnut\u00e9 v tomto z\u00e1kone s\u00fa zvy\u010dajne mimo dosahu ERISA.<\/li>\n<\/ul>\n\n\n\n<p>Pre viac inform\u00e1ci\u00ed v\u00e1m WorldCare odpor\u00fa\u010da poradi\u0165 sa so svoj\u00edm pr\u00e1vnikom. Ak by ste sa chceli porozpr\u00e1va\u0165 s jedn\u00fdm z na\u0161ich odborn\u00edkov na druh\u00fd lek\u00e1rsky n\u00e1zor, po\u0161lite n\u00e1m e-mail&nbsp;<a href=\"mailto:connect@worldcare.com\">info@worldcare.com<\/a>&nbsp;a dohodneme si s vami term\u00edn na rozhovor.<\/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\/sk\/wp-json\/wp\/v2\/posts\/3001","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.worldcare.com\/sk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.worldcare.com\/sk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.worldcare.com\/sk\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.worldcare.com\/sk\/wp-json\/wp\/v2\/comments?post=3001"}],"version-history":[{"count":0,"href":"https:\/\/www.worldcare.com\/sk\/wp-json\/wp\/v2\/posts\/3001\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.worldcare.com\/sk\/wp-json\/wp\/v2\/media\/549"}],"wp:attachment":[{"href":"https:\/\/www.worldcare.com\/sk\/wp-json\/wp\/v2\/media?parent=3001"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.worldcare.com\/sk\/wp-json\/wp\/v2\/categories?post=3001"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.worldcare.com\/sk\/wp-json\/wp\/v2\/tags?post=3001"}],"curies":[{"name":"pracovn\u00fd list","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}