1. ALABAMA | FLORIDA | GEORGIA | MISSISSIPPI | WASHINGTON DC TELEHEALTH: WHEN THE REGULATORS CATCH UP R. PEPPER CRUTCHER, JR. www.acareview.com

2. ALABAMA | FLORIDA | GEORGIA | MISSISSIPPI | WASHINGTON DC WILD, WILD WEST PROVIDERS, SALES AGENTS AND IT HAVE A BIG LEAD ON REGULATORS JURISDICTION IS UNCLEAR State insurance regulators – health insurance, HMO Network adequacy? Medical profession regulators DOL / EBSA plan audits “employee welfare benefit plan” / “group health plan” “excepted benefits” SALES AGENTS ARE UNAWARE OF LEGAL ISSUES EMPLOYERS SEE PRACTICAL AND LEGAL ADVANTAGES Practical: low cost, good user experience (all many need) Legal: if 100% of “preventive services” ($0), may be ACA MEC

3. ALABAMA | FLORIDA | GEORGIA | MISSISSIPPI | WASHINGTON DC WHEN THEY CATCH UP NOT “IF.” EXAMPLE: WELLNESS PLANS (ACA, ADA, ERISA, HIPAA) RISKY: AS AN ANCILLARY BENEFIT MOST RISKY: AS THE SOLE MEC PLAN OFFERED BY AN ALE (REIMBURSING EMPLOYEE SUBSCRIPTIONS PRE-TAX) LEAST RISKY: DESIGNATED PROVIDER SERVICES UNDER A SELF- FUNDED, ERISA GROUP HEALTH PLAN INDEPENDENTLY SATISFYING 26 U.S.C. §4980H DEPENDING ON STATE REGULATION, GROUP HEALTH INSURANCE COVERAGE WITH APPROVED PROVIDERS SHOULD BE MINIMALLY RISKY.

4. ALABAMA | FLORIDA | GEORGIA | MISSISSIPPI | WASHINGTON DC HOW LONG? FEDERAL REGULATORS ARE BACKLOGGED (2018?) STATES AND PROFESSIONAL ORGANIZATIONS PROBABLY WILL LEAD UNTIL EMPLOYERS MOVE TELEHEALTH INSIDE GROUP HEALTH PLANS AND / OR THE FEDS IMPOSE ORDER QUESTIONS?