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Older News | August 21, 2014
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Domestic Violence Leave Becomes Law in Massachusetts
Fisher & Phillips LLP More items by Fisher & Phillips LLP
8/20/2014 [Guidance Overview]

"Except where there is a threat of imminent danger, employees are required to provide 'appropriate notice' of their need for leave. While the statute does not specifically define 'appropriate notice,' employers should use the same notice period required in their other leave policies. This notice may be communicated by either the employee or another person acting on the employee's behalf. If an unscheduled absence occurs, an employer may not take any negative action against the employee if the employee produces documentation within 30 days."
Embracing the Trend: Has Your 401(k) Plan Considered Relaxing Eligibility Requirements?
Pension Consultants Inc. More items by Pension Consultants Inc.
8/20/2014

"If the plan's goal is to help participants become ready for retirement, then relaxing the eligibility requirements could help them save sooner and longer. If your plan hasn't embraced the trend of loosening participant eligibility, then ask yourself some simple questions: What is the primary purpose of having the current eligibility period? Is the eligibility period satisfying its purpose? Does the current eligibility period drive positive participant behavior results?"
Carefully Choosing the Right Benefits Package Pays Off for Employees -- and Employers
Healthcare Reform Magazine More items by Healthcare Reform Magazine
8/20/2014

"There are a few important tips that can increase the success of employers as they create a balanced and cost-effective benefits package that will appeal to current and future employees. Ask questions-and the important ones.... Choose a customized benefits plan over an off-the-shelf package.... Build it around the workforce.... Start a healthcare literacy program to help employees help themselves."
Inside the Structure of Defined Contribution/401(k) Plan Fees, 2013: A Study Assessing the Mechanics of the 'All-In' Fee (PDF)
Investment Company Institute [ICI] More items by Investment Company Institute [ICI]
8/20/2014

36 pages. "Many fee structures and arrangements exist in the defined contribution marketplace. Plan size (in terms of number of participants) was found to be a significant driver of a plan's 'all-in' fee. Larger plans tend to have lower 'all-in' fees as a percentage of plan assets. A correlation also exists between the 'all-in' fee and the average participant account size in the defined contribution plan. Plans with larger average participant account balances tend to have lower 'all-in' fees as a percentage of plan assets. Plans with a higher percentage of plan assets invested in diversified equity holdings tend to have higher 'all-in' fees"
Massachusetts Employers Now Required to Grant Employees Domestic Violence Leave
Choate Hall & Stewart LLP More items by Choate Hall & Stewart LLP
8/20/2014 [Guidance Overview]

"The leave must be used for addressing domestic violence issues, including meeting with law enforcement or district attorneys; attending child custody proceedings; seeking medical attention or counseling; obtaining victim services or legal assistance; securing housing, or other issues 'directly related' to the abusive behavior against the employee or employee's family member. An employer can decide whether any leave taken is paid or unpaid."
Health Plans Experiment with New Benefit Designs to Give Value
Bloomberg BNA More items by Bloomberg BNA
8/20/2014

"Health insurers offering plans in the [ACA] marketplaces are experimenting with new types of benefit designs aimed at giving consumers some value before subjecting them to deductibles or other cost-sharing requirements. But the benefit designs may confuse many consumers.... Some plans, dubbed 'doughnut hole' plans, require copayments before deductibles are met and coinsurance payments afterward ... Some plans require separate deductibles for drugs, or separate copayments for hospitalizations, which can be significant, ... [T]wo plans side by side [may] look like they have the same deductible. But one plan covers primary care services pre-deductible and the other plan, it's more of a traditional type where you have to pay everything out of pocket until the deductible is met."
ERISA at 40: Federal Preemption and the ACA (PDF)
Buck Consultants at Xerox More items by Buck Consultants at Xerox
8/20/2014

5 pages. "A sweeping preemption provision that constricted the ability of states and localities to regulate employer-sponsored benefit plans was a major feature of ERISA as enacted, designed to create administrative uniformity for employers who sponsor benefit plans covering employees nationwide.... This article discusses the reach of ERISA preemption as it concerns pre-ACA health care reform laws designed to expand employer-provided health coverage, the status of those laws in the wake of the ACA, and the role and motivation of states and localities in regulating employer-sponsored coverage in a post-ACA world."
Compensation of Top 200 Directors Increased by 2.7% in 2013
Steven Hall & Partners More items by Steven Hall & Partners
8/20/2014

"Median total remuneration paid to non-employee directors was $268,333 in 2013, an increase of +2.7% over 2012 levels.... Pay mix for non-employee directors has remained relatively unchanged since 2008. Directors continue to receive just over half of their total compensation in the form of equity (55% in 2013), in accordance with governance best practices. Annual cash board retainer increased $5,000 in 2013 to a median of $90,000 and the median annual equity board retainer remained constant at $140,000. Equity compensation is delivered predominantly in full value shares."
ACA Medical Device Tax Not Meeting Revenue Goal
The Hill More items by The Hill
8/20/2014

"A tax imposed on medical devices included in the [ACA] is raising roughly three-quarters of the revenue originally expected, according to a new government report.... The Treasury Inspector General for Tax Administration (TIGTA) said the IRS needs to continue to tweak its compliance rules for the tax, identifying several mistakes when it came to collecting money owed the government. IRS agents were still having a hard time determining exactly which medical device manufacturers were subject to the tax; both the returns filed and revenue raised have come in well short of expectations."
Former DOL Deputy Director Declares Scandal in IRA Rollovers
Employee Fiduciary More items by Employee Fiduciary
8/20/2014 [Opinion]

"The current standards allow brokers to present sales pitches that appear to be similar to investment advice. Retail investors have a difficult (impossible?) time distinguishing between a sales pitch and unbiased advice. The result is that many investors are lured away from appropriate and low-cost investments into higher-priced investment vehicles sold by someone who puts his or her own fees ahead of the best interests of the investor. Allowing these practices just adds to the many challenges people face in saving for retirement. Financial advisors should be in the business of helping people succeed at investing. Period."
ERISA Accounts and Fiduciary Duties (PDF)
The Wagner Law Group More items by The Wagner Law Group
8/20/2014

"By recapturing fees, ERISA accounts help solve the issue that arises when a recordkeeper receives revenue sharing that exceeds the fee stated in its contract with the plan.... Very large plans may be less interested in establishing ERISA accounts, because they tend to have less revenue sharing, given the availability of alternative investments, such as separate accounts and collective trusts. However, due to the unpredictability of revenue sharing payments from year to year, best practice suggests that most plan sponsors consider the use of some kind of fee recapture account."
Text of DOL Request for Information Regarding Standards for Brokerage Windows in Participant-Directed Individual Account Plans
Employee Benefits Security Administration [EBSA], U.S. Department of Labor More items by Employee Benefits Security Administration [EBSA], U.S. Department of Labor
8/20/2014 [Official Guidance]

"[T]he RFI will focus on why, under what circumstances, and how often these brokerage windows are offered and used in ERISA plans, and the legal and policy issues that relate to such usage. The Department wants to make sure that participants are not exposed to undue risks from brokerage windows and that plan fiduciaries properly understand the scope of their ongoing responsibilities with respect to brokerage windows. The information received in response to this RFI will assist the Department in determining whether, and to what extent, regulatory standards or safeguards, or other guidance, are necessary to protect participants' retirement savings.... Interested persons also are encouraged to address any other matters they believe to be germane to the general topic of this RFI."
Ensuring Participant 401(k) Contributions and Loan Repayments Meet DOL Regs
Retirement Management Services More items by Retirement Management Services
8/20/2014

"The most effective way to ensure that standards are met is to implement internal controls with set procedures.... Frequent payroll reconciliations -- once a month (or every pay period)... Deposit with each payroll ... Review and sign off on manual input ... Reconcile totals with each pay period ... Annually, review total deferrals per the W-3 to a list of payroll periods with the pay date and related deferral amounts ... Cross-train employees on payroll deposit procedures."
Employers Expect Health Care Costs to Rise 5.2% in 2015 But Hope to Whittle Down to 4%
Towers Watson More items by Towers Watson
8/20/2014

"U.S. employers expect a 4% increase in 2015 health care costs for active employees after plan design changes, according to [Towers Watson]. If no adjustments are made, employers project a 5.2% growth rate, putting absolute cost per person for health care benefits at an all-time high.... Of particular concern on the cost front is the [ACA's] excise tax, which goes into effect in 2018. Nearly three-quarters (73%) of employers said they are somewhat or very concerned they will trigger the tax based on their current plans and cost trajectory. More than four in 10 (43%) said avoiding the tax is the top priority for their health care strategies in 2015."
Why More, Not Fewer, People Might Start Getting Health Insurance Through Work
The New York Times; subscription may be required More items by The New York Times; subscription may be required
8/20/2014

"It's early yet to be sure of a strong trend, but the Walmart experience mirrors evidence from early polls and the historical experience of Massachusetts, which enacted a law similar to the [ACA] in 2006. More people may be signing up for employer-based coverage than did before.... What Walmart's experience reminds us is that there were also uninsured people who simply chose not to buy coverage before there was a law requiring them to do so. Now they may be changing their minds."
Variable Annuities Rise on Regulators' Radar
The Wall Street Journal; subscription may be required More items by The Wall Street Journal; subscription may be required
8/20/2014

"One particularly troublesome area involves advisers persuading clients to liquidate one variable annuity to buy another, say regulators in Illinois, Florida and Massachusetts. Investors may think they are getting a better product with better terms, but they can be hit with large surrender fees and tax bills."
Why a Roth Conversion May Be a Bad Idea Even If Taxes Are Higher in the Future
Michael Kitces in Nerd's Eye View More items by Michael Kitces in Nerd's Eye View
8/20/2014

"[T]he simple reality is that there are many paths to higher tax burdens in the future that don't necessarily involve higher marginal tax rates on IRA withdrawals. Which means ultimately, advisors should be very cautious about doing Roth conversions -- especially conversions at rates that are 33% or higher -- and the best possible thing to do with a pre-tax IRA may simply be to continue to hold it, and wait for tax burdens to increase... because when paired with a compression of tax brackets that leads to lower marginal tax rates, not converting to a Roth could actually be one of the best long-run tax savings strategies around!"
2014 Retirement Confidence Survey of the State and Local Government Workforce
Center for State and Local Government Excellence, and TIAA-CREF Institute More items by Center for State and Local Government Excellence, and TIAA-CREF Institute
8/20/2014

"One-third of public sector employees have been with their current employer for less than 10 years and one-third for 20 years or longer. When considering the future, two-thirds do not expect to leave their current employer anytime soon. Respondents ranked job security, health insurance, retirement benefits, and salary as the most important job elements they would consider in deciding whether to switch employers. The vast majority of state and local employees are covered by a primary defined benefit pension plan and expect to receive retiree health care benefits; one-quarter of these workers reported changes to these benefits over the past two years and one-quarter expect (more) changes in the next two years."
DOL Guidance Provides Help for Finding Your Plan's Missing Participants
Littler More items by Littler
8/20/2014 [Guidance Overview]

"The decision to set up an interest-bearing account or transfer the funds to the state should be an absolute last resort because these two options have potential adverse tax consequences to the participant. In fact, according to the DOL, 'a fiduciary would violate ERISA section 404(a)'s obligations of prudence and loyalty by causing such negative consequences rather than making an individual retirement plan rollover distribution.'"
Proposal Would Extend the Federal Thrift Savings Plan to 78 Million Americans
Milliman Retirement Town Hall More items by Milliman Retirement Town Hall
8/20/2014

"Recently, members of Congress reintroduced the idea of opening the government-employees-only Thrift Savings Plan (TSP) to all Americans not currently covered by an employer-sponsored plan.... With [Thrift Savings Plan (TSP)] membership this massive, government agencies would have a greatly increased, more powerful role in the retirement savings industry, and selection of investment fund options might take on a political element (at least the perception of such).... Potential compliance issues would be introduced as the TSP is exempt from ERISA and [IRS] regulations that govern the private sector."
ISS Announces Equity Plan Data Verification Portal for Issuer Review (PDF)
Frederic W. Cook & Co., Inc. More items by Frederic W. Cook & Co., Inc.
8/20/2014

"On August 14th, Institutional Shareholder Services (ISS) announced the release of a new portal for companies to review and verify the accuracy of data used by ISS in its evaluation of equity compensation plan proposals submitted to shareholders after September 8, 2014.... [The portal] offers U.S. companies the opportunity to ensure ISS has accurately captured key aspects of its new or amended equity plan prior to the release of ISS' s vote recommendation. Equity plan data verification items cover equity plan provisions, outstanding stock and convertibles, equity grant activity, and shares reserved and outstanding under the equity compensation program."
Health Care Data Breaches Have Hit 30 Million Patients and Counting
The Washington Post; subscription may be required More items by The Washington Post; subscription may be required
8/20/2014

"Since federal reporting requirements kicked in, the [HHS] database of major breach reports (those affecting 500 people or more) has tracked 944 incidents affecting personal information from about 30.1 million people.... There's still concern, though, about the health-care industry's ability to prevent and respond to data breaches. About 69 percent of health security professionals in a 2013 survey said their organization has a data breach plan in place, up from 62 percent in 2012. Another 27 percent said they were still developing a strategy[.]"
U.K. Retirement Savings and Income Market Could See Wave of New Products
State Street Corporation More items by State Street Corporation
8/20/2014

"[T]he main focus will be on income drawdown followed by products with capital and income guarantees, then U or J shaped annuities where income can go up as well as down to match retirement income needs, and investment structures concentrating on residential properties."
IRS Guidance on Application of the Windsor Decision to Retirement Plans (PDF)
Prudential More items by Prudential
8/20/2014 [Guidance Overview]

5 pages. "[S]ome plans had extended spousal rights and benefits to same-sex spouses prior to the Windsor decision under special provisions that may have also covered domestic partners and civil union partners. Sponsors of these plans need to carefully review all such provisions and make appropriate amendments, keeping in mind that domestic partners and civil union partners are not considered to be spouses under any IRS guidance issued so far."
Text of Letter from ASPPA and ACOPA to IRS Requesting HTFA Funding Guidance (PDF)
American Society of Pension Actuaries [ASPPA] and ASPPA College of Pension Actuaries [ACOPA] More items by American Society of Pension Actuaries [ASPPA] and ASPPA College of Pension Actuaries [ACOPA]
8/20/2014 [Opinion]

6 pages. "ASPPA and ACOPA recommend that the IRS issue guidance that minimizes the additional time and expense required to comply with the [Highway Transportation Funding Act of 2014 (HTFA)] .... If the schedule SB for a plan year beginning in 2013 has already been filed, no supplemental or amended filing should be required... Rules similar to those in Notice 2012-61 should apply for plans that apply the extended 10% corridor to the 2013 plan year for purposes of Section 430 or Sections 430 and 436 and to all plans for 2014 plan years ... An election to elect out of HTFA segment rates for 2013 must not be considered an election to opt out of using the modified funding target determination period provided in section 2003(d) of HTFA."
Multiemployer Trustee Selection and Orientation: 2014 Survey Results (PDF)
International Foundation of Employee Benefit Plans [IFEBP] More items by International Foundation of Employee Benefit Plans [IFEBP]
8/20/2014

27 pages. "The vast majority of fund representatives believe it is more challenging to be a trustee today compared to the past.... Concern about keeping up with constantly changing regulations is the most common challenge for current trustees.... Respondents regarded employee benefits, business, and accounting/finance as the top three educational backgrounds for good trustees... The majority of representatives believe it takes between three and five years to develop a competent trustee."
Managers and Supervisors Often Surprised by Breadth of FMLA's Coverage
Society for Human Resource Management [SHRM] More items by Society for Human Resource Management [SHRM]
8/20/2014

"Supervisors can ... be educated about 'red flags' that result in them consulting a human resources professional to gather additional guidance on how to address a particular situation ... Managers often think of the FMLA as a law that comes into play only when an employee is getting ready to take a maternity leave or when they have a debilitating illness requiring an extended hospital stay. Those are obviously scenarios where the FMLA is implicated, but the act provides much greater coverage than that."
Survey by New York Federal Reserve: Higher Health Costs, More Part-Time Workers Due to Obamacare
U.S. Chamber of Commerce More items by U.S. Chamber of Commerce
8/20/2014

"More than 73% of manufacturers and 58% of service firms said the health care law has increased costs this year. Companies are also more pessimistic about Obamacare next year. Over 80% of manufacturers and 74% of service firms expect health plan costs to increase in 2015."
The Art and Science of Stable Value Investment Guidelines: Optimizing the Balance Between Risk and Return (PDF)
MetLife More items by MetLife
8/20/2014

7 pages. "This [article] focuses on the role that investment guidelines play in enabling stable value to appropriately balance market opportunities with effective risk management in all types of market conditions. It suggests that stable value has reached an inflection point at which stable value wrap providers, asset managers and the plan sponsor community they serve should consider taking a fresh look at stable value investment strategies and guidelines to ensure that they appropriately balance the opportunities of the current market environment with return expectations and liability risks."
Specialty Tier Pharmacy Benefit Designs in Commercial Insurance Policies: Issues and Considerations
State Health Reform Assistance Network, a program of the Robert Wood Johnson Foundation More items by State Health Reform Assistance Network, a program of the Robert Wood Johnson Foundation
8/20/2014

8 pages. "The one design that has survived and emerged as the most common approach [to moderating the costs of providing prescription drug coverage] is the tiering of benefits, or benefit designs that assign covered prescription drugs to a 'tier' based on cost-sharing and other requirements, like preauthorization.... [F]or those in need of drugs on the higher tiers with the most cost-sharing, three important issues have emerged for regulators to consider: [1] the affordability of prescription drug therapies for those who need them most; [2] the adherence challenges that result from loss of affordability; and [3] the potential for tiered pharmacy benefit designs to violate the anti-discrimination provisions of the ACA."
ERISA at 40: The Evolution of Employee Benefits
Practical Law Company More items by Practical Law Company
8/20/2014

"This article explores ERISA's history, focusing on the major developments that have emerged over the years. It also includes thoughts from leading practitioners on the future of employee benefits law and practice." [Contributors include: Alvin H. Brown, Alan D. Lebowitz, Andrew L. Oringer, Prof. Kathryn J. Kennedy, and David N. Levine.]
Pushed to Make Own Choices, Investors Turn to Advisors for Help with Retirement Planning (PDF)
Insured Retirement Institute [IRI] More items by Insured Retirement Institute [IRI]
8/20/2014

14 pages. "Nearly three in four (72%) investors have saved at least $250,000 for retirement. Despite significant savings, investors lack deep knowledge regarding financial products. 62% of investors save through a broker or financial planner. Investors rely more on the recommendation of their advisors to select investments than any other factor. Nearly four in 10 investors own annuities."
America Has a Retirement Spending Problem
The Brookings Institution More items by The Brookings Institution
8/20/2014 [Opinion]

"The ongoing debate about Americans' saving behavior during their working years ... misses the equally important question of whether retirees will spend their nest egg in the right way. For millions of older Americans, securing a sound retirement means both accumulating wealth while working and, importantly, transforming that wealth into lifetime security through vehicles such as annuities, long-term care insurance, and even reverse mortgages.... The problem for many retirees is that they simply don't have access to or knowledge of insurance products that can help to provide security."
California Repeals 60-Day Limit on Eligibility Waiting Periods, Now Conforms to ACA's 90-Day Rule
Benefit Revolution More items by Benefit Revolution
8/20/2014 [Guidance Overview]

"[T]he text of the new statute itself is confusing because it consistently states: 'A health benefit plan for group or individual coverage shall not impose any waiting or affiliation period.' ... In reading the [California Health and Safety Codes], however, it is important to remember that the relevant code sections only apply to California's insurers. Therefore ... the law has been amended to tell California's HMOs and PPOs that they can't apply waiting periods. This frees up employers to set their waiting periods at whatever they deem appropriate as long as it complies with PPACA's 90-day (or maybe 90-days plus a month ... ) limit."
Providing Compliant Services for Participant Rollovers: The Duties of Broker-Dealers and RIAs
FredReish.com More items by FredReish.com
8/20/2014

"[T]he compliance procedures and 'scripts' for participants with small account balances are often more difficult to develop than for the individualized treatment that can be financially justified for wealthier participants. Nonetheless, the regulators -- FINRA, the SEC and the DOL -- now expect broker-dealers and RIAs to have compliant procedures for 'capturing' IRA rollovers.... [T]his is not an easy job."
Lobbying to Replace the 401(k) Model Is Lunacy
Phil Chiricotti, via Fiduciary News More items by Phil Chiricotti, via Fiduciary News
8/20/2014 [Opinion]

"401k plans are the most successful savings vehicle in history... [C]ritics often paint 401k plan liquidity features as a negative, but these features are a huge advantage and one of the primary reasons low income workers participate. Another major positive is the fact that 401k plans do not require annuitized payouts. The states are positioning to reassert their rights and while some of the proposals may provide an income stream that can't be outlived, many of the payouts will be next to nothing. This is also the worst possible time in history to annuitize an income stream, something the media, policymakers, and academics conveniently ignore."
DC Benchmarking Survey, 2013-2014 Edition: Stronger Economy Provides Building Blocks for Positive Trends in DC Plans (PDF)
Deloitte More items by Deloitte
8/20/2014

85 pages. "[T]he survey revealed that the number one reason for lack of employee participation in a DC plan is no longer 'uncertain economy/job market' (14% in 2013 compared to 24% in 2012), shifting to 'lack of awareness or understanding' (30% in 2013 compared to 21% in 2012) ... [T]he survey showed the average employee participation rate climbing to 77% in 2013 from 71% in 2012, and the average account balance rising to more than $95,000 in 2013 from $85,600 in 2012. This is welcome news for 51% of plan sponsors that ranked 'high level of participation' as the top indicator of plan effectiveness."
Divided Fourth Circuit Panel Rules on Burden of Proving Loss Causation in ERISA Fiduciary Breach Case
Proskauer's ERISA Practice Center More items by Proskauer's ERISA Practice Center
8/19/2014

"The Fourth Circuit's decision makes a number of significant statements and rulings on the burdens of proof related to loss causation, the meaning of 'objective prudence,' and the standards for reviewing decisions pertaining to stock funds in the wake of the Supreme Court's ruling in Fifth Third v. Dudenhoeffer. Some of the Court's pronouncements are difficult to reconcile with existing case law. If not set aside on en banc or Supreme Court review and if adopted elsewhere, the decision could substantially impact the future conduct of fiduciary breach litigation, as well as plan practices in administering stock funds." [Tatum v. RJR Pension Investment Committee, No. 13-1360 (4th Cir. Aug. 4, 2014)]
Retirees Living on Less
Center for Retirement Research at Boston College More items by Center for Retirement Research at Boston College
8/19/2014

"The majority of the recent retirees reported their annual income is between $25,000 and $100,000. Social Security is the largest single source of that income, and smaller but equal shares come from defined benefit pensions and from retirement savings plans. Many of the retirees report their households are managing to get by on less than the 70 percent to 80 percent of their pre-retirement income that most financial planners and retirement experts estimate they need. And four out of 10 are living on 60 percent or less."
Kill the Income Tax Exclusion for Health Insurance
National Review More items by National Review
8/19/2014 [Opinion]

"This tax break has been praised as a pillar of our employer-based private health-insurance system, but its age is showing. A growing list of critics agree that the tax exclusion needs to be changed. The key questions are when and how. We should expect a significant overhaul, but not a full retirement party, within the next five to ten years."
A Tribute to Retirement Security Hero Bob Nagle
Pension Rights Center More items by Pension Rights Center
8/19/2014

"As General Counsel of the Senate Committee on Labor and Public Welfare, Bob was responsible for crafting and securing passage of the Employee Retirement Income Security Act of 1974, the seminal law that safeguards retirement protections for American workers and retirees. Later, as Executive Director of the Pension Benefit Guaranty Corporation from 1979 to 1982, he implemented the law's insurance program. In recent years, Bob was a lawyer in private practice, an arbitrator, a neutral trustee for two mining industry pension and health funds, a participant in the Pension Rights Center's Conversation on Coverage, and a Michael S. Gordon Fellow at the Center."
Robert Nagle, an Architect of ERISA, Dies at 84
Pensions & Investments More items by Pensions & Investments
8/19/2014

"Robert E. Nagle, who as general counsel of the Senate Committee on Labor and Public Welfare was one of the architects of the Employee Retirement Income Security Act of 1974, died on Saturday [August 16, 2014] in McLean, Va., following a battle with cancer. He was 84."
District Court Finds Termination During FMLA Leave Not Unlawful
Bass, Berry & Sims More items by Bass, Berry & Sims
8/19/2014

"A leave under the FMLA does not insulate an employee from the consequences of misconduct if the employer would have taken the action anyway, regardless of the leave. Proceeding with an investigation into the misconduct while the employee is on leave is often the better option rather than awaiting the employee's return (or announced return) and then beginning the investigation. The employer had enforced the policy violation consistently, a key element." [Bloom v. Group Health Plan, Inc., No. 12-3060 (D. Minn. Aug. 13, 2014)]
Pittsburgh Health Care Giants Take Fight to Each Other's Turf
National Public Radio More items by National Public Radio
8/19/2014

"For decades, Highmark BlueCross/Blue Shield and University of Pittsburgh Medical Center worked together. But as the line between insurance companies and health care providers across the country blurs, these longtime allies are venturing into each other's business and becoming competitors.... There's another reason an insurance company would decide to become a healthcare provider: the Affordable Care Act. It tells insurance companies what basic services to offer; who they must insure and even what percent of premiums can go to administrative expenses and profits. That takes away a lot of what insurance companies used to do, so they're looking for new reasons to exist."
Will Taxpayers Bail Out Health Insurers?
National Center for Policy Analysis More items by National Center for Policy Analysis
8/19/2014

"If the reinsurance fund raises less revenue than expected and 2014 medical claims in the exchanges are higher than HHS anticipates, the fund will fall short of satisfying insurers' claims against losses. They will look elsewhere to be made whole. That 'elsewhere' is the risk corridors.... [R]isk corridors appear to be revenue neutral, requiring no increase in government spending of taxpayers' funds. But this is not the case, because payments are based on premiums paid, not claims incurred.... In March 2014, the administration proposed a rule that, among other things, increased taxpayers' exposure to Obamacare's risk corridors by adjusting the risk corridors formula."
HMO, PPO, EPO: How's a Consumer to Know Which Health Plan Is Best?
Kaiser Health News More items by Kaiser Health News
8/19/2014

"Ideally, plan type provides a shorthand way to determine what sort of access members have to providers outside a plan's network, including cost-sharing for such treatment, among other things. But since there are no industry-wide definitions of plan types and state standards vary, individual insurers often have leeway to market similar plans under different names."

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