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BenefitsLink Health & Welfare Plans Newsletter
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[Official Guidance]
Text of Request by IRS, DOL, HHS for Information on Stop Loss Insur.ance (PDF)
"This document is a request for information regarding the use of stop loss insur.ance by group health plans and their plan sponsors, with a focus on the prevalence and consequences of stop loss insur.ance at low attachment points.... Employers and plans that purchase stop loss insur.ance generally are not subject to State health insur.ance laws including coverage laws, rating policies, and other State and Federal consumer protections applicable to health insur.ance, including certain patient protections under the Patient Protection and Affordable Care Act.... It has been suggested that some small employers with healthier employees may self-insure and purchase stop loss insur.ance policies with relatively low attachment points to avoid being subject to these requirements while exposing themselves to little risk. This practice, if widespread, could worsen the risk pool and increase premiums in the fully insured small group market[.]"
(Internal Revenue Service; Employee Benefits Security Administration; Centers for Medicare & Medicaid Services)
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[Guidance Overview]
New Guidance on Computing Taxes Payable by Health Plan Sponsors and Insurers
"The Research Tax generally will apply to major medical benefits. Many other benefits—such as a dental plan, vision plan and health flexible spending arrangement—will often be an 'excepted benefit' and not subject to the tax. [The chart in this article] discusses how the Research Tax applies to various benefits that may be offered by an employer. See [also a description of] an important 'non-duplication' rule, which can reduce the tax owed by an employer."
(Quarles & Brady LLP)
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[Guidance Overview]
IRS Describes New Fees Coming Next Year for Group Health Plans
"The Patient Protection and Affordable Care Act (PPACA) created the [Patient Centered Outcomes Research Institute] fee to promote research to evaluate and compare health outcomes and the clinical effectiveness. It will apply to some, but not all, health plans with years ending on or after Sept. 30, 2012. The excise tax will be $1 times the average number of covered lives for the plan year. The tax increases to $2 per covered life for plan years ending on or after Oct. 1, 2013[.]"
(SmartHR Manager)
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[Guidance Overview]
IRS Proposes Regs Allowing Deduction for Some Employee Local Lodging Expenses
"Despite the characterization of local lodging as a personal expense, employers could still take a compensation deduction for local lodging. However, the working condition fringe rules (for lodging provided in-kind) and the accountable plan rules (for lodging reimbursements) could not be used to provide local lodging on a tax-free basis when the exception created by Notice 2007-47 for temporary lodging did not apply. The proposed regulations provide more certainty for employers wanting to provide local lodging on a tax-free basis."
(Thomson Reuters/EBIA)
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Creating a Culture of Wellness & Well-Being Congress [Advert.]
Achieve preventive health management, personal health accountability, measurable productivity enhancements and cost-savings by integrating wellness into the fabric of your organizational culture and environment. May 7-8, 2012 - Chicago, IL
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Online Resources About the Supreme Court's Review of the Health Reform Law
Handy links to key documents and coverage of the issues by trade publications and law professors. "This resource center serves as an objective gateway to a wide range of credible information, including general background materials, details about the lawsuit, arguments and key issues, gauges of public sentiment, predictions, and, in due course, summary and analysis of the ruling and assessment of its implications"
(MedeAnalytics)
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Mental Health Spending By Private Insur.ance: Implications for The Mental Health Parity and Addiction Equity Act
"More than 90% of enrollees used well below the maximum 30 inpatient days or outpatient visits typical of health insur.ance plans before parity. Simulations indicated that even large increases in utilization would increase total health care expenditures by less than 1%. [The study concludes that the Mental Health Parity and Addiction Equity Act] is unlikely to have a large effect on the growth rate of employers' health care expenditures." (PsychiatryOnline is charging $35 for a full-text download of the article.)
(PsychiatryOnline)
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The Families and Work Institute's 2012 National Study of Employers (PDF)
"The 2012 [survey enables the Institute] to assess the extent to which businesses are providing a number of the factors ... identified as components of effective and flexible workplaces and predictive of workers' productivity and well-being. Overall, [looking] at the workplace flexibility landscape for the nation, [there are] two broad trends emerging. Flexibility that enhances an employee's ability to decide when and where they accomplish their work tasks is on the rise with increases in the proportion of employers allowing at least some employees access to flex time and place and choices in managing time since 2005. On the other hand, flexibility around reduced time, caregiving leaves and flex careers has declined since 2005."
(Families and Work Institute)
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Employer Reporting Under Health Reform—How Much Is Too Much, IRS Wants to Know
"Beginning in 2014, employers that sponsor health plans will have to watch closely if any employees qualify for a premium tax credit, triggered whenever the employer-sponsored coverage is unaffordable, or does not provide minimum value. On April 26, the IRS requested comments on how to determine whether a health plan provides 'minimum value.'"
(SmartHR Manager)
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New Jersey Politicians Grandfather Own Benefits But Limit Those of New Workers
"[Figures obtained as part of a Star-Ledger analysis of sick and vacation time records for lawmakers and other public employees across the state] show that politicians can reap generous rewards from the same system they are charged with policing. The payouts also take sizable chunks out of local budgets that are already under duress."
(nj.com)
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Oregon Group Backs Human Rights Status for Health Care
"Oregon reform advocates plan to launch a major campaign to have health care declared a human right.... Now, [a spokesman said,] it's time for a new tactic: a broad-based effort to mobilize public support for the notion that everyone deserves access to health care."
(gazettetimes.com)
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'Choosing Wisely' Campaign Aims to Curb Wasteful Medical Spending by Consumers
"The American Board of Internal Medicine, in collaboration with Consumer Reports, has recently launched an initiative called Choosing Wisely, which aims to reduce unnecessary medical treatments. Some organizations have estimated that up to one-third of all medical spending in the United States is unnecessary; this spending includes unnecessary hospitalizations, money spent on unproven treatments and ineffective new drugs, and futile end of life care."
(The American Journal of Managed Care)
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Examining the Difference in Health Insur.ance Premiums between Ages 20 and 60 (PDF)
"Simply put, age rating is the practice of varying health insur.ance premiums based on age. Much like medical underwriting, which varies premiums based on health condition; age rating is another way health insurers can segment risk. For example, in some states, an elderly person could be charged a health insur.ance premium over five times more than a young person, solely based on age. Currently, age rating exists to a certain degree in every state."
(GoHealth Insur.ance)
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Health Care Spending Flattening Out
"Much of the slowdown is because of the recession, and thus not unexpected, health experts say. But some of it seems to be attributable to changing behavior by consumers and providers of health care—meaning that the lower rates of growth might persist even as the economy picks up."
(The New York Times; free registration required)
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[Opinion]
Saving for Future Health Care Expenses
"Newly announced regulations under the [PPACA] threaten the very existence of consumer directed health plans in the individual market (including the anticipated health insur.ance exchanges) ... Yet according to a RAND study, these plans have the potential to reduce health care spending by 30% without causing any harm, even to vulnerable populations. [This article reviews] some of the advantages and disadvantages of the various health savings options."
(National Center for Policy Analysis)
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[Opinion]
Why Limiting Health Flexible Spending Accounts Makes Sense
"Under the ACA, starting in 2011, people can use FSAs and other accounts to buy over-the-counter items only with a doctor's prescription. There are several reasons to limit the purchase of over-the-counter health products with tax-favored accounts."
(Center on Budget and Policy Priorities)
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[Opinion]
The Medical Loss Report: Fiddling While Rome Burns
"The Wall Street Journal, citing a Goldman analysis, is reporting that Aetna will be paying out $177 mil.lion in rebates. But Aetna has $11 bil.lion in premium so that's only a 1.6% rebate. UnitedHealth will be paying out $307 [m]illion but that is only 1% of its $28.8 bil.lion in premium. Wellpoint will pay out $94 mil.lion in rebates but that is only .28% of its premium for the year. The average cost of employer-provided family health insur.ance is now about $13,000 per year. A family rebate of perhaps $200 will amount to only about 1.5% of premium for the relatively few people who will even get one."
(The Health Care Blog)
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[Opinion]
Text of Comments from American Academy of Actuaries on LTC Reform Options (PDF)
"[These comments are] in response to the National Conference of Insur.ance Legislators' ... request for information on strategies to reduce costs related to LTC coverage. The task force that developed this response includes actuaries with a broad spectrum of expertise in LTC financing and Medicaid—actuaries who understand and can explain the advantages and disadvantages of various approaches to LTC, including providing an analysis of the Community Living Assistance Services and Supports (CLASS) Act."
(American Academy of Actuaries)
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Benefits in General; Executive Compensation
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Hedging Nonqualified Deferred Compensation Plans (PDF)
"NQDC Plans create both economic and accounting volatility; companies who sponsor plans may decide a hedge of the NQDC liability is prudent to offset these risks. The NQDC Plan appears as an operating expense on the employer's income statement ... and creates an increasing liability on its balance sheet until benefits are paid. The eventual payment of the benefits will result in a funding requirement. The change in the size of the NQDC Plan due to change in value of the underlying reference investments creates volatility on the plan sponsor's income statement."
(BNY Mellon)
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Press Releases
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