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October 30, 2012          Get Retirement News  |  Advertise  |  Unsubscribe
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Consulting/Enrolled Actuary
for Independent Consulting Firm Located in North Carolina Servicing Clients in the Southeast in NC

Pension Administrator
for Cornerstone Group in RI

Benefit Services Specialist
for Northwestern Benefit Corporation of Georgia in GA

Plan Administrator Support Analyst
for Nationwide Insurance in OH

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Recent Studies and Commentary About Consumer-Directed Health Plans
Includes summary and links to various studies, including a Blue Cross Blue Shield survey, a survey of employers in Michigan, a study by the Robert Wood Johnson Foundation, and an op-ed article about Indiana's HSA program. (John Goodman's Health Policy Blog)


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Medical Tourism Doesn't Necessarily Mean Leaving the Country to Get Treatment
"Competitive fees at doctor-owned hospitals and the high quality of surgery are responsible for turning Oklahoma City into a health-care hub, said [the founder of a Vancouver firm that] brokers deals between U.S. hospitals and patients from the United States and Canada.... [He] said his U.S. clients typically seek affordable surgery while his Canadian patients want to avoid long waits under their country's government-controlled health-care system." (The Washington Post; free registration required)

Ten Common Questions About HSAs in Operation
"(1) Can employees change their HSA contribution amounts at any time during a plan year or are they restricted to making a change only if a qualifying event occurs as defined by the IRS?... (2) Can HSA funds be used to pay for medical expenses incurred prior to the establishment of the HSA, but while an individual was covered under the HDHP? ... (3) Can an employee who is not currently eligible to contribute to an HSA use funds remaining in his or her account? ... (4) If the account holder dies with an HSA balance, is the money taxable to the beneficiary or can it be used by the beneficiary for eligible medical expenses? " [Article includes 6 more Q&As.] (Verrill Dana LLP)

Coverage of Women's Preventive Services Without Cost-Sharing Begins in 2013 for Non-Grandfathered Plans
"The requirement to cover the preventive services without cost-sharing does not apply to services that are performed out-of-network; if a participant receives the preventive services at an out-of-network provider, cost-sharing can be imposed. In addition, the agencies have given plans allowance to use 'reasonable medical management techniques' to determine the frequency, method, treatment, or setting for the preventive services, to the extent that those items are not covered in the preventive-services guidelines. Open questions remain regarding the coverage of women's preventive services[.]" (Faegre Baker Daniels)

Fewer Employers Offering Retiree Health Benefits
"Most of the employers that do offer retiree health benefits have already implemented or intend to implement additional cost-cutting measures. Approximately 75 % of these employers reported that they increased premiums for early-retiree coverage between 2011 and 2012, as well as for Medicare-eligible retires. Thirty-four percent responded that they increased cost-sharing for early retirees, and 31 % did so for Medicare-eligible retirees during this time." (Littler Mendelson LLC)


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Employers With Insured Health Plans Must Be Careful When Providing Healthcare Subsidies to Departing Executives
"In addition to a cash payment or salary continuation for a period of time following termination, many employment agreements and severance arrangements include some sort of post-termination subsidy of the cost of healthcare coverage. The [ACA] ... creates new issues for employers to deal with and may eventually prohibit certain long-standing practices that had been undertaken by employers that maintain insured health plans." (Littler Mendelson P.C.)

What Employers Need to Know for 2012 and 2013 Under the ACA
"The [ACA] requires employers that sponsor group health plans to take a number of legal compliance steps related to their group health plans. With the end of 2012 quickly approaching, and for 2013 planning purposes, [this article] is a high-level list of the important changes you should be aware of under the PPACA and the effective date of those required changes." (McDermott Will & Emery)

Deloitte Health Care Reform Memo, October 29, 2012
"Health costs impact corporate profits and global competitiveness for large multi-nationals -- that's well documented. But even among smaller and mid-sized companies, it's about access to a productive workforce without being hampered by health costs that defer growth and innovation." (Deloitte)

Self-Insurance Institute of America Appeals Michigan Case Allowing State Tax on Health Plan Claims Even When ERISA Applies
"The Self-Insurance Institute of America Inc. is appealing a federal court ruling that said [ERISA] did not pre-empt a 2011 Michigan law imposing a 1% tax on paid health care claims.... U.S. District Court Judge Abele Cook of the Eastern District Court of Michigan disagreed. The Michigan law 'does not mandate any particular benefit structure or bind administrators to certain benefit structures,' he wrote[.]" (Business Insurance; free registration required)

Health Law's Costs Continuing to Grow
"[I]n its brief existence, the ACA entitlement has already increased in cost by nearly 25 percent ... Given the continued rise in health care costs in the United States, the stagnation of incomes during the post-2009 recovery, and the large upside risk due to employers no longer providing insurance, there is substantial reason to suspect that the price tag could rise much further yet." (The Hill)

Consumer Advocate Cautions That State Rules Will Impact Scope of Federal Health Law
"[T]he devil is in the details when it comes to implementation of the health care overhaul. The rules that are established will determine whether it is easy or hard for consumers to meet their obligation to have insurance, for example, or take advantage of the comprehensive benefits promised under the law. From recommending standardized enrollment periods to limiting the amount of leeway insurers have in determining benefits, [a recent] report suggests ways to remove obstacles and help ensure consumers benefit from the law." (Kaiser Health News)

Health Care Cost Estimates Crucial to Retirement Income Planning
"Nearly 60% of financial advisers say their clients really want to talk about their health care costs in retirement, but more than half of the advisers surveyed admit that it is 'challenging' to 'very challenging' to discuss information about their clients' health, according to [a recent survey]. Only 30% of advisers say they are confident in their ability to estimate their clients' health care costs in retirement." (Investment News; free registration required)

Canada's Health Costs for Seniors Rising Slowly
"A [recent] study ... finds that per capita Medicare spending on the elderly has grown nearly three times faster in the United States than in Canada since 1980. (Canada's program, which covers all Canadians, not just the elderly, is also called Medicare.) Costs grew more slowly in Canada despite a 1984 law banning co-payments and deductibles.... 'Had U.S. Medicare spending per elderly enrollee increased as slowly as in Canada, the savings from 1980 through 2009 would have totaled $2.156 trillion,' said [the study's author]. 'That's equivalent to more than one-sixth of the U.S. national debt.'" (Physicians for a National Health Program)

Irresistible Forces: Cost of Healthcare Has Risen Four Times More Than Inflation Rate
"[The vice president of global benefits for Walmart once said to the author that] 'No industry can grow indefinitely at a multiple of general inflation. It will eventually become so expensive that purchasers will simply abandon it.' ... Health care is playing out this way. From 1999 to 2011, health care premium inflation grew steadily at 4 times the general inflation rate. During that same period, the percentage of non-elderly Americans with employer-sponsored health coverage fell from 69.2 to 58.6 percent, a 15.3 percent erosion rate." (Cracking Health Costs)

12 Steps Every Employer with a Health Plan Should Do Now
"While most employers and insurers of employment-based group health plans view with great concern radically expanded health plan responsibilities taking effect in 2014, many are failing to take steps critical to manage exposures and costs already arising from the Affordable Care Act (ACA) and other federal health plan regulations." (Texas CEO Magazine)

[Opinion]

Why Buying Medical Care Is Not Like Buying a Car
"If we bought cars the way we buy health care, the car salesman would tell us when we needed a car, what kind of car we need and how much it would cost. But we wouldn't care how much it costs because we aren't paying for it. The more cars the manufacturer produced and sold, the more money he would lose. And because 20 percent of the customers buy 80 percent of the cars, he would know exactly whom to not sell cars to! ... The patient/customer usually has little control when illness hits, no choice of what must be done (the doctor/hospital decides) or what the cost is, but doesn't care (insurance is paying)." (Physicians for a National Health Program)

Benefits in General; Executive Compensation

Share Pledging: An Important But Overlooked Policy Change Proposed by ISS
"One of the proposed changes that many seem to have overlooked is under the section 'Management Say-On-Pay Proposals (U.S.),' one of the 'Key Changes Under Consideration' is: '3. Add pledging of shares as a factor that may lead to negative recommendations under the existing problematic pay practices evaluation.' This addition, without qualifications and exceptions, could result in an unjustified increase in the number of adverse vote recommendations on management say-on-pay proposals. The pledging of shares is not a uniformly deleterious practice that warrants the inclusion on the list of problematic pay practices." (Winston & Strawn LLP)

Report of Ad Hoc Committee to Pawtucket, Rhode Island Mayor on Pension, Health Plan Funding Issues
This news article includes a link to the text of the report, prepared by Rhode Island's former auditor general. Excerpt: "This report presents a non-partisan, non-ideological and fact based analysis of the complex issues related to pensions and OPEB facing the citizens and policy makers. This problem is not unique to the City of Pawtucket. In this report, you will find the definition of the problem, it causes and effects, and a list of potential solutions to put the city on a pathway to success." (WPRI.com)

Press Releases

Barry Max Levy Inaugurated as 44th President of ASPPA
American Society of Pension Professionals & Actuaries (ASPPA)



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