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November 21, 2012          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

Trust Accountant for 401(k)/Defined Contribution Plans
for R.J.L. Pension Services, Inc. in FL

Manager System & Data National Penn Capital Advisors
for National Penn in PA

Employee Benefits Plan Administrator
for MERIT BENEFITS GROUP, Inc. in IL

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Webcasts and Conferences

Preparing for a Pension Risk Transfer - Webcast
Nationwide on December 12, 2012 presented by Mercer


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[Official Guidance]

Text of IRS Notice 2012-72: Standard Mileage Rates for 2013 (PDF)
"The standard mileage rate for transportation or travel expenses is 56.5 cents per mile for all miles of business use (business standard mileage rate).... The standard mileage rate is 14 cents per mile for use of an automobile in rendering gratuitous services to a charitable organization under Section 170.... For automobiles a taxpayer uses for business purposes, the portion of the business standard mileage rate treated as depreciation is 21 cents per mile for 2009, 23 cents per mile for 2010, 22 cents per mile for 2011, 23 cents per mile for 2012, and 23 cents per mile for 2013." (Internal Revenue Service)


[Advert.]

Nat'l Health Benefits Conf & Expo (HBCE) Jan.29-30, 2013 -- Clearwater Beach, FL

Sponsored by Health Benefits Conference & Expo (HBCE)

Speakers wrote the books on wellness, onsite clinics, disease management, obesity and health reform. Hear from public employers, universities, Boeing, FirstEnergy, JetBlue, Mayo Clinic, many more. Low cost, high quality! www.HBCE.com Ph: 941-484-1430 info@HBCE.com


Implementing Health Reform: The Dam Bursts
"Proposed rules were published addressing the ACA insurance market reforms and rate review; essential health benefits, actuarial value, and accreditation standards; and wellness programs. An appendix to the essential health benefits rule was also published describing the essential health benefit benchmark plan for each of the fifty states, listing state benefit mandates ... and providing a guide to understanding the proposed state benchmark plans. The proposed wellness program rule was supplemented by a fact sheet and a study on current wellness programs. HHS issued a letter to state Medicaid directors addressing the Medicaid essential health benefits, as well as a series of frequently asked questions addressing Medicaid issues presented by ACA implementation. HHS also published a notice recognizing the NCQA and URAC for accreditation of qualified health plans. HHS issued its actuarial value calculator and continuance tables and a description of its actuarial value calculator methodology. Finally, HHS published for comment a series of Paperwork Reduction Act listings addressing data collection for rate review, certification of qualified health plans, assessing market reform compliance, and recognizing accrediting entities." [The linked article includes hypertext links to the various documents.] (HealthAffairs Blog)

CCIIO Overview of Proposed Rule for Health Insurance Market Reforms
"The Centers for Medicare & Medicaid Services (CMS) is publishing a proposed rule to implement several key provisions of the Affordable Care Act to prevent insurance companies from discriminating against people with pre-existing conditions and protect consumers from the worst insurance company abuses. Today, as many as 129 million -- or 1 in 2 -- non-elderly Americans have some type of pre-existing health condition, ranging from life-threatening illnesses like cancer to chronic conditions like diabetes, asthma, or heart disease." (Healthcare.gov)

Administration Releases New Health Care Reform Regs for Insurers, Employers
"While insurers and consumer groups were cautious about issuing an immediate assessment of the proposals, a quick review showed that no one group won everything it wanted. For example, insurers did not succeed in getting the government to phase-in a requirement that limits their ability to charge older applicants more than younger ones. And consumer groups, which wanted specific details on the benefits required in 10 broad categories, instead saw continued discretion given to state regulators to pick 'benchmark' plans and benefits." (Kaiser Health News)

Obama Administration Pushes Health Care Reform Forward With Rules for Insurers
"[H]ealth insurers would be able to vary their premiums based only on age, tobacco use, family size or geography under proposed U.S. rules meant to protect people with pre-existing illnesses. In addition, [HHS] outlined conditions and services insurers must cover, and laid out rules to let companies expand employee wellness programs ... The rules also include a concession to pharmaceutical companies that may force health plans to offer a wider variety of branded drugs." (Bloomberg)

Healthcare Reform Rules Give Patients a New Bill of Rights
"Health insurance companies, state regulators and consumer advocates have eagerly awaited these rules since Obama enacted the health care overhaul in March 2010. The details contained within the 331 pages of regulations are crucial for health insurance companies and states preparing for the new options that will be available to uninsured people and small businesses starting in 2014." (The Huffington Post)

Administration Defines Benefits Under Health Care Reform
"The rules also give employers new freedom to reward employees who participate in workplace wellness programs intended to help them lower blood pressure, lose weight or reduce cholesterol levels. The maximum permissible reward would be increased to 30 percent of the cost of coverage, from the current 20 percent. The rules would further increase the maximum reward to 50 percent for wellness programs intended to prevent or reduce tobacco use." (The New York Times; free registration required)

U.S. Releases New Health Care Reform Rules
"The only major benefits change from last December, according to officials, is a richer prescription drug benefit. Instead of requiring insurers to offer one drug per class, the rule calls for either one drug or the same number as the benchmark plan, whichever is greater. However, critics said the new rules lack important details and definitions about relatively new coverage for the disabled, the mentally ill and substance dependent, which are subject to a mandate that eliminates lifetime spending limits in health insurance plans." (The New York Times; free registration required)

Obama Administration Gives Smokers a Way Out of Higher Insurance Premiums
"Under the proposed regulation, employees who use tobacco can avoid paying those higher premiums if they participate in a program to quit. The regulation also allows states to eliminate higher rates for smokers altogether.... Lewis Maltby, president of the National Workrights Institute, a research and advocacy organization on employment issues, criticized the rule as 'a dumb idea' that was likely to rankle employers and insurers. 'The penalty is kind of a joke if all you do is have to take a course and then can go back to smoking,' he said." (Kaiser Health News)

With More Americans Opting to Pay Penalty Rather Than Buy Health Insurance, Adverse Selection Is Issue
"With the Congressional Budget Office (CBO) projecting last month that 6 million Americans will pay a penalty rather than purchase insurance coverage as part of the health reform law, there is growing concern [that] ... Such a large number of individuals out of the insurance market -- most of them likely young and healthy -- could lead to adverse selection in the market. Although industry experts ... agree that the penalty likely was set too low in the first few years to persuade some individuals to purchase coverage, they disagree on whether a large number of people out of the insurance market will have a profound effect." (AISHealth.com; free registration required)

Could Healthcare Law Cure Job Lock and Loosen Up the Labor Market?
"Plenty of workers claim they're only hanging on to their jobs for the health insurance ... Some of those cubicle-bound soldiers might just be waiting until 2014, when the health insurance coverage mandated by the [ACA] goes into effect. The ACA, which requires states to offer fairly-priced insurance on public exchanges, [is] expected to make coverage cheaper and easier for individuals and small businesses. This development could also boost the job market, helping solve a problem that economists and benefits experts call 'job lock': the reluctance of workers to leave their jobs because doing so would mean losing health insurance." (The Wall Street Journal)

Don't Write Off Employer-Sponsored Health Care Yet
"[Robert Galvin, an M.D. and CEO of Equity Healthcare, said] 'the government doesn't want employer-sponsored insurance to go away ... Someone's got to pay for this.' He added that even for employers who are tempted to pay per-employee penalties rather than provide health insurance, 'the math really doesn't work out. They [employers] found out that you can't split the workforce. That's a discrimination issue.'" (Employee Benefit News)

Everything You Need to Know About Obamacare's Regulations
"What's that? You were looking for 112 pages of actuarial value in health exchanges regulations? You, sir, are in luck!" (The Washington Post; free registration required)

Can a Non-Compete Provision be Added to a Severance Agreement?
"Even though the employer had some discretion with respect to the form of separation agreement, [a federal district court in Illinois] would not permit the employer to condition the severance payment on compliance with a no compete. To add such a requirement, the employer should have amended the severance plan; the proposed separation agreement was not itself such an amendment." [Pactiv Corp. v. Rupert, No. 11C7247 (N.D. Ill., Nov. 1, 2012)] (BenefitsNotes, a blog by Leonard, Street and Deinard)

Many Americans Unaware of Changes Under Health Care Reform
"[A] growing body of research suggests that most low-income Americans who will become eligible for subsidized insurance have no idea what is coming. Part of the problem, experts say, is that people who will be affected do not realize the urgency, because the subsidies will not begin for another year. But policy decisions are being made now that will affect tens of millions of Americans, and the lack of public awareness could jeopardize a system that depends on having many people involved." (The Washington Post; free registration required)

Private Health Care Exchanges May Be a Model for the Future
"If competition is allowed to flourish in the private market, it is possible that a situation may arise in which more small businesses opt for public state-based exchanges while larger employers join private exchanges[.]" (Bloomberg BNA)

Uninsured Have Higher Mortality After Surgery for Brain Tumors
"Among patients with brain tumors with no other major medical condition, uninsured patients (but not necessarily Medicaid recipients) have higher in-hospital mortality than privately insured patients, a disparity that was pronounced in teaching hospitals. These findings further reinforce prior data indicating insurance-related disparities in medical and surgical settings." (Physicians for a National Health Program)

Official Report: A Review of the U.S. Workplace Wellness Market (PDF)
"[T]he purpose of this report is to describe the current state of workplace wellness programs in the United States, including a description of typical program components; assess current uptake among U.S. employers; review the evidence for program impact; and evaluate the current use and the impact of incentives to promote employee engagement." (Office of Policy and Research, Employee Benefits Security Administration and Office of Health Policy, Assistant Secretary for Planning and Evaluation of Department of Health and Human Services)

[Opinion]

No One Seems Ready for Obamacare
"For industry outsiders, you need to know that a typical insurance company needs at least a year to plan and implement a new health insurance product. Guess what? They're not going to get it. With the national health law's political future now entrenched, a deluge of new rules is expected in the coming days and weeks as the Obama administration fleshes out the law's complex components[.]" (John Goodman's Health Policy Blog)

[Opinion]

AHIP Statement on Proposed HHS Regs Defining Essential Health Benefits
"While additional flexibility on essential health benefits (EHB) is a positive step, [AHIP remains] concerned that many families and small businesses will be required to purchase coverage that is more costly than they have today. It also is important to recognize that the new EHB requirements will coincide with the new restrictions in age rating rules that also go into effect on January 1, 2014. Both of these provisions may incentivize young, healthy people to wait to purchase insurance until they are sick or injured, driving up costs for everyone with insurance." (America's Health Insurance Plans)

Benefits in General; Executive Compensation

[Official Guidance]

U.S. Department of Labor Issues Compliance Guidance for Employee Benefit Plans in Wake of Hurricane Sandy
"The guidance provided in this statement applies to employee benefit plans, plan sponsors, as well as service providers to such employers, located on October 26, 2012 in one of the counties or Tribal Nations that have been identified as covered disaster areas because of the devastation caused by Hurricane Sandy.... The Department recognizes that some employers and service providers acting on employers' behalf, such as payroll processing services, located in designated affected areas will not be able to forward participant payments and withholdings to employee pension benefit plans within the prescribed timeframe. In such instances, the Department will not, solely on the basis of a failure attributable to Hurricane Sandy, seek to enforce the provisions of title I with respect to a temporary delay in the forwarding of such payments or contributions to an employee pension benefit plan to the extent that affected employers, and service providers, act reasonably, prudently and in the interest of employees to comply as soon as practicable under the circumstances." (Employee Benefits Security Administration)

Do I Have a Top Hat Plan?
"A recent decision from the federal district court for the Eastern District of Kentucky considered the percentage of the total workforce invited to join the plan (less than 1%) and the nature of the plan members' employment duties (generally high ranking management personnel) to determine that the plan constituted a top hat plan.... [The court rejected] an argument that the plan did not qualify as a top hat plan because a few plan participants were not 'high ranking management personnel' ... holding that so long as the plan was maintained 'primarily' for the purpose of providing the deferred compensation for the top hat group, the plan met the 'top hat' group requirement." [Cramer v. Appalachian Regional Healthcare, Inc., No. 5:11-49-KKC (E.D. Ky, Oct. 29, 2012)] (BenefitsNotes, a blog by Leonard, Street and Deinard)

Miller Chevalier Focus on Employee Benefits, November 20, 2012
This issue includes: SIIA Appeals Decision Upholding Michigan Tax on Claims Paid under Employer-Sponsored Plans; IRS Announces Qualified Plan Relief for Hurricane Sandy Victims; IRS Invites Public Comments on Furnishing Form 1099-C upon Expiration of Non-Payment Testing Period; Agencies Issue Additional Guidance on PPACA's Pay-or-Play and Waiting Period Provision. (Miller & Chevalier Chartered)

2012 Year-End Benefit Plan Compliance Checklist and Reminders for Employers
"[The authors] offer the following summary of some of the more significant requirements employers should keep in mind ... Final Pension Protection Act amendment to reflect Code Section 436 funding-based benefit restrictions ... Cycle B determination letter applications due January 31, 2013 ... Self-correction of significant errors ... QDIA Notice ... 401(k) Automatic Enrollment Notice ... 401(k) Safe Harbor Notice ... $2,500 limit on employee contributions to health FSAs ... Notice regarding state health insurance exchange ... Increased Medicare tax on high-income filers ... Section 409A Correction Deadline for Deferred Compensation Plans." [Editor's note: this excerpt omits several others.] (Verrill Dana LLP)

Plan Administrator's 'Consultation' with Self-Funded Disability Plan's Sponsor Did Not Create Structural Conflict of Interest
"We know that an ERISA plan administrator both administering and funding the plan is operating under a 'structural conflict of interest.' This 'structural conflict of interest' may lower the deference a trial court will give to the plan administrator's benefits decision. So, ERISA plans frequently delegate a plan administrator different from the funding source of the plan to eliminate this structural conflict of interest. But what happens if the plan administrator 'consults with' the plan (with a separate funding source) in making benefit decisions? Is that enough to create a structural conflict of interest anyway?" [Day v. AT&T Disability Income Plan, 2012 WL 5359628 (9th Cir., Nov. 1, 2012)] (Lane Powell PC)

Changing Sources of Income Among the Aged Population
"[T]he large shift over the past two decades in the composition of the income of the aged (65+), increasing the role of earned income and reducing the importance of income from their own assets ... can be attributed to delayed exit from the labor force by workers at older ages. [The authors] attribute the increase in work time to a rise in the proportion of more educated workers who choose to continue working, changes within the pension system that previously encouraged early retirement, and a decline in the availability of retiree health insurance. The increase in work time is concentrated among the highest income groups and those with the most education, suggesting that it is largely voluntary." (Center for Retirement Research at Boston College)

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