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December 31, 2012          Get Retirement News  |  Advertise  |  Unsubscribe
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ERISA Paralegal
for Arnall Golden Gregory LLP in GA

Director, Transamerica Research Foundation - Healthcare
for Transamerica in MD

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[Guidance Overview]

IRS Issues Proposed Regs and FAQs on Employer Mandate
"There are ... few surprises in the proposed rule. The preamble to the rule shows, however, that the IRS is putting a great deal of thought into identifying and blocking stratagems that employers may use to try to evade the requirements of the mandate. The preamble also reveals that there are still complex issues that the IRS has not entirely worked through, and on which it requests comments. Comments on the proposed rule are not due until March 18, 2013, and a public hearing will be held on the proposal on April 23, 2013." (Health Affairs Blog)

Illinois Catholic Employer Wins Relief from ACA Contraceptive Mandate
"In issuing an injunction, the 7th Circuit majority said the [company's owners] had established a reasonable likelihood of success on the merits of their RFRA claim, and that the government had not yet justified the apparent 'substantial burden' on their religious exercise. The court also said the [owners] had established irreparable harm, because absent an injunction they would have to choose between maintaining insurance coverage they considered inappropriate or facing substantial financial penalties." (Chicago Tribune)

Religious Employer Wins Big -- at Least Temporarily
"In the most significant federal appeals court ruling so far on the new federal health care law's contraceptives mandate, the Seventh Circuit Court on Friday night temporarily barred the federal government from enforcing that requirement against an Illinois construction company whose Roman Catholic owners see it as a threat to their religious freedom.... In a key passage in the panel majority's ruling, it remarked that the fact that the [company's owners] 'operate their business in the corporate form is not dispositive of their claim...The contraception mandate applies to K&L Contractors as an employer of more than 50 employees, and the [owners] would have to violate their religious beliefs to operate their company in compliance with it.' ...While other courts that have refused pleas to block enforcement of the mandate have relied upon the argument that the mandate does not impose a direct obligation on employers to provide actual access to birth control and other contraceptives measures, but only to provide insurance in the event women workers chose to use it for that purpose, the Seventh Circuit majority concluded that the mandate involves 'coerced coverage of contraceptives, abortifacients, sterilization and related services' and not the later purchase or use of those services. That, it said, is the potential violation of religious freedom." (SCOTUSblog)

Healthcare Law May Mean Less Hiring in 2013
"Many businesses plan to bring on more part-time workers next year, trim the hours of full-time employees or curtail hiring because of the new health care law ... The health care law will particularly affect companies with 40 to 45 workers that plan to expand and hire. Many are holding off so they don't cross the 50-employee threshold[.]" (USA TODAY)

Pennsylvania Mennonite Firm Wins Reprieve In ACA Contraceptive Mandate Battle
"[A Federal District Court judge in Pennsylvania has] imposed a temporary restraining order sparing the Conestoga Wood Specialties Corp. from complying with the women's preventive health-care regulations of the [ACA].... [The order states] that the facts of the case were still being gathered, but that there appeared to be potential for 'imminent, irreparable' harm. 'Within a matter of days, Plaintiffs will have to decide between paying substantial fines or committing an act which they have shown to have a likelihood of violating their rights to religious freedom[.]'" (InsuranceNewsNet)

ACA Federal Funds Tracker
"This online tool tracks funds received by the states, local governments, employers, community organizations, and other entities to implement provisions in the Affordable Care Act. Click on any state for a profile of its health reform-related grant information. You can also view data on per capita funding as a supplement to the data available in the interactive tool." (Kaiser Health Reform)

New California Disability Regulations Took Effect on December 30, 2012
"The regulations offer an expansive list of accommodations that employers should be prepared to offer, such as modification of duties, work practices, schedules, and policies; allowing more frequent breaks (e.g., to use the restroom); providing furniture (e.g., stools or chairs) or modifying equipment or devices; and lactation breaks." (Morgan, Lewis & Bockius LLP)

Wellness Programs: Proposed Regs Enable Employers to Keep Up With the Times
"According to a recent survey by the U.S. Bureau of Labor Statistics, the percentage of private industry employers providing wellness programs increased from 23% to 31% between 2005 and 2010.... The new proposed regulations implement the nondiscrimination provisions of the Affordable Care Act and in large part mirror the 2006 final HIPAA regulations, though with some significant changes." (Pillsbury Winthrop Shaw Pittman LLP)

[Opinion]

Text of Comments to HHS on Proposed Regs Implementing Insurance Market Rules and Rate Review (PDF)
Consumers Union Recommendations: "Revise the regulation to cap the number of rating areas a state may propose as an alternative to (b)(3) at no more than fifteen rating areas.... Add a provision that triggers a special enrollment period 30 days in advance of a known triggering event. Extend the time frame for special enrollment to 60 days from the triggering event. When an insurer is responsible for the triggering event, require the insurer to provide 14 day advance notice to consumers before a special enrollment period commences.... [D]evelop strict standards to measure, evaluate, and penalize a health insurance issuer, employee, agent or other party acting on behalf of the issuer that is undertaking marketing practices that discourage enrollment of individuals with significant health needs in health insurance coverage." (Consumers Union)

[Opinion]

Text of Comments to CMS on Health Care Quality for Exchanges (PDF)
"[Consumers Union urges] that Exchanges provide measures that inform consumers whether issuers are operating in a manner that would facilitate enrollees in getting the care they need, responding to complaints or appeals, and running a business that truly serves its customers ... [CU recommends] that Exchanges provide measures that inform consumers whether the health care providers within the insurers' networks are providing care of high quality and safety[.]" (Consumers Union)

[Opinion]

Text of Comments to HHS on Proposed Regs for Health Insurance Market Rules and Rate Review (PDF)
"[While the Chamber appreciates] CMS's recognition of the importance of state flexibility generally, we urge CMS to provide this flexibility as it promulgates rules regarding the number of geographic rating areas and family rating.... CMS is overreaching and in scope the protecting included in the law to inappropriately advance ideological goals. While the statute does include a provision requiring the review of unreasonable premium increases prior to implementation of the increase, it does not require health insurance issuers to report all rate increases as the Proposed Rule suggests." (U.S. Chamber of Commerce)

[Opinion]

Text of Comments to HHS on Proposed Regs for Transitional Reinsurance Fee (PDF)
"HHS should defer collection of the $5 billion U.S. Treasury contribution beyond 2016.... The regulation should make clear that States may not collect additional fees from self-insured plans.... [and] should define 'major medical coverage'.... HHS should clarify that the enrollee counting methods exclude plan participants who do not have major medical coverage.... The regulation should provide a 'single life' rule for covered HRAs.... identify a group health plan by reference to the COBRA rules.... [and] permit employers to disaggregate plans that offer both self-insured and insured coverage options to different groups.... The plan aggregation rules should be permissive rather than mandatory, and should apply only to overlapping coverage.... HHS should, in the future, comply with the Administrative Procedure Act by allowing a meaningful comment period." (The ERISA Industry Committee)

[Opinion]

Text of Comments to HHS on Proposed Regs for Notice of Benefit and Payment Parameters for 2014 (PDF)
"[The Chamber remains] concerned about the Administration's apparent procedural short-cuts and worry that it will deter the public from participating in the regulatory process.... [Further, the Chamber remains] concerned that several parts of the Proposed Rule are overreaching to inappropriately advance ideological goals. The statutory language imposes significant burdens on employers, insurers and individuals. Additional burdens will only harm the affordability of coverage and undermine the goal of improving access to affordable coverage.... Finally, the Chamber has serious concerns about the economic impact analysis in the Proposed Rule [and is] gravely troubled that the lack of economic analysis conducted and provided by HHS and CMS will inhibit the public's ability to properly assess the proposal." (U.S. Chamber of Commerce)

Benefits in General; Executive Compensation

Quick Tips to Fight FMLA Abuse Around the Holidays
"[E]mployers need not settle for patterns of absences or even suspicious excuses for absences. Keep in mind a few best practices to combat FMLA abuse: Recognize whether the employee is seeking leave that might be covered by the FMLA ... Require that Employees complete a written leave request form for all absences ... Enforce usual and customary call-in procedures ... Prepare a list of probative questions you ask of all employees when they call in to report an absence ... Use medical certification and recertification to your advantage ... Conduct a comprehensive audit of your FMLA policy, procedures and use of leave[.]" (FMLA Insights)

2013 Reporting & Disclosure Calendar for Benefit Plans
"The latest version of this annual Sibson Consulting publication summarizes the 2013 reporting and disclosure requirements of [ACA, HHS, DOL, IRS and PBGC] of interest to sponsors of single-employer benefit plans. The 2013 Reporting & Disclosure Calendar for Benefit Plans lists and describes the forms, schedules and notices that must be filed with each organization for which plan types and by what deadlines. It also indicates who must file and whether copies must be provided to participants." (The Segal Company)

Same-Gender Marriage Becomes Legal in Maryland: Employee Benefit Ramifications
Same-gender marriage is legal in Maryland as of January 1, 2013. A two-part series of articles discusses how this will affect employee benefits in that state. The first part discusses employee benefits of private employers. The second part discusses employee benefits of governmental and religious organizations. (Calhoun Law Group)

Press Releases

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