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January 11, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

Managing Actuary
for Consulting Firm in NY

ERISA Paralegal - Experienced in Employee Benefits
for Blitman & King LLP in NY

Defined Contribution Consultant
for The Benefit Practice in CT

Vice President, Sales
for Prudential in CA

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Webcasts and Conferences

Voluntary Fiduciary Correction Program Webinar
Nationwide on January 30, 2013 presented by U.S. Department of Labor, Employee Benefits Security Administration (EBSA)

Wellness Programs: Overcoming Compliance Hurdles and Looking Toward 2014
Nationwide on January 10, 2013 presented by Thomson Reuters / EBIA

Avoid Penalties with New Health Care Reform Tools
Nationwide on January 16, 2013 presented by Davidson Marketing Group -- FutureOffice Network

Health Care Reform and State Exchange Panel Event Decisions & Actions for Employers Before 1/1/2014 State Exchange
in California on January 24, 2013 presented by No. Calif. Chapter of Certified Employee Benefits Specialists (ISCEBS)

View All Webcasts and Conferences


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[Guidance Overview]

Self-Insured Health Plan Sponsors, Health Insurers Brace for New ACA-Imposed PCORI Fees
"[H]ealth insurers and plan sponsors must file a Form 720, Quarterly Federal Excise Tax Return along with the required payment once a year on or before July 31 of the calendar year following the last day of the policy year or plan year for which the fee is required to report and pay the fee.... The Preamble to the Regulations states that a self-insured plan sponsor must pay the fee with respect to arrangements where the plan design layers a self-insured portion of the plan with an insured portion, even though the insurer also must pay the fee with respect to the insured portion." (Solutions Law Press)


[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, BAE Systems, FirstEnergy, JetBlue, Mayo Clinic, many more. Low cost, high quality! HBCE.com Ph: 941-484-1430 info@HBCE.com


[Guidance Overview]

Proposed IRS Regs Address Employer 'Shared Responsibility'
"One assessable payment applies if an employer sponsoring a group health plan fails to offer its full-time employees and their dependents 'minimum essential coverage' and the employer has received a certification from [HHS] that one or more of the employer's full-time employees has received subsidized health insurance coverage through a 'premium tax credit' or a 'cost-sharing reduction' in connection with the purchase of insurance on an exchange. The other assessable payment applies even though an employer offers its full-time employees and their dependents minimum essential coverage under its group health plan if the coverage is 'unaffordable' or does not provide 'minimum value.'" (Sidley Austin LLP)

[Guidance Overview]

ACA Regs Include Industry-Specific Definitions for 'Full-Time Employee'
"Federal agencies will accept alternate definitions of full-time employee for purposes of health reform's play-or-pay mandate, to allow for industry-specific labor norms and seasonal workers. Some business owners and workers requested special methods of calculating hours for employees: (1) whose compensation is not based on hours, such as salespeople on commission; and (2) whose work hours are subject to safety-related limits, such as airline pilots." (Thompson SmartHR Manager)

[Guidance Overview]

HHS Guidance Addresses Essential Health Benefits and Actuarial Value (PDF)
"This guidance does not address the application of the EHB requirements to self-insured or large group health plans. While self-insured and large group health plans are not required to offer EHB, the prohibition of annual and lifetime dollar limits on EHB does apply to those plans. In a bulletin released earlier in 2012, HHS stated that these plans will be using a permissible definition of EHB 'if the definition is one that is authorized by the Secretary of HHS. Furthermore, the Departments intend to use their enforcement discretion and work with those plans that make a good faith effort to apply an authorized definition of EHB to ensure there are no annual or lifetime dollar limits on EHB.'" (Buck Consultants)

CMS Proposes Surveys to Aid in Understanding Awareness and Service Needs for Users of Federal Insurance Exchange, Requests Comments
"Because the Marketplace will provide coverage to the almost 50 million uninsured in the United States through individual and small employer programs, [CMS has] developed one survey to be administered to individual consumers most likely to use the Marketplace and another to be administered to small employers most likely to use the Small Business Health Options portion of the Marketplace. These brief surveys, designed to be conducted quarterly, will give CMS the ability to obtain a rough indication of the types of outreach and marketing that will be needed to enhance awareness of and knowledge about the Marketplace for individual and business customers.... The surveys will provide information on media use, concept awareness, and conceptual or content areas where education for customer service delivery can be improved. Awareness and knowledge gaps are likely to change over time based not only on effectiveness of CMS' marketing efforts, but also of those of state, local, private sector, and nongovernmental organizations." (Centers for Medicare & Medicaid Services (CMS))

California Insurance Commissioner Wants Power To Reject Health Insurance Rate Increases
"[California] State Insurance Commissioner Dave Jones says ... some parts of the [ACA] may prove ineffective unless his office is given the power to reject unreasonable health insurance rate increases.... [W]ithout the power to review rate increases, Jones said, health insurers and health maintenance organizations would be free to hand large premium hikes to consumers required to buy coverage -- or pay a penalty if they don't. Jones is backing a November 2014 ballot measure that would grant the insurance commissioner the power to approve health insurance rate changes. It is a power that 37 states already have, he said." (InsuranceNewsNet.com)

Electronic Records Systems Have Not Reduced Health Costs, Report Says
"Optimistic predictions by RAND in 2005 helped drive explosive growth in the electronic records industry and encouraged the federal government to give billions of dollars in financial incentives to hospitals and doctors that put the systems in place.... But evidence of significant savings is scant, and there is increasing concern that electronic records have actually added to costs by making it easier to bill more for some services." (The New York Times; free registration required)

U.S. Healthcare Spending Could Drop by $2 Trillion If Feds Would Use Clout
"The United States could save $2 trillion in healthcare spending over the next decade, if the U.S. government used its influence in the public and private sectors to nudge soaring costs into line with economic growth ... [T]he study recommends holding the $2.8 trillion U.S. healthcare system to an annual spending target by having Medicare, Medicaid, other government programs and private insurers encourage providers to accelerate adoption of more cost-effective care." (Reuters)

Massachusetts to Revamp Retiree Health Care
"Gov. Deval Patrick plans to propose legislation calling for sweeping changes in future retiree health care benefits for state and municipal employees that officials estimate will save up to $20 billion over the next 30 years. The changes would include raising the number of years an employee needs to be vested in the retiree health care system, cut the state's contribution to health care premiums for many workers, and raise the eligibility age for health benefits from 55 to 60 for most employees" (Boston.com)

Hobby Lobby Says It Can Delay ACA Contraceptive Mandate by Shifting Plan Year
"An attorney for Oklahoma City-based Hobby Lobby says ... the company will shift the plan year for employee health insurance that will delay by several months the Jan. 1 effective date of the requirement." (The New York Times; free registration required)

Health Insurance Exchanges: A Guide for Consumers and Small Employers
"It seems like a simple idea: create new marketplaces, called 'exchanges,' where consumers can comparison shop for health insurance, sort of like shopping online for a hotel room or airline ticket..... If done well, proponents say, exchanges could make it easier to buy health insurance and possibly lead to lower prices because of increased competition. But, if designed poorly, experts warn, healthy people could avoid the exchanges, leaving them to sicker people with rising premiums." (Kaiser Health News)

IRS to Employers: Pay Obamacare 'Shared Responsibility' or Else
"[E]mployers with 50 or more employees must provide health coverage to their employees. If they don't they will have to pay an 'assessable payment' of up to $2,000 per employee. At least that's what the law is supposed to require. Who knows if that's what the proposed regulations say. The problem is that not all employer-worker relationships are that simple." (Forbes)

Franchises Squeezed Tightly by ACA Employer Mandate
"[M]ulti-unit franchisees are withholding expansion in the face of the Affordable Care Act's employer mandate.... [The general manager of Visiting Angels Living Assistance Services] said single owner deals continue to come in ... But for many of those nearing the 50-employee level, where the employer mandate kicks in and health-care is a requirement or a $2,000 annual penalty per employee is due, they're staying put. 'Everyone is in a holding pattern,' he said. 'In the last year, we have between 30 and 40 [multi-franchise] deals that have been held off, because it's not a perfectly clear picture.'" (Fox Business)

Massachusetts Bill Proposes Repeal of State Law Mandate of Employer Health Plan Sponsorship
"This new legislation, if enacted, will repeal the [requirement] ... that employers doing business in Massachusetts either provide health coverage to full time employees that satisfies certain rules, or pay a contribution to the Commonwealth equaling $295 per employee per year.... These changes are proposed in recognition of the Federal Affordable Care Act's employer mandate ... The bill also proposes the creation of an Employer Responsibility Trust Fund, intended to fund the provision of subsidized health care for low-income Massachusetts residents." (Mintz Levin)

Health Insurance Exchanges: If You Build It, Will They Come?
"Billions of dollars are being spent to build insurance exchanges, and millions more will be spent to promote them to the consumers who are expected to begin enrolling just 10 months from now. But what if enrollment fails to reach the numbers that exchanges need to become self-sustaining in 2015, as required by the Affordable Care Act? The cost of running a state insurance exchange could range from $20 million a year to more than $60 million. And those costs likely will be passed on to consumers in the form of higher premiums or fees." (AISHealth.com; free registration required)

Growth In Medicare Spending Per Beneficiary Continues To Hit Historic Lows
"Medicare spending per beneficiary grew just 0.4% per capita in fiscal year 2012, continuing a pattern of very low growth in 2010 and 2011.... The success in reducing the rate of spending growth has been achieved without any reduction in benefits for beneficiaries. To the contrary, Medicare beneficiaries have gained access to additional benefits, such as increased coverage of preventive services and lower cost-sharing for prescription drugs." (Assistant Secretary for Planning and Evaluation, Department of Health and Human Services)

[Opinion]

ACA Savings for Prescriptions Are Illusory
"Pharma executives have argued that they need high profit margins to invent life-saving medications. I get that argument and I support a free market system.... However, many top manufacturers currently spend twice as much on marketing and sales as they do on research and development. The glut of direct-to-consumer advertising for the latest brand drugs not only increases spending, it also encourages higher, and sometimes unnecessary, utilization of office visits, diagnostic testing, and other health services.... We should continue to promote the use of lower cost generics but what else should we do to bring down prescription drug costs?" (The Segal Company)

Benefits in General; Executive Compensation

[Guidance Overview]

January 31 Deadline Looms for Information Statements and Returns for Incentive Stock Option and Employee Stock Purchase Plans
"Effective for ISO exercises and initial transfers of legal title to shares acquired under an ESPP occurring in 2010 and later years, the final regulations under Section 6039 require the transferring corporation to file information returns with the IRS, as well as provide information statements to the affected employees and former employees. The information returns, Form 3921 for ISO exercises and Form 3922 for initial ESPP share transfers, must be filed electronically by any corporation required to file 250 or more of a particular return and may otherwise be filed either electronically or in paper form." (DLA Piper)

At Top of the List of Executive Compensation Issues for 2013: Strike Suits
"The strike suit lawyers have been sending demand letters to many public companies shortly after they file their annual proxy statement ... The letters are often followed by a lawsuit seeking a preliminary injunction of the shareholder vote to be held at the Company's annual meeting (which is the equivalent of Armageddon to most public companies) ... [alleging] that the companies' disclosure of executive compensation information in the proxy was insufficient to allow an informed shareholder vote.... [T]he consequences of postponing the annual shareholders meeting are so high and the period between the lawsuit and the meeting is so short, that many companies have paid settlements of between $250,000-$650,000 and made an amended SEC filing just to make the lawsuit go away." (Winston & Strawn LLP)

Director Compensation: A Survey of Certain Practices at Emerging Growth Companies
"The role and responsibilities of a director of a public company have greatly increased over the past ten years. After financial and corporate governance failures, new regulations have been implemented that impose additional requirements on directors.... To determine what impact this has had on companies that have only recently become subject to extra scrutiny by going public, this Article examines non-employee director compensation policies of certain companies that conducted initial public offerings (IPOs) in 2012. In particular, this Article focuses on US emerging growth companies (EGCs), which benefit from reduced regulatory requirements under the Jumpstart Our Business Startups Act of 2012 (JOBS Act)." (Practical Law Company)

Amara v. Cigna Corp. -- The Beat Goes On
"On December 20, 2012, Judge Janet Bond Arterton of the United States District Court for the District of Connecticut held that a class of 25,000 plaintiffs are entitled to benefits in addition to those provided by the terms of their cash balance benefit plan based on her reformation (rewriting) of the plan terms.... [T]he district court considered whether reformation and surcharge were appropriate equitable remedies under ERISA Section 502(a)(3), following the Supreme Court's 2011 remand ... [which] held that reformation and surcharge were not available remedies under ERISA Section 502(a)(1)(B), but suggested that ... the district court might award such relief under Section 502(a)(3) as 'appropriate equitable relief'.... The Amara saga marches on now to the Court of Appeals for the Second Circuit." [Amara v. CIGNA Corp., No 3:01-cv-2361, 2012 U.S. Dist. LEXIS 180355 (D. Conn. Dec. 20, 2012)] (Seyfarth Shaw LLP)

Transparency and Total Compensation: Should Employers Be Doing More?
"With the W-2 reporting requirement to disclose the amount both employee and employer spend on healthcare costs beginning in January 2013, as well as recent fee disclosure requirements for defined contribution plans, benefit cost information for employees is becoming more and more accessible and transparent. Yet, in a time when 40% of employees don't know the cost of their health insurance (LIMRA, 2011) it begs the question, are companies doing enough to take advantage of a consistent and deliberate communications strategy?" (Retirement Town Hall)

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