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January 17, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

Document Specialist
for The Newport Group in FL, NC

Reviewing Actuary
for Kravitz, Inc. in ANY STATE, CA

Sr. Manager, Retirement Plans
for AutoNation, Inc. in FL

401k Administrator
for Third Party Administrator in East Tennessee in TN

Retirement Plan Processor
for Katz, Sapper & Miller in IN

Retirement Specialist
for Ascension Health in MO

Part-time Retirement Planning Consultant
for Diversified in IL

Defined Contribution Pension Analyst
for United Retirement Plan Consultants in TX

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Webcasts and Conferences

"To Roth or Not to Roth" Web Seminar
Nationwide on February 15, 2013 presented by SunGard Relius

"In-Plan Roth Transfers: The New Wrinkle" Web Seminar
Nationwide on February 14, 2013 presented by SunGard Relius

Practical Advice on the Affordable Care Act: What You Must Do NOW and How To Prepare For 2014 - 2018
in New York on February 7, 2013 presented by Bressler, Amery & Ross, P.C.

Healthcare Reform - The Employer Pay or Play Rules! Webcast
Nationwide on January 30, 2013 presented by Trucker Huss

DOL Audits of Health and Welfare Plans: Be Prepared to Show Compliance With Health Care Reform and Other Laws
Nationwide on February 14, 2013 presented by Thomson Reuters / EBIA

View All Webcasts and Conferences


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[Guidance Overview]

Proposed HHS Regs Address Verification of Employer-Sponsored Coverage and Appeals Procedures under Exchanges
"Although largely focused on Medicaid and Children's Health Insurance Program (CHIP) issues, the proposed regulations also include rules addressing: [1] Employer verification of an individual's eligibility for employer-sponsored health plan coverage. [2] The procedures for an employer to dispute whether an individual is eligible for coverage under the health insurance exchanges." (Practical Law Company)


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[Guidance Overview]

IRS Regs Address Employer Shared Responsibility Under ACA
"The proposed regulations include a series of clarifications and new rules that are generally employer-friendly. This is not to say that compliance will be a simple matter; it will not. The statutory scheme is too complex for that. Nevertheless, in a handful of instances, the proposed regulations adopted common sense rules that smooth over some of the Act's rougher edges." (Mintz Levin)

[Guidance Overview]

Prompt Action Required by Employers on Health Care Reform As IRS Issues 'Play or Pay' Regs
"The proposed regulations ... provide a transitional rule for multiemployer plans, but otherwise request guidance on multiemployer plan rules and treatment.... Until safe harbors or presumptions are provided to assist new employers, a new employer will be a Large Employer if it is 'reasonably expected' to employ at least 50 Full-Time Employees during the current calendar year. Comments are also invited with respect to application of the rules to staffing agencies, and the preambles indicate that the regulators are planning to address potential employer abuse in utilizing staffing agencies in the final regulations." (Nixon Peabody LLP)

Ahead of Healthcare Law, Small Employers Worry About Crossing the Crucial 50-Person Threshold
"Many small-business owners haven't yet realized that the way they structure their firm in 2013 could determine their status under the law in a year's time. The government issued the little-noticed regulatory guidance on Dec. 28.... To avoid the health-care law's penalties, many employers are considering hiring only part-time employees or deliberately curbing growth so that they have no need to hire." (The Wall Street Journal, via House Ways and Means Committee)

Five Actions for Employers to Take During 2013 in Preparation for ACA Enforcement
"While affected employers can avoid facing penalties until 2014 for not making health care coverage available to their workforce, the [DOL] has begun auditing employers' group health plans for compliance with other requirements of the law that are already in effect. As the DOL steps up its audit efforts ... [here] are five actions that employers should consider taking in 2013. [1] Assess the Workforce ... [2] Choose Whether to 'Pay' or to 'Play' ... [3] Evaluate Existing Wellness Programs and/or Implement New Wellness Programs to Enhance Employees' Health Profiles and to Avoid or Minimize the 'Cadillac Tax' ... [4] Understand and Be Ready to Comply with New Tax-Related Changes and Requirements [and] ... [5] Conduct Self-Audits to Ensure Compliance." (Epstein Becker & Green, P.C. via Bloomberg BNA)


[Advert.]

Attorney-Reviewed 2013 Health Care Reform Checklist

HR360's checklist includes: $2,500 Annual Limit on FSA Contributions, Employer Notice Regarding Health Insurance Exchanges, Reporting Employer-Sponsored Health Coverage on Forms W-2 and much more. Download today!


[Guidance Overview]

Many Self-Insured Health Plans Subject to New Annual Fees This Year (PDF)
"In preparation for compliance with the PCORI fee and TRP contribution requirements, plan sponsors are encouraged to take the following actions: [1] Review the options available for determining the PCORI fee and TRP contribution amounts, and elect a counting method to be used, beginning with the data for the 2012 plan year; [2] If more than one employer participates in the health insurance plan, amend the plan before July 31, 2013 (for calendar-year plans) to specify the plan sponsor for PCORI and TRP purposes; [and 3] Calculate expected costs, in coordination with insurers and third-party administrators, and take such costs into account in setting participant premiums[.]" (Pillsbury Winthrop Shaw Pittman LLP)

UnitedHealth's Fourth Quarter Revenue Rises As Costs Kept in Check; MLR at 80.5%
"UnitedHealth Group Inc, the largest U.S. health insurer, said ... it kept fourth-quarter costs under control and increased revenue by more than 11 percent ... The company, which provides health care benefits through both employer and government-paid insurance plans and serves individuals and military members, also backed its forecast for 2013 revenue growth of at least 11 percent and said earnings would be in a range of slightly down to up 4 percent.... UnitedHealth said that while fourth-quarter commercial medical costs rose, they were a bit lower than it expected. Its medical loss ratio, or the percentage of premiums paid for medical expenses, was 80.5 percent." (Reuters)

The High Cost of Raising the Medicare Age
"If seniors were not allowed to enroll in Medicare until 67 starting next year, federal spending would drop by $5.7 billion in 2014, according to the Kaiser Family Foundation. But Americans enrolled both in private health insurance plans and Medicare, as well as employers and states, would see expenses jump by $11.4 billion." (CNNMoney.com)

How Is a Health Insurance Premium Determined? Here's a More Complete Picture
"[C]ore health care trend provides the foundation for any premium increase, but the actual increase in claims experienced by a health insurance policy is subject to many additional factors beyond the core health care trend. [These include:] Changes in the covered population.... Fixed cost-sharing effects (e.g., deductible leveraging).... Legislative and regulatory impacts.... Discretionary design changes/'benefit buy-down.' [and] ... Additional plan-specific factors impacting premium increases." (America's Health Insurance Plans (AHIP))

Iowa OKs 12-13% Increase in Health Premiums by Wellmark Blue Cross and Blue Shield
"Iowa's insurance commissioner on Wednesday approved a contentious premium increase requested by Wellmark Blue Cross and Blue Shield, saying it was justified because of higher spending on health care services.... The increase will affect 150,000 individual policyholders who buy insurance on their own instead of through an employer." (San Francisco Chronicle)

Countdown to Health Care Reform: DC Plan Designs on Horizon
"If you like your 401(k) retirement savings account, you're going to love what healthcare reform does to your employer-provided health care plan. In a post-Obamacare future, expect more employers to adopt defined contribution healthcare plans. Instead of providing coverage, they will throw a set amount of cash at workers and have them buy their own coverage on private employer-sponsored exchanges." (Reuters)

[Opinion]

IRS Warns Employers Not to 'Abuse' Rules for Mandatory Health Coverage
"We're 11 months from full implementation and the real-world impact of Obamacare is hitting the newswires. Taco Bell and Wendy's just cut the hours of hundreds of employees to avoid the Obamacare employer health insurance mandate.... Now, the [IRS] is warning employers not to avoid the employer mandate. The IRS issued a 144-page notice which says they will soon issue proposed regulations with 'anti-abuse rules'.... The IRS intends to penalize any employer who dares to follow the law by finding the Obamacare's legal loopholes and employing perfectly legal tactics to avoid its penalties." (Citizens' Council for Health Freedom)

[Opinion]

Navigating the Obamacare Rules
"[I]t seems the new rules effectively do away with association plans. Employers in such associations will now be subject to all the same regulations and choices as other independent employers. This is puzzling because I thought small business associations had worked to get a so-called 'SHOP' provision in the law to encourage the efficiency such associations provide.... Carriers will have to have a single risk pool for all its individual market plans for rating purposes. So, if an insurer offers a plan that is highly efficient (say an HSA program or an HMO), the enrollees of that plan will not be allowed to benefit from their economizing behavior. This is puzzling because I thought one of the purposes of this law was to encourage cost containment. This does precisely the opposite." (John Goodman's Health Policy Blog)

[Opinion]

Is It Time To Re-Examine Workplace Wellness 'Get Well Quick' Schemes?
"Virtually unheard of thirty years ago, workplace wellness is now embedded in large self-insured companies. These firms pay their workers an average of $460/year to participate in worksite wellness programs.... Yet the implausible, disproven, and often mathematically impossible claims of success underlying the 'get well quick' programs promoted by the wellness industry raise many questions about the wisdom of these decisions and policies." (Health Affairs Blog)

[Opinion]

Can We Control Costs Through Checkups and Wellness Programs for the Healthy?
"General health checks are one of the most common reasons adults seek medical care, with an estimated 44 million seeing a physician for this reason each year from 2002 through 2004. During these health checks, an estimated $322 million is spent annually on laboratory tests that no guideline groups recommend. The costs of downstream testing and overtreatment are likely to be much larger.... It is likely that follow-up testing from general health checks substantially contributes to the estimated $210 billion in annual spending on unnecessary medical services." (Physicians for a National Health Program)

Benefits in General; Executive Compensation

[Guidance Overview]

A Checklist for the New NASDAQ Compensation Committee Rules
The linked article is a detailed list of the requirements for establishing a compensation committee and for the independence of its members, as required by NASDAQ rules. (Dodd-Frank.com, a blog by Leonard, Street and Deinard)

Business Groups Propose Raising Minimum Age for Social Security and Medicare Benefits
"The Business Roundtable, which represents chief executives of major U.S. companies, proposed shoring up Social Security and Medicare by raising the eligibility age without increasing taxes on income subject to the Social Security payroll tax.... The group also offered a plan for the Medicare health program for the elderly that would raise the eligibility age to 70 and create a system of private plans to compete with the government-sponsored program ... [and] proposed expanding means testing in Medicare, or reducing benefits for upper-income recipients." (Bloomberg)

Controlled Group Rules for Employee Benefit Plans
"The controlled group rules identify whether two or more corporations and certain other groups of related trades or businesses are treated as if they were one employer under many provisions of [ERISA] and the Internal Revenue Code (IRC) applicable to employee benefit plans. These rules: Differ depending on the type of controlled group under ERISA and the IRC. Affect several IRS qualification requirements for employee benefit plans. Can result in liability for each member of the controlled group on a joint and several basis to the extent they are violated. Apply in several contexts for welfare plans and deferred compensation plans." (Practical Law Company)

Sixth Circuit Will Not Rehear Decision that Severance Pay in Connection with a Reduction in Force Is Not Subject to FICA; Supreme Court Next Step?
"It is unclear at this time how the IRS will respond to refund claims. New claims filed as a result of the Quality Stores decision may be rejected by the IRS due to the split in the circuits or may be held without action. Until this controversy is resolved, it is prudent for employers to continue withholding FICA taxes on SUB payments made in connection with the present or future involuntary termination of employees that do not meet the strict definition provided in IRS Revenue Ruling 90-72 for exemption." (Proskauer Rose LLP)

A Widening Gap for Cities: Shortfalls in Funding for Pensions and Retiree Health Care
"Besides pensions, many localities also have promised health care, life insurance, and other non-pension benefits to their retirees, but few have started saving to cover these long-term costs. These unfunded liabilities loom even larger than for pensions ... As of fiscal year 2009, the cities in this report had promised at least $118 billion more than they had in hand to cover retiree health care benefits. Wide disparities exist in how prepared cities are to fulfill their pension obligations ... Cities have more in common when it comes to gaps in funding for retiree health care and other non-pension benefits. As of fiscal year 2009 ... Only Los Angeles and Denver had even half of the money needed." (Pew Center on the States)

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