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January 25, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

Plan Compliance Specialist
for Lincoln Financial Group in ANY STATE, IL, IN

Pension Analyst (DB)
for Long Island Employee Benefits Group, Ltd. in NY

Defined Benefit/ERISA Client Relationship Manager
for Goldleaf Partners in MN

Vice President, Benefits Strategy
for Fidelity Investments in MA

DC Plan Specialist
for Acuff & Associates, Inc. in TN

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Webcasts and Conferences

The New HIPAA Omnibus Rule & Your Liability Webinar
Nationwide on January 30, 2013 presented by Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.

The Impact of the Recent Elections and Legislative Updates on Employee Benefit, Health and Retirement Plans: A Professionalís Perspective
in California on February 7, 2013 presented by Western Pension & Benefits Conference, San Francisco Chapter

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[Official Guidance]

Text of DOL FAQ About Affordable Care Act Implementation: Part XI
[Editor's Note: This set of eight Frequently Asked Questions addresses the employer notice of coverage options, health reimbursement arrangements, disclosure of information related to firearms, employer group waiver plans supplementing Medicare Part D, fixed indemnity insurance and payment of PCORI fees.] Excerpt: "The Department of Labor has concluded that the notice requirement under FLSA section 18B will not take effect on March 1, 2013 for several reasons. First, this notice should be coordinated with HHS's educational efforts and Internal Revenue Service (IRS) guidance on minimum value. Second, we are committed to a smooth implementation process including providing employers with sufficient time to comply and selecting an applicability date that ensures that employees receive the information at a meaningful time. The Department of Labor expects that the timing for distribution of notices will be the late summer or fall of 2013, which will coordinate with the open enrollment period for Exchanges." (U.S. Department of Labor, Wage and Hour Division)


[Advert.]

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[Guidance Overview]

HHS Provides Amendments to HIPAA Privacy and Security Regulations to Conform Regulations to HITECH, GINA and Add Some Additional Changes (PDF)
"The Changes impose a number of additional requirements that must be incorporated into the notice of privacy practices each group health plan must provide to participants. The notice of privacy practices must be updated for the Changes and this requirement does not have a delayed effective date or any special transition rule beyond September 23, 2013. So as employers are preparing for open enrollment for calendar year plans facing the 2014 health reform changes, they must also be working to meet the deadline for issuing the new updated HIPAA Privacy notice by September 23, 2013." (Haynes and Boone)

[Guidance Overview]

Omnibus Final HIPAA Rule Is Here
"Subcontractors are specifically included right in the modified definition of 'business associate'.... (A subcontractor is now defined as a person to whom a business associate delegates a function, activity, or service, other than in the capacity of a member of the workforce of such business associate.) ... HHS clarifies that this extension of the rules is not limited to 'first tier' subcontractors but also applies to downstream contractors that create, receive, maintain or transmit PHI for or on behalf of business associates or subcontractors." (Pepper Hamilton LLP)

[Guidance Overview]

Determining If Your Business Is an 'Applicable Large Employer' for 2014
"Step #1: Is your business an 'employer' for purposes of the shared responsibility requirements? ... Step #2: Who are your 'employees' that must be counted? ... Step #3: How many 'full-time employees' does your business have? ... Step #4: How many 'full-time equivalent employees' does your business have? ... Step #5: What is your business's average number of full-time employees for 2013?" (McDonald Hopkins LLC)

[Guidance Overview]

The Play-or-Pay Penalty: Practical Administration Update
"It is expected that a process will be established under which the IRS will contact employers to inform them of their potential liability and provide them an opportunity to respond before any liability is assessed or notice and demand for payment is made. The contact by the IRS for a given plan year will not occur until after employees' individual tax returns are due for that year claiming premium tax credits and after the due date for applicable large employers to file the information returns identifying their full-time employees and describing the coverage that was offered (if any)." (Troutman Sanders)

[Guidance Overview]

DOL Clarifies Requirements for FMLA Qualifying Leave
"The [Administrator's Interpretation] acknowledges, however, that [a] servicemember's injury may have an impact that lasts beyond the single 12-month period covered by the military caregiver leave entitlement. The expanded definition of a disability ... as well as [this] clarification that when an adult son or daughter's disability commences is not determinative of whether he or she qualifies as a 'son or daughter' under the FMLA, may allow parents of adult children who have been wounded or sustained an injury or illness in military service to take FMLA leave beyond that provided under the special military caregiver leave provision of the statute, as long as all other FMLA requirements are met." (Ford & Harrison LLP)

[Guidance Overview]

IRS Clarifies Rules on Deductibility of Medical and Dependent Care Expenses
"While the 2012 Publications are substantially similar to their 2011 counterparts, relevant dollar amounts have been revised to reflect their 2012 inflation adjusted values. In addition, the 2012 version of Pub. 502 provides taxpayers with the following new guidance: an explanation of the lodging expense rules as applied to individuals travelling with the person receiving medical care, and an updated explanation of the health coverage tax credit." (HighRoads)

Obamacare Needs Delay, Head of State Insurance Association Says
"President Barack Obama may need to delay his health-care overhaul or risk 'chaos' when subsidized insurance plans go on sale in October, the head of the National Association of Insurance Commissioners said. It's unclear how well the federal government or any of the participating states will perform on Oct. 1, when millions of Americans are supposed to begin shopping at online markets created by the law, [he said]." (Bloomberg)

Health Care Threatens to Crush U.S. Growth
"The 2012 annual report for the federal government ... continues to use dubious accounting standards to avoid putting the cost of government retirement promises into the headline deficit of $1.1 trillion.... One example is the cost, in today's dollars, to make Social Security and Medicare solvent for the next 75 years. This grew to $38.6 trillion, an increase of $4.7 trillion over the prior year. According to the report, Americans' aging drove $1.6 trillion of the increase; the rest mostly reflected poorer-than-expected economic growth." (The Washington Post; free registration required)

Texas Bill Proposing Tax Break Targets Contraceptive Coverage Mandate
"A bill filed Thursday in the Texas House would give religiously based businesses, such as Hobby Lobby, a state tax break if the businesses were forced to comply with the federal government's mandate that employers provide contraception coverage. 'It is simply appalling that any business owner should have to choose between violating their religious convictions and watching their business be strangled by the strong arm of Federal mandates and taxation,' [said a state legislator]." (The Texas Tribune)

Challenge to HHS Mandate Filed on Behalf of Ohio Companies and Owners
"The lawsuit contends the HHS mandate forces the owners to 'violate their religious beliefs and moral values' or face crippling fines and penalties. For the two companies combined, the fines and penalties would total nearly $40,000 a day, amounting to $14.4 million annually, which the owners contend will be 'ruinous' for their businesses. The companies face an April 1, 2013, renewal date for their health insurance coverage." (American Center for Law and Justice)

Health Care Reform Arrives: Get Ready to Make Changes
"Only the most die-hard of policy wonks could claim mastery of the sprawling health-care legislation, which was written by five different congressional committees and runs to nearly 1,000 pages.... [T]he next 12 months will bring significant changes, particularly for small-business owners, the currently uninsured and self-employed people with pre-existing conditions -- a group that includes more baby boomers than younger workers." (MarketWatch.com)

Claimant's Contradictory Statements to SSA on Commission-vs.-Bonus Characterization Can Be Used To Deny ERISA Disability Claim
"What happens when an ERISA claimant submits contradictory statements to the Social Security Administration and the ERISA plan administrator? Can these contradictory statements be used to deny the ERISA claim? YES. What's the difference between a 'Commission' and a 'Bonus' in calculating a claimant's monthly benefit? The dissent in this new [Eighth Circuit] decision provides guidance." [Govrik v. UNUM Life Insurance Company (8th Cir. Jan. 10, 2013] (Lane Powell PC)

TurboTax, Not Travelocity, May Be Better Analogy for Health Exchanges
"For years, we've been hearing that health insurance exchanges created by the [ACA] are going to be 'online marketplaces, like Travelocity' where people will buy health policies like plane tickets. But a consumer focus group in Colorado suggests people are going to want something more like TurboTax.... Consumers said they know very little about insurance and will need a lot of customer support to use the exchange." (Kaiser Health News)

Average Health Insurer Rejects More Than 1 In 5 Applications
"A new analysis ... shows that the health insurance industry averages an application rejection rate of 22 percent of submitted individual and family applications nationally. States with the highest percentage of area insurer rejections are Montana (45%), Alabama (40%), District of Columbia (37%), Arkansas (35%) and Alaska (34%).... Some insurers have declination rates greater than 70 percent; others rarely decline applicants." (InsuranceNewsNet.com)

Penalty Allowed by ACA Could Keep Smokers Out of Health Insurance
"Millions of smokers could be priced out of health insurance because of tobacco penalties ... [The ACA] allows health insurers to charge smokers buying individual policies up to 50 percent higher premiums starting next Jan. 1. For a 55-year-old smoker, the penalty could reach nearly $4,250 a year. A 60-year-old could wind up paying nearly $5,100 on top of premiums." (The New York Times; free registration required)

The Public's Health Care Agenda for the 113th Congress
"Key Findings: 55 percent of respondents, including majorities of Republicans and Democrats, say that establishing state insurance exchanges should be a 'top priority' for their governor and legislature. 52 percent support the expansion of Medicaid in their state. 58 percent oppose any spending cuts to Medicare and 46 percent oppose any cuts to Medicaid." (Robert Wood Johnson Foundation)

Poll Finds Bipartisan Public Support for Creating State Insurance Exchanges Despite Continuing Party Divisions Over ACA
"A majority of Americans put the creation of state-based health insurance exchanges at the top of the priority list for health policy in their state this year, according to a survey ... by the Kaiser Family Foundation, the Robert Wood Johnson Foundation and the Harvard School of Public Health. Fifty-five percent of the public, including majorities of Republicans and Democrats, say that establishing the exchanges ... is a 'top priority' for their governor and legislature." (Robert Wood Johnson Foundation)

Survey Explores Flexible Work Arrangement Offerings and Employee Participation Rates
"[A]bout half (53 percent) of organizations provided at least some of their employees with the option of flexible work arrangements, including full- or part-time telecommuting, flexible scheduling and compressed workweeks. But among those organizations, only about one-third (34 percent) reported that a majority of their employees were allowed to take advantage of these benefits." (Society for Human Resource Management)

State of Wellness Initiatives in the Workplace
"Seven out of 10 organizations offered some type of wellness program, resource or service to their employees, according to [an SHRM survey]. Among these organizations: [1] 43 percent reported having increased their investment in employee-wellness initiatives in 2012 from 2011. [2] Almost half (45 percent) extended wellness initiatives to employees' dependents. Nearly all (99 percent) of these organizations allowed spouses to participate in wellness initiatives, and 69 percent allowed dependent children to participate." (Society for Human Resource Management)

Employers Rely on Increased Employee Contributions to Help Control Health Care Costs
"The top three activities organizations have engaged in to control health care costs ... were: [1] Increasing the employee share contributed to the total costs of health care (52 percent of respondents). [2] Providing educational initiatives related to health and wellness (52 percent). [3] Providing lower-cost generic prescription or over-the-counter drugs (50 percent). Almost half (47 percent) of organizations reported increasing the amount that employees must contribute to the total costs of health care in plan year 2012." (Society for Human Resource Management)

A Different Model: Medical Care in Cuba
"For a visitor from the United States, ... the Cuban health care system ... seems unreal. There are too many doctors. Everybody has a family physician. Everything is free, totally free -- and not after prior approval or some copay. The whole system seems turned upside down. It is tightly organized, and the first priority is prevention. Although Cuba has limited economic resources, its health care system has solved some problems that ours has not yet managed to address." (Physicians for a National Health Program)

[Opinion]

The Affordable Care Act: What to Expect in 2013
"Going forward, we can expect to see wild battles across the health care landscape ... [1] Continued mergers among the major players, including insurance companies, hospital systems, medical groups and others, which will end up increasing costs and prices while limiting patients' choices of physician and hospital. [2] Continued lobbying by the insurance industry to mold accountable care organizations and insurance exchanges in their interests ... [3] Efforts by insurers to limit definitions of minimal essential benefits. [4] Further fragmentation and increasing bureaucracy of our market-based health care system with worse health outcomes." (The Huffington Post)

[Opinion]

Two Charts That Should Be in Every Health Care Discussion
"We spend more on government-provided health care than they do in Canada, France, Germany, Israel, Italy, Japan, Sweden or the United Kingdom. And all those countries have government-based systems that cover everybody. We don't.... The American health-care system is simply uniquely inefficient." (The Washington Post; free registration required)

[Opinion]

Health Care Reform: Employers Face the Big Decisions
"One thing that will underlie how companies respond to the health-care reform law is the impact on their brand. They have to be sensitive to making decisions that give the appearance they don't have a direct interest in their employees' well-being and thus harm their reputation. On the other hand, organizations with large segments of part-time workers who historically had very limited medical plans are appropriately concluding that in almost all situations, part-time employees will be better off using the public exchanges [scheduled to be available in 2014], since most such employees will be eligible for federal subsidies." (CFO)

Benefits in General; Executive Compensation

Cypen & Cypen Newsletter for January 24, 2013
Covers employee benefit developments with an emphasis on governmental plans. Topics in this issue include: GIGO Adds To Public Pension Woes; BLS Reveals Defined Benefit and Defined Contribution Retirement Plan Costs; Pension Fund Trustees Shoot Themselves in the Foot?; NHLers Achieve Hat Trick With New Pension Plan; Potential Macroeconomic Consequences of an Aging Population With Insufficient Savings. (Cypen & Cypen)

Press Releases

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