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January 29, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
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Qualified Plan Administrator
for Trust Company of America in CO

Account Manager Employee Benefits
for Employee Insurance / Financial Firm in CT

Defined Benefit Administrator
for A Pension Store, LLC - Metro Atlanta Area in ANY STATE, GA

Benefits Plan Manager/Account Executive (Taft-Hartley TPA)
for BeneSys Administrators in CA

Benefits Administrator
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Webcasts and Conferences

Overview of Types of Plans, IRA/DOL Guidance
Nationwide on April 11, 2013 presented by McKay Hochman Co., Inc.

401(k) Advisor Symposium - Tampa, FL
in Florida on February 21, 2013 presented by 401(k) Rekon

401(k) Advisor Symposium - Newton, MA
in Massachusetts on February 27, 2013 presented by 401(k) Rekon

It's Not Your Grandfather's Plan Anymore: Health Care Reform Exemptions
Nationwide on January 30, 2013 presented by Davidson Marketing Group -- FutureOffice Network

Governmental Pension Reporting The New Standards Webcast
Nationwide on February 11, 2013 presented by Accounting Continuing Professional Education Network (ACPEN)

The Fiscal Cliff: Crisis Averted? Webcast
Nationwide on February 7, 2013 presented by Multnomah Group

"401(k) Testing Techniques" Web Seminar
Nationwide on February 19, 2013 presented by SunGard Relius

Qualified Plan Essentials Plus Series
Nationwide on April 11, 2013 presented by McKay Hochman Co., Inc.

Designated Roth Accounts and Roth Conversions
Nationwide on April 18, 2013 presented by McKay Hochman Co., Inc.

Participant Loans
Nationwide on June 20, 2013 presented by McKay Hochman Co., Inc.

View All Webcasts and Conferences


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[Guidance Overview]

FAQs Address Exchange Notices, HRAs and Indemnity Plans
"By adopting a fairly narrow definition of an 'integrated' HRA, these FAQs essentially foreclose various arrangements that employers have adopted (or considered adopting) in response to the ACA. For instance, an employer-sponsored HRA may not be integrated with an individual insurance policy -- even if that policy is part of an employer plan." (Spencer Fane)


[Advert.]

Online HIPAA Privacy Training For Employers

Sponsored by IFEBP (International Foundation of Employee Benefit Plans)

This course is an excellent tool for annual HIPAA training! It provides an overview of HIPAA Privacy including who must comply, rules for using Protected Health Information, administrative requirements and more. Enroll now for just $50!


[Advert.]

FAQs Part XI: Exchanges, Medicare Part D, Guns, and More!
"[S]ome self-insured plans that offer additional drugs beyond what Medicare Part D requires could potentially be required to comply with health reform. This would only be the case of the Part D benefit was aggregated with or part of the active group health plan. (If it was retiree-only, it would be exempt.) While there is an exception for Medicare supplemental coverage that is insured, no similar exemption exists for self-funded plans. The Departments said they would not take enforcement action against those self-funded plans for non-compliance with health reform, pending further guidance." (Benefits Bryan Cave)

[Guidance Overview]

HIPAA/HITECH Omnibus Final Rule Ushers in Significant Changes
"'Sweeping changes' is how Leon Rodriquez, of the [HHS] Office of Civil Rights (OCR), characterized the effect of the final omnibus [HIPAA] rule ... These include, among others: [1] modification to the standard for reporting breaches of unsecured personal health information (PHI); [2] extension of HHS enforcement authority over business associates; [3] expansion of the definition of the term business associate to include Health Information Organizations, E-prescribing Gateways, entities that provide data transmission services for PHI and which require routine access to such PHI, and personal health record vendors[.]" (Proskauer Rose LLP)

[Guidance Overview]

HHS Publishes Long-Awaited Final HIPAA Omnibus Rule
"Notably missing from the Rule are provisions relating to how covered entities must respond to individuals requesting an accounting of disclosures made through an electronic health record, which was the subject of a separate Notice of Proposed Rulemaking published on May 1, 2011. This topic will be addressed in future rulemaking." (Leonard Street and Deinard)

[Guidance Overview]

New HIPAA Omnibus Rule Implements Provisions of the HITECH Act
"The Omnibus Rule tightens the restrictions on the use or disclosure of PHI for marketing purposes by Covered Entities and Business Associates. Prior patient authorization for nearly all treatment and health care operations communications where the Covered Entity is marketing the products or services of a third party and receives 'financial remuneration' for making the communications (subsidized communications) is required. The authorization must state that remuneration is involved but may apply broadly to subsidized communications so long as the authorization otherwise meets the requirements of a valid authorization." (Perkins Coie LLP)


[Advert.]

Executive Summit on On-Site Employee Health Clinics

Sponsored by World Congress

Two separate educational tracks and additional keynote presentations from leading and innovative companies provide you the ultimate benefit of proven data on ROI, strategy, and integration through numerous case studies. Promo Code BLINK3 - $300 discount.


Health Care Among Early Leaders in the S&P 500
"Health care stocks have started off the year on a tear. The industry group that includes health care providers, drugmakers and biotechnology companies has advanced 7.3 percent this year, making it the second-best in the Standard and Poor's 500 index, trailing only energy companies. Even drugmakers, traditionally considered a safe-haven play, are outperforming the market." (The New York Times; free registration required)

Loss of HIPAA Breach Notice Threshold, New Business Associate Rules Pose Challenges
"The elimination of a risk of harm threshold for when breach notice is required under [HIPAA], announced with the Jan. 25 publication of the long-anticipated final omnibus HIPAA rule ... is perhaps the most significant change from interim final rules ... In addition, the omnibus rule's broad requirements for business associates and their contractors that do business with health care companies to comply with many of the HIPAA Privacy Rule, Security Rule, and Data Breach Rule obligations will be an ongoing challenge[.]" (Bloomberg BNA)

Think Preventive Medicine Will Save Money? Think Again, Some Economists Say
"One big reason why preventive care does not save money, say health economists, is that some of the best-known forms don't actually improve someone's health. These low- or no-benefit measures include annual physicals for healthy adults. A 2012 analysis of 14 large studies found they do not lower the risk of serious illness or premature death. But about one-third of U.S. adults get them ... for a cost of about $8 billion a year." (Reuters via Yahoo News)

States Rethink High-Risk-Pool Plans
"[A] recent change in how the Department of Health and Human Services plans to run a three-year, $20 billion fund -- known as reinsurance -- to cushion health plans that end up with lots of high-cost customers is forcing states to rethink their own timetable for shifting some of their highest-risk people into the exchanges. The fear, of course, is that if all the sick people flood the exchanges and younger, healthier ones hold back, premiums could surge. The health law has a bunch of mechanisms to try to avert rate shock -- but questions remain about how well they will work." (Politico)

Mapping Accountable Care Activity in the States
"Bolstered by state legislative mandates, as well as provisions in the Affordable Care Act to re-orient federal health spending to promote accountable care, states are developing a variety of initiatives to improve value -- achieving better health outcomes at lower cost -- and foster accountability for the value of care provided.... As these new initiatives have continued to spread across the country, patterns have begun to emerge in state approaches to fostering accountable care." (National Academy for State Health Policy)

HSAs and HRAs: Assets, Account Balances and Rollovers, 2006-2012
"In 2012, there was $17.8 billion in health savings accounts (HSAs) and health reimbursement arrangements (HRAs), spread across 11.6 million accounts, according to data from the 2012 EBRI/MGA Consumer Engagement in Health Care Survey ... This was up from 2006, when there were 1.3 million accounts with $873.4 million in assets, and 2011, when 8.5 million accounts held $12.4 billion in assets. After leveling off, average account balances increased: After average account balances leveled off in 2008 and 2009, and fell slightly in 2010, they increased in 2011 and 2012." (EBRI)

Overview by SBA: Key ACA Provisions for Employers with Fewer Than 25 Employees
"Some of the provisions that may impact employers with fewer than 25 employees include: Small Business Tax Credits... Small Business Health Options Program (SHOP).... Summary of Benefits and Coverage (SBCs) Disclosure Rules.... Medical Loss Ratio Rebates.... Limits on Flexible Spending Account Contributions.... Additional Medicare Withholding on Wages.... New Medicare Assessment on Net Investment Income.... Elimination of Deductions for Medicare Part D Retiree Prescription Drug Subsidy.... 90-Day Maximum Waiting Period.... Transitional Reinsurance Program Fees." (U.S. Small Business Administration)

U.S. Small Business Administration Launches Informational Website on Health Care Reform
"The site -- www.sba.gov/healthcare -- breaks down the key provisions, based on business size. It also provides links to other useful information for small companies, including a glossary of key health-care reform terms, an interactive time line with dates when certain reforms will be implemented and a state-by-state breakdown of health-care options." (Milwaukee Business Journal)

Dispute Over Illinois Retiree Health Premiums Heads to Court
"The battle over whether retired public employees should be required to pay health insurance premiums may finally be headed to a Springfield courtroom.... All of the lawsuits argue that retiree health insurance is a protected pension benefit, just like a retirement check. The lawsuit filed by Craven and Springfield attorney John Myers also contends that workers who took advantage of the state's early retirement incentive a decade ago are a special class because they relied on the promise of premium-free health insurance in deciding whether to retire early." (The State Journal-Register)

Preparing Navigators and Other Assisters to Meet New Consumer Needs (PDF)
"As states design their navigator and in-person assistance programs, they will need to consider the barriers consumers face when enrolling in health coverage and issues consumers may need help with regarding exchange coverage. The people served by exchanges will need help with many different issues, including assistance in new areas that are unique to the coverage options created by the health care law. This tool kit begins with an overview of the requirements for navigator programs that were laid out in the [ACA] and in subsequent guidance from [CMS] ... The next section answers some of the key questions facing states as they seek to establish effective navigator programs." (Families USA)

Filling in Gaps in Consumer Assistance: How Exchanges Can Use Assisters (PDF)
"Navigators will facilitate enrollment in exchange health plans and conduct public education and outreach about the new coverage options. However, these navigator programs may not have enough resources to meet consumer needs in the first year of enrollment. 'In-person assisters,' similar programs that were recently described in federal guidance, can help fill the gap. Assisters will be allowed to help consumers file applications, obtain eligibility determinations, report changes in status, compare coverage options, and select and enroll in qualified health plans." (Families USA)

Young and Healthy Will Likely Pay Higher Premiums Due to Age Rating Changes Required by ACA
"'[An] irony of the Patient Protection and Affordable Care Act is that if you're young and healthy, [you're] likely to end up paying higher premiums for individual health insurance than someone who is old and frail or with high-cost medical conditions.' This is due to the health reform law's restrictions on age rating, which limits age rating bands to 3:1. Forty-two states currently have a 5:1 age rating band." (America's Health Insurance Plans (AHIP))

Expiration of Health Coverage Tax Credit Will Affect Participants' Costs and Coverage Choices Under ACA
"The HCTC pays 72.5 percent of health plan premiums for certain workers who lost their jobs due to foreign import competition and for certain retirees whose pensions from their former employers were terminated and are now paid by the [PBGC].... The HCTC program will expire at the end of 2013 when premium tax credits and cost-sharing subsidies become available to eligible individuals who purchase health plans through health insurance exchanges under PPACA.... This report examines (1) how the HCTC's expiration and the implementation of the PPACA premium tax credit, cost-sharing subsidies, and Medicaid expansion will affect HCTC participants and nonparticipants, and (2) how the coverage that will be available through the PPACA exchanges compares to HCTC participants' health plan coverage." (U.S. Government Accountability Office)

[Opinion]

The Individual Mandate Penalty May Be Large Enough Over Longer Term
"Insurers may be correct that the penalties in the first 2 years will be too low, but it is harder to make the case that the fully phased-in penalties will be too low. Our best evidence comes from Massachusetts, where a very similar mandate and penalty scheme have been in place since 2007. Because of these provisions, overall coverage in the state is high (about 96% insured) and the associated degree of adverse selection is very low." (JAMA Forum)

[Opinion]

How Congress Could Have Ducked the Fight Over Contraceptive Drugs Mandate
"Congress could have avoided these fights by embracing an alternative approach to healthcare reform that had bipartisan support but was in some ways more radical than the Affordable Care Act: ending the country's reliance on employer-provided health insurance.... There's no question that the transition ... would have been rife with problems.... The irony here is that the strongest argument in favor of moving away from employer-based coverage is also one of the best rebuttals to employers' complaints about contraception coverage." (Los Angeles Times)

[Opinion]

Health Care Reform Places Undue Burden on Businesses
"We were told we needed health-care legislation because of the 40 million uninsured. Conestoga -- a successful, family-owned business that provided health insurance to its employees without any prodding from Washington -- wasn't even part of the problem. Sadly, rather than embrace employers like [them], the Obama administration has turned potential allies into adversaries, and it has run roughshod over religious liberties in the process." (Philadelphia Inquirer)

[Opinion]

Deloitte Health Care Reform Memo, January 28, 2013
"Small businesses in health care don't get much notoriety. They can't afford the big consulting firms and compete for talent against the bigger companies that can pay more. Their CEOs are also the company's chief strategist and salesman. The hours are long, the recognition missing, and the pace frenetic, placing stress on personal health and family stability. So in some circles, 'small business' and 'the health care industry' are not thought to be synonymous but in reality they are." (Deloitte Center for Health Solutions)

[Opinion]

Text of Comments to EBSA on Proposed Regs for Incentives for Nondiscriminatory Wellness Programs in Group Health Plans (PDF)
"The Chamber is concerned about several substantive components of the Proposed Rule including: (1) the requirement that employers provide essentially personalized wellness programs based on each individual employee's exacting circumstances; (2) the unwarranted level of customization that the proposed rule requires regarding the offering of a reasonable alternative reward; and (3) the regulatory proposal to improperly link of the definition of 'tobacco use' under carrier rating requirements and wellness programs." (U.S. Chamber of Commerce)

Benefits in General; Executive Compensation

Employees Willing to Pay for a Range of Voluntary Benefits
"With benefit costs outpacing inflation in many countries and employers unable to pass along these costs to employees, voluntary benefits represent an attractive option for employers who wish to reign in expenses while maintaining broad benefit offerings. Employees pay for these benefits, but often at discounted prices and with less underwriting compared to the same products in the open market. Mercer's Making Smart Benefit Choices Survey, conducted in 10 markets, shows which benefits employees would be most willing to pay for themselves." (Mercer)

Health TPA Can Be Sued for ERISA Benefits Although Not Named as Plan Administrator
"This [Fifth Circuit] decision should strike a cautionary note for TPAs and plan sponsors, reminding all that function prevails over contractual language, and that plan interpretation must be consistent with plan language. Even if this TPA does not ultimately have to pay the participants' benefits, it is out its litigation expenses and the award of attorney's fees (and may have contractual obligations to the plan sponsors as well)." [LifeCare Mgmt. Servs. LLC v. Insurance Mgmt. Adm'rs Inc., 2013 WL 57035 (5th Cir. 2013)] (Thomson Reuters / EBIA)

Press Releases

PBGC Sues the Renco Group Inc. for $97 Million in Pension Liabilities
Pension Benefit Guaranty Corporation (PBGC)

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