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January 30, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
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Webcasts and Conferences

Employee Plan Compliance Resolution Systems (EPCRS) 2013
Nationwide on February 12, 2013 presented by McKay Hochman Co., Inc.

Top-Heavy Contributions
Nationwide on May 23, 2013 presented by McKay Hochman Co., Inc.

Defined Benefit Basic Concepts
Nationwide on June 27, 2013 presented by McKay Hochman Co., Inc.

"403(b) Plans for 401(k) Practitioners" Web Seminar
Nationwide on February 26, 2013 presented by SunGard Relius

Communicating Your ESOP
Nationwide on February 5, 2013 presented by National Center for Employee Ownership

Is an ESOP Right for You?
in Arizona on February 6, 2013 presented by National Center for Employee Ownership

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[Official Guidance]

Text of HHS Sample Business Associate Contracts under HIPAA Omnibus Rule
"This document includes sample business associate agreement provisions to help covered entities and business associates more easily comply with the business associate contract requirements. While these sample provisions are written for the purposes of the contract between a covered entity and its business associate, the language may be adapted for purposes of the contract between a business associate and subcontractor." (U.S. Department of Health and Human Services)


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[Guidance Overview]

A Few Highlights of the HIPAA/HITECH Final Rule
"[A]ny impermissible use or disclosure (which also encompasses any impermissible access or acquisition) is a breach unless the plan (really, the plan administrator) can demonstrate otherwise.... [A] plan (administrator) can demonstrate the 'low probability' only by performing a 'thorough risk assessment.' In other words, now every breach needs to have a risk assessment, no matter how small or how low the likelihood of harm to the individuals whose information was used or disclosed." (Benefits Bryan Cave)

[Guidance Overview]

Final HIPAA Rule Has Sweeping Impact on Covered Entities and Business Associates
"Covered entities and business associates will need to act now to ensure compliance by the compliance deadline. Recommended steps include: Assess existing policies and procedures for compliance gaps.... Covered entities and business associates need to review and update their form of business associate agreement, and identify a plan for transitioning existing agreements onto that form. Notice of Privacy Practices ... need to be reviewed and updated as necessary. Covered entities must identify and develop a plan for meeting applicable distribution requirements." (Katten Muchin Rosenman LLP)

[Guidance Overview]

Final Omnibus HIPAA Rule Issued
"Some of the most significant changes applicable to health care providers include: Making business associates of covered entities directly liable for compliance with certain of the HIPAA Privacy and Security Rules' requirements. Creating a presumption that all breaches are reportable unless the covered entity or business associate, through performance of a risk assessment, determines there is a 'low probability' that protected health information (PHI) has been compromised, a standard that likely will result in an increase in the number of reportable breaches. Increasing the amount of civil money penalties for violations of the HIPAA rules based on the level of negligence, with a maximum penalty of $1.5 million per violation per year. Strengthening the limitations on the use and disclosure of PHI for marketing and fundraising purposes, and prohibiting the sale of PHI without individual authorization. Expanding individuals' rights to receive electronic copies of their health information and restricting disclosures to a health plan concerning treatment for which the individual has paid out of pocket in full. Requiring modifications to a covered entity's notice of privacy practices. Modifying the individual authorization and other requirements to facilitate research and disclosure of child immunization proof to schools. Enabling access to decedent information by family members and others." (Thompson Hine)

[Guidance Overview]

Significant Changes for Health Care Providers, Health Plans, Business Associates and Subcontractors in Final HIPAA Privacy Regs
"One of the most significant changes under the HITECH Act is that it makes Business Associates ('BAs') directly liable under certain provisions of the HIPAA privacy and security rules ('HIPAA Rules'). In addition, the Final Rule provides further guidance concerning which entities are BAs, resulting in the treatment of certain subcontractors of BAs as BAs themselves, directly subject to the HIPAA Rules." (Jackson Lewis LLP)

[Guidance Overview]

HITECH Final Rule Results in Significant Changes to HIPAA Provisions
"The final rule broadens the definition of 'breach' of unsecured protected health information (PHI), resulting in more circumstances in which covered entities and business associates must give notice of a breach." (Faegre Baker Daniels LLP)

[Guidance Overview]

Health Care Reform FAQs Address HRAs
"In questions 2-4 of the FAQs, the agencies stated that they anticipated issuing the following future guidance relating to HRAs: 1) An employer-sponsored HRA cannot be integrated with individual market coverage or with an employer plan that provides coverage through individual policies. 2) An employer-sponsored HRA may be treated as integrated with other coverage only if the employee receiving the HRA is actually enrolled in that coverage." (Faegre Baker Daniels)

[Guidance Overview]

HHS Releases Proposed Application Process for Affordable Insurance Programs
"The proposed regulations outline the development of: A process for the automatic transfer of financial information from a federal data services hub to an applicable exchange when an individual is determined to be ineligible for Medicaid or other program available for low-income individuals and their families. Standardized notices relating to eligibility and enrollment denials. A uniform certification procedure for application counselors (to assist individuals in enrolling for the appropriate coverage program). Minimum requirements for the designation of authorized representatives. A consolidated appeal process for the adjudication of appeals of individual eligibility for the various programs, as well as employer-sponsored coverage and Small Business Health Insurance Options Program (SHOP) eligibility determinations." (Ballard Spahr)

Reporting of Health Plan Premiums on W-2s May Be Eye-Opener for Many Employees
"As workers open their W-2 forms this month, many will see a new box with information on the total cost of employer-sponsored health insurance coverage. To some, it will be a surprise, perhaps even a shock.... Workers often have little idea how much they and their employers are paying for coverage. In many cases, economists say, workers give up cash compensation to get and keep health benefits." (The New York Times; free registration required)

Evidence Growing of 'Very High' Increases In Health Care Costs Due to Consolidation
"Evidence is growing that in more markets across the country, private sector health plans and employers are facing 'very high price increases year-to-year' in some of the same markets where accountable care organizations have been approved by Medicare, the chief executive officer of Equity Healthcare at the Blackstone Group said ... [Karen Ignagni, president and chief executive officer of America's Health Insurance Plans (AHIP) said] the industry is not able to set up tiered networks in Medicare Advantage, the private sector segment of Medicare ... That is 'a barrier to actually achieving the kinds of things we're doing in the commercial arena that could be thought about.'" (Bloomberg BNA)

Annual Form 5500 Reporting Requirements for Welfare Benefit Plans
"Some plan sponsors believe that they can file all their welfare benefit plans on a single Form 5500 filing. Absent a written 'wrap' plan document combining the sponsor's welfare benefits into a single plan, filing for all benefit plans on a single Form 5500 is not permitted. If discovered in audit or review, the IRS or DOL can impose missed filing penalties as noted above and take corrective action by rejecting the filing and requiring that each of the plans re-file separately for all prior years. In the absence of a plan document that combines the benefits into a single plan, the DOL will assess penalties based on each policy or benefit separately." (EisnerAmper LLP)

Health Savings Accounts Grow to $15.5 Billion in 2012
"The total number of HSA accounts rose to more than 8.2 million with assets totaling $15.5 billion, a year over year increase of over 22% for accounts and a 27% increase in assets for the period from December 31st, 2011 to December 31st, 2012. Average account balance steadily grows. The average account balance at the end of 2012 grew to $1,879 from $1,807 at the end 2011, a 4% increase." (Devenir)

How Consumer-Directed Plans Affect the Cost and Use of Health Care (PDF)
"Families that switched from a traditional health plan to a consumer-directed health plan spent an average of 21 percent less on health care in the first year after switching than similar families remaining in traditional plans. Two-thirds of the savings came from initiating fewer episodes of care; one-third came from spending less per episode. Enrollees cut back on the use of some beneficial services, including preventive care, such as cancer screenings, even though such care was fully covered under consumer-directed plans. If the proportion of Americans with employer-sponsored insurance who enrolled in consumer-directed plans increased to 50 percent, annual health care costs would fall by an estimated $57 billion." (RAND Corporation)

What If They Threw an Exchange and Nobody Came? (PDF)
"Health plan chains (multiple insurance companies with a single owner) gave notice that they will not even bother to apply to participate in health exchanges in half of all states. The revelation at investor conferences is a warning that despite all the political verbiage most private carriers do not need (or want) a large book of business in the small group and individual markets, and have no intention of losing money to sell rich benefits to people with higher-than-average underwriting risk." (HealthPlanMarkets)

Model Business Associate Agreement Provisions Reflect Final HIPAA Regulations
"The model agreement reflects various obligations to be performed by business associates under a business associate agreement, for example: Using appropriate safeguards regarding electronic protected health information (PHI). Ensuring that subcontractors that create, receive, maintain or transmit PHI on a business associate's behalf agree to the same restrictions and conditions regarding the PHI as apply to the business associate. Maintaining and making available information required to provide an accounting of disclosures." (Practical Law Company)

DOL FAQs Limit Use of HRAs for Exchange-Purchased Coverage
"The FAQs clarify that an HRA that is not integrated with group health plan coverage but provided as a stand-alone benefit is subject to the Patient Protection and Affordable Care Act ... prohibition on limiting the amount of an employee's annual health care spending subject to insurance coverage. Because of the prohibition on annual dollar limits, an employer-sponsored, stand-alone HRA cannot be used to fund the purchase of individual market coverage, or an employer plan that provides coverage through individually purchased policies, including those that might be purchased on a government-run exchange." (Society for Human Resource Management)

Senate Panel Diagnoses Primary Health Care Crisis
"According to a report released at the hearing, as many as 45,000 people die each year because they do not have health insurance and do not get to a doctor on time. A significant reason for the lack of access to care is that less than one-third of all doctors in America today practice primary care, down for half of all physicians 50 years ago. The problem is likely to get worse because many primary care doctors are nearing retirement and fewer and fewer medical students are interested in becoming family practitioners." (Physicians for a National Health Program)

[Opinion]

Why Obamacare Helps Small Business -- and What That Means for the Rest of Us
"While the [ACA] was intended to link employment and health insurance, what it has really done is handed many small nimble interlocked businesses another leg-up against their large traditional mainframe competitors. For example ... 'new' pharma companies are really marketing departments that outsource manufacturing that, in turn, outsources supply management that outsources I.T. that outsources its cloud services. It's the only way they can compete. The new economics of health insurance will only accelerate similar trends in other manufacturing and service sectors of the economy." (The Health Care Blog)

[Opinion]

Could Wasteful Health Care Spending Be Good for the Economy?
"By some estimates one of every three dollars spent on health care is unnecessary and therefore wasteful. ObamaCare's 'wellness exams' for Medicare enrollees -- so touted during the last election -- is an example.... According to new Keynesianism, we are in a liquidity trap when nominal interest rates hit zero. At that point, according to the theory, hurricanes and earthquakes are good for the economy. So are sudden increases in the price of oil." (John Goodman's Health Policy Blog)

[Opinion]

A Health Check on Annual Physicals
"[A recent study] found no benefit to the risk of death or serious illness among seemingly healthy people who had general checkups, compared with people who did not.... Among possible harms from health checks, they listed 'overdiagnosis, overtreatment, distress or injury from invasive follow-up tests, distress due to false positive test results, false reassurance due to false negative test results, adverse psychosocial effects due to labeling, and difficulties with getting insurance.' Furthermore, they wrote, 'general health checks are likely to be expensive and may result in lost opportunities to improve other areas of health care.'" (The New York Times; free registration required)

[Opinion]

On Workplace Wellness, Don't Throw The Baby Out With The Bath Water
"Stated positively, good worksite programs deserve credit and should be supported by the business community, not condemned. This is because there is good and growing evidence, reported in a rigorous scientific literature, that 'best-practice' worksite health promotion programs improve population health and save money for businesses. Savings are realized from lower health care cost trends, reduced absenteeism, and heightened worker productivity.... It should be noted that it's not easy to achieve those positive outcomes." (Health Affairs Blog)

[Opinion]

To Outsmart Obamacare, Go Protean
"We've already seen many of America's biggest companies respond to the new law by laying off employees, putting them on part-time, or raising prices. But those are short-term solutions. Ultimately, these corporations will have to innovate and restructure to thrive in the era of ObamaCare.... In the context of ObamaCare, a small business could go protean by offering current employees contracts for doing their current work as a corporate entity instead of as an employee. Entrepreneurial employees will jump at the chance to form a corporation and run their own business. Non-entrepreneurial employees can choose to move on and find other work -- or work hard to join the core company." (The Wall Street Journal)

[Opinion]

Stronger Opt-Out Penalty Needed to Keep Health Care Reform Affordable
"We've all heard about the federal reform's mandate requiring everyone to get insurance. Trouble is, the penalty is initially a slap on the wrist -- the greater amount of $285 or 1 percent of income per family in 2014 -- which for most is far less than the cost of insurance. The penalty reaches its peak of a maximum of $2,085 or 2.5 percent of family income, whichever is greater, by 2016." (The Coloradoan)

Benefits in General; Executive Compensation

Drafting a Private Company Equity Incentive Plan
"When drafting an equity incentive plan, private companies should consider several issues, including: The types of awards that will be available for issuance under the plan. The appropriate share reserve. The appropriate vesting schedule for awards granted under the plan. The methods participants can use to pay the exercise price of stock options. The permissible methods for satisfying tax withholding obligations. The definition of change in control to be included in the plan and what will happen to outstanding awards on a change in control." (Practical Law Company)

Obamacare Potentially Affecting Employer-Sponsored Retirement Plans
"Because of its definition of affordability, beginning next year the [ACA] may affect retirement savings.... Were an employer to reduce wages and salaries (or fail to increase them) and compensate employees by introducing an employer-matching pension plan, the employee is likely to benefit by receiving additional government assistance with his health-insurance costs. The pension contributions will add to the worker's income during retirement, except that the income of elderly people does not determine health-insurance eligibility to the same degree, because the elderly participate in Medicare, most of which is not means-tested." (The New York Times; free registration required)

EBSA Publishes Changes to Delinquent Filer Voluntary Compliance Program
"Recent updates to the DFVC Program website include changes to reflect the Department's final regulation mandating electronic filing of annual reports as part of the implementation of a wholly electronic ERISA Filing Acceptance System (EFAST2) for those reports. In addition, an electronic online payment option was added to the Program's website that uses an online calculator to help filers calculate the applicable penalty payment." (The ERISA Industry Committee)

Press Releases

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