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January 31, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

Account Spec On Site
for The Standard in TX

Sr. Qualified Plan Administrator
for DST Systems, Inc. in MO

Lead Manager, Strategic Marketing
for T. Rowe Price in MD

Client Service Manager
for New York Life Retirement Plan Services in MA

Third Party Administrator/Client Service Manager
for Tegrit Group - Akron and Columbus in OH

Administrator DC/DB Plans
for Benetech, Inc. in GA

Director - Legal (ERISA)
for Charles Schwab in OH

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Webcasts and Conferences

Sustaining a Company of Owners Over the Long Term Seminar
in California on September 25, 2013 presented by National Center for Employee Ownership

EPCRS and Beyond: Protecting Your Clients and Your Practice
Nationwide on March 21, 2013 presented by Actuarial Systems Corporation (ASC)

CBG Benefits and Mintz Levin to Co-Host Health Care Reform Seminar
in Massachusetts on March 7, 2013 presented by CBG Benefits

Handling the ESOP Repurchase Obligation Seminar
in Minnesota on October 22, 2013 presented by National Center for Employee Ownership

View All Webcasts and Conferences


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[Official Guidance]

Text of HHS Proposed Regs on Exchange Functions: Eligibility for Exemptions; Miscellaneous Minimum Essential Coverage Provisions
"This proposed rule would implement certain functions of the Affordable Insurance Exchanges ... These specific statutory functions include determining eligibility for and granting certificates of exemption from the shared responsibility payment for not maintaining minimum essential coverage as described in section 5000A of the Internal Revenue Code. Additionally, this proposed rule implements the responsibility of the Secretary of Health and Human Services, in coordination with the Secretary of the Treasury, to designate other health benefits coverage as minimum essential coverage by providing that certain coverage be designated as minimum essential coverage. It also outlines substantive and procedural requirements that other types of individual coverage must fulfill in order to be certified as minimum essential coverage under the Internal Revenue Code." (U.S. Department of Health and Human Services)


[Advert.]

Employer Health & Human Capital Congress - February 21-22, 2013 - Orlando, FL

Sponsored by World Congress

With deadlines looming, and Private Exchanges potentially shifting the employer-health care marketplace, focus on strategy planning and benchmarking. Talk directly to your counterparts in similar industries about next steps in these uncertain times.


[Official Guidance]

Text of Proposed IRS Regs: Shared Responsibility Payment for Not Maintaining Minimum Essential Coverage
"This document contains proposed regulations relating to the requirement to maintain minimum essential coverage enacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 ... These proposed regulations provide guidance on the liability for the shared responsibility payment for not maintaining minimum essential coverage.... The proposed regulations provide that employee includes a former employee. Thus, an individual eligible to enroll in retiree coverage under a group health plan that is an eligible employer-sponsored plan ... is treated as eligible to purchase minimum essential coverage under an eligible employer-sponsored plan under the same rules applicable to current employees.... [T]he proposed regulations provide that an individual eligible to enroll in continuation coverage required under Federal law, such as COBRA, or a comparable State law is eligible to purchase minimum essential coverage under an eligible employer-sponsored plan only if the individual enrolls in the coverage." (Internal Revenue Service)

[Official Guidance]

Text of Final IRS Regs: Health Insurance Premium Tax Credit
"The proposed regulations [issued on August 17, 2011] provided that, for taxable years beginning before January 1, 2015, an eligible employer-sponsored plan is affordable for related individuals if the portion of the annual premium the employee must pay for self-only coverage (the required contribution percentage) does not exceed 9.5% of the taxpayer's household income. While several comments supported this rule, other comments asserted that the affordability of coverage for related individuals should be based on the portion of the annual premium the employee must pay for family coverage. These final regulations adopt the proposed rule without change.... [For example:] C is married to J and X's plan requires C to contribute $5,300 for coverage for C and J for 2014 (11.3 percent of C's household income). Because C's required contribution for self-only coverage ($3,450) does not exceed 9.5 percent of household income ... X's plan is affordable for C and J, and C and J are eligible for minimum essential coverage for all months in 2014." (Internal Revenue Service)

[Official Guidance]

Text of IRS Questions and Answers on the Shared Responsibility Provisions Applicable to Individuals, Dated January 30, 2013 (PDF)
This set of 24 questions and answers has been published by the IRS and is directed at individual taxpayers. Topics include [1] Basic Information; [2] Who is Affected? [3] What is Minimum Essential Coverage? [4] Exemptions; and [5] Reporting Coverage or Exemptions or Making Payments. (Internal Revenue Service)

[Guidance Overview]

Administration Proposes Broad Exemptions from Individual Mandate Penalties
"The Obama administration's proposed rules governing the individual mandate include such extensive exemptions that only 2% of the population would owe a penalty, or 'shared responsibility payment' for not having coverage under a health plan.... Those who would be exempt include taxpayers with incomes below the filing threshold, those who can not afford coverage, members of Indian tribes, people who qualify for hardship exemptions, individuals who have short coverage gaps, those who don't want to purchase health insurance for religious reasons, members of 'health sharing ministries,' and individuals who are incarcerated." (HealthLeaders Media)

[Guidance Overview]

IRS to Base Insurance Affordability on Single Coverage
"In deciding whether an employer's health plan is affordable, the Internal Revenue Service said it would look at the cost of coverage only for an individual employee, not for a family. Family coverage might be prohibitively expensive, but federal subsidies would not be available to help buy insurance for children in the family." (The New York Times; free registration required)

[Guidance Overview]

Employers Catch Some Unexpected Breaks On ACA Mandate
"The federal government's outline of how it will enforce the health reform law's mandate that large employers provide medical benefits contains unexpected revisions likely to make compliance easier, attorneys say, including a grace period, badly needed flexibility for parent corporations and a favorable method for measuring affordability. One of the most well-received policies in rulemaking published earlier this month provides leeway to companies with non-calendar-year health plans, exempting them from the mandate's coverage and affordability provisions until their plans come up for renewal, as opposed to having to comply beginning Jan. 1." (Mintz Levin)

[Guidance Overview]

Employer Penalties Regarding Healthcare Coverage Apply in 2014
"To avoid the No Coverage Penalty, a Large Employer must offer 'minimum essential coverage' to essentially all FTEs and their dependents. To avoid the Inadequate Coverage Penalty, the minimum essential coverage must also be 'affordable' and provide 'minimum value.' Regulations under PPACA have been released that provide guidance to determine whether an employer will be subject to the Penalties." (Haynes and Boone, LLP)

[Guidance Overview]

Guidance Issued on Employer Shared Responsibility Requirements (PDF)
"Employers may want to consider coordinating the ongoing employee administrative and stability periods with the plan year for the health plan. The example below illustrates this approach for a 2015 calendar year plan. The standard measurement period would be the 12-month period from October 15, 2013 through October 14, 2014. The administrative period would be coordinated with the annual open enrollment period from October 14, 2014, through December 31, 2014. The resulting stability period would be the 2015 calendar year." (Buck Consultants)

Some Families Who Can't Afford Coverage on the Job Won't Get Government Money to Buy Health Coverage
"Congress said affordable coverage can't cost more than 9.5 percent of family income. People with coverage the law considers affordable cannot get subsidies to go into the new insurance markets.... [But] Congress went on to say that what counts as affordable is keyed to the cost of self-only coverage offered to an individual worker, not his or her family.... So if the employer isn't willing to chip in for family premiums -- as most big companies already do -- some families will be out of luck." (The Washington Post; free registration required)

Why Some Families Won't Qualify For Subsidized Health Insurance
"Under the federal health law, low- and moderate-income workers with job-based coverage that is deemed unaffordable can opt out of it and turn to new marketplaces, called exchanges, to buy subsidized insurance. But the rule defines the standard for affordability more narrowly than most consumer groups had hoped. The threshold is defined as less than 9.5 percent of household income to cover the employee's share of premium costs -- not on what he or she must pay to cover the entire family, which is generally more expensive." (National Public Radio)

Few Americans Switch Employer Health Plans for Better Quality, Lower Costs
"Less than 2.5 percent of nonelderly Americans in 2010 with employer coverage -- about the same proportion as in 2003 -- initiated a change in health plans to reduce their health insurance costs or get a better quality plan, according to a new national study ... Overall, about one in eight (12.8%) people younger than 65 with employer coverage switched health plans in 2010 -- down from one in six (17.2%) in 2003 ... As was true in 2003, about 5 percent of people with employer coverage switched plans in 2010 because of a job change. However, the proportion of people changing plans for other reasons fell from 12 percent in 2003 to 7.5 percent in 2010." (Center for Studying Health System Change)

How Entrepreneurs Could Solve Medicare's Problems
"In competitive markets, entrepreneurs discover new, more efficient ways of producing products and providing services. They must also compete to attract new customers and always seek to improve quality. In Medicare, this happens only sporadically, if at all. True reform falls into four basic categories: freeing the patient, freeing the doctor, freeing the market and freeing the insurer." (John C. Goodman, Greg Scandlen and Devon M. Herrick, via National Center for Policy Analysis)

To Cover or Not: Employers Weigh Health Insurance Options
"Company number crunchers are stressed. Workers twist in limbo. But health insurance advisers predict that when employers master the new math and consequences of Obamacare, most will opt to keep providing coverage." (Ventura County Star)

Reform Storm: The Coming Seismic Shift in Health Care
"Health care as we know it evolved organically, giving us a market that covers people who are employed full-time but leaves millions un- or under-covered in a system imploding under the strain of its costs. Before the tipping point of 1/1/2014, there's much to be done:" (ExtendHealth)

Only 38 Percent Feel Positive About Health Reform
"In 2012, only 38 percent felt positively about the Patient Protection and Affordable Care Act (ACA), down from 49 percent in 2011, according to recent research ... 27 percent of consumers felt that health care reform will successfully increase access to health insurance coverage and 20 percent believed that reform is likely to be successful in increasing the quality of care, motivating individuals to improve their health (20 percent), better coordinating care (20 percent), and ensuring access to the latest technologies (21 percent). However, only 16 percent felt that the ACA will successfully decrease health care costs overall." (Wolters Kluwer Law & Business)

TRICARE Drug Co-Pay Hike on Horizon
"Some TRICARE beneficiaries will pay higher co-pays for prescription drugs beginning Feb. 1. Those affected will pay anywhere from $4 to $19 more for brand name and nonformulary medications that are not filled at military clinics or hospitals. The fiscal 2013 Defense Authorization Act mandated the increases, but it could have been worse. Congress decided to reject the Obama administration's proposal that would have doubled and tripled what beneficiaries spend on pharmacy drug co-payments." (GovExec.com)

Federal Reserve Economist Steps Into Dispute on Geographic Differences in Health Spending
"[New research] by Louise Sheiner, an economist at the Federal Reserve, ... examines health spending differences among states and the health of people in those states. She concludes health and socioeconomic factors -- things like the prevalence of smoking, obesity and diabetes -- best explain why health spending in some regions of the country is higher." (Kaiser Health News)

Americans See Real Rewards from Workplace Wellness Programs
"Sixty-two percent of workers, up from 55 percent [in] 2011, believe workplace wellness activities are successful in improving health and reducing health risks. The index ... surveys American workers at growing businesses with 10-1,000 workers ... These findings focusing specifically on wellness attitudes and behaviors among American workers were taken from the fourth quarter 2012 Index." (The Principal Financial Group)

Consumer Criteria for Value-Based Insurance Designs (PDF)
"The California Health Benefit Exchange (Covered California) may allow Qualified Health Plans to vary from the standard benefits package that will be offered all enrollees, through value-based insurance design (VBID) options. VBID incorporates financial incentives into health insurance cost-sharing approaches to encourage healthy outcomes. Consumers Union has developed a set of criteria that Covered California and other Exchanges should use to evaluate whether the proposals are in the best interest of consumers." (Consumers Union)

Selling Health Insurance by the Pound: Charging Lower Premiums for Healthier Employees
"For the past few years, companies have experimented with tying health insurance premiums to people's health.... Those with high scores on cholesterol, glucose and blood-pressure and -- or with chronic conditions like diabetes -- are told they will have to pay higher premiums unless they actively try to improve their risky condition.... But since body-mass index is the rough equivalent of a fat score, some critics say forcing employees to pay fees for being fat is too personal and unfair." (MarketWatch.com)

[Opinion]

Your Prevention Plan Does Not Save Money -- Yet Again
"Companies are facing a crisis in health care costs, yet spending zillions trying to save money through prevention, when they really need to be doing things that will actually save money. One thing you can do is to focus your energy on the outliers in your benefit plans. Make sure they have the right diagnoses and treatment plans. That will save big dollars." (Cracking Health Costs)

[Opinion]

'State-Run' Exchanges? No, In the End It's a Single-Seller Federal Marketplace
"According to [HHS], individuals should go to the 'Health Insurance Marketplace' to buy health insurance. As in THE marketplace. Just one. This is the federal government's imposed national chain of Obama's 'health insurance exchanges' with state names (e.g. ... 'Vermont Health Connect' [and] 'Covered California' ...). Each one uses a 24/7 internet infrastructure connected to the Federal government through the Federal Data Services Hub." (Citizens' Council for Health Freedom)

[Opinion]

Buying Health Coverage Is Insanely Confusing. Can Obamacare Fix That?
"As part of its universal coverage plan, Massachusetts launched the Connector: An online portal where consumers could compare and purchase health insurance plans. The idea was to create something like an Expedia for health coverage, where an array of options would show up on one screen. Purchasing health coverage turned out to be more complex than a plane ticket. New research shows that more than 40 percent of shoppers found the information difficult to understand. One in five were overwhelmed with choices, and wished someone would help narrow their options." (The Washington Post; free registration required)

[Opinion]

'Shared Responsibility Payment' on Individual Taxpayers Buys You Nothing
"The proposed regulations also codify the statute's nine categories of individuals who are exempt from the shared responsibility payment.... Basically, the exempt individuals will be those for whom there are no affordable plans, those whose income falls below the threshold for filing tax returns, or those who would qualify for Medicaid under federal law but their state elected not to expand eligibility.... With all of the administrative waste that characterizes our health care system, this rule adds even more administration complexity by providing opportunities to allow individuals to remain uninsured. And the reward is, if they qualify, they don't have to make a shared responsibility payment. Hurray!" (Physicians for a National Health Program)

[Opinion]

Text of Comments to HHS on Incentives for Nondiscriminatory Wellness Programs in Group Health Plans (PDF)
"From the [Business Roundtable's] review of the Guidance, there appears to be a conflict between the rules regarding the requirement that plans offer a 'reasonable alternative' and the requirement that 'the program be reasonably designed.' We recommend that this conflict be resolved in favor of the rules that apply under the 'reasonable alternative' standard. ... BRT also suggests that, in order to protect employee dignity and privacy, the Departments consider placing the onus of establishing a medical condition on the employee rather than on the employer." (Business Roundtable)

[Opinion]

Obamacare-Compliant Exchange Would Violate Idaho's Health Care Freedom Act
"[A] letter sent to Idaho legislators ... explains, 'establishing a PPACA state health insurance exchange in Idaho would conflict with the state's Health Care Freedom Act' [which] protects the 'right of all persons residing in the state of Idaho in choosing the mode of securing health care services free from the imposition of penalties' including 'any civil or criminal fine, tax, salary or wage withholding, surcharge, fee or any other imposed consequence.'" (Cato Institute)

Benefits in General; Executive Compensation

Compensation and Benefits Costs Rose During Fourth Quarter of 2012
"Compensation costs for civilian workers increased 0.5 percent, seasonally adjusted, for the 3-month period ending December 2012 ... Wages and salaries (which make up about 70 percent of compensation costs) increased 0.3 percent, and benefits (which make up the remaining 30 percent of compensation) increased 0.6 percent.... Compensation costs for private industry workers increased 1.9 percent over the year.... The increase in the cost of benefits was 2.2 percent for the 12-month period ending December 2012, down from the December 2011 increase of 3.6 percent. Employer costs for health benefits increased 2.8 percent over the year." (U.S. Bureau of Labor Statistics)

GAO Report on Federal Rulemaking Finds Agencies Could Take Additional Steps to Respond to Public Comments (PDF)
"Agencies did not publish a notice of proposed rulemaking (NPRM), enabling the public to comment on a proposed rule, for about 35 percent of major rules and about 44 percent of nonmajor rules published during 2003 through 2010.... [A]gencies, though not required, often requested comments on major final rules issued without an NPRM, but they did not always respond to the comments received. Agencies may solicit comments through the Federal Register when publishing a final rule without an NPRM, but the public does not have an opportunity to comment before the rule's issuance, nor is the agency obligated to respond to comments it has received.... For example, in one [rule], an agency defined a pre-existing condition to implement the [ACA] and sought public comment. The agency received 4,627 comments, but has not published a response to them." (U.S. Government Accountability Office)

Workers Planning to Work Longer to Keep Health Coverage (PDF)
"More than half of all workers say they intend to work longer than they would like in order to keep their health insurance at work, according to new research ... However, the actual experience of retirees suggests that may be wishful thinking: Less than 1 in 5 (19 percent) retirees say they were able to work longer to continue receiving health insurance through their jobs[.]" (EBRI)

Press Releases

Pentegra Names New Chief Operations Officer
Pentegra Retirement Services

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