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February 21, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

Defined Benefit Analyst
for New York Life Retirement Plan Services in MA

Area Assistant Vice President Compliance Counsel
for Arthur J. Gallagher & Co. in IL

Project Manager - New Business Installation (Cincinnati, OH)
for Transamerica in OH

401(k) Plan Administrator
for Limestone Pension Associates, LLC in DE

Implementation Analyst
for Great-West Financial in CO

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Webcasts and Conferences

"Form 5500 Workshop 2013: Issues and Answers," April-June, 25 Cities
Nationwide on April 18, 2013 presented by SunGard Relius

International Assignments: What Benefits Professionals Need to Know (NY CLE Program)
in New York on March 14, 2013 presented by WEB (Worldwide Employee Benefits Network ), New York Chapter

"401(k) Plan Workshop 2013: Tax Reform and the 401(k) Plan," April - June, 26 Cities
Nationwide on April 19, 2013 presented by SunGard Relius

Extreme Benefits & Total Rewards ó from Millenials to Boomers: How Benefits Can Help Differentiate Your Employer Brand
Nationwide on March 19, 2013 presented by bswift

Free Webinar: A Straightforward Approach to HIPAA HITECH
Nationwide on March 19, 2013 presented by Davidson Marketing Group -- FutureOffice Network

Decisions, Decisions: Choices That Affect Retirement Income Adequacy Policy Forum
in District of Columbia on May 9, 2013 presented by Employee Benefit Research Institute (EBRI)

View All Webcasts and Conferences


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[Official Guidance]

HHS Fact Sheet on Final Essential Health Benefits Standards
"The final rule reflects extensive collaboration and work with states, small businesses, consumers, and health insurance issuers.... The final rule provides that all plans subject to EHB offer benefits substantially equal to the benefits offered by the benchmark plan. This approach best strikes the balance between comprehensiveness, affordability, and state flexibility. The final rule also gives issuers the flexibility to offer innovative benefit designs and a choice of health plans.... HHS is providing a publicly available AV Calculator, which issuers will use to determine health plan AVs based on a standard population... The final rule includes standards and considerations for plans with benefit designs that the AV Calculator cannot easily accommodate. Consumer-driven health plans, such as high-deductible health plans integrated with health savings accounts, are compatible with the AV Calculator." (Department of Health and Human Services)


[Advert.]

A pivotal year - Prepping for ACA's full implementation & more

Sponsored by Health & Benefits Leadership Conference

Benefits-related decisions you make in the coming months will determine your organization's overall success -- or failure in 2013. Gain forward-thinking business strategies & success stories needed to help you make the right moves. April 22-24 Benefitsconf.com


[Guidance Overview]

Implementing Health Reform: The Essential Health Benefits Final Rule
"The most remarkable characteristic of the final regulation is how little of the proposed regulation it changes. Although HHS received 5,798 public comments -- including 600 total unique letters -- responding to the proposed EHB rule, the final rule makes virtually no changes of significance in the proposed rule. This is undoubtedly due to the fact that HHS had published bulletins on both the EHB and on actuarial value, met with stakeholders to discuss its approach, and received approximately 11,000 comments before it even published the proposed rule." (Timothy Jost in Health Affairs Blog)

[Guidance Overview]

Feds Outline What Insurers Must Cover, Down To Polyp Removal
"The final, 149-page rule retains requirements that insurers offer at least one drug per therapeutic category, or the same number as a state's benchmark plan, whichever is greater. Many state benchmark plans require at least two drugs per class. Responding to concerns from some advocacy groups, the final rule also states that insurers must have procedures to allow patients to get 'clinically appropriate' prescriptions not on the plan's list of covered medications." (Kaiser Health News)

[Guidance Overview]

Preventive Care Guidance Released
[T]the guidance provides that plans may cover a generic contraceptive drug without cost-sharing and impose the regular cost-sharing for branded contraceptive drugs, but with an important caveat. In that case, a plan must accommodate any individual for whom the generic drug (or a brand name drug) would be medically inappropriate, as determined by the individual's health care provider, by having a mechanism for waiving the otherwise applicable cost-sharing for the branded or non-preferred brand version. Further, if a generic version is not available, or would not be medically appropriate for the patient, then a plan must provide coverage for the brand name drug without cost sharing." (Kilpatrick Townsend)


[Advert.]

The Only Conference Series 100% Dedicated to Innovative Health and Benefit Management

Sponsored by IHC

The IHC FORUM East helps employers, TPAs, benefit brokers, consultants and regional health plan providers learn to implement health care consumerism strategies and save money on health and benefit management programs. May 9-10, Atlanta - Code LINK - $100 discount.


[Guidance Overview]

HHS Issues Final Rule on Essential Health Benefits, Plan Value
"An employer-sponsored plan is deemed to provide minimum value (MV) if the percentage of the total allowed costs of benefits provided under the plan is no less than 60 percent. In order to determine whether a plan provides minimum value, an employer-sponsored plan may use the MV calculator provided by the HHS and the Internal Revenue Service, or avail itself of 'an array of design-based safe-harbors published by HHS and the Internal Revenue Service in the form of checklists to determine whether the plan provides MV.'" (Littler Mendelson LLC)

[Guidance Overview]

OCR Issues Final Modifications to HIPAA Privacy, Security,Breach Notification and Enforcement Rules to Implement HITECH Act (PDF)
"As required by the HITECH Act, business associates are directly liable for civil money penalties (CMPs) and criminal penalties for violations of the Privacy Rule and Security Rule.... [S]ubcontractors of a business associate are also liable for violations of the Privacy Rule and Security Rule. The definition of a breach of unsecured PHI is revised to make it more difficult for a covered entity or business associate to avoid reporting an unauthorized use or disclosure of PHI to the affected individuals and OCR. Except in limited cases, a covered entity may not receive cash or other financial remuneration for marketing communications made for a third party's products or services." (McDermott Will & Emery)

[Guidance Overview]

Final Rule on Affordability of Family Health Coverage and Health Insurance Premium Tax Credit
"[F]amily members of an employee who is offered affordable, self-only coverage will not be subject to the PPACA individual mandate penalty, which is applicable to individuals who do not obtain insurance if the employee's premium share for family coverage exceeds 8% of household income and family members do not enroll in the coverage. This proposed rule cannot be relied upon at this time. Employers should review their employee contribution and eligibility strategy for all employees to avoid unnecessarily limiting premium tax credit options under the exchanges for employees and their dependents." (Healthcare Town Hall)

HHS Releases Rule on Insurers' Essential Health Benefits
"[T]he rule doesn't include any surprises: A proposed rule released in November looks much the same as today's version.... HHS has said there are mechanisms built in that would keep costs down for everyone, including subsidies for people whose incomes fall below 400% of the poverty line and preventive care that is expected to keep long-term health care costs down." (USA TODAY)

Just Say Don't: Doctors Question 135 Routine Tests and Treatments
"Now there are 135. That's how many medical tests, treatments and other procedures -- many used for decades -- physicians have now identified as almost always unnecessary and often harmful, and which doctors and patients should therefore avoid or at least seriously question.... One large medical group with 300,000 patients ... calculated that following the Choosing Wisely advice on just two procedures, superfluous EKGs (electrocardiograms) and bone-density scans, would reduce its billings by $1 million a year. Nationally, that translates into some $1 billion in savings." (Fox News)

Employer and Worker Contributions to Health Reimbursement Arrangements and Health Savings Accounts, 2006-2012 (PDF)
"The percentage of workers reporting that their employers contribute to the account increased. Among those with employer contributions, overall contribution levels for individuals with employee-only coverage increased in 2012, and have been increasing since 2009. Workers with employee-only coverage did not increase their own contributions, but those with family coverage did." (EBRI)

CMS Establishes System of Records for Health Insurance Exchanges
"The system of records will contain [Personally identifiable information (PII)] about certain individuals who apply or who are applying on someone's behalf and will include personal, employment, financial, demographic, pregnancy status, and tobacco use. The system also will contain information about qualified employers who are seeking to obtain health insurance coverage for qualified employees through a Small Business Health Options Program (SHOP). The CMS will utilize PII for functions such as determining eligibility, enrollment, appeals, payment processes, and consumer assistance." (Wolters Kluwer Law & Business)

Few Americans Switch Employer Health Plans for Better Quality or Lower Costs
"Fewer than 2.5 percent of nonelderly Americans in 2010 with employer coverage initiated a change in health plans to reduce their health insurance costs or get a better quality plan ... About one in eight (12.8%) of workers younger than 65 with employer coverage switched health plans, 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." (Wolters Kluwer Law and Business)

ML Strategies Health Care Reform Update, February 19, 2013 (PDF)
Update on developments in federal and state health care reform legislation and regulations, including summaries of recent announcements and regulatory activity by HHS, CCIIO, IRS and CMS. (Mintz Levin)

A Texas-Sized Incentive to Defy ACA's Contraceptive Mandate
"Texas state Rep. Jonathan Stickland ... [has introduced] a bill (TX H.B. 649) that would grant companies a tax break if they offer healthcare to their employees (as required by ACA) but refuse to include emergency contraceptive coverage because of the religious convictions of their owners. This bill attempts to neutralize any federal fines by giving a business a tax break equal to the amount paid in federal penalties, up to the total amount the company pays in state taxes." (Benefits Bryan Cave)

Seven Million Americans Live In Areas Where Demand For Primary Care May Exceed Supply By More Than 10 Percent
"The Affordable Care Act's expansion of insurance coverage is expected to increase demand for primary care services. We estimate that the national increase in demand for such services will require 7,200 additional primary care providers, or 2.5 percent of the current supply.... Seven million people live in areas where the expected increase in demand for providers is greater than 10 percent of baseline supply, and forty-four million people live in areas with an expected increase in demand above 5 percent of baseline supply." (Health Affairs; purchase required to view full article)

Of Golf Carts and Doctors: A Retirement Community Builds Its Very Own Health Insurance Plan
"UnitedHealth announced ... a partnership with the Villages, the country's largest retirement community, located in central Florida, to create a private Medicare plan that will exclusively serve its 93,000 residents. The new partnership reflects some larger trends in the health-care industry: It will attempt to tamp down on health-care costs by making a large investment in primary care." (The Washington Post; free registration required)

Health Savings Account Snapshot Shows Consumer Contributions Reach Highest Levels in Eight Years
"The average accountholder is saving approximately $500 in taxes annually (assuming a 28 percent federal income tax rate). Average balances are also increasing by approximately $500 per account per year an account is open. The average balance in 2012 for new HSA accounts rose to its highest level in eight years growing two percent from 2011 to $1,009. The average HSA balance in 2012 was $1,736 -- up six percent from 2011." (JPMorgan)

[Opinion]

Obamacare Waivers for Friends, But Not for Conscience
"Recently, Sally Jewell, President Obama's nominee for Interior Secretary, received an Obamacare waiver for her private company's firm. Ironically, the president and Congress who came up with Obamacare are not about to subject themselves, nor their friends, to the tens of thousands of pages of anticipated regulations they are writing for us. Meanwhile, pro-life outfits and for-profit religious entities are still unable to get a broad conscience exemption from the administration's HHS mandate, which forces them to pay for contraceptive care, including abortifacient drugs, despite its 'new and improved' rules." (Metrowest Daily News)

[Opinion]

Labor Unions That Pushed Obamacare Through Want Out
"Major unions like the AFL-CIO and the Teamsters are now demanding that they be allowed to stay on their current health care plans and receive government subsidies to cover the increased costs some of Obamacare's provisions will impose on lower-income workers." (Washington Times)

[Opinion]

Text of AHIP Statement on Essential Health Benefits
"We appreciate the work the administration has done to balance the requirements of the statute with the need for affordable coverage, including giving states more control over their benchmark plan and preserving flexibility in benefit design. At the same time, the minimum essential health benefits standard will still require many individuals and small businesses to purchase coverage that is more comprehensive and more expensive than they choose to purchase today." (America's Health Insurance Plans)

Benefits in General; Executive Compensation

Importance of Benefits in Choosing a Job Remains High, Despite Recent Decline (PDF)
"The 2012 Health Confidence Survey (HCS) found that 69 percent of respondents report that benefits were very important when choosing a job, and another 20 percent reported they were somewhat important. Health insurance continues to be by far the most important employee benefit: 6 in 10 (58 percent) list health insurance as the most important benefit, distantly followed by 18 percent who cite a retirement savings plan." (EBRI)

Supreme Court Review of Marriage Cases Could Require Significant Changes to Employee Benefits
"Because the Supreme Court rulings will likely take immediate effect when they are issued, employers should start thinking now about how they will handle benefits for [same-gender] spouses if Section 3 of DOMA is overturned. Employers need to consider how they will implement all federally mandated spousal benefits and protections and whether their plans will require amendments to effect the changes." (Snell & Wilmer L.L.P.)

Press Releases

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