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February 26, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

Pension Administrator
for Retirement Strategies, Inc. in GA

Senior Legal Consultant
for Mercer in DC

Experienced Pension Consultant/Sales Associate
for TPA Firm in MA

Pension Plan Administrator
for TPA Firm in Northern New Jersey in NJ

Benefits & Compensation Attorney
for Dorsey & Whitney LLP in MN

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Webcasts and Conferences

Tracking Full-Time Employees Under Health Care Reform: Understanding and Applying the IRS Safe Harbors
Nationwide on March 21, 2013 presented by Thomson Reuters / EBIA

Get Ready to Talk Health Care Reform to Your Employees Webcast
Nationwide on February 28, 2013 presented by Mercer

Health Care Reform Webinar: Preserving and Expanding Immediate Access to Coverage
Nationwide on March 1, 2013 presented by Davidson Marketing Group -- FutureOffice Network

Preparing Client Portfolios for Rising Interest Rates Webcast
Nationwide on March 19, 2013 presented by InvestmentNews

View All Webcasts and Conferences


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[Official Guidance]

Text of HHS Sub-Regulatory Guidance Regarding Age Curves, Geographical Rating Areas and State Reporting (PDF)
"This guidance provides important information concerning two of the factors, age and geography, and also details the process of state reporting as required by sections 147.103 and 156.80(c) of the final rule [on the Health Insurance Market Rules]." (Department of Health and Human Services)


[Advert.]

ACA University: A New Virtual Learning Center

Sponsored by IFEBP (International Foundation of Employee Benefit Plans)

Introducing ACA University! This virtual learning environment will help you navigate Affordable Care Act regulations with live webcasts, Q&A with industry experts, podcasts, recorded conference sessions and more. Join now to participate!


[Guidance Overview]

Immediate Preventive Care Coverage Changes May Be Required for Employer-Sponsored Health Plans
"The existing guidance defines 'preventive care benefits' by cross-referencing certain lists of recommended preventive care. Because these lists were developed mainly as best practices lists for health care providers in providing preventive care, it is not always clear how the lists translate into what items and services must be covered." (Jones Day)

[Guidance Overview]

New FAQs Provide Guidance on Cost-Sharing and Preventive Care
"[T]he limit on deductibles for non-grandfathered health plans only applies to plans and issuers in the small group market. The Agencies confirm that position in the FAQs and state that they will take public input on this point before finalizing that position. Until then, self-insured and large group health plans can rely on the Agencies' current position that they do not have to comply with the limits on deductibles. In contrast, the Agencies believe that all non-grandfathered group health plans must comply with the ACA's limits on out-of-pocket maximums." (Seyfarth Shaw LLP)

[Guidance Overview]

Treatment of Seasonal Employees Under Health Care Reform
"Many employers rely on seasonal workers -- over the holidays, during the summer, or for a harvest season.... [S]hould these employees be counted in determining whether an employer is large enough to be subject to the ACA's 'play or pay' mandate? And assuming an employer is subject to this mandate, how do seasonal employees affect the penalties the employer might have to pay?" (Spencer Fane)

[Guidance Overview]

HHS Releases Final Regs on Health Insurance Market, Rate Review, Pre-Existing Conditions and Other ACA Market Reform Rules
"Among other thing, the Final Regulations: ... Direct health insurance issuers to offer coverage to and accept every employer or individual who applies for coverage in the group and individual market ... Direct health insurance issuers to renew or continue in force coverage in the group and individual market ... Codify the requirement that issuers maintain a single risk pool for the individual market and a single risk pool for the small group market[.]" (Solutions Law Press)


[Advert.]

Driving Compliance and ROI through Wellness Programs - April 22-24, San Francisco

Sponsored by Human Resources IQPC

Focus on building, enhancing and implementing strategic wellness programs. HR, Benefits and Wellness professionals discuss how to move beyond making the business case to implement and expand your program. 1-800-822-8684 for registration - Code BLINK1 - $100 discount.


[Guidance Overview]

OSHA Regs Address Retaliation Complaint Procedures Under Health Care Reform
"Starting in 2014, employees will be protected from retaliation (for example, by restricting or ending the coverage) not only by their employer, but by insurers that provide employer-sponsored health coverage to employees. Health care reform adopts the procedures, notifications, burdens of proof, remedies and statutes of limitations in the Consumer Product Safety Improvement Act of 2008[.]" (Practical Law Company)

[Guidance Overview]

EHB and Minimum Value Standards Prescribed by HHS
"HHS has finalized a benchmark-based approach to EHB, which allows states to select a benchmark plan from options offered in the market, which are equal in scope to a typical employer plan.... The final rule also limits the annual amount of cost sharing that individuals will pay across all health plans and provides details on accreditation standards for qualified health plans that will be offered through the new state healthcare exchanges." (Wolters Kluwer Law and Business)

Coordinated Health Care Could Save California $110 Billion
"California could cut $110 billion in healthcare spending over the next decade, saving the average household $800 a year, by quickly moving away from conventional fee-for-service medicine and embracing more coordinated care [according to a recent study].... 78% of the state's healthcare costs, or about $245 billion annually, are still paid through fee-for-service arrangements, which can encourage medical providers to perform unnecessary tests and procedures. The report calls for reducing the share of fee-for-service payments to 50% by 2022." (Los Angeles Times)

Key Long-Term-Care Insurer To Raise Women's Premiums
"Starting next year, the [ACA] will largely prohibit insurers who sell individual and small-group health policies from charging women higher premiums than men for the same coverage. Long-term-care insurance, however, isn't bound by that law, and the country's largest provider of such coverage has announced it will begin setting its prices based on [gender] this spring.... Genworth Financial says the new pricing reflects the fact that women receive two of every three claims dollars." (Kaiser Health News)

OSHA Rules on Health Reform's Whistleblower Provisions
"An employer may not retaliate against an employee for receiving a premium tax credit or cost-sharing reductions while enrolled in a qualified health plan through a health insurance exchange if the employer does not offer a coverage option that is affordable and provides a minimum value. The rules note that certain large employers that fail to offer MV plans may be assessed a tax penalty if any full-time employees receive a premium tax credit through the exchange." (Thompson SmartHR Manager)

Health Care Panel, Lacking Budget, Is Left Waiting
"One of the biggest threats to the success of President Obama's health care law comes from shortages of doctors, nurses and other health care professionals. But a 15-member commission created to investigate the problem has never met in two and a half years because it has no money from Congress or the administration." (Reuters, via The New York Times; free registration required)

Determining Eligibility for Insurance Affordability Programs
"Nearly two-thirds (64.3%) of nonelderly adults with incomes at or below 400 percent of the federal poverty level will become income-eligible for Medicaid or cost-sharing reductions or tax credits for private health insurance. Basing eligibility for Medicaid on current income, but eligibility for cost-sharing reductions and tax credits on annual income, could leave some low-income people without any insurance, either public or private. Determining Medicaid eligibility based on current income will be particularly difficult for applicants -- especially the self-employed -- who cannot determine their exact income until they file their yearly tax return." (Robert Wood Johnson Foundation)

Towers Watson Joins Aon Hewitt, Mercer As Private Exchange Competition Sizzles
"Competition in the multi-carrier private exchange space is accelerating quickly ... Ken Sperling, Aon Hewitt's national health care exchanges strategy leader, [says] he sees growing interest among both employers and employees in the private health care exchange concept. 'In fact, according to Aon Hewitt's data, more than 26% of employers see a future where exchanges are the preferred approach to employer-sponsored health care benefits,' he says." (AISHealth.com; free registration required)

Three Trends that Will Shape Healthcare in 2013
"We're entering a new age of consumerism and, as a result, individuals must have access to comprehensive cost and quality information to help guide them in their decision making.... [W]atch for these three trends to shape the way Americans interact with their health benefits in 2013 and beyond: Launch of Health Insurance Exchanges (HIXs) ... Continued Shift in Benefit Plan Types ... Costs are Growing More Slowly, But They're Still Growing." (TRENDSparency)

Previous Medicare Advantage Cuts Caused Seniors to Lose Coverage
"The Centers for Medicare and Medicaid Services (CMS) recently proposed a 2.2 percent reduction in Medicare Advantage payments for 2014. These cuts are in addition to the $200 billion in Medicare Advantage cuts and the new health insurance tax included in the health care reform law.... Following the Medicare Advantage cuts in the Balanced Budget Act of 1997, millions of seniors across the country saw higher premiums, a reduction in benefits, and loss of coverage[.]" (America's Health Insurance Plans)

[Opinion]

Deloitte Health Care Reform Memo, February 25, 2013
"The convergence of delivery and payments in fully or virtually integrated health systems seems inevitable.... Alignment is not easy, but it no less necessary, especially now. It takes a board committed to breaking down sector silos that constrain alignment inside and outside the organization." (Deloitte Center for Health Solutions)

[Opinion]

Now for the Rest of the Story on Massachusetts Health Care Cost Control
"A bureaucracy-centric governing philosophy is spreading in health care, and with it comes heavy reliance on 'experts' to determine how to curb costs outside the normal legislative and democratic process.... [T]he unintended consequences of using this method to reform health care have not been fully explored." (Timothy Jost in Health Affairs Blog)

[Opinion]

Health Insurance: The Complexities and Ethics of Health Care Financing
"Recent federal health care legislation has exacerbated the situation by implicitly asserting the supremacy of government's moral judgments over those of employers and workers who finance private health plans. The Heritage Foundation's Edmund F. Haislmaier, Senior Research Fellow in Health Policy Studies ... concluded that respect for freedom of conscience in addressing the moral dimensions of medical care should lead to a preference for health policy solutions built around the primacy of patients." (The Heritage Foundation)

[Opinion]

Bitter Pill: Why Medical Bills Are Killing Us
"As currently constituted, Obamacare is going to require people ... to get private insurance coverage and will subsidize those who can't afford it. But the cost of that private insurance -- and therefore those subsidies -- will be much higher than if the same people were enrolled in Medicare at an earlier age. That's because Medicare buys health care services at much lower rates than any insurance company. Thus the best way both to lower the deficit and to help save money ... would seem to be to bring ... near seniors into the Medicare system before they reach 65." (Physicians for a National Health Program)

[Opinion]

Increased Tax on Health Insurance Will Burden New Yorkers
"[The ACA's] health insurance tax, slated to begin in 2014 and estimated to add hundreds of dollars annually to premiums for individuals, families, business owners and the elderly. This is a tax on health insurance itself and it begins at $8 billion in 2014 and increases to $14.3 billion by 2018. The tax is expected to total $101.7 billion over 10 years. Congress estimates that the tax will add about $400 a year to family premiums in 2016 alone." (Buffalo News)

Benefits in General; Executive Compensation

[Guidance Overview]

Impact of New State Same-Gender Marriage Laws on State Taxation of Health Benefits
"[Same-gender] married couples must file their Maine income tax as either 'Married filing Jointly' or 'Married filing Separate,' even if they file a federal income tax return using the status of 'Single.' For benefit plans, that means that the cost of health care coverage will not result in imputed income for state tax because the coverage is available tax-free for a spouse.... [Same-gender] married couples are treated the same for Maryland tax as for federal tax ... [They] will have imputed income for purposes of state income tax (unless the spouse is a tax dependent)." (Faegre Baker Daniels)

IRS Appeals Decision Striking Down Tax Return Preparer Registration Program
"The IRS on Wednesday filed a Notice of Appeal to the United States Court of Appeals for the District of Columbia Circuit of the Jan. 18 district court decision that struck down the IRS's registered tax return preparer program and enjoined it from enforcing the regulations ... On Monday, the IRS made a motion asking the district court to stay the injunction, pending the outcome of the appeal. Earlier, the IRS had attempted unsuccessfully to have the injunction lifted[.]" (Journal of Accountancy)

Comparison of Hours of Service for Purposes of Qualified Plans and Employer Shared Responsibility Under ACA (PDF)
"[This detailed chart compares units] used for determining an employee's credit toward participation, vesting and benefit accrual entitlements under employee pension benefit plans [with units] used for determining the full time status of an employee for purposes of offering an opportunity to enroll in minimum essential coverage under employer-sponsored plan." (Alston & Bird, via American Benefits Council)

Press Releases

CalPERS Board Committee Chairs and Vice Chairs Chosen
CalPERS (California Public Employees' Retirement System)

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