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March 8, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

Retirement Benefits Specialist
for DIRECTV in CA

Senior Associate
for Craford Benefit Consultants in OR

Retirement Plan Services Manager
for Dixon Hughes Goodman LLP in VA

Retirement Plan Administrator
for Bates & Company, Inc. in FL

VP, Contracts
for Prudential in NJ

Clinical Consultant / Disability Insurance
for Prudential in NJ

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Webcasts and Conferences

July Business Services Advisor Symposium - Coming to Englewood, CO
in Colorado on April 4, 2013 presented by Rekon Intelligence

ABC of Greater Twin Cities: Washington Update & New EPCRS Program & Real Life Corrections
in Minnesota on April 16, 2013 presented by Greater Twin Cities ABC

View All Webcasts and Conferences


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[Guidance Overview]

Deciding Whether to Play or Pay Under the ACA
"Because Exchange subsidies are available only to individuals with household incomes of at least 100 percent and up to 400 percent of the federal poverty line ... employers that pay relatively high wages may not be at risk for the penalty ... Likewise, because Exchange subsidies are not available to individuals who are eligible for Medicaid, employers may be partially immune to the penalty with respect to their low-wage employees ... by 'playing' for employees who would otherwise be eligible for an Exchange subsidy, employers can ensure they are not subject to any penalty, even if they don't 'play' for all employees." (Jones Day)


[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]

2012 Retroactive Transit Pass Increase
"The IRS [has] indicated that this relief is mandatory, and failure to properly reflect the exclusion could result in tax reporting penalties on the employer. Therefore, although the amounts involved are small, we anticipate many employers will make the adjustment on Form W-2, and employers are encouraged to file for a refund of the employee and employer share of FICA taxes on Forms 941-X." (Groom Law Group)

[Guidance Overview]

Nursing Mother Break Requirement Spurs Investigations, Lawsuits
"This all seems straightforward until one begins to ponder such things as how many daily breaks are required, how much time is 'reasonable,' and so on. Many of the answers necessitate individualized evaluations based on a particular employee's (and child's) circumstances." (Employee Benefit News)

[Guidance Overview]

Proposed ACA Accommodations for Religious-Affiliated Organizations (PDF)
"Actuaries, economists and insurance carriers estimate that this coverage will be cost-neutral. The carrier will be insuring the same women under both the group health plan and the individual contraceptive-only policies. Because this coverage may improve women's overall health and decrease unwanted pregnancies, the carrier may even have lower costs." (McGraw Wentworth)

[Guidance Overview]

MEWA Form M-1 and Final Regs Released
"MEWAs are still required to certify compliance with part 7 of ERISA by using the 36-page checklist/questionnaire that needs to be completed as part of the form. As with previous years, there are penalties associated with incomplete or incorrect forms. Additionally, all plan administrators must now file the Form M-1 electronically using the online filing system." (Ford & Harrison LLP)


[Advert.]

Join us at the World Health Care Congress – April 8-10, 2013 in National Harbor, MD

Sponsored by World Congress

Improving global healthcare by convening business, political, and academic healthcare leaders to actively share information and work together to improve the overall quality and cost of health delivery. Promo Code BLINK3 good for $300 off registration fee.


[Guidance Overview]

Final HHS Regulations Address Transitional Reinsurance Fee
"Employers with calendar-year plans need to build this expense into budget rates for the 2014 calendar year ... Employers also need to identify who will administer the TRF payment within their organization, as recordkeeping and calculation of the average number of covered lives will be required." (Towers Watson)

[Guidance Overview]

DOL Updates Model FMLA Forms (PDF)
"The DOL also removed its forms from the text of the FMLA regulations, which should make it easier for the DOL to make changes to the model forms in the future. However, the DOL did not update its medical certification for an employee's serious health condition form to include language recommended by the U.S. Equal Employment Opportunity Commission (EEOC) to prevent the disclosure of genetic information[.]" (The Chelko Consulting Group LLC)

Top Republicans Demand Obama Continue to Provide Costly Coverage to People with Pre-Existing Conditions
"[A] group of top House Republicans have written a letter to President Obama asking him to preserve a temporary program included in the law that provides health care coverage to people with pre-existing conditions.... The $5 billion program, which covers only sick people is incredibly costly, and will soon stop processing new applicants. Republicans ... are demanding that the White House shift funds from prevention or comparative effectiveness research to keep the PCIP running." (ThinkProgress)

How Rolls Royce Health Plan Drives Pentagon Spending
"Costs for the Pentagon's health care program, known as TRICARE, have been quietly but dramatically rising for the last decade. In just one decade, from 2001 to 2012, DOD health care spending rose from $17 billion to $52.2 billion. Health care spending now accounts for 10 percent of the Pentagon's non-war budget." (The Fiscal Times)

Obamacare Insurance Plans Will Be Bare Bones -- and Expensive
"There's mounting evidence that come fall, the health plans sold through the Obamacare exchanges will be bare bones affairs -- with narrow networks of providers to select from, and heavy co-insurance once patients go 'out of network'.... Quality of coverage is just one issue. Price is the other.... [E]ven though the new health coverage will be austere, it'll still be pricey." (RealClearMarkets)

Your Company's Next Health Plan: Drop that Doughnut
"[A] new survey draws a picture of the brave new world of Obamacare, in which large companies are rewarding employees for lowering their cholesterol and submitting to monitoring from a 'primary nurse case manager'.... You might want to tell your significant other to drop the doughnut, too: Sixty percent of companies said they will extend such incentives to spouses." (CNBC)

Evidence Mounts: Health Care Law Hurts Jobs, Increases Costs
"[The Federal Reserve's] Kansas City regional bank reported, 'Firms continued to report changes in health care policy and fiscal uncertainty as reasons for delayed hiring.' A Gallup survey found ... the percentage of the work force composed of part-time workers reached 20.6% in February, its highest level since 2010." (U.S. Chamber of Commerce)

Most Large Employers Plan to Keep Health Insurance Benefit
"Only about 26 percent of large employers surveyed were very confident their company will offer healthcare benefits in 10 years. That is a slight increase from last year's 23 percent, but a sharp drop from 73 percent five years ago." (The Baltimore Sun)

Workers' Share of Health Costs Is Likely to Continue Rising
"[E]mployees contribute 42 percent more for heath plan coverage than they did five years ago, as against a 32 percent increase for employers ... [T]he share of the total cost of health care borne by employees, including both premiums and costs paid out-of-pocket, climbed to 37 percent in 2013, from 34 percent in 2011[.]" (The New York Times)

Three More States Get Federal Nod for Health Exchanges
"Michigan, New Hampshire and West Virginia are the final three states to receive conditional federal approval to run state partnership health insurance exchanges under the 2010 health care law, the Department of Health and Human Services announced Thursday." (USA TODAY)

The Limited Reach of Employer-Based Health Insurance
"The share of the U.S. population over the age of 15 covered by employment-based health insurance (either by their own employer or as a dependent) has been falling, dropping from 64.4% in 1997 to 56.5% in 2010." (Conversable Economist)

Health Insurers Launch TV War Over Medicare Advantage Cuts
"The health insurance industry is escalating its lobbying battle against a proposed Medicare Advantage pay cut to insurers by launching a television and online advertising campaign to garner public support among the program's 14 million beneficiaries.... The commercial, presented by an industry-sponsored group called the Coalition for Medicare Choices, fails to mention that the payment cuts are aimed at insurers, not beneficiaries." (Reuters)

Federal Reserve Says Obama's Health Law Leading to Layoffs
"'Employers in several Districts cited the unknown effects of the [ACA] as reasons for planned layoffs and reluctance to hire more staff,' said the March 6 [Federal Reserve] beige book ... [T]he Atlanta district noted that healthcare regulations are so burdensome there is a shortage of compliance specialists." (The Hill)

Most Employers Do Not Understand True Cost of Complying with Health Care Reform
"[A recent survey] noted that 50 percent indicated that health care reform has increased their costs. While 60 percent of employers stated that avoiding ACA cost increases is very important to their businesses, employers are relying upon inaccurate 'perceptions of cost' as they plan their responses to health care reform[.]" (Wolters Kluwer Law & Business)

[Opinion]

Getting the Record Straight on Health Care Reform
"Employers for decades have adjusted employee work hours so they can avoid offering not just benefits such as health insurance but also vacations and paid time off -- any benefits that have minimum hours for eligibility associated with them. The health care law will not change this pre-existing behavior." (The Huffington Post)

[Opinion]

CalPERS Long-Term Care Insurance Rate Hike Upsets Employees
"The $3.6 billion privately funded pot of money is too small to cover higher-end policies and hold down premiums for those plans.... Most of the 148,000 policyholders have the most lavish plans with lifetime benefits and coverage that keeps up with inflation. Unlike with CalPERS' pension fund, taxpayers don't cushion losses. Policyholders have to absorb them." (Sacramento Bee)

[Opinion]

Creating a Workforce for the New Health Care World
"[T]he entire health sector requires far more transparency. One can't fix what one can't see, and many of the solutions to the problems involving health costs and provider availability are impossible to ascertain as a result. How many providers would we need if we could eliminate unnecessary care as a result of our volume-driven health care infrastructure?" (Timothy Jost in Health Affairs Blog)

Benefits in General; Executive Compensation

Prime ERISA Areas for Supreme Court Review (PDF)
"This article focuses on four distinct areas of ERISA litigation that are in need of clarification by the Supreme Court during the current or upcoming terms. They involve the evidence to be considered in a benefits denial claim under the de novo standard of review; the standard of review in a breach of fiduciary case where a profit sharing plan invests in employer stock that is declining in value (the so-called 'stock drop' cases); an employer's modification or termination of retiree health care benefits in collective-bargaining contexts in light of the terms of the employee benefits plan and the collectively bargained agreement; and the plan administrator's enforcement of subrogation clauses under a health care plan." (Prof. Kathryn J. Kennedy, The John Marshall Law School, in the Tax Management Compensation Journal)

Supreme Court Declines Review of Ruling in Fifth Circuit ERISA Preemption Case
"The Supreme Court's denial of UHC's petition in this case leaves unresolved the existing split among the U.S. circuit courts of appeal regarding the interpretation and application of ERISA preemption to certain state law claims." (Haynes and Boone, LLP)

Fourth Circuit Opens Door to Extrinsic Evidence in Considering Claim for Benefits
"[T]he Court held that 'a district court may consider evidence outside of the administrative record ... when such evidence is necessary to adequately assess the Booth factors and the evidence was known to the plan administrator when it rendered its benefits determination'.... [The] Court suggested a dramatically increased discovery burden, requiring the administrator to make exhaustive searches into past decisions -- something for which the administrator would not necessarily have had any reason to search in reviewing the claimant's benefit claim, as every claimant's case is based upon its own unique facts. " [Helton v. AT&T, Inc. Pension Benefit Plan, 2013 U.S. App. LEXIS 4575 (4th Cir., Mar. 6, 2013)] (Wombyle Carlyle)

Cypen & Cypen Newsletter for March 7, 2013
Covers employee benefit developments with an emphasis on governmental plans. Topics include: [1] How does smoothing affect funding of defined benefit plans? [2] Union did not have standing to challenge termination of member who settled and released city; [3] Agreement by county to provide perpetual healthcare benefits to employees may be implied; [4] Disability rate among government benefit recipients varies. (Cypen & Cypen)

Press Releases

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