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Employee Benefits Jobs
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Webcasts and Conferences
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[Guidance Overview]
Using the Employer Coverage Tool and Exchange Verification of Employer-Sponsored Coverage
"[The HHS] Employer Coverage Tool can be used as the pre-enrollment template to obtain information about the employer's coverage options. HHS anticipates employers will find additional ways to provide this information to their employees, including posting this pre-populated tool on a company website, or making this information available during benefit fairs. HHS also indicated that employers could combine the Employer Coverage Tool with the Exchange Notice and distribute them together."
(Seyfarth Shaw LLP)
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[Guidance Overview]
New Jersey Enacts Domestic Violence Leave Law
"A bill providing protected leave to victims of domestic violence or sexual assault has been signed into law and is expected to take effect on November 1, 2013. The new law will require New Jersey employers with 25 or more employees to provide 20 days of job-protected leave to eligible employees.... To be eligible for the leave, an employee must have worked for the employer for at least 12 months and for at least 1,000 hours during the immediately preceding 12-month period....Employees must take the leave within one year of the qualifying event. The leave will run concurrently with any other leave entitlements, such as [FMLA leave], and employers will be permitted to require employees use available accrued leave."
(Ford & Harrison LLP)
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[Official Guidance]
Text of HHS Semi-Annual Regulatory Agenda
"This agenda presents the rulemaking activities that the Department expects to undertake in the foreseeable future ... The agenda furthers several Departmental goals, including strengthening health care; advancing scientific knowledge and innovation; advancing the health, safety, and well-being of the American people; increasing efficiency, transparency, and accountability of HHS programs; and strengthening the nation's health and human services infrastructure and workforce."
(U.S. Department of Health and Human Services)
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[Guidance Overview]
Risk Adjustment Hurdles Facing Plans and Providers Under the ACA
"[P]roposed regulations ... allow HHS to impose civil monetary penalties on plan issuers that (1) substantially fail to comply with standards under the risk adjustment program (including access to and timely submission of data), or (2) intentionally or recklessly misrepresent or provide false information to HHS ... In order to succeed within the ACA risk adjusted payment system health plans must (1) educate their employees and providers about the risk adjustment program standards, (2) effectively contract with providers, (3) implement meaningful quality assurance and audit programs, and (4) properly engage coders and coding review services."
(Mintz Levin via Bloomberg BNA Health Insurance Report)
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Oklahoma District Court Bars Enforcement of ACA Contraceptive Mandate (PDF)
"If the injunction does not issue, Hobby Lobby and Mardel must either face penalties that could conceivably amount to $1.3 million/day or the violation of their newly recognized religious rights, as for-profit corporations, under [the Religious Freedom Restoration Act of 1993 (RFRA)]. On balance, the court finds the threatened injury to the corporations if the injunction does not issue outweighs the potential harm to the government." [Hobby Lobby v. Sebelius, CIV-12-1000-HE (W.D. Okla. July 19, 2013)]
(U.S. District Court for the Western District of Oklahoma)
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Contraception Dispute Advances with Oklahoma District Court Injunction
"U.S. District Judge Joe Heaton became the first to flatly bar the federal government from enforcing any part of the contraceptive mandate in the new federal health care law. Other courts have only delayed the mandate while court appeals went forward. The government now has the option of appealing Judge Heaton's order to the Tenth Circuit Court ... That court, in fact, fell just short of ruling finally in favor of the challenging firms on June 27, in an en banc decision, but it left it to Judge Heaton to decide whether to go the rest of the way and issue a binding order against enforcement."
(SCOTUSblog)
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FMLA Absences Up, Some Industries Hit Harder Than Others
"While leave under [FMLA] can be troublesome for any employer, it is particularly disruptive for manufacturers, call centers and health care organizations whose operations depend on fixed schedules ... FMLA absences are on the rise ... and some sectors -- call centers, hotels, government entities, manufacturers and health care organizations -- far surpass others in terms of absenteeism rates. Almost half of hospitality employees and roughly 40 percent of health care employees have an open FMLA leave at any time[.]"
(Thompson SmartHR Manager)
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Demystifying Health Savings Accounts (PDF)
"Most people are not sure about what HSAs are, including how they differ from Health Flexible Spending Accounts (FSAs). Current HSA account holders are very satisfied overall with their experience with the HDHP -- from the quality of coverage to the various HSA features -- and the vast majority intend to re-enroll in an HDHP next year. Those who decline an HDHP make their choice right at the beginning of the Open Enrollment period, while those who enroll in an HDHP spend more time weighing their health benefits options.... Some 37% of survey respondents who recently declined to enroll in an HDHP will likely make the same choice next year."
(Fidelity)
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Indiana Says Health Plan Costs Will Spike to $570 But That's Not the Full Story
"The $570 figure that Indiana put out Friday doesn't, in fact, tell us much at all. It's pretty much just a great number to make the cost of health insurance sound expensive in Indiana and a horrible one to use in thinking about how much Hoosiers will pay for coverage come January."
(Sarah Kliff in The Washington Post)
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Medi-Cal and Obamacare: More Confusing Twists
"If my family of six qualifies for Medi-Cal under the [ACA], do we have to sign up for that? Or can we still buy subsidized health care plans through Covered California? ... Starting in January, Medi-Cal will broaden its eligibility requirements as a result of ObamaCare, allowing applicants with higher incomes and those who were previously ineligible, such as childless adults, to get coverage. But whether you're eligible for Medi-Cal now or become eligible then, that fact alone disqualifies you from tax subsidies on the health insurance exchange, which is called Covered California."
(The Fresno Bee)
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Five Biggest Mistakes When Designing a Supplemental Disability Plan
"[1] Deciding not to offer a supplemental plan and opting to change the definition of earnings in the current plan, as well as raising the group plan's long-term disability cap.... [2] Choosing a very good technology platform over a better guaranteed-issue offer.... [3] Failing to develop a well thought out enrollment strategy.... [4] Settling for an inadequate guaranteed issue offer on an employer-sponsored program.... [5] Unnecessarily subjecting your employee group to underwriting."
(Employee Benefit News)
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Detroit Wants to Unload 19,389 Retirees Into Obamacare's Marketplaces
"Cities have a few options for reducing their health-care commitments.... Cities can change eligibility for the program or pare back benefits. Some that offer supplemental coverage for Medicare might just have the over-65 crowd rely solely on the federal program. The [ACA] created a new option: moving retirees onto the public health-insurance exchanges. There, state retirees could shop for coverage and purchase their own plans. And, if their salaries were low enough, they might qualify for federal assistance."
(Sarah Kliff in The Washington Post)
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Humana Fills Blank Spots In Mississippi Obamacare Map
"[As] the Oct. 1 opening date drew near for Mississippi's exchange, not one insurer had applied to offer subsidized coverage in some of the poorest and most rural parts of that state. Humana's agreement to expand its exchange offerings from four Mississippi counties to 40 ensures that at least one company will sell subsidized plans to individuals everywhere in the state[.]"
(Kaiser Health News)
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Democratic Senator Wants to Allow Small Businesses to Enroll in Federal Health Plans
"A Democratic lawmaker has introduced a plan to ease small businesses' transition into new requirements in the [ACA] by allowing them to opt into the federal employees health care system.... [T]he Healthy Competition for Small Business Act would grant small business owners the opportunity to enroll their employees in the Federal Employees Health Benefits Plan if fewer than two insurance plans are available in the small business exchange of the state in which the business is located."
(Government Executive)
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State Action Roundup on ACA Implementation, July 19, 2013
"California, the District of Columbia, Massachusetts, New Jersey, New York, Rhode Island, and Vermont have decided not to charge smokers higher premiums. Arkansas, Colorado, and Kentucky will charge smokers a higher premium, but not as high as the law allows.... Minnesota is using the state's own insurance program for low-income people, MinnesotaCare, to implement the Basic Health Program. It is the only state in the country so far to move forward with this option.... To promote enrollment in Connecticut, the state is planning to hand out sunscreen at the beach with 'Get Covered' on the bottle, and fly planes over the beaches with banners touting outreach messages."
(The Commonwealth Fund)
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Ways and Means Committee Releases Draft Legislation to Reform Medicare
"The proposal outlines three key policies to modernize cost-sharing within the Medicare program: (1) reducing premium subsides for wealthier seniors in Medicare Parts B & D; (2) increasing the annual Medicare Part B deductible; and (3) establishing a home health co-pay. All provisions can be found in the President's FY2014 budget."
(Committee on Ways and Means, U.S. House of Representatives)
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House Hearing to Examine Employer Mandate Delay
"On Tuesday, July 23 at 10:00 a.m., the Subcommittee on Health, Employment, Labor, and Pensions, chaired by Rep. Phil Roe (R-TN), and the Subcommittee on Workforce Protections, chaired by Rep. Tim Walberg (R-MI), will hold a joint hearing entitled, 'The Employer Mandate: Examining the Delay and its Effect on Workplaces'.... [This] hearing will provide an opportunity for members to hear witnesses discuss the consequences of the employer mandate and how the decision to delay its implementation will affect workers and job creators." [Live webcast will be available.]
(Committee on Education & the Workforce, U.S. House of Representatives)
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District Court Imposes $1.8 Million Penalty on Employer for COBRA Violations Outsourced to Multiple TPAs
"Visteon's COBRA notice system was not reasonably designed to ensure that Visteon complied with the law. Although ... corporations with large workforces may need to utilize third-parties to [administer their] various benefit programs, there is no evidence in the record to support a conclusion that Visteon knew whether or not its various (multiple) TPAs were properly administrating their individual functions at any given time until 2007 ... [T]here is no evidence that it was anyone's job at Visteon to keep track of which employees experienced a qualifying event, much less whether that individual received a COBRA notice.... This penalty is large enough to act as a deterrent to Visteon and to others who similarly operate a large number of facilities and choose to use multiple TPAs to perform various benefit functions, but not so large as to be a windfall for the Class." [Pierce et al. v.
Visteon, No. 1:05-cv-01325-LJM-DKL (S.D. Ind. June 25, 2013)]
(U.S. District Court for the Southern District of Indiana)
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Software Upgrade With Inadequate Safeguards Leads to $1.7 Million HIPAA Security Settlement
"The absence of a [corrective action plan (CAP)] seems noteworthy ... Since these improper disclosures happened more than three years ago, perhaps OCR was convinced that the health plan had taken sufficient remedial steps in the interim to make a CAP unnecessary. Or, it may be that a business associate of the health plan was primarily responsible for the software upgrade (and the associated security deficiencies). At the time of these incidents, OCR did not have authority to enforce the HIPAA security rule directly against business associates. The compliance landscape will change beginning September 23, 2013, when final regulations ... [authorize OCR] to enforce HIPAA's security rules directly against business associates."
(Thomson Reuters / EBIA)
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How a Secretive Panel Uses Data That Distorts Doctors' Pay
"Unknown to most, a single committee of the AMA, the chief lobbying group for physicians, meets confidentially every year to come up with values for most of the services a doctor performs. Those values are required under federal law to be based on the time and intensity of the procedures. The values, in turn, determine what Medicare and most private insurers pay doctors. But the AMA's estimates of the time involved in many procedures are exaggerated, sometimes by as much as 100 percent[.]"
(The Washington Post)
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[Opinion]
Did You Know the Federal Government Thinks Doctors Can Work 50-Hour Days?
"Thirty-one people meet in private, once every three years, to determine the entire country's health care prices.... The American Medical Association spends $7 million developing these prices. Medicare has a half-dozen, part-time workers to review the data.... If the RUC's estimates were right, some doctors would literally work more than 24 hours each day.... Medical productively and technology keep increasing. But, for some reason, so do health care prices.... The economists who created the RUC now think the RUC works horribly.... Doctors tell the RUC how valuable their work is."
(Sarah Kliff in The Washington Post)
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[Opinion]
Why the White House Is Panicking About Obamacare
"Millions of people are turning down (Medicaid) health insurance, even though it's free! Millions of others are turning down their employers' offers. Since employees pay about 27% of the cost of their health insurance, on the average, millions of workers are passing up the opportunity to buy health insurance for 27 cents on the dollar.... Welcome to the huge disconnect in health reform. On the one hand there are the people who are supposed to benefit from health reform. On the other hand there are the people who talk about it and write about it."
(John Goodman's Health Policy Blog)
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[Opinion]
Obamacare Playing Small Ball But Republicans Are Winning the Battle Over the Big Idea
"It shouldn't be a surprise that this administration, now buried in the minutia of injecting an extraordinary amount of micro management into a sixth of our economy, would think a $100 rebate for someone already paying thousands of dollars in health insurance premiums would be a major accomplishment."
(Health Care Policy and Marketplace Review)
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[Opinion]
What Makes U.S. Health Insurance Exchanges So Complicated?
"Why would it take almost three years to set up the American exchanges? And why will American buyers of health insurance need specially trained navigators to help them navigate these exchanges? There are several reasons. For one, the exchanges are but one small component of America's highly complex health insurance system and must be stitched smoothly onto its many facets ... [S]tate-based exchanges must coordinate with the [IRS] to determine eligibility for subsidies and their magnitude. The American exchanges must also work with the state-administered Medicaid programs, to determine whether an applicant on the exchanges should be referred to Medicaid, and with small employers. Furthermore, some American exchanges will be 'active' -- they will actually negotiate premiums with insurers."
(The New York Times; subscription may be required)
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[Opinion]
Doctors Should Be Rewarded for Quality Care, Not for Cutting Corners
"The incentives to cut costs are strong, but the individual quality measures chosen by CMS to assess quality in the new programs are limited in scope, and that can adversely affect patient care. These measures are focused on processes of care, rather than clinical outcomes, and do not measure quality for most complex diseases and conditions, including major heart procedures, neurological conditions, orthopedic procedures, or cancer treatments. Policymakers need to fix this problem without undermining the goals of the new systems."
(Jeffrey Binder in Health Affairs)
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Benefits in General; Executive Compensation
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Crafting Made-To-Order Benefit Packages for Younger Employees
"To reach out to millennials, employers will have to transform traditional enrollment communications to something that speaks to a younger generation ... Benefit packages designed to meet the needs of the under-30 workforce should incorporate social networking and mobile technology and include offerings that acknowledge work-life balance[.]"
(Human Resource Executive Online)
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Detroit Filing Sends Benefits Warning to Other Cities
"In recent decades, many municipalities have provided their workers with generous retirement benefits, both pensions and health coverage, often in lieu of pay increases. But this has created an unsustainable future burden for budgets that has only been exacerbated by the loss of real estate and other tax revenue in the financial crisis. In particular, cities like Chicago and Santa Fe, New Mexico, have worryingly high pension liabilities compared to revenue, investors and analysts say."
(Reuters)
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Orr Tells Detroit Retirees: Your Pensions, Benefits Are Safe for 6 Months Amid Bankruptcy
"[Detroit emergency manager Kevin] Orr provided retirees some temporary relief Friday, telling the Free Press that pension and health care benefits are safe for at least the next six months.... Orr has not yet specified the cuts to pensions he will seek through the bankruptcy process. He has proposed freezing pensions and moving workers to a 401(k)-style plan to help alleviate the pension systems' unfunded liabilities of $3.5 billion. He also wants to move retirees to Medicare or health care exchanges being set up through the Affordable Care Act."
(Detroit Free Press)
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Plaintiffs Achieve Another Victory in Litigation Over Executive Compensation Disclosures, This Time in Delaware Federal Court
"[T]he proxy statement included standard, albeit, imperfect language, regarding deductibility ... The suit alleged that the representations about the availability of tax deductions were materially false or misleading ... Qualcomm and the IRS entered into an Issue Resolution Agreement ('IRA'), pursuant to which the IRS concurred with Qualcomm that the 2011 LTIP approved by shareholders was compliant with Code Sec. 162(m).... The Court determined that the IRA did not 'formally bind the IRS.' Therefore the IRA did not 'definitively rule out nondeductibility and resultant harm to Qualcomm, particularly where [plaintiff] has pled reasons the IRA may be inaccurate.'"
(Michael S. Melbinger, Winston & Strawn LLP)
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[Opinion]
Senate Finance Committee Mulls Executive Compensation Changes
"[H]ere are the proposals that the Finance Committee 'may wish to consider' as it moves forward ... Revise the limits on the deductibility of executive compensation... Modify or repeal Code Section 409A.... Repeal NQDC.... Repeal incentive (at the money) stock options.... Modify deductibility of stock options.... Revise golden parachute rules."
(Benefits and Compensation with John Lowell)
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Press Releases
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