Defined Contribution Client Manager
Milliman
in CA

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An Introduction to the Next Generation Medicare Plus Model
November 26, 2013 WEBCAST
(Magellan Risk Management)

Ethical Considerations for Employee Benefits Practitioners
December 5, 2013 WEBCAST
(ASC Institute)

Managing Benefits Leadership Workshop
December 11, 2013 in FL
(Rhodes-Joseph & Tobiason Advisors, LLC)

Professionalism and Ethics for Enrolled Actuaries
December 12, 2013 WEBCAST
(American Society of Pension Professionals & Actuaries (ASPPA))

Voluntary Benefits Option: Adding Benefits Without Increasing Costs
December 12, 2013 WEBCAST
(Lorman Education Services)

Affordable Care Act 101
December 19, 2013 WEBCAST
(U.S. Small Business Administration (SBA))

Women Business Leaders Forum
June 9, 2014 in CA
(American Society of Pension Professionals & Actuaries (ASPPA))

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[Guidance Overview]

Applying ACA Market Reforms to HRAs, FSAs and Other Health Accounts
"Given the implications of the new rules, employers might want to reconsider offering stand-alone HRAs. Health insurance market reforms generally do not apply to retiree-only HRAs and thus should not affect employers' decisions to offer them." (Towers Watson)  

[Advert.]

The New Health Care Reform Law: What Employers Need to Know

This popular reference guide covers the full range of health care reform issues in a helpful question-and-answer format. It will help employers and service providers comply with dates, deadlines and coverage mandates under the law. Order Now!

[Guidance Overview]

Final Regs Issued on Mental Health and Substance Use Disorder Benefits Parity Under ACA
"In conjunction with the final regulations, the EBSA issued [FAQs] about the ACA and mental health parity implementation. The FAQs address, among other issues, plans that are exempt from the MHPAEA.... The FAQs also explain that the MHPAEA provides that the criteria for medical necessity determinations with respect to mental health or substance use disorder benefits must be made available by the plan administrator or the health insurance issuer to any current or potential participant, beneficiary, or contracting provider upon request." (Wolters Kluwer Law & Business)  

The White House's Obamacare Fix Is About to Create a Big Mess
"Under the change that the administration is announcing this morning, the hypothetical Americans with a policy that ends in June 2014 would have the option to renew that exact same plan for one more year -- if their insurance company decides to provide that option. Keep in mind, this change is not ordering insurers to offer their products for another year; health plans regularly take their offerings on and off the market. Instead, its a very nice ask on the part of the administration, to insurance carriers and regulators, to play ball on this one." (Ezra Klein in The Washington Post; subscription may be required)  

Everything You Need to Know About the Plans to 'Fix' Obamacare
"The insurance industry is furious. They've been working with the White House to get HealthCare.Gov up and running and they've been devoting countless man hours to dealing with the problems and they've been taking the heat from their customers over canceled plans, and now the Obama administration wants to make them into a scapegoat. 'This doesn't change anything other than force insurers to be the political flack jackets for the administration,' an insurance industry insider told Evan McMorris-Santoro. 'So now, when we don't offer these policies, the White House can say it's the insurers doing this and not being flexible.'" (The Washington Post; subscription may be required)  

As Released by HHS: 'Health Insurance Marketplace: November Enrollment Report' (PDF)
"To date, 106,185 persons have selected a Marketplace plan -- this includes 79,391 in [State-Based Marketplaces] and 26,794 in [the Federally-Facilitated Marketplace]. An additional 975,407 persons who have been determined eligible have not yet selected a plan through the Marketplace. To date, the Marketplaces have processed eligibility determinations and assessments for 98 percent (1,477,853) of the 1,509,883 persons who have applied for coverage[.]" [Also available is an Infographic summarizing these results.] (Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services)  

[Advert.]

23rd Annual National Health Benefits Conference & Expo

The Biggest Challenge Remains: Addressing the Most Intractable Cost Problem Facing Employers, Employees & Governments at All Levels - January 28-29, 2014 - Clearwater Beach, FL. High quality, moderate cost - Register now for best rates!

The October Exchange Enrollment Report: What It Means
"[T]he number of enrollees is the smallest number in the report (other than the number of enrollees from individual states -- 42 enrollees from North Dakota).... The most interesting number in the report ... is the number of those who were determined eligible for coverage who also qualified for financial advance premium tax credits -- 326,130, or about 30 percent of those determined eligible for enrollment in qualified health plans. This is far below previous estimates of the percentage of exchange enrollees who would obtain subsidies ... [T]hose who are tenacious enough to get through to enrollment at this point are higher-income, highly motivated individuals who know the value of health insurance but can afford it." (Timothy Jost in Health Affairs Blog)  

Employee with Crying Spells After Daughter's Sexual Assault Has Viable FMLA Claim
"[C]ourts are focusing far less on the definition of a serious health condition and more on the FMLA interference and retaliation claims themselves ... This case serves as yet another example of how quickly a court will send a case to a jury as a result of one indiscreet comment.... [C]ourts should not act as a super-personnel department in second guessing the situation. Nevertheless, the court did so here. The result is that employers must be mindful not to 'load up' on any employee returning from FMLA leave." [Nelson v. Clermont Cnty. Veterans Service Cmmn., No. 1:11-cvB335-HJW (S.D. Ohio)] (FMLA Insights)  

Federal Health Care Spending: Why Is It Growing? What Can Be Done About It?
"Federal health care spending is growing because of a combination of the aging of the population, an expansion of federal subsidies for health insurance, and rising health care costs per person. Since a central goal of policies regarding health and health care is to help people live longer, the more successful our policies are, the more population aging we will have. Hence, efforts to reduce federal health care spending need to be directed at the other two factors pushing up spending." [Accompanied by 36 presentation slides that detail current and projected costs, effects, and possible solutions.] (Congressional Budget Office)  

New Premium Structures Change How Small Employers Calculate Employee Contributions
"Small employers (those under 50 employees) are seeing a big change in how their insurance premiums are calculated for 2014 ... [T]he premium costs are determined for each employee based on geographic location, gender, and age. Many employers base the employee premium contribution strategy on a percentage of the premium. This can obviously cause the contribution rates for employees to increase or decrease depending on the employee's factors.... [Some employers are] averaging the actual monthly premium for a given coverage level among all employees enrolled in that level. This certainly puts a bit more risk on the employer if there are personnel changes mid-year that would alter this, but may make the transition for employees a bit easier." (Kushner & Company)  

With Exchanges Now Operating and the Excise Tax Ahead, Finance Executives Increase Involvement in Healthcare Benefits
"46% of finance executives are more involved in health care benefit decision making today than they were three to five years ago.... [S]urvey respondents whose organizations have increased finance involvement are more likely to cite rethinking health care strategy for active employees as a top priority (64% versus 48%), to strongly believe that health care reform will lead to higher costs (42% versus 27%) and to plan to make significant changes to their health benefit programs by the start of 2016 (34% versus 17%)." (Towers Watson)  

Prepare Now to Apply Complicated ACA Definition of 'Full-Time Employee'
"Large employers in particular will be most wise to take steps now to learn the government's definition of full-time employee as it relates specifically to the ACA ... and begin the extensive process of measuring and managing their potential covered population so that by this time next year they are prepared to make informed decisions ... [T]he government's definition of who qualifies as full-time under the ACA can be difficult to decipher and how you go about measuring it is cumbersome at best." (healthstat)  

Health Care Costs, Benefits, and Reform: What's the Next Move for Employers?
"Seeking better value and health outcomes for their investment, many employers are dissatisfied with the performance of the health care system, considering it to be costly, wasteful, underperforming, and lacking in transparency.... [T]hree years into implementation and facing decisions around insurance exchanges and the employer mandate, the [ACA] remains largely a mystery to many employers.... Employee cost-sharing tactics are in place but there is a gap between what employers are currently using and tactics they think could have high impact in managing costs." (Deloitte Center for Health Solutions)  

Employers Facing Higher Costs, Reducing Full-Time Jobs, Due to ACA
"31 percent of franchise and 12 percent of non-franchise businesses report they have already reduced worker hours because of the impending law, more than a full year before the employer mandate goes into effect. Additionally, 27 percent of franchise and 12 percent of non-franchise businesses have already replaced full-time workers with part-time employees because of the law.... [Among business owners with 40 to 70 employees], 59 percent of franchises and 52 percent of non-franchises, say that they 'will make personnel changes to stay below the 50 full-time equivalent threshold.'" [Also available are a Fact Sheet and 22-slide Executive Summary.] (International Franchise Association and U.S. Chamber of Commerce)  

Seventh Circuit Bars Enforcement of Contraceptives Mandate Against For-Profit Corporations
"The Seventh Circuit held that: [1] The corporate plaintiffs are persons under the RFRA, and could invoke the statute's protections. [2] The contraceptives mandate substantially burdened the free exercise rights of all the plaintiffs (corporate and individual). [3] The federal government failed to justify the mandate under strict scrutiny.... [T]he Seventh Circuit reversed the district court and remanded with instructions to enter preliminary injunctions barring enforcement of the contraceptives mandate against the plaintiffs." (Practical Law Company)  

Many Individuals Would Give Health Plans Private Info to Save Money (PDF)
"[A] poll of more than 2,000 U.S. adults found that a majority would be 'very willing' to have various tests and share the results with their health insurer -- provided there was a financial incentive, such as a lower monthly premium or smaller co-pays. Many were even open to intrusive measures. Just over half said they'd agree to let their health plan monitor any exercise regimen they were using to lose excess pounds or control diabetes. What's more, nearly half said they'd undergo genetic tests to gauge their risks of 'cancer or inherited medical conditions.'" (Harris Interactive)  

International Profiles of Health Care Systems, 2013 (PDF)
[138 pages.] "This publication presents overviews of the health care systems of Australia, Canada, Denmark, England, France, Germany, Japan, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States. Each overview covers health insurance, public and private financing, health system organization and governance, health care quality and coordination, disparities, efficiency and integration, use of information technology and evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views." (The Commonwealth Fund)  

Access, Affordability, and Insurance Complexity Are Often Worse in the United States Compared to Ten Other Countries
"U.S. adults were significantly more likely than their counterparts in other countries to forgo care because of cost, to have difficulty paying for care even when insured, and to encounter time-consuming insurance complexity. Signaling the lack of timely access to primary care, adults in the United States and Canada reported long waits to be seen in primary care and high use of hospital emergency departments, compared to other countries." (Health Affairs)  

[Opinion]

Statement by House Ways and Means Chairman Dave Camp on Obamacare Enrollment Numbers
"'Even if this data was an accurate picture, the Administration would need to enroll 68,000 people per day to meet their year-end goal. However, the website isn't even designed to handle that much traffic and is currently capable of only handling less than half that much. With the little data we have so far, I fear we could see a fundamental breakdown of the insurance market with coverage gaps and skyrocketing premiums -- pricing millions of Americans out of health care, yet still forced to pay the individual mandate tax." (Committee on Ways and Means, U.S. House of Representatives)  

2013 Executive Stock Ownership Guidelines Report (PDF)
"The prevalence of Fortune 100 companies with publicly disclosed executive stock ownership policies increased from 86.3% in 2011 to 89.4% in 2012.... Between 2010 and 2012, the number of companies that used both ownership guidelines and holding requirements as their share retention method increased by 6.0%.... Ownership guidelines that define ownership targets as a multiple of base salary are the most prevalent guideline design.... Among companies with ownership guidelines, only 11.4% include options in determining ownership guideline compliance, compared with 43.0% that explicitly exclude options." (Frederic W. Cook & Co., Inc.)  

Decision Time for Nonqualified Deferred Compensation: Top Issues When Choosing Salary Deferrals for the Year Ahead
"[T]he fourth quarter of the year is the most common period during which salary deferrals are elected through NQDC plans for the year ahead.... Issues to consider in your decision-making at enrollment include the following. [1] Maximizing the amount you can contribute to your 401(k) plans.... [2] Cash needs for the year ahead and multi-year projections for your income.... [3] The financial security of your company, and your job security.... [4] Company match.... [5] The thresholds for higher taxes and rates." (myStockOptions.com)  

Ask Not 'What Is the Risk of Doing a Complete NQDC Plan Review,' But Rather ...
"A review is not complete if it does not consider the impact of the plan on the bottom line, [its] effectiveness in attracting and retaining key talent, and its ability to mitigate impending tax increases, and its ability to drive robust plan participation. A complete due diligence review looks at your organization's unique business situation and asks: Is the plan compliant with current regulatory requirements? Is this plan helping plan sponsors reach their goals? Is this plan helping plan participants reach their goals? Is the communications program driving enrollment? Can the cost of the plan be reduced? What is the impact of the informal funding strategy and alternatives?" (Fiduciary Plan Governance, LLC)  

10 Tips to Avoid Identity Theft On- and Offline
Hyatt Legal Plans, a MetLife company

Segal Group Expands East Region Health Practice
The Segal Group

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