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December 17, 2008

Here are the Web's best new links about compliance and cost aspects of plan operation, design and policy.


Today's sponsor is BeneCom Associates, LLC

(Click on company name or banner to learn more.)
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[Guidance Overview]
Massachusetts Health Connector Issues Administrative Bulletin Detailing Actuarial Equivalence for Minimum Creditable Coverage Purposes

Excerpt: "In the recently issued Administrative Bulletin 01-08, the Connector set out procedures for demonstrating actuarial equivalency, and also provided clarification on mental health and substance abuse benefits and Health Savings Accounts (HSAs) coupled with High Deductible Health Plans (HDHPs). This advisory explains the key features of Administrative Bulletin 01-08." (Mintz, Levin, Cohn, Ferris, Glovsky and Popeo P.C.)


[Guidance Overview]
Mandatory Medicare Secondary Payer Reporting Requirements Beginning in 2009 (PDF)

1 page. Excerpt: "Beginning January 1, 2009, employer-sponsored group health plans will be required to begin collecting and soon thereafter reporting Medicare Secondary Payer (MSP) data to the Centers for Medicare and Medicaid Services (CMS). The new reporting requirements are designed to identify cases prospectively (rather than after claims are paid by Medicare) in which the employer plan is primary ? not Medicare. Insured health plans and third party administrators (TPAs) self-insured plans should automatically take care of MSP reporting for plan sponsors. Plans that are both self-insured and self-administered must register with CMS, but can delegate reporting to an agent." (Hay Group)


[Guidance Overview]
Transition Relief Extended for Using Health FSA and HRA Debit Cards at Drug Stores and Pharmacies

Excerpt: "The IRS has issued Notice 2008-104 to extend by six months the transition relief for using health flexible spending arrangement (Health FSA) and health reimbursement arrangement (HRA) debit cards at certain merchants with Drug Store and Pharmacy merchant category codes (MCCs). . . . Basically, the notice gives these merchants until June 30, 2009 ? instead of December 31, 2008 ? to implement the inventory information approval system described in Notice 2006-69, 2006-31 I.R.B. 107. " (Deloitte via BenefitsLink.com)


[Opinion]
The Politics of Healthcare Reforms in U.S. Presidential Elections

Excerpt: "One of the major problems faced by large sectors of the population is their limited access to medical services in time of need, their insufficient health benefits coverage if they do have health insurance, and their difficulties in paying premiums to the health insurance companies and paying the medical bills they receive. None of these problems, experienced in the U.S., are found in the publicly funded health services of the E.U. (or in Can.ada for that matter)." (Harvard Health Policy Review via Physicians for a National Health Program)


Paying for a Doctor's Visit in the Age of Medical Consumerism
Excerpt: "For all the effort in recent years to make patients act more like consumers, people are still unable to buy health care the way they might buy a television. The reasons are many: Health care prices vary depending on where you live and who your insurance company is; doctors can tell you how much they charge, but they can't necessarily tell you how much you owe (unless you are paying a simple co-pay); and even if you know how much you owe, paying it becomes a hurdle if you don't have enough cash in a health savings account to do so. While most people are willing to go into debt to finance a car, few believe they should do so to fix a broken arm. Some technology companies, however, are addressing the difficulties consumers face paying for health care." (Workforce Management; free registration required)


Recorded Webcast: Using Data to Improve Health Plan Performance - A Case Study
Excerpt: "In a troubled economy where health care costs continue to soar, it's more important than ever to find ways to improve the performance of your health benefit program. Benchmarking can be an invaluable tool -- and most companies are rich with data. But how the data are used can make a big difference in whether your organization struggles to keep up with costs or proactively manages them. To learn more about who's succeeding and how, please listen to this complimentary Webcast presented by Towers Perrin and Grant Thornton . . . ." (Towers Perrin)


WhyNotTheBest.org - A Health Care Quality Improvement Resource
Excerpt: "WhyNotTheBest.org was created and is maintained by The Commonwealth Fund, a private foundation working toward a high performance health system. It is a free resource for health care professionals interested in tracking performance on various measures of health care quality. It enables organizations to compare their performance against that of peer organizations, against a range of benchmarks, and over time. Case studies and improvement tools spotlight successful improvement strategies of the nation's top performers. [Watch this demo at http://www.commonwealthfund.org/usr_doc/site_docs/flash/WNTBdemo/WNTB_FlashDemo_v01.html to learn how to use the site.]" (The Commonwealth Fund)


Private Sector Employees Cut Back on Health Spending
Excerpt: "As health care costs continue to climb and the economy slumps, many employees are taking drastic actions to save money, according to the new Watson Wyatt study called Employee Perspectives on Health Care. In the workplace, only 19% of employees now (as opposed to 38% in 2007) are willing to pay higher premiums to keep deductibles and copays lower and more predictable." (Employee Benefit News; free registration required)


Carriers to Offer Health Facility Cost Information
Excerpt: "A group of 5 Blue Cross and Blue Shield companies will be posting facility-specific medical procedure rates on the Web. The participating companies are WellPoint Inc., Indianapolis; Blue Cross Blue Shield of Michigan, Detroit; Blue Cross and Blue Shield of Minnesota, Eagan, Minn; Highmark Inc., Pittsburgh; and Premera Blue Cross, Mountlake Terrace, Wash." (National Underwriter Life & Health Magazine)


Insurer Renegotiates Out-of-Network Surgery Benefits for Federal Employee Health Plan
Excerpt: "Blue Cross Blue Shield has reached an agreement with the Office of Personnel Management to change out-of-network benefits for nonemergency surgeries under its Standard Option plan, the carrier announced this week. The new arrangement will require enrollees to pay 30 percent of the plan allowance for an out-of-network procedure, plus any difference between the allowance and the billed amount, the carrier stated in a letter to members." (GovernmentExecutive.com)


Insurers Seek Presence at Health Care Discussion Sessions
Excerpt: "When supporters of President-elect Barack Obama hold house parties to discuss ways of fixing the health care system over the next two weeks, they may find some unexpected guests. The health insurance industry is encouraging its employees and satisfied customers to attend. A trade group representing some of the nation's largest health care businesses, including drug companies, is organizing several meetings. The American Medical Association and other medical societies are encouraging doctors to get involved." (The New York Times; free registration required)


State Health Care Reform Update
Excerpt: "For the last few years, states have been leading the way toward more comprehensive health care coverage to ensure that more people have or can obtain health insurance. Because of the potential impact of this ongoing activity on employer-provided health insurance benefits, Spencer's Benefits Reports provides regular updates about state health care reform." (Wolters Kluwer)


Obama's Plan for Health Care Reform: What Does It Mean for Employers? (PDF)
5 pages. Excerpt: "Although the election is over, the issues discussed throughout the campaign remain. In fact, many of these issues are even more critical now with job loss at a 26-year high, businesses on the brink of bankrup.tcy, and two ongoing wars abroad." (Buck Consultants)


Price Controls on Prescription Drugs Could Have Adverse Effect on Life Spans, Study Says
Excerpt: "Placing price controls on prescription drugs in the U.S. would result in modest cost savings but would shorten life spans as the pace of drug innovation slowed, according a study in Health Affairs, Reuters reports. Some policymakers recently suggested that the U.S. develop a form of prescription drug price regulation as a way to slow rising costs, according to Reuters." (Kaiser Family Foundation)


Congress Fixes Mental Health Parity Deadline for Certain Bargained Health Plans
Excerpt: "Congress has clarified the effective date for mental health and substance abuse parity rules for collectively bargained plans. The new rules will apply the later of (1) plan years starting on or after Jan. 1, 2010, or (2) the termination date of the last bargaining agreement (CBA) relating to the plan. . . . President Bush is expected to sign the measure. [The target page has a link to the full text of the technical correction bill.]" (Mercer LLC)


Milwaukee to Impose Paid Sick Leave Mandate
Excerpt: "A voter-approved mandate requiring employer-paid sick leave for Milwaukee employees has withstood an initial challenge, with the city council denying a local association's request to repeal or not to enforce the ordinance. The association plans to go forward with its court challenge, but employers probably will need to comply with the mandate as planned on Feb. 10, 2009. . . . [Full text of the city ordinance mandating paid sick leave is linked from the target page.]" (Mercer LLC)



Links to Items on Executive Comp, Benefits in General

[Guidance Overview]
ERISA Plan Claims Dismissed As Jurisdictionally Flawed

Excerpt: "Is a plan a proper plaintiff to assert breach of fiduciary claims? That was the issue before the district court in the Harter case. The facts involved various allegations of misfeasance and professional malpractice against a set of consultants and insurance brokers." (Health Plan Law blog by Attorney Roy F. Harmon III)


Results from The Wall Street Journal/Hay Group 2007 CEO Compensation Study
Excerpt: "In 2008, Hay Group partnered with The Wall Street Journal for the first time to conduct the newspaper's annual CEO Compensation Study. This year's study is an analysis of Fiscal Year (FY) 2007 CEO pay from the first 200 US companies with FY 2007 revenue of at least $5 billion that filed their proxy statements electronically between October 2007 and late March 2008. Some of the findings included in this report were originally published in The Wall Street Journal on April 14, 2008, and cover companies from ten broad industry groups." (Journal of Compensation and Benefits via Hay Group)


[Guidance Overview]
Reporting and Wage Withholding under Section 409A

Excerpt: "Until the Treasury Department and the IRS issue further guidance, compliance with the provisions of the proposed regulations with respect to the calculation of the amount includible in income under IRC ? 409A(a) and the calculation of the additional taxes under IRC ? 409A will be treated as compliance with the requirements of this notice." (Deloitte via BenefitsLink.com)




Newly Posted Events
(Post Yours!)

Medicare Secondary Payer Mandatory Reporting Requirements Webcast
Nationwide on December 17, 2008
presented by ALI-ABA (American Law Institute-American Bar Association)

Steps Employers Can Take to Prevent Health Care Fraud and Improve Quality Webcast
Nationwide on January 8, 2009
presented by International Foundation of Employee Benefit Plans



Newly Posted Press Releases
(Post Yours!)

Hewitt Survey Reveals Most Global Companies Missing the Mark in Managing Pension Risk
Hewitt Associates LLC

Benefit Software Releases Fringe Facts® Communicator 8.0 with New Design Options to Produce Custom, High-impact Total Compensation Statements
Benefit Software Inc.

Diversified Investment Advisors, Inc. Sees Multi-Vendor Approach as Contributing Factor to IRS 403(b) Compliance Deadline Extension
Diversified Investment Advisors

Northern Trust Launches Improved Online Benefit Payments Reporting for Pension Plan Sponsors
Northern Trust



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for Chittenden Bank
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