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| February 27, 2009 |
| Here are the Web's best new links about compliance and cost aspects of plan operation, design and policy. |
Today's sponsor is International Foundation of Employee Benefit Plans
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| E-learning from the International Foundation of Employee Benefit Plans |
| The International Foundation’s E-learning courses provide the fundamentals as well as the latest on compliance. Courses are continuously updated to reflect recent regulatory changes. Many courses include fun interactive features that will help you fully understand concepts and implications—not just memorize terms. If you are interested in training your team, ask us about our convenient, cost-effective token program. For more information on e-learning courses and team training, visit www.ifebp.org/elearning. |
[Official Guidance]
DOL Updates COBRA Web Page with Information About Effect of Stimulus Law
Includes a 'COBRA Premium Reduction Fact Sheet,' 'Flyer for Employees,' 'COBRA Continuation Health Coverage FAQs for Employees,' and 'COBRA Continuation Health Coverage FAQs for Employers.' Note: two of the linked documents have not been updated to reflect the stimulus bill: 'Basic COBRA Information for Employees,' and 'Basic COBRA Information for Employers." (Employee Benefits Security Administration, U.S. Department of Labor)
[Guidance Overview]
CHIP Renewal Law Impact on Employer-Sponsored Group Health Plans
Excerpt: "Effective April 1, 2009, the Act enables states to offer a premium assistance subsidy for qualified employer-sponsored coverage ('QESC') to targeted low-income children. QESC is health coverage offered through an employer (i) that qualifies as 'creditable coverage' as a group health plan under the Public Heath Service Act; (ii) for which the employer contribution toward any premium for such coverage is at least 40%; and (iii) that is offered to all individuals in a manner that would be considered a non-discriminatory eligibility classification under Sec. 105(h) of the Internal Revenue Code of 1986 (the 'Code'), which provides special requirements for self-funded employer health plans. QESC does not include benefits provided under a flexible spending arrangement or a high-deductible health plan." (McGuireWoods LLP)
[Guidance Overview]
American Recovery and Reinvestment Act Changes to HIPAA
Excerpt: "The recently passed American Recovery and Reinvestment Act ('ARRA') makes extensive changes to the privacy and security regulations of the Health Insurance Portability and Accountability Act ('HIPAA'). The good news - immediate action is not required. The bad news - business associate agreements, policies and procedures, notices of privacy practices and training materials must be updated once additional guidance and/or effective dates arrive." (Holland & Hart LLP)
[Guidance Overview]
HealthNet's Benefit Denial Based Upon Lack of Medical Necessity Rejected
Excerpt: "In an unpublished opinion, a Second Circuit panel found HealthNet's benefit denial for lack of medical necessity unsupported by the record before the Court. Often a source of contention in benefit denial cases, the standards necessary to show medical necessity often fall short of an objective metric." (Health Plan Law)
Obama Offers Broad Plan to Revamp Health Care
Excerpt: "President Obama's budget would make a down payment toward his goal of covering the uninsured, and he would pay for it in part by cutting federal payments to hospitals, insurance companies and drug companies. He would also increase premiums charged to Medicare beneficiaries with higher incomes for prescription drug coverage." (The New York Times; free registration required)
Obama Budget: Health Care Section (PDF)
Pages 27-30. Excerpt: "Financing health Care Reform. The reserve fund is financed by a combination of rebalancing the tax code so that the wealthiest pay more as well as specific health care savings in three areas: promoting efficiency and accountability, aligning incentives toward quality, and encouraging shared responsibility (see Table 1). Taken together, the health care savings would total $316 billion over 10 years while improving the quality and efficiency of health care, without negatively affecting the care Americans receive." (U.S. Office of Management and Budget via American Benefits Council)
President Obama's Budget Outline Would Provide $634B Over 10 Years for Universal Health Coverage
Excerpt: "President Obama on Thursday released an outline of a more than $3.1 trillion fiscal year 2010 budget proposal that will include a 10-year, $634 billion reserve fund to help finance universal health coverage, the New York Daily News reports (Bazinet/McAuliff, New York Daily News, 2/26). According to the proposal, Obama would remain 'committed to working with the Congress to find additional resources' to finance the remainder of the cost of health care reform (Wolf, USA Today, 2/26)." (Kaiser Family Foundation)
Expanding Health Insurance Coverage for Dependents (PDF)
12 pages. Excerpt: "Young adults are one of the fastest growing groups without health insurance. Those between the ages of 19 and 29 make up about one in three people who are uninsured. Young adults need health coverage to shelter them from medical debt and ensure they get essential care. One solution is simple: change state laws to allow young people to remain on their parents' health insurance plans beyond age 18. This is a smart strategy during a fiscal crunch, as there is no cost to the state and typically little extra cost to parents and insurers. This policy is particularly important in a time of an economic downturn, when many people are losing jobs and health insurance." (Community Catalyst, Inc.)
HSA Asset Portability Creates New Opportunities for Banks
Excerpt: "[C]onsumers are catching on to the fact that they can take their HSAs to any bank that offers custodial services, especially when they leave an employer. 'And in today's economy, many employees are being forced to leave,' . . . . He notes that a growing number of insurance products are becoming more 'plug and play' in nature, meaning that HSAs can be linked to any compatible high-deductible health plan." (AISHealth.com)
State Laws Mandating or Regulating Mental Health Benefits, Updated February 12, 2009
Excerpt: "There is not a general consensus that state government should require coverage for mental health. 46 states currently have some type of enacted law but these laws vary considerably and can be divided roughly into three categories: mental health 'parity' or equal coverage laws; minimum mandated mental health benefit laws; mandated mental health 'offering laws'." (National Conference of State Legislatures)
Senate Hearing: Addressing Underinsurance in National Health Reform
U.S. Senate Committee on Health, Education, Labor, and Pensions, February 24, 2009. Witnesses were Cathy Schoen, The Commonwealth Fund, Gail Shearer, Consumers Union, Diane Rowland, The Henry J. Kaiser Family Foundation, and Grace-Marie Turner, Galen Institute. (U.S. Senate Committee on Health, Education, Labor, and Pensions)
Many Insured U.S. Residents Forgo Care Because of Cost, Witnesses Say at HELP Committee Hearing
Excerpt: "Many U.S. residents with health insurance delay or forgo needed medical care because of cost, according to witnesses at a Senate Health, Education, Labor and Pensions Committee hearing on Tuesday examining the problem of underinsurance, CQ HealthBeat reports. Sen. Jeff Bingaman (D-N.M.), who chaired the meeting, said underinsurance is defined as 'an insured individual whose family medical expenditures total 10% or more of their income or whose health plan includes deductibles greater than 5% of their income.'" (Kaiser Family Foundation)
[Opinion]
The Commonwealth Fund's Plan for Universal Coverage: Which Tier Would You Be On?
Excerpt: "Last week the Commonwealth Fund published a proposal for a 'High-Performance Health Care System' that is ambitious, and admirably honest. Unlike many health care pundits, the lead author, Cathy Schoen, understands our Byzantine health care system from the inside out. As a result, she does not try to paper over the complexities, inefficiencies and inequities of U.S. health care. She acknowledges them as she struggles to make an irrational system rational. The Commonwealth Fund's 90-page report deserves a close reading. But before I begin to analyze it, let me stress that whatever objections I may raise about the Commonwealth proposal only illustrate just how hard it is to devise a plan that will deliver high quality, affordable, sustainable health care to all Americans." (The Century Foundation)
[Opinion]
President Obama's Budget: Progress on Health Care
Excerpt: "Mr. Obama's budget plan makes a bold and long overdue commitment to overhaul the dysfunctional and far-too-costly American health care system. The plan will not guarantee affordable health coverage for all Americans, the ultimate goal, and it contains no blueprint for comprehensive reform of the system. Those issues will have to be thrashed out with Congress." (The New York Times; free registration required)
[Opinion]
Investing in Health Care Reform
Excerpt: "The Commonwealth Fund Commission on a High Performance Health System, in its new report, The Path to a High Performance U.S. Health System (Path proposal),1 has endorsed a set of health care policies that would produce savings for the system: the creation of a national health insurance exchange with a choice of private plans and a new public-plan option; investment in systemic changes, such as accelerated adoption of health information technology and health insurance benefits that are based on evidence of the comparative effectiveness of treatment options; realignment of incentives for health care providers under Medicare and the public plan to encourage accountability for patient outcomes and prudent use of resources; and public health measures, including increasing taxes on harmful products as a way of combating smoking and obesity. All these policies would require substantial changes in the financing and delivery of health care, and all would be politically difficult to accomplish." (The New England Journal of Medicine)
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Newly Posted Events
2009 SouthWest Benefits Association Internal Revenue Service Plan Administration Skills Workshops
in Texas on March 6, 2009
presented by SouthWest Benefits Association
COBRA Provisions of the American Recovery and Reinvestment Act
in Minnesota on March 26, 2009
presented by Employers Association, Inc.
Compensation Issues for Tax-Exempt Organizations
Nationwide on March 24, 2009
presented by ABA Joint Committee on Employee Benefits
Ct Chapter of NIPA-Quarterly Pension Seminar
in Connecticut on March 25, 2009
presented by National Institute of Pension Administrators-CT Chapter
The New COBRA Premium Assistance Law: What You Need to Do to Comply Now
Nationwide on February 24, 2009
presented by EBIA / Thomson Reuters
Wellness Statistics and Strategies
in Minnesota on March 17, 2009
presented by Employers Association, Inc.
Newly Posted or Renewed Job Openings
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DC / 401(k) Compliance Consultant
for The Savitz Organization
in DE, NJ, PA
Manager Fund Accounting (TPA/Insurance)
for Zenith Administrators - National Operations (any Zenith location)
in IL
Pension Administrator
for Dorfman & Associates
in NY
EmployeeBenefitsJobs.com (Sponsor)
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