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April 14, 2009 |
| Here are the Web's best new links about compliance and cost aspects of plan operation, design and policy. |
www.ftwilliam.com (Advert.)
What you need to know about EFAST 2. On April 22nd, ftwilliam.com will provide a preview of the new EFAST 2 filing system. We will review registration requirements for plan sponsors and electronic confirmation of filings by DOL. Attendees will also learn how the ftwilliam.com 5500 software will leverage the EFAST 2 system to provide new features such as workflow management and client portal capabilities. Stop by our website and sign up for our webinar today www.ftwilliam.com! |
[Guidance Overview]
COBRA Worries Cash-Poor Businesses: Firms Must Pay Now, Wait for Reimbursement
Excerpt: "[Employers] must pay 65 percent of the COBRA premium and then file for reimbursement through a payroll tax credit. Employees pay the other 35 percent. Some companies are worried the federal requirement could cause cash flow problems because of the up-to-three-month delay for reimbursement, said Sue Mathiesen, director of research at McGraw Wentworth, a Troy, Michigan-based employee benefits and consulting company." (Workforce Management; free registration required)
[Guidance Overview]
COBRA Subsidy Application to State 'Mini-COBRA' Health Plans (PDF)
4 pages. Excerpt: "While most attention has been focused on eligibility for the 65% health care continuation coverage premium subsidy for COBRA continuation coverage, the subsidy is also available to persons eligible for continuation coverage under State insurance law provided by small employers not covered by COBRA. Several States have also taken action to adopt a special delayed election right similar to that enacted for COBRA." (Pillsbury Winthrop Shaw Pittman LLP)
[Guidance Overview]
New Medicare Secondary Payer Reporting Obligations for Workers' Compensation Plans
Excerpt: "Beginning July 1, 2009, many employers and insurance companies will be required to report claims for workers' compensation claimants that are also Medicare beneficiaries to the Centers for Medicare and Medicaid Services (CMS) and become subject to a $1,000 per day per claimant penalty for failure to comply with this mandatory reporting requirement." (Littler Mendelson P.C.)
[Guidance Overview]
San Francisco's Health Care Security Ordinance Filing Deadline (PDF)
4 pages. Excerpt: "Every covered employer is required to provide information to San Francisco on an annual basis regarding its health care expenditure compliance. April 30, 2009, is the due date for the first Annual Report Form ('ARF'). This information must be reported on the Office of Labor Standards Enforcement's Health Care Security Ordinance mandatory annual reporting form, which will be mailed to all businesses registered to do business in San Francisco. Please note that only one ARF is to be filed for all entities within the same 'group of controlled corporations' (as defined for purposes of income tax filing)." (Jones Day)
[Guidance Overview]
The New COBRA Requirements (PDF)
6 pages. Excerpt: "The IRS has issued Notice 2009-27, which provides additional guidance on the new COBRA subsidy rules. In question and answer format, the IRS addresses such issues as what constitutes an involuntary termination, who is an assistance eligible individual, and how the subsidy amount is calculated. Almost concurrently, DOL updated the Q&As on its website to include additional guidance on the provision of notices under the new COBRA requirements." (Buck Consultants)
[Guidance Overview]
2010 Medicare Part D Benefit Parameters (PDF)
2 pages. Excerpt: "The Centers for Medicare and Medicaid Services (CMS) has updated the Medicare Part D standard benefit parameters and the cost thresholds and limits for qualified retiree prescription drug plans for 2010." (Buck Consultants)
[Guidance Overview]
Major Changes to HIPAA Privacy and Security Rules
Excerpt: "The civil monetary penalties for a violation of the HIPAA Privacy Rule or Security Rule have been significantly increased. In general, the penalty for violations due to reasonable cause and not to willful neglect has increased ten times, from $100 per violation to $1,000 per violation. Violations that are found to be due to willful neglect (even if corrected) are subject to a penalty of $10,000 per violation. Additionally, although there is still no individual private cause of action under HIPAA, state attorneys general can now bring an enforcement action and obtain damages (including attorneys' fees) on behalf of residents of that state." (Tax Management Inc.)
[Guidance Overview]
IRS Explanation on Why Standard Mileage Rate for Medical Expenses Is Substantially Less Than Rate for Business Expenses
Excerpt: "Transportation expenses that are deductible medical expenses under Code Section 213 generally can be paid or reimbursed on a tax-free basis by a health FSA, HRA, or HSA. (Some employers' health FSAs or HRAs exclude medical transportation expenses from the list of reimbursable items to simplify plan administration.) The explanation in the information letter can help health FSA and HRA administrators, who may be asked why the medical and business rates differ so much." (Employee Benefits Institute of America)
[Guidance Overview]
Breast Pumps Used for General Health Are Not Medical Care Expenses
Excerpt: "EBIA Comment: There is nothing new about the position that breast pumps used merely to benefit general health (or for convenience, scheduling, or other personal reasons) are not medical care expenses. However, the information letter, like earlier Treasury Tax Correspondence on this subject . . ., does not mention that breast pumps are sometimes used to treat a medical condition (e.g., a breast abscess). At least one IRS official has informally indicated that breast pumps may qualify as medical care expenses if there are medical reasons for their use. Indeed, many health FSAs treat breast pumps as dual-purpose items that can be reimbursed if the participant provides a note from a medical practitioner recommending the breast pump to treat a specific medical condition." (Employee Benefits Institute of America)
Diabetes Disease Management Pilot Program Yields Big Cost Savings
Excerpt: "A diabetes disease management program conducted by the American Pharmacists Association Foundation is being made available to employers nationwide as a result of a series of successful tests. The program, the Diabetes Ten City Challenge, has yielded substantial savings for employers even after they've waived co-payments for participants and paid for individual counseling. Patients also saved money and improved in several key clinical areas associated with the condition, officials said." (Workforce Management; free registration required)
Hospitals and Nonprofits Offer Packages of Basic Care Directly to Small Businesses
Excerpt: "As the Obama administration wrestles with how to expand health-care coverage to the millions of uninsured Americans, some local organizations are finding creative ways to help cover one of the most affected groups -- employees of small businesses. The programs typically involve collaboration between business owners, nonprofit groups and local hospitals, which offer enrollees a range of medical services at a reduced rate. The plans keep costs down partly by bypassing the extra costs that come with traditional insurance. That can be a big help for small-business employees who can't afford traditional insurance. But for patients with costly chronic diseases or catastrophic illnesses, the coverage would likely be inadequate." (The Wall Street Journal)
Integrated Health Care Can Improve Chronic Illness Treatment
Excerpt: "Improving care for people with chronic illnesses will require addressing barriers such as fragmented care, poor transitions between care settings, and payment that does not recognize the value of better integration of services, according to a recent report from AARP. Other obstacles to improving care for those with chronic illnesses are 'poor information systems' that make it difficult for medical providers to track patients over time, to integrate care among different providers and different care settings, and to track medication adherence and prevent drug interactions." (Wolters Kluwer)
San Diego Studies Shift to Defined-Contribution for Retiree Health Care
Excerpt: "At a hearing Tuesday, the San Diego City Council will discuss a proposal to rework the retiree health care benefits system for city workers, moving to a defined-contribution system that could leave retired workers to shoulder more of their own health care costs, Voice of San Diego reports. Currently, the city uses a defined-benefit system that provides up to $8,880 toward each retiree's health care costs. The contribution can increase by as much as 10% annually to help address rising health care costs." (California HealthCare Foundation)
Primary Care Physicians' Perspectives on Access to Mental Health Care
Excerpt: "About two-thirds of primary care physicians (PCPs) reported in 2004-05 that they could not get outpatient mental health services for patients--a rate that was at least twice as high as that for other services. Shortages of mental health care providers, health plan barriers, and lack of coverage or inadequate coverage were all cited by PCPs as important barriers to mental health care access. The probability of having mental health access problems for patients varied by physician practice, health system, and policy factors." (Health Affairs)
New York Employers Billed for Assessment Increase
Excerpt: "Employers with employees living in New York are receiving bills from the state's Department of Health requiring them to pay in a lump sum a retroactive increase in a special supplemental health care-related assessment. The covered lives assessment on employers with employees living in New York is used to help fund a state pool used to pay for graduate medical education. Earlier this year, New York legislators approved a budget bill that boosted that assessment by about 13%, according to calculations by benefit consultant Mercer L.L.C. For example, the annual assessment for employers with employees in New York City climbed to $613.56 from $543.20. That increase was retroactive to Jan. 1 and was reflected in the bills sent to employers the next month." (Business Insurance)
U.S. House Passes Bill to Require Health Plans to Highlight Coverage Limitations
Excerpt: "A bill that would require health insurers to report limitations and restrictions on coverage in clear, understandable language to group health plan sponsors and participants has cleared the House of Representatives and is being considered by the Senate. The Health Insurance Restrictions and Limitations Clarification Act of 2009 (H.R. 1253) passed in the House by a vote of 422 to 3 on March 31. It has been referred to the Senate Committee on Health, Education, Labor and Pensions." (AISHealth.com)
Self-Insured Companies Going After Doctors to Recover 'Overpaid' Claims
Excerpt: "Since late last year, thousands of doctors in Georgia and Tennessee have received letters from HRI [Health Research Insights] . . . . The Indiana State Medical Assn. says it has received a warning from HRI that it will start collection efforts in that state. Like health plans, HRI identifies physicians it believes are above the norm in the number of high-level codes they submit and targets them for recoupments. Unlike health plans, however, HRI does not analyze individual medical records along with the claims. It uses, by the company's own description, an algorithm to determine the amount of upcoding and overpayment -- then demands that the physicians produce the medical records and other paperwork to fight the claim." (Passion for Subro)
[Opinion]
The End of Private Health Insurance: When Government 'Competes,' Guess Who Wins?
Excerpt: "Above every other health-care goal, Democrats this year want to institute a 'public option' -- an insurance program financed by taxpayers, managed by government and open to everyone, much like Medicare. This new middle-class entitlement is the most important debate in Congress this year, because it really is the last stand for anything resembling private health insurance." (The Wall Street Journal)
EmployeeBenefitsJobs.com (Advert.)
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Webcasts and Conferences
(Click to post your webcast or conference)Stayin' Alive Through Change
in Minnesota on July 29, 2009
presented by Employers Council on Flexible Compensation (ECFC)
Press Releases
(Click to post your press release)19th Annual Retirement Confidence Survey: As Worker Expectations for Comfortable Retirement Plummet, Many Expect to Work Longer Before Leaving Their Jobs
Employee Benefit Research Institute (EBRI)
Most Employers Underestimate Full Costs of Employee Health on Productivity
National Pharmaceutical Council
NextStep Defined Contribution, Inc. Purchases Assets of BenefitStreet
NextStep
Retirement Plan TPAs Gaining Market Share
Retirement Research, Inc.
Employee Benefits Jobs
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