Health & Welfare Plans Newsletter |
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| July 31, 2009 \ Compliance \ Costs \ Administration \ Design \ Policy | ||
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[Guidance Overview]
Medicare Secondary Payer Reporting Requirements Spur Requests for Dependent Social Security Numbers (PDF)
3 pages. Excerpt: "The new reporting mandate under the Medicare, Medicaid and SCHIP Extension Act of 2007 will require group health plan 'responsible reporting entities' (RREs) to submit the Social Security numbers of many employees' covered dependents to the CMS coordination of benefits contractor by October 1, 2009. Although employers are generally not RREs, they may be asked by the RRE to help obtain that information." (Buck Consultants)
[Guidance Overview]
Alternative Coverage Case Involving Premium Hike Raises COBRA Issues
Excerpt: "A Michigan federal district court denied a former employee's claim for subsidized COBRA coverage following 12 months of coverage at active rates. The claim was denied, even though the employer had mistakenly confirmed a lower premium for the COBRA coverage, because the employer's clear plan terms explained that terminated employees would get 12 months of continued coverage at active rates followed by 18 months of coverage at full cost. The case is Ten Harmsel v. Pfizer Inc., 2009 WL 1771377 (W.D. Mich., June 18, 2009)." (Thompson Publishing Group Inc.)
Proposed Tax on Generous Health-Insurance Packages Tests Obama on Campaign Vow
Excerpt: "A plan under debate in Congress would impose a new tax on insurers or employers who provide so-called gold-plated health-care plans. Many economists say a significant part of the cost would eventually be passed to employees, through higher insurance payments or slower wage growth. That could conflict with Mr. Obama's often-repeated promise not to raise taxes on middle-class families. The challenge for the White House was underscored Wednesday, when John Sweeney, president of labor confederation AFL-CIO, issued a statement citing 'real concerns' about the proposed tax, which Mr. Obama has said he is willing to entertain. While corporate executives' gold-plated plans might be the intended target of the tax, Mr. Sweeney said the tax 'could well end up hitting benefits of working families and retirees.'" (The Wall Street Journal)
Senate Appears to Support Employer-Friendly Health Bill
Excerpt: "In the Senate Finance Committee plan, according to the source, employers would be required to offer coverage but not pay for it. The health plans offered to employees would have to be valued at 60 percent of the value of the health plans enjoyed by federal employees. That would mean high-deductible health plans with health savings accounts would qualify. A House bill would require plans to provide more benefits. Employees would be allowed to drop employer coverage but employers would have to repay any government subsidy used by employees to purchase health care. Employees, meanwhile, could opt out of an employer health plan, but doing so would make them ineligible for government health care subsidies." (Workforce Management; free registration required)
Say Goodbye to Reimbursement of Over-the-Counter Medications Through FSAs, HRAs, MSAs
Excerpt: "The House Ways and Means Committee's amendment to the America's Affordable Health Choices Act (H.R. 3200) would prohibit employees from using health FSA dollars to pay for over-the-counter medications. The proposal is estimated to raise $8.2 billion over 10 years. The proposal also would extend to health savings accounts (HSAs), health reimbursement arrangements (HRAs) and Archer Medical Savings Accounts (Archer MSAs)." (Wolters Kluwer)
House Panel Passes Amended Federal Employee Domestic Partner Benefits Bill
Excerpt: "In a party-line vote, a House subcommittee on Thursday passed a bill that would extend health care and other benefits to the partners of g.ay and les.bian federal employees, modifying it to ensure retirees are covered. . . . At the recommendation of Office of Personnel Management officials, the subcommittee passed technical amendments ensuring that retirees are covered and clarifying the benefits included." (GovernmentExecutive.com)
Actuarial Issues and Policy Implications of a Federal Long-Term Care Insurance Program (PDF)
13 pages. Excerpt: "Our actuarial analysis indicates that the proposed structure and funding approaches in the CLASS Act, as introduced on June 9th, will not only be unsustainable within the foreseeable future, but are unlikely to cover more than a very small proportion of the intended population. In the absence of an actuarially sound requirement, we project that the Fund will be insolvent as early as 2021, or within 11 years. The opt-out and guaranteed issue provisions of the plan pose a significant and likely risk that, in a relatively short time period, the program will either need increased premiums and/or significant reductions." (American Academy of Actuaries)
Understanding the Role of the 'Exchange' or 'Gateway' in Health Insurance Reform (PDF)
4 pages. Excerpt: "Who Would Use the Exchange to Shop for Health Insurance? All current health reform proposals would allow individuals who do not have coverage through their employers to purchase coverage through an exchange. They would also allow small businesses to use the exchange plans to furnish coverage for their employees. In some proposals, large businesses could participate later on." (Families USA)
Health Care Costs for Small Businesses Considered
Excerpt: "[Health] and Human Services Secretary Kathleen Sebelius hosted a live health care discussion on Facebook, where she said that small business owners have the most to gain from the bill, The Las Vegas Sun reports. 'The bill proposes the creation of a pool that small businesses can buy into with other companies, lowering costs and premiums for businesses and employees. 'Health reform will be good for small businesses, make them competitive in the global marketplace and be able to attract and retain good employees,' she said' . . . ." (Kaiser Family Foundation)
More Employers Embrace Cost-Sharing As Utilization Management Tool in Prescription Drug Programs, According to New Survey
Excerpt: "Buck's 'Prescription Drug Benefit Survey', completed in July 2009, found that more than three-quarters (76%) of 140 respondent firms use employee cost sharing as a utilization management tool, up substantially from 51% a year ago. According to the survey, the most common target cost-sharing range is 11% to 20% of claim costs (used by 39% of respondents)." (PLANSPONSOR.com; free registration required)
How We Can Pay for Health Care Reform
Excerpt: "The researchers also provide estimates for a range of government revenue sources and suggest that spreading the costs broadly across an array of options is the best financing approach. For example, over 10 years: A progressive payroll tax on employers that do not offer insurance coverage could generate $570 billion; A cap on the tax exclusion for employer-sponsored insurance could add as much as $456 billion . . . ." (Robert Wood Johnson Foundation)
[Opinion]
'Anonymized' Medical Data Protects Privacy and Improves Care
Excerpt: "Some non-treatment uses of health data -- including quality, research and public health -- can be done with data where sufficient patient identifiers have been removed to make it anonymous to the recipient. For example, such 'anonymized' data can be used to assess the efficacy of health care treatments and strengthen our capacity to provide patients with better, more efficient health care. But our health privacy laws today do not promote the use of anonymized data. Instead, our laws, in many cases, either permit or require the use of fully identifiable data (including patient names, addresses, phone numbers, etc.) for these functions, providing little incentive to remove identifiers from data before its use." (California HealthCare Foundation)
[Opinion]
Health Care Realities and the Federal Government
Excerpt: "[H]ealth reform must climb a wall of misinformation. It's not just that many Americans don't understand what President Obama is proposing; many people don't understand the way American health care works right now. They don't understand, in particular, that getting the government involved in health care wouldn't be a radical step: the government is already deeply involved, even in private insurance. And that government involvement is the only reason our system works at all." (The New York Times; free registration required)
[Opinion]
The House Health Reform Bill Would Harm Businesses' Ability to Offer Insurance
Excerpt: "The worst thing that can be said about the House health bill is what's in it. Presumably that explains why Speaker Nancy Pelosi's office zapped as 'false and misleading' one of our recent editorials -- on the 1974 federal law known as ERISA that lets large businesses offer insurance with minimal government interference. Among the rebuttals is the 'fact' that Democrats will give 'all American families more choices of quality, affordable health care.' Then again, 151 businesses and industry groups that depend on ERISA agree that the House bill will result in fewer insurance choices for employees, not more, once all benefits are exposed to political tampering. In a letter to Mrs. Pelosi this week, the coalition -- including everyone from American Airlines to Xerox -- says the bill includes 'numerous provisions that increase the requirements and burdens on employer-sponsored coverage and limit employer flexibility to meet the needs of their workforce by requiring them to meet federal one-size-fits-all standards after a five-year 'grace period.''" (The Wall Street Journal)
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Links to Items on Executive Comp, Benefits in General
[Official Guidance]DOL Seeks Nominees for ERISA Advisory Council
Excerpt: "The terms of five members of the Council expire on November 14, 2009. The groups or fields they represent are as follows: (1) Employee organizations; (2) employers; (3) actuarial counseling; (4) investment counseling; and (5) the general public." (Employee Benefits Security Administration, U.S. Department of Labor)
[Guidance Overview]
A Summary of Judge Sotomayor's ERISA Decisions at the Second Circuit Court of Appeals (PDF)
5 pages. Excerpt: "As a general proposition, there is nothing talismanic in Judge Sotomayor's ERISA decisions. They tend to follow existing law, rather than create it. Her opinions are clear, intelligent and thoughtful. They tend to reflect a thorough research of precedent, a comprehensive study of the record and a methodical examination and analysis of the arguments of the parties. . . . While on the Second Circuit Court of Appeals, Judge Sotomayor was a member of the panel deciding approximately twenty ERISA related cases. We will briefly discuss the five cases in which she has written the opinion for the Court." (Reish & Reicher)
The Bank Bonus Culture: No Rhyme or Reason (PDF)
22 pages. Excerpt: "As one would expect, in describing their compensation programs, most banks emphasize the importance of tying pay to performance. Indeed, one senior bank executive noted recently that individual compensation should hot be set without taking into strong consideration the performance of the business unit and the overall firm. As this executive put it, 'employees should share in the upside when overall performance is strong and they should all share in the downside when overall performance is weak.' But despite such claims, one thing is clear from this investigation to date: there is no clear rhyme or reason to the way banks compensate and reward their employees. In many ways, the past three years have provided a virtual laboratory in which to test the hypothesis that compensation in the financial industry was performance-based. But even a cursory examination of the data suggests that in these challenging economic times, compensation for bank employees has become unmoored from the banks' financial performance." (State of New York, Attorney General via U.S. House of Representatives Committee on Oversight and Government Reform)
Rep. Towns' Letter to New York State Attorney General Andrew Cuomo on Executive Pay Practices (PDF)
2 pages. Excerpt: "Chairman Towns, who is conducting an investigation into the financial bailout and lack of oversight of TARP recipients, concurs with Attorney General Cuomo's conclusion that executive pay last year at bailed-out firms had no relation to executive performance, no relation to managing risk, and no relation to company performance. In addition, through their separate investigations into the financial bailout, Chairman Towns and Attorney General Cuomo have determined that the executive compensation model on Wall Street was a major driver of risky decisions that led directly to the current economic crisis. . . . In [this] letter to Attorney General Cuomo, Chairman Towns announced that he intends to hold a hearing after the August recess to examine the Obama administration's reforms to rein in executive pay practices at companies receiving TARP funding." (U.S. House of Representatives Committee on Oversight and Government Reform)
Webcasts and Conferences
Changes to Cafeteria Plans: What You Need to Know to PrepareNationwide on October 19, 2009
presented by Lorman Education Services
Form 5500 Reporting Update
Nationwide on September 16, 2009
presented by Lorman Education Services
Meeting Your Fiduciary Responsibilities Under ERISA
Nationwide on September 29, 2009
presented by Lorman Education Services
Pitfalls of Participant Loans in Retirement Plans
Nationwide on August 11, 2009
presented by Lorman Education Services
Providing Investment Advice to Retirement Plan Participants Without Triggering Liability
Nationwide on August 26, 2009
presented by Lorman Education Services
SPARK Accredited Retirement Plan Consultant (ARPC) Training and Designation Program
in Massachusetts on September 24, 2009
presented by SPARK -- Society of Professional Asset-Managers and Record Keepers
Wellness Programs: Legal Developments, Requirements and Risks
Nationwide on October 5, 2009
presented by Lorman Education Services
(Click to post your webcast or conference)
Press Releases
PBGC Moves to Protect Pensions at Metaldyne Corp.Pension Benefit Guaranty Corporation (PBGC)
'Stable Value' Investment Options in 401(k) Plans Can Be Risky Too
Securian Retirement Services
U.S. Labor Department Solicits Nominations for 2010 ERISA Advisory Council
U.S. Department of Labor, Employee Benefits Security Administration (EBSA)
IFLC Endorses Fiduciary Committee
Investment Fiduciary Leadership Council (IFLC)
Inspira Adds Regional Director of Institutional Sales
Inspira
(Click to post your press release)
Employee Benefits Jobs
401(k) Plan Salesfor Ingham Retirement Group
in FL
VP, Benefits
for Selective Insurance Company of America
in NJ
Mental Health Case Manager
for The Standard
in OR
Actuarial Analyst
for New York Life Retirement Plan Services
in MA
(Click to post your job opening | View all jobs |
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Handy Links:
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