Health & Welfare Plans Newsletter |
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| September 18, 2009 \ Compliance \ Costs \ Administration \ Design \ Policy | ||
Opal Events (Advert.)
The Future of Medicare Advantage under the New Administration Opal Events brings together the best and brightest of the Medicare Advantage community to discuss the problems and solutions facing the managed care industry today. Topics to be covered include: logistics of transitioning members from PFFS to a network; MIPPA interpretations; risk-adjusted reimbursement issues; compliance specific to Part D; and HR6331. |
[Official Guidance]
Text of Proposed Prohibited Transaction Exemption for GM VEBA's Employer Securities (PDF)
12 pages. Excerpt: "According to the Applicants, when the New GM VEBA Plan acquired the New GM Common Stock, the Preferred Stock, the Note and the Warrants, each asset might not have been a 'qualifying employer security' within the meaning of section 407(d)(5) and therefore the acquisition of each would not be permitted under section 406(a). Additionally, the Applicants note that even if the New GM Common Stock, the Preferred Stock, the Note and the Warrants were considered qualifying employer securities, the aggregate fair market value of employer securities held by the New GM VEBA Plan would exceed the 10 percent limitation in section 407(a)(2)." (Employee Benefits Security Administration, U.S. Department of Labor)
[Guidance Overview]
Governance and Compliance Advisory Update: September 2009
Excerpt: "Most of these developments relate to health and welfare plans, particularly IRS guidance on over-the-counter items for FSAs. The HHS released final regulations covering security breaches under new HIPAA rules; Ohio initiated required health care coverage for uninsured and older dependent children, and Massachusetts clarified rules under its 'pay or play' mandate." (Towers Perrin)
[Guidance Overview]
New Law Will Have Significant Impact on Group Health Plans Insured in New York (PDF)
2 pages. Excerpt: "[Significant group health plan legislation was passed by the New York] legislature and signed by Gov. David A. Paterson on July 29. The new legislation will extend dependent coverage and expand Consolidated Omnibus Budget Reconciliation Act (COBRA) protections to health plan participants in the state, and may raise interesting questions in its coordination with the federal COBRA statute." (Pension & Benefits Reporter via McDermott Will & Emery)
[Guidance Overview]
Wisconsin Amends FMLA to Include Domestic Partners (PDF)
Excerpt: "The Wisconsin Biennial Budget, singed into law on June 29, 2009, by Gov. Jim Doyle, contains provisions that extend the Wisconsin Family and Medical Leave Act (WFMLA) to domestic partners. The WFMLA requires Wisconsin employers with 50 or more employees to provide unpaid leave to eligible employees as follows: Up to six weeks for the birth or adoption of a child; Up to two weeks for the care of a qualifying family member with a serious health condition; and Up to two weeks for the employee's own serious health condition." (Drinker Biddle Reath LLP)
[Guidance Overview]
Deadline for Medicare Part D Creditable Coverage Notices Approaches (PDF)
2 pages. Excerpt: "Medicare Part D notices of creditable or non-creditable coverage must be provided to Medicare-eligible individuals prior to November 15 of each year. Many employers satisfy this requirement by including the notice in enrollment materials or in separate mailings in the fall. In preparing materials for distribution this fall, employers should be aware of revised model notices provided by the Centers for Medicare & Medicaid Services (CMS)." (Buck Consultants)
U.S. Labor Department Proposes Rule Exemption for GM Asset Transfer to Retiree Health Plan
Excerpt: "The U.S. Labor Department proposed Thursday a regulatory exemption that would allow the old GM to transfer various company securities and assets to a health plan sponsored by the new GM, General Motors Co. Items in the transfer would include common stock, preferred stock and a $2.5 billion promissory note, and would go to a health plan established for the company's retirees, according to Labor's Employee Benefits Security Administration. The retiree health plan will cover approximately 700,000 retirees and dependents when it becomes effective Dec.31. This exemption proposal has been put forth because a large transfer of employer securities to the health plan violates federal pension law - Employee Retirement Income Security Act, or ERISA. However, the pension law gives the Labor Department the ability 'to grant exemptions that protect the interests of plan participants and beneficiaries.'" (Dow Jones via The Wall Street Journal)
Businesses Not Interested in Absorbing Costs for Healthcare Reform
Excerpt: "Nearly nine-of-10 human resources and benefits executives at several hundred midsized and larger companies say their bottom line won't absorb any additional costs that may result from healthcare reform, according to a new survey. The poll of 433 executives, conducted by Stamford, CT-based financial and risk managers Towers Perrin, found that employers are prepared to reduce benefits, raise prices for customers, and even reduce their workforces if the healthcare reforms that emerge from Congress increase the cost of providing employee coverage." (HealthLeaders Media)
Banks, Insurers Battle for Health Savings Accounts in Health Reform
Excerpt: "If Congress passes a health-care overhaul bill, all health plans would have to meet certain criteria to qualify as adequate coverage. Most people's current coverage would be grandfathered in but, if they switched plans, those plans would need to meet the new standards. Not all HSA-qualified plans, in particular those sold by insurers to individuals and small businesses, would make the grade, according to industry experts. 'It's a concern. We want the accounts to be viable going forward,' says Kevin McKechnie, staff director of the American Bankers Association's HSA Council, which represents banks, insurance companies and their technology providers. More than 2,000 banks, credit unions and brokerage firms offer HSAs." (The Wall Street Journal)
Health Care Reform: The Perils of Inaction and the Promise of Effective Action
Excerpt: "With health care expenses at an all-time high, and some of the proposed congressional health care reform bills threatening to add hundreds of billions to government spending, many are debating the cost of health care reform. In this paper, Business Roundtable turned that idea around and asked: What is the cost of doing nothing? To answer this question, Business Roundtable commissioned a report from Hewitt Associates to explore the cost of inaction and to identify ways to build an improved, more efficient structure." (Business Roundtable)
Utah Exchange May Offer New U.S. Health Care Insurance Model
Excerpt: "Utah state officials have launched an online health insurance exchange for small businesses and individuals that they believe could be a national model for market-based health care reform. The Utah Health Exchange, open to a limited number of small businesses this fall, is being described as a way for employers to make fixed-dollar contributions to the health insurance of their employees, who will use the money to shop for health insurance much like consumers shop for airfares on Web sites such as Travelocity.com. The exchange, the product of health care reform legislation signed in March, is intended to help employers provide health care without worrying about unpredictable spikes in health care costs." (Workforce Management; free registration required)
New Tax in Senate Health Plan Draws Bipartisan Fire
Excerpt: "Senators of both parties said Thursday that they would seek significant changes in a Democratic proposal to tax generous high-cost health insurance policies. The tax, proposed as a way to help finance coverage of the uninsured, would be levied on insurance companies. But the senators said they worried that it would be passed on to individual policyholders, families and employers who buy insurance for their workers." (The New York Times; free registration required)
Employee Assistance Group Releases EAP Guide
Excerpt: "The Employee Assistance Society of North America (EASNA) has released a review of the nature and value of employee assistance programs (EAP). A news release from the Arlington, Virginia-based EASNA said the report, 'Selecting and Strengthening Employee Assistance Programs: A Purchaser's Guide,' provides education, guidelines, data, and inside information on employee assistance programs (EAPs). It reviews the benefits of having an EAP, lists what to look for and consider when choosing an EAP provider, cites ways to evaluate your current EAP, and discusses how to get the most out of an EAP program." (PLANSPONSOR.com; free registration required)
Health Coverage Not Universal for Federal Workforce
Excerpt: "The health insurance program that covers President Obama and members of Congress has been touted during the current debate as a model for overhauling the nation's health-care system. But one overlooked aspect of the Federal Employee Health Benefits Program is that many federal workers go without health insurance for themselves or members of their families. . . . It's not certain how many federal workers can't afford health insurance. Information from the Office of Personnel Management indicates 11 percent of the workforce does not participate in the program. (There are approximately 2 million civilian employees, not including postal workers.) Some of those nonparticipants probably have insurance through a spouse." (The Washington Post; free registration required)
Do 'Free' EAPs Offer Value? It Depends Who You Ask
Excerpt: "There has been a clear trend in recent years for health insurance companies, disability carriers, group retirement plans and payroll management organizations to bundle employee assistance program services into their core products and offer the EAP as 'free.' Under this arrangement, an insurance plan buys an inexpensive EAP from a vendor partner or provides an EAP within an affiliated division, then embeds the EAP in the plan to create product distinction and a competitive advantage." (Employee Benefit News; free registration required)
U.S. Workers' Health Costs Soaring, Studies Show
Excerpt: "U.S. workers getting health insurance for their families through employers have seen their premiums more than double in the last decade and the trend toward higher health costs is expected to continue, according to two reports released on Tuesday. The Kaiser Family Foundation said the average premium for a company-provided family health insurance plan rose from $5,791 in 1999 to $13,375, a 131 percent jump. Separately, the Business Roundtable, an organization that represents large U.S. corporations, said per-employee costs will jump to $28,530 in 2019 from $10,743 currently if nothing is done." (Reuters)
Special Report on Health Care Benefits: Dealing with Obesity in the Workplace
Excerpt: "[O]bese workers and obesity experts say that employers' activism often occurs with little understanding of what it's like to be an obese person in the workplace. They don't grasp the prejudice these workers face and the impact their experiences may have on their ability to lose weight or lead healthier lives. Weight-related health care and workplace policy can end up punishing workers for their obesity rather than helping them overcome a condition that has been linked to -- though is not always synonymous with -- higher health care costs." (Workforce Management; free registration required)
[Opinion]
Large Employer Association Reacts to Senate Finance Health Care Reform Proposal (PDF)
Excerpt: "From HR Policy's perspective, the proposal represents a significant improvement over the House and Senate HELP proposals and is a step in the right direction to achieving true reform, but it still falls short of the key consensus objectives identified in the HR Policy Association's Position Regarding the Reform of the U.S. Health Care System and significantly raises the cost of employer-provided health care. Several provisions are consistent with the Association's position, including . . . ." (HR Policy Association)
[Opinion]
'Mini Medicare' Reform Could Cut Retirement Health Benefit Costs for Public Workers
Excerpt: "Today's Medicare benefits are unaffordable and unsustainable. To achieve actuarial balance, we need to both raise the payroll tax and raise the eligibility age for those we subsidize. Both reforms are achievable and must be joined at the hip to receive bipartisan support -- while at the same time providing a competitive alternative in the health insurance marketplace that 'bends the cost curve' and thus reduces state and local government retiree health care costs." (Governing.com)
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Press Releases
ERIC Urges Lawmakers Not to Eviscerate Workplace Wellness ProgramsERIC (ERISA Industry Committee)
Alliance Benefit Group Carolinas Adds to Advisor Service Team
Alliance Benefit Group Carolinas, LLC
TBGH Report on Status of Diabetes in Texas Indicates Growing Severity of Problem and Higher Cost of Care than National Average
Texas Business Group on Health
The Vitality Group Joins Efforts to Improve Health of U.S. Workforce
The Vitality Group
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