Health & Welfare Plans Newsletter |
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| October 6, 2009 \ Compliance \ Costs \ Administration \ Design \ Policy | ||
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[Guidance Overview]
Complying with the Mental Health Parity and Addiction Equity Act of 2008
Excerpt: "[The economic stimulus package] was adopted in October 2008 included the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (the 'Wellstone Act'). The changes made by the Wellstone Act will be effective for non-union plans for plan years beginning on or after October 4, 2009. Plan sponsors that have calendar year plans will have to comply as of January 1, 2010. In anticipation of this rapidly approaching deadline, this newsletter provides a review of these new mental health parity rules, as well as some action items to consider." (Snell & Wilmer L.L.P.)
[Guidance Overview]
Interim Final Rules Prohibiting Discrimination Based on Genetic Information (PDF)
2 pages. (Milliman)
[Guidance Overview]
FMLA Protection Applies Before Leave Starts, According to Court
Excerpt: "In a recent decision, the Third Circuit Court of Appeals ruled that an employee does not need to actually begin a leave under the Family and Medical Leave Act (FMLA) to establish a claim for interference or retaliation under the FMLA. The court pointed out that 'it would be patently absurd if an employer who wished to punish an employee for taking FMLA leave could avoid liability simply by firing the employee before the leave begins.'" (American Banker)
[Guidance Overview]
Former Employees Have No Claim Against Bankrupt Employer for Unpaid Medical Bills, But Can Seek Unpaid Employee Health Premiums
Excerpt: "EBIA Comment: At the end of the day, the only relief that these employees could seek from their employer was the recovery of the employee portion of the unremitted health insurance premiums. This illustrates not only the litany of claims that employees may make when their employer fails to remit health insurance premiums, but also the harsh reality that in many instances this is a wrong without a remedy." (Employee Benefits Institute of America)
[Guidance Overview]
Online Form and Instructions Available for Reporting Breaches of Unsecured PHI to HHS
Excerpt: "EBIA Comment: Covered entities (including health plans) will likely appreciate this relatively straightforward form, as well as the ability to complete and file it online. It is worth noting that, for breaches affecting more than 500 individuals, ARRA requires that some of the information provided on this form be made publicly available by posting on the HHS website. ARRA also requires that OCR provide an annual report to Congress regarding the number and nature of breaches that are reported each year and the actions taken to respond to such breaches." (Employee Benefits Institute of America)
Supreme Court Asks for Obama Administration's Stance on Healthy San Francisco
Excerpt: "The justices' action Monday is not unusual. The court regularly asks the federal government for its position in important cases, particularly those that involve a possible conflict between federal and state or local laws. Such requests indicate that one or more justices are undecided about granting review, which requires four votes on the nine-member court." (San Francisco Chronicle)
Obama Administration May Decide Healthy San Francisco's Fate
Excerpt: "The US Supreme Court has delayed a decision on the Golden Gate Restaurant Association's legal challenge to the Healthy San Francisco program, instead asking for the Obama Administration's opinion on whether the required employer contributions that fund the universal health care plan violate federal law. The GGRA suit contends the employer mandate violates the Employee Retirement Income Security Act (ERISA), a view that was supported by the Bush Administration but opposed by the city and the Ninth Circuit Court of Appeals, whose ruling against GGRA the Supreme Court is deciding whether to hear, a decision that had been expected today." (San Francisco Bay Guardian)
As Health Reform Debate Continues, Some Employers Are Attempting Innovative Ideas to Engage Their Workers
Excerpt: "Employers are venturing beyond many 'tried and true' cost-containment strategies because some believe they have shifted as much cost as possible, while others are concerned that healthcare reform will lead to additional cost sharing not being a viable long-term option. 'Past recessions gave rise to innovative, often untested new solutions such as point-of-service plans and managed care,' according to Mercer. 'The current recession appears to be following the familiar path.'" (Human Resource Executive Online)
Variation in Insurance Coverage Across Congressional Districts: New Estimates from 2008 (PDF)
48 pages. Excerpt: "New data on health insurance coverage from the American Community Survey show extensive variation in rates of private and public coverage and uninsurance across congressional districts in the United States. This survey reveals those districts that face the greatest deficiencies in private coverage and pinpoints the districts where public coverage closes some of the gap left by low rates of private coverage. The picture that emerges is that (1) rates of private coverage are lowest in districts that have higher poverty rates, which tend to be concentrated in the South and West; (2) the needs in these high-poverty districts have led many to have above average rates of public coverage; and (3) despite these higher rates of public coverage, uninsurance remains most serious in districts with low rates of private coverage. This analysis identifies the districts in which residents would have the most to gain from health reforms that are designed to increase health insurance coverage toward a higher and more uniform national standard." (Urban Institute)
WellPoint Cuts Workers' Health Insurance Benefits
Excerpt: "WellPoint health insurance company, which has encouraged its employees to lobby against health care reform, is now cutting their benefits. The insurance giant plans to raise deductibles and premiums for some of its employee health benefits. 'Your cost per paycheck will probably increase,' said a memo to Wellpoint employees that was obtained by Bloomberg News." (The Huffington Post via Consumer Watchdog)
Massachusetts Health Reform: Employer Coverage from Employees' Perspective
Excerpt: "Despite the economic downturn and rising health care costs, access to employer-based coverage in Massachusetts has increased, as has the scope and quality of coverage as assessed by workers, according to an analysis of the state's health reform plan. However, some employees in small firms have seen a significant rise in premiums and out-of-pocket expenses." (The Commonwealth Fund)
Health Care Reform Update
Excerpt: "Included are links to items already covered, brief summaries of actions taken by the federal government, recent reports and studies on health care reform, policy statements by major stakeholders, and other recent health care reform activity." (Wolters Kluwer)
Policies for Fighting Obesity: What Happens When City Governments Step In?
The three articles are titled: Zoning For Health? The Year-Old Ban On New Fast-Food Restaurants In South LA; New York City's Fight Over Calorie Labeling; Calorie Labeling And Food Choices: A First Look At The Effects On Low-Income People In New York City. (Health Affairs)
Obama Administration Mulls Extending COBRA Subsidy
Excerpt: "An economic stimulus law that went into effect early this year includes a provision in which the federal government pays 65% of the COBRA premium for up to nine months for workers who are involuntarily terminated through the end of this year. Without an extension, employees who lost their jobs earlier this year soon will lose the federal COBRA subsidy. The availability of that subsidy resulted in a doubling of the percentage of laid-off employees opting for COBRA, found a Hewitt Associates Inc. survey released in August." (Business Insurance)
HHS Officials Provide Informal Views on Upcoming HIPAA Guidance and More
Excerpt: "The Joint Committee on Employee Benefits (JCEB) of the American Bar Association has reported on its May 2009 Q&A session with officials from HHS's Office for Civil Rights (OCR). Highlights include the following informal, nonbinding remarks regarding HIPAA privacy rule issues . . . ." (Employee Benefits Institute of America)
Regulation of Private Health Insurance Markets: Lessons from Enrollment, Plan Type Choice, and Adverse Selection in Medicare Part D
Excerpt: "We study the Medicare Part D prescription drug insurance program as a bellwether for designs of private, non-mandatory health insurance markets that control adverse selection and assure adequate access and coverage. We model Part D enrollment and plan choice assuming a discrete dynamic decision process that maximizes life-cycle expected utility, and perform counterfactual policy simulations of the effect of market design on participation and plan viability. Our model correctly predicts high Part D enrollment rates among the currently healthy, but also strong adverse selection in choice of level of coverage. We analyze alternative designs that preserve plan variety." (National Bureau of Economic Research; paid subscription or individual purchase required to retrieve fulltext)
Reform Is No Cure for Insurer Discrimination, Health Experts Say
Excerpt: "Any health-care overhaul that Congress and President Obama enact is likely to have as its centerpiece a fundamental reform: Insurers would not be allowed to reject individuals or charge them higher premiums based on their medical history. But simply banning medical discrimination would not necessarily remove it from the equation, economists and health-care analysts say." (The Washington Post; free registration required)
[Opinion]
How Should California Pay for Public Employee Retiree Health Benefits?
Excerpt: "California has a number of options, including reducing or reneging on benefits, raising taxes, cutting spending elsewhere, earmarking surplus money for unfunded health premiums, issuing bonds and doing nothing. We asked several stakeholders how California should deal with its retiree health care obligations." (Center for State and Local Government Excellence)
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Links to Items on Executive Comp, Benefits in General
[Guidance Overview]IRS's Business Travel Expense Guidance
Excerpt: "The Internal Revenue Service (IRS) issued Revenue Procedure 2009-47 on September 30, 2009. The guidance updates the rules for determining the amount of an employee's ordinary and necessary business expenses for lodging, meals, and incidental expenses incurred while traveling away from home that are deemed substantiated under Section 1.274-5 of the Income Tax Regulations." (Hewitt Associates)
[Guidance Overview]
Eleventh Circuit Upholds ERISA's Plan's Benefit Denial Under Doyle Test
Excerpt: "The unpublished decision in Keith v. Prudential affords further insight into the Eleventh Circuit's take on the proper approach to judicial review in cases of conflicted fiduciaries. The Court has previously held that Met Life v. Glenn implicitly abrogated its prior approach which involved a heightened standard of review and burden shifting. In Keith, the Court signals how this change can make a practical difference in outcomes." (Roy Harmon III via Health Plan Law)
Webcasts and Conferences
409A Correction Program-Last Chance for Pre-2008 Violations, New Breaks for 2009 and Laterin New York on October 15, 2009
presented by WEB (Worldwide Employee Benefits Network ), New York Chapter
Free Webinar - 401k Advisors' Plan Sponsor Education Series for October: "How Healthy is Your Retirement Plan?"
Nationwide on October 27, 2009
presented by 401k Advisors
Free Webinar - 401k Advisors' Plan Sponsor Education Series for October: "How Healthy is Your Retirement Plan?"
Nationwide on October 29, 2009
presented by 401k Advisors
(Click to post your webcast or conference)
Press Releases
Transamerica Enhances Annual Retirement Plan Review with Comparative Industry Analysis and Detailed Action PlanTransamerica Retirement Services
The Conference Board Finds That The Recession Did Not Substantially Alter Institutional Investment
Conference Board, The
ESCA Heralds New Legislation To Promote Employee Ownership Among Private Companies
Employee Owned S Corporations of America
Integrated Benefits Institute Announces Availability of 2008 IBI Benchmarking Industry Reports
Integrated Benefits Institute
Cammack LaRhette Consulting Launches 403(b) Curriculum
Cammack LaRhette Consulting
(Click to post your press release)
Employee Benefits Jobs
Regional Sales Director, Northern CA, OR, WA, ID, WY, UTfor DailyAccess Corporation
in CA, ID, OR, UT, WA, WY
Defined Contribution Administrator
for First American Bank
in IL
Flex Benefits Administrator, Dallas, TX
for DailyAccess Corporation
in TX
Pension Administrator
for Applied Pension Services, LLC - Katz Zlotnick & Associates
in NY
(Click to post your job opening | View all jobs |
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EmployeeBenefitsJobs.com (Sponsor)
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