Health & Welfare Plans Newsletter |
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| October 7, 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 HHS Regs on GINA Changes to HIPAA Privacy Rule (PDF)
13 pages. Excerpt: "In accordance with section 105 of GINA 2 and the Department's general authority under sections 262 and 264 of HIPAA, the Department proposes to modify the HIPAA Privacy Rule to: (1) Explicitly provide that genetic information is health information for purposes of the Rule; (2) prohibit health plans from using or disclosing protected health information that is genetic information for underwriting purposes; (3) revise the provisions relating to the Notice of Privacy Practices for health plans that perform underwriting; (4) make a number of conforming modifications to definitions and other provisions of the Rule; and (5) make technical corrections to update the definition of 'health plan.'" (U.S. Department of Health and Human Services)
[Official Guidance]
Text of GINA Regulations from U.S. Department of Health and Human Services, IRS, DOL (PDF)
35 pages, from Federal Register of October 7, 2009; 'Prohibiting Discrimination Based on Genetic Information; Interim Final Rules; HIPAA Administrative Simplification; Genetic Information Nondiscrimination Act; Proposed Rules" (U.S. Department of Health and Human Services, Internal Revenue Service, U.S. Department of Labor)
[Guidance Overview]
GINA Regulations: Prohibiting Discrimination in Health Plans Based on Genetic Information and Revising Privacy Rules (PDF)
4 pages. Excerpt: "The proposed regulations would require plans and insurance issuers to revise their Notices of Privacy Practices to include a statement that genetic information cannot be used or disclosed for underwriting purposes. The Privacy Rule generally requires plans to issue an updated notice within 60 days of a material change to the notice. HHS indicated that it understands that this timing may be burdensome and that distributing revised notices may be costly. Thus, HHS solicited comments on ways to mitigate these burdens, such as by allowing a revised notice to be distributed with annual open enrollment materials or allowing a specific extension of time in this instance. The amendments to the Privacy Rule are proposed to be effective 180 days after final regulations are published in the Federal Register. Comments are due on the proposed regulations within 60 days after publication in the Federal Register." (Sutherland Asbill & Brennan LLP)
[Guidance Overview]
Genetic Information Nondiscrimination Act Health Insurance Regulations Issued
Excerpt: "Highly anticipated regulations on the Genetic Information Nondiscrimination Act (GINA) will require many employers to modify health risk assessments (HRAs) and other aspects of group health plans and wellness programs. Under the interim final rules, plans and insurers cannot collect genetic information, including family medical history, before or as part of enrollment or use genetic information to adjust premiums or contributions. This restriction means HRAs tied to incentives may need changes." (Mercer LLC)
[Guidance Overview]
Broad Scope of 'Disability' Reflected under New ADA Regulations
Excerpt: "The ADA Amendments Act of 2008 amended the Americans with Disabilities Act (ADA) effective January 1, 2009, to expand the definition of 'disability' to include certain impairments and to reverse certain Supreme Court interpretations (and EEOC regulations) that had narrowed the definition. As a result, the determination of whether an individual has a disability is expected to require less analysis, and to result in more individuals being able to demonstrate that they have a disability for ADA purposes. The EEOC observed that this new definition will allow far more cases to focus on whether discrimination actually occurred - rather than whether the individual was able to demonstrate he or she met the definition of disability." (Deloitte via BenefitsLink.com)
[Guidance Overview]
HIPAA Obligations Create Legal Challenges
Excerpt: "Until Sept. 23, when consumers' health information was accidentally disclosed, they might not have known about it. But under the new regulation, breaches must be reported to the Department of Health and Human Services and to the individuals affected. If providers cannot locate them, they must report the violation on their Web site and to the local media. The media must also be notified if a breach affects more than 500 individuals. Here's where the regulation gets a little murky . . . . It's left up to the businesses themselves to make fact-based determinations as to whether notification is necessary, based on whether there has been a 'significant risk of financial, reputational, or other harm' to the patient. 'It's a bit of a judgment call. We're waiting to see what that turns out as,' . . . ." (Wisconsin Law Journal)
[Guidance Overview]
Health Plan Open Enrollment: Effect of GINA
Excerpt: "On October 1, 2009, the Department of Labor and the Centers for Medicare & Medicaid released interim final rules and the Internal Revenue Service ('IRS') issued temporary and final rules to implement certain provisions of GINA, including the prohibition on the collection of genetic information by group health plans and group health insurance issuers. These rules, which will become effective on December 7, 2009, will have an immediate impact on the information that can be requested, required, or purchased from individuals in connection with enrollment or for underwriting purposes, particularly the continued use of health risk assessments (referred to in this Commentary as 'HRAs') and wellness programs. Because many employers are in the process of soliciting information from employees and their dependents in connection with annual open enrollment, immediate action may be required to comply with the new rules. Monetary penalties may apply in the case of violations that are not corrected promptly." (Jones Day)
[Guidance Overview]
IRS Final Regs on COBRA, HIPAA and HSA Penalty Reporting, Clarifies HSA Comparability Rules
Excerpt: "Final IRS rules require filing Form 8928 to report and pay excise taxes for violations of HIPAA portability, COBRA, or comparability rules for employer contributions to health savings accounts (HSA) outside of a cafeteria plan or to Archer medical savings accounts. The regulations also clarify certain HSA comparability rules, including the allowance for some higher-paid employees and contributions for midyear plan entrants. The new requirements and clarifications apply to filings due and employer HSA contributions made on or after Jan. 1, 2010." (Mercer LLC)
[Guidance Overview]
HITECH Breach Notification Guidance and Employer Next Steps (PDF)
7 pages. Excerpt: "Significant new data security obligations apply to employer health plans under the Health Information Technology for Economic and Clinical Health Act (HITECH) that was enacted February 17, 2009 as part of the American Recovery and Reinvestment Act of 2009. . . . To avoid potentially significant notice requirements, plan sponsors will need to review their current policies, procedures, and safeguards under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and decide how best to proceed." (Aon Consulting)
Patient Advocates Fear Bias In Wellness Incentives
Excerpt: "On Capitol Hill, lawmakers seem eager to encourage employers to create and expand programs that tie a portion of workers' health insurance premiums to their willingness to change unhealthy behaviors. But there's growing concern that some of those programs represent a new way to discriminate against those in less than perfect health. By a vote of 18-4, the Senate Finance Committee added to its health overhaul bill an amendment offered by Sens. John Ensign (R-NV) and Tom Carper (D-DE) that would expand existing rules that let workplace 'wellness' programs pay bonuses in the way of reduced premiums to workers to lose weight, quit smoking, control their blood pressure or practice other healthy behaviors." (Morning Edition via National Public Radio)
An Actuarial Perspective on the Proposed Method for Taxing 'Cadillac' Plans
Excerpt: "The idea of taxing so-called Cadillac plans may not sound unreasonable upon first glance. But an actuarial view quickly reveals that the high cost of these plans has as much to do with the characteristics of the covered population as it does with benefit richness. It also reveals that the method of determining the taxable benefit threshold may create unintended consequences -- especially when coupled with other benefit-level requirements under various reform proposals, leaving little room between benefit floors and the ceiling in certain slices of the insurance market." (Milliman)
Four Senators' Concerns Reflect Health Care Challenge
Excerpt: "[Senator] Ron Wyden of Oregon warns that the bill would lock many workers into health plans selected by their employers, without allowing them to shop for better, cheaper plans, an alternative that could help drive down costs for everyone. . . . Taken together, the four senators represent the spectrum of concerns Democrats will face in trying to assemble the 60 votes they need to get a bill through the full Senate using regular procedure. Satisfying each of them, without alienating the others, is the challenge facing Democratic leaders." (The New York Times; free registration required)
Economic Crisis Exacerbates Nation's Obesity Epidemic
Excerpt: "In the midst of the most vigorous national health care debate in 15 years, more questions have developed about a link between our work life and our weight. Two-thirds of the workforce is overweight. The economic crisis has exacerbated the obesity epidemic: Workers are putting in longer hours, afraid of losing their jobs. With less time to exercise, more than a third of employees report that work drains them of energy, leaving nothing for their personal lives." (The Tribune-Review Publishing Co.)
[Opinion]
Health Care Economics: Why Prices Are Not Costs & Why That Matters
Excerpt: "The nonpartisan Joint Committee on Taxation has revised estimates of the tax burden imposed by the Senate bill. According to the report, the bill would raise $121 billion in fees on drug companies, health insurers and the makers of medical devices, up from the $29 billion over the amount it reported last month. Of course, only the very naive would fail to understand that these taxes will be passed on to consumers." (Roy Harmon III via Health Plan Law)
[Opinion]
Can a City Make Employers Offer Insurance or Pay a Fee?
Excerpt: "As part of San Francisco's push toward broader health-insurance coverage, city businesses with 20 or more employees must offer health insurance or pay a fee that goes toward health care for the uninsured. Now, the U.S. Supreme Court wants to know what the Obama administration thinks of that idea. The city's restaurant association has been fighting the ordinance in court, arguing that federal law says only the federal government can mandate employer benefits. Lower courts have gone back and forth on the issue; the Supremes earlier this year refused to issue an emergency order blocking the fees while the case is pending, the San Francisco Chronicle notes." (The Wall Street Journal)
BenefitsLink Newsletter (Advert.)
We Have Your Target Audience Advertise your company's products and services right here in the BenefitsLink newsletter. Our subscribers care about employee benefit plan compliance, administration, costs and design. Roles include in-house benefits directors and administrators, TPAs, consultants, attorneys, trust officers, auditors and investment managers. Your ad will show both your banner and a paragraph of text -- more exposure than you'll find anywhere else. And, of course, a clickable link to any page on your web site. Contact Mary Hall for details. |
Links to Items on Executive Comp, Benefits in General
[Guidance Overview]IRS's 2009 Version of Form 3903 for Use by Individuals Reporting Deductible Moving Expenses
Excerpt: "EBIA Comment: Code Section 132(g) allows employers to provide certain moving expense reimbursements directly or indirectly to their employees on a tax-free basis, so long as the moving expenses would have qualified for a deduction from income on the employee's individual income tax return. In addition, employers often provide nonqualified moving expense benefits, which are includible in the employees' taxable income. Form 3903 helps employees calculate the amount they can exclude from income if tax-free reimbursements do not cover all of their qualifying expenses, or the amount they must report as additional taxable income if untaxed reimbursements exceed their qualifying expenses." (Employee Benefits Institute of America)
[Guidance Overview]
Say on Pay Is Coming: Are You Ready? (PDF)
7 pages. Excerpt: "Executive compensation and increased communication and transparency for shareholders are among the hot-button issues in economic reform. One need only look to the discussions at the recent G20 London Summit or the responses to Securities and Exchange Commission (SEC) calls for comments to understand that momentum is swinging toward allowing shareholders more access in matters of compensation. This memorandum will address recent legislative and regulatory developments in executive compensation as they relate to Say on Pay Proposals and will analyze ways in which companies can position themselves to better prepare for mandatory shareholder input into executive compensation." (Sutherland Asbill & Brennan LLP)
Webcasts and Conferences
"EFAST2: The Future of Form 5500" in Charlottein North Carolina on November 12, 2009
presented by SunGard Relius
"EFAST2: The Future of Form 5500" in Chicago
in Illinois on November 12, 2009
presented by SunGard Relius
"EFAST2: The Future of Form 5500" in Detroit
in Michigan on November 12, 2009
presented by SunGard Relius
"EFAST2: The Future of Form 5500" in Knoxville
in Tennessee on November 9, 2009
presented by SunGard
Cross-Tested Plans - A 3-part Web Seminar Archive
Nationwide on October 5, 2009
presented by SunGard Relius
Understanding Health FSA Reimbursements: From Acne Treatment to Weight-Loss Programs and Beyond
Nationwide on November 5, 2009
presented by EBIA / Thomson Reuters
(Click to post your webcast or conference)
Press Releases
Despite Economic Improvements, Most Companies Not Ready to Restore Executive Pay Cuts, Watson Wyatt Survey FindsWatson Wyatt
U.S. Employers Face Huge Pension Funding Tabs Without Relief, Watson Wyatt Analysis Finds
Watson Wyatt
Health Reform Comparison Tool Now Reflects Amendments To Senate Finance Committee Proposal
Kaiser Family Foundation
Most Employers Making Changes to Their 2010 Medical Program Expect to Increase Employee Contributions: Aon Consulting Survey
Aon Consulting
TD AMERITRADE Unveils New Online Retirement Center
TD AMERITRADE
House Dems: Don't Tax 'Cadillac' Plans
Politico.com
(Click to post your press release)
Employee Benefits Jobs
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Cafeteria Plan Specialist
for Swerdlin and Company
in GA
Defined Contribution Plan Administrator
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in GA
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in NJ
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