Health & Welfare Plans Newsletter |
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| November 11, 2009 \ Compliance \ Costs \ Administration \ Design \ Policy | ||
Employee Benefits Institute of America (EBIA) (Advert.)
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[Guidance Overview]
HHS's Increases in Civil Monetary Penalties for HIPAA Violations
Excerpt: "On October 30, 2009, the Department of Health and Human Services (HHS) published an interim final rule that significantly amends the civil monetary penalty guidelines for violations of the Health Insurance Portability and Accountability Act (HIPAA) (the 'Interim Final Rule'). These amendments, mandated by the Health Information Technology for Economic and Clinical Health Act (HITECH Act), become effective on November 30, 2009, but apply to violations occurring on or after February 18, 2009." (Troutman Sanders LLP)
[Guidance Overview]
Recorded Webinar on the Flu Season and H1N1: Preparing the Workplace
Excerpt: "Questions addressed . . . include: What OSHA obligations must be met by employers? What training do you need to provide to your employees? What benefit programs will apply? Can you make vaccinations mandatory -- and if so, should you do so? What other legal obligations come into play when an employee has the flu? What do you do if your employees are well, but need to stay home with children if schools and childcare facilities are closed? Should you have any policy regarding screening employees before allowing them into the workplace?" (Nixon Peabody LLP)
Health Care Reform Legislation As Passed by U.S. House (PDF)
Excerpt: "We have revised our high level side-by-side comparison of the House and Senate proposals to reflect the final House legislation. This comparison will continue to be updated as legislation moves through Congress and updates can be accessed through this same link. Buck has also prepared an annotated flow chart which compares the employer mandate requirements in the House, SFC, and HELP committee proposals." (Buck Consultants)
The Essential Benefits Package in House Health Reform Bill: An Employer Model
Excerpt: "The Affordable Health Care for America Act, H.R. 3962, which the House approved by a narrow margin on Saturday, Nov. 7, eventually requires employer-sponsored health insurance plans to provide, at a minimum, a certain essential benefits package. Abortion services definitely will not be a part of this package, as yesterday's post indicates. And, since the essential benefits package would be based on the benefits typically covered by employer-sponsored health insurance, it appears that employers need not worry about major adverse effects of this particular health reform bill." (Wolters Kluwer)
Detailed Summary of Health Reform Bill Passed by the U.S. House (PDF)
10 pages. Excerpt: "Benefits. Outlines broad categories of covered services in the law, and creates a Health Benefits Advisory Commission, with physicians and other expert members, to help the Secretary of HHS define the essential benefit package. Cost-sharing varies by four tiers ranging in actuarial value (AV) from 70 percent to 95 percent ("basic," "standard," "premium," and "premium plus"). In other words, in a 70 percent plan, the plan pays 70 percent of the costs and an individual would pay the other 30 percent of expenses on average. The fourth tier plan ("premium plus") will offer additional benefits such as adult dental or vision, gym memberships, or private hospital rooms. All plans will limit annual out-of-pocket expenses for enrollees at a maximum of $5,000 for an individual and $10,000 for a family, with lower levels for lower and middle-income families." (U.S. House of Representatives Committees on Ways and Means, Energy and Commerce, and Education and Labor)
Employer Groups Blast House Health Reform Measure
Excerpt: "Helen Darling, president of the National Business Group on Health, which represents about 280 large U.S. employers, identified 10 major items that should concern plan sponsors that provide health care benefits to their workers. According to Darling: 1) the bill lacks meaningful ways to control health care costs; 2) the bill takes us down the road to even worse deficits and crushing national debt by not getting more savings from the health system and making the coverage more affordable; 3) there is no support for strong evidence-based medicine or a way to make certain that we don't pay for treatments that are not effective; 4) there is not a strong independent Commission that could help Congress make the politically hard but obvious good decisions to eliminate wasteful and harmful treatments and spending; 5) it does nothing to correct medical liability problems and related costly defensive medical practices; 6) it doesn't expand employers' ability to help employees to actively engage in wellness activities or achieve health goals; 7) it undermines ERISA and opens ERISA plans to unacceptable burdens; 8) there are serious questions about the public plan and how it would operate; 9) an employer who provides comprehensive benefits could still be subject to an 8% payroll tax if employees decline employer coverage because it costs more 12% of the employee's income; and 10) it contains a particularly outrageous requirement that any employer still offering retiree medical coverage would have to continue it indefinitely thereby hurting employers who have done what they could to maintain benefits for retirees." (Employee Benefit News; free registration required)
Congressional Members Propose Emergency H1N1 Sick Days Bill
Excerpt: "Two leading members of Congress on the issue of employee leave will team up to write a bill that would provide paid time off for workers who contract the H1N1 flu. Sen. Christopher Dodd, D-Connecticut and chair of the Senate health subcommittee on children and families, announced at a hearing Tuesday, November 10, that he and Rep. Rosa DeLauro, D-Connecticut, intend to formally introduce the legislation in coming weeks. He and DeLauro portrayed paid sick leave as the best way for workers to follow government directives to stay home if they fall ill." (Workforce Management; free registration required)
Access to Health Insurance at Small Establishments: What We Learn from Analyzing Other Fringe Benefits
Excerpt: "Just as workers employed by small businesses are less likely than those in large ones to be offered fringe benefits like pension plans, paid sick leave, and paid vacations, they are also less likely to be offered health insurance. Administrative costs -- and not insurance market flaws -- are likely the major reason why so many smaller firms do not offer health benefits to their employees." (The Commonwealth Fund)
Impact of Health Care Price Transparency on Price Variation: The New Hampshire Experience
Excerpt: "Price variation for medical procedures performed in both hospital outpatient departments and freestanding facilities has not decreased in New Hampshire since the state launched the HealthCost price transparency program in early 2007 . . . . New Hampshire stakeholders cited weak provider competition as the key reason for lack of impact. The state's hospital market is geographically segmented in rural areas and has few competitors even in urban areas. In addition, few consumers have strong incentives to shop based on price: Only 5 percent of the state's privately insured residents were enrolled in high-deductible plans in 2007. However, some observers suggested that HealthCost -- along with other state price transparency initiatives -- has helped to focus employer and policy maker attention on provider price differences and has caused some hospitals to moderate their demands for rate increases." (Center for Studying Health System Change)
Tweeting Health Benefits . . . in 140 Characters or Fewer
Excerpt: "Benefits managers are getting over their aversion to talking publicly about health benefit plans and using social media to cut through the clutter of information and connect with employees." (Workforce Management; free registration required)
Lawmakers Call for Emergency Sick-Leave Requirement
Excerpt: "Sen. Christopher J. Dodd wants businesses to offer 7 paid sick days a year, so workers with the flu can stay home. Critics say the H1N1 flu pandemic is being exploited to push flawed legislation." (Los Angeles Times)
[Opinion]
Excise Tax on Very High-Cost Health Plans Is Sound Element of Health Reform, Revised November 10, 2009
Excerpt: "The Finance Committee's health reform bill represents a very substantial improvement over the current health insurance system. However, it also has some significant shortcomings. The biggest problem is that the premium tax credits in the bill need to be stronger to make insurance affordable for more people of modest means -- and thereby to enable the mandate for people to have insurance to be strengthened. Otherwise, the new health insurance exchanges could be faced with a sicker-than-average pool of beneficiaries, which would drive up insurance premiums and threaten the ability of the exchanges to function effectively. This issue is at the heart of making health reform work. And addressing it will require increased expenditures for premium tax credits -- which means that Congress will need to find more, not fewer, offsets. Removing or seriously weakening the excise tax would make it even more difficult to address this crucial issue and strengthen the premium credits, and thus would weaken the prospects for effective health reform." (Center on Budget and Policy Priorities)
BenefitsLink Vendor Directory (Advert.)
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Links to Items on Executive Comp, Benefits in General
[Guidance Overview]California Supreme Court Addresses Forfeiture Provisions in Incentive Compensation Agreement
Excerpt: "Last week, the California Supreme Court issued its highly anticipated decision in Schachter v. Citigroup, Inc., unanimously holding that the forfeiture provision contained in Citigroup's stock purchase plan did not violate California Labor Code wage payment requirements. The decision provides helpful guidance to California employers regarding the structuring of incentive compensation plans generally. Moreover, in reaching its holding, the court relied upon a variety of principles helpful to employers that had emerged from earlier cases." (Wilson Sonsini Goodrich & Rosati)
Roundup of Recent 409A Developments for NQDC Plans
Excerpt: "Several 409A-related developments of interest to sponsors of nonqualified deferred compensation plans shed some light on current IRS views and compliance activities. The American Bar Association has posted a set of Q&As on 409A and other benefit issues, recapping informal Treasury and IRS guidance offered at meetings earlier this year. In addition, a recently released IRS chief counsel advisory raises 409A concerns about salary advances that offset deferred compensation. Finally, a number of companies have received 409A questionnaires from IRS auditors that focus on certain compliance areas." (Mercer LLC)
Transportation, Other IRS Dollar Limits Remain Unchanged for 2010
Excerpt: "Next year's dollar limits that apply to employer-provided transportation plans will stay the same as this year's, the IRS has decided. The value of excludable benefits under a qualified commuter benefit plan will be limited to $120 a month, and the value of qualified parking benefits will be limited to $230, the IRS said this week." (Employee Benefit Adviser; free registration required)
Press Releases
Deputy Secretary of Labor Testifies before Senate Subcommittee on Paid Sick Leave for Workers and FamiliesU.S. Department of Labor, Employee Benefits Security Administration (EBSA)
ERIC and NBGH Urge Obama Administration to Ensure Preservation of ERISA National Uniformity and Federal Preemption
ERIC (ERISA Industry Committee)
Milliman Analysis Indicates Sixth Straight Month of Pension Funding Declines
Milliman USA
SHRM Testifies Before Senate on H1N1 and Need for Flexible Paid Leave Policies
Society for Human Resource Management (SHRM)
How Would a New Government-run Public Health Insurance Plan Work? Who Would be Eligible to Enroll?
Robert Wood Johnson Foundation
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