The Department of Defense Appropriations Act for 2010 extends the COBRA premium subsidies that were enacted last year in the American Recovery and Reinvestment Act. The new law is retroactive (as if included in the ARRA) and will require immediate attention from plan sponsors and their COBRA administrators. The International Foundation’s e-learning course will focus on what plan sponsors need to do to administer those requirements.
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[Official Guidance]
Text (MS Word Document) of Model Notice for Employers to Use Regarding Eligibility for Premium Assistance Under Medicaid or CHIP
3 pages. Excerpt: "If you are eligible for health coverage from your employer, but are unable to afford the premiums, some States have premium assistance programs that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums. If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, you can contact your State Medicaid or CHIP office to find out if premium assistance is available."
(Employee Benefits Security Administration)
[Guidance Overview]
DOL Publishes Model Employer CHIP Notice
Excerpt: "CHIPRA requires employers offering group health plans to notify all employees of their potential CHIPRA rights to receive premium assistance under a state's Medicaid or CHIP program. Employers may combine this notice with other information (e.g., open enrollment materials) as long as it goes to the entire employee population, not just participants. The requirement applies to employers that offer medical care benefits in any of 40 states that currently provide premium assistance."
(Infinisource)
[Guidance Overview]
Does Your Health Plan Violate the New Mental Health Parity Rules? (PDF)
6 pages. Excerpt: "[T]he interim final regulations will require employers to consider -- or, in many cases, reconsider -- issues such as: Separate deductibles for mental health/substance abuse and standard medical/surgical benefits; Medical management standards, prescription drug formulary design and other 'nonquantitative' treatment limitations that plans set for mental health and substance abuse benefits; Operational differences between how mental health and substance abuse benefits are administered and how medical benefits are administered; How the general parity rule applies to a multi-tiered prescription drug program; Specialist copays that could apply to nearly all mental health or substance use claims, but only a fraction of medical claims."
(Ogletree Deakins)
[Guidance Overview]
Discovery of Disability Claims Administrator's Personnel Records Permitted on Question of Bias
Excerpt: "The plaintiff sought performance reviews of the insurance carrier's employees involved in evaluation of the claim in dispute, namely: the 'performance evaluations or performance reviews for each of [Unum's] employees [who were involved in the evaluation of Plaintiff's claim] . . . for the years 2005, 2006, and 2007.'"
(Health Plan Law blog by Attorney Roy Harmon III)
Recession, Demographics Hasten Shift Away From Employer-Based Health Care
Excerpt: "Private-sector job losses of the last two years have sped up the shift to government payment. Last year, the number of people who received their insurance through the private market declined by 1.2 percent, despite generous federal subsidies in the stimulus bill to help laid off workers continue their employer-based coverage."
(Workforce Management)
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Executive Compensation; Benefits in General
[Guidance Overview]
Relief and New Concerns: Notice 2010-6 and Correcting Section 409A Document Failures
Excerpt: "Although the Notice provides guidance, its examples also give employers cause for concern. For example: . . . The phrase 'termination of employment' may violate section 409A if it leads to payments in situations not permitted under section 409A (for example, where an employee reduces their hours or is re-hired as an independent contractor providing significant services after termination of employment). Previously, the IRS had informally indicated that the term was acceptable. . . . [Further, severance] payments contingent on a release of claims or the end of a rescission period may violate section 409A (if the compensation to be paid is subject to section 409A)."
(Dorsey & Whitney)
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