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Health & Welfare Plans Newsletter

April 7, 2010

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This timely Webcast will address the key elements of the Patient Protection and Affordable Care Act and the related provisions of the Health Care & Education Affordability Reconciliation Act of 2010. Three industry experts will present their views on key elements of health care reform legislation, timeline of required compliance dates, impact on stakeholders and plan design implications.

[Guidance Overview]
Health Care Reform Provision Requires Break Time for Nursing Mothers
Excerpt: "The new law also states employers must comply with any state law that specifically requires paid break times for nursing mothers. Although many states currently have laws to protect nursing mothers, many states, including Michigan, do not. Thus, employers operating in multiple states will continue to be subject to differing obligations. A summary of state laws dealing with breastfeeding . . . can be found [at www.ncsl.org/issuesresearch/health/breastfeedinglaws/tabid/14389/default.aspx]."
(Warner Norcross & Judd LLP)

[Guidance Overview]
FLSA Amendment Requires Break Time for Nursing Mothers to Express Milk (PDF)
2 pages. Excerpt: "The Patient Protection and Affordable Care Act, signed into law by President Obama on March 23, 2010, amends the Fair Labor Standards Act (FLSA) to require employers to provide time for nursing mothers to express breast milk. Specifically, Section 4207 of the new law, 'Reasonable Break Time for Nursing Mothers,' provides that, for a period of up to one year following a child's birth, employers must give an employee 'reasonable break time' each time she needs to express milk. The law also requires employers to provide a location, other than a bathroom, shielded from view and free from intrusion where the employee can express milk."
(Alston & Bird LLP)

[Guidance Overview]
Inclusion of Employer-Sponsored Health Coverage on the W-2
Excerpt: "Starting in 2011, employers are required to disclose on the employee's Form W-2 the aggregate cost of 'applicable employer-sponsored coverage' provided to employees annually. Regardless of whether the employee or employer pays for the coverage, the aggregate cost of the coverage reported is determined under rules similar to those used to determine the applicable premiums for purposes of COBRA continuation coverage."
(Wolters Kluwer)

[Guidance Overview]
Eleventh Circuit Rules That Employer's Absence of Knowledge Causes Employee's Claims of FMLA Retaliation and Interference and ERISA Inteference to Fail
Excerpt: "In Krutzig v. Pulte Home Corporation, No. 09-12512 (11th Circuit 2010), the plaintiff had been terminated from employment with her employer, the defendant, and had claimed that the termination was an act of retaliation and interference with her rights under the Family and Medical Leave Act ('FMLA') to take FMLA leave, and an act of interference with her request under ERISA for short-term disability benefits. The district court had entered summary judgment on those claims in favor of the defendant."
(Stanley D. Baum of Fellheimer & Eichen LLP)

[Guidance Overview]
Is Your Company's Maternity Leave Policy Legal? The EEOC May Not Think So
Excerpt: "Under Title VII of the Civil Rights Act of 1964, employers are permitted to provide women with leave specifically for the period that they are incapacitated because of pregnancy, childbirth, and related medical conditions. Employers, however, may not treat females more favorably than males with respect to other kinds of leave, including leave for childcare purposes, under Title VII. Indeed, according to the Equal Employment Opportunity Commission (EEOC), employers who grant more liberal leave to new mothers than to new fathers without tying that leave to a pregnancy-related disability may be guilty of sex discrimination."
(Troutman Sanders LLP)

Four Key Health Reform Provisions That Will Affect Health Insurers This Year
Excerpt: "[S]everal changes become effective on Sept. 23 -- six months after the health reform law was enacted. Here's a look at four provisions that go into effect this year . . . ."
(AIS Health.com)

Four-Tier Pharmacy Benefit Designs Are Increasingly Used by Employers
Excerpt: "Employers continue to be concerned about their drug costs, prompting them to look for ways to help mitigate their spend, according to a recent report from the Pharmacy Benefit Management Institute. To that end, more of them are turning to adding additional tiers on their formularies, says the 2009-2010 Prescription Drug Benefit Cost and Plan Design Report."
(AIS Health.com)

Timeline of Effective Dates for Various Provisions of Health Care Reform
The timeline lists provisions by year to be effected.
(Towers Watson)

UAW Suing GM Over $450 Million for Retiree Health Benefits
Excerpt: "The Detroit Free Press: '[T]he UAW contends that GM was obligated through a labor contract and the bankruptcies of both GM and [its former parts division] Delphi to pay $450 million intended for the UAW's Voluntary Employee Beneficiary Association for Delphi workers."
(Henry J. Kaiser Family Foundation)

Funding Squeeze to Force Patient-Focused Health Care, According to PricewaterhouseCoopers
Excerpt: "Pressure from global recession and relentlessly rising costs of chronic disease will force health care systems across the world to become more patient-focused, a report on the industry said on Tuesday. A report by consultants PricewaterhouseCoopers' Health Research Institute said the industry's response to the pressures would be to encourage people to take more responsibility for their own health."
(Reuters via Business Insurance)

Health Reform 2010: Present and Future Outlook for Employers and Employees
Excerpt: "This Advisory highlights some of the more important components of the PPACA, as amended, that will directly affect employers and their employees."
(Buchanan Ingersoll & Rooney PC)

Case Outcome May Help Determine Whether Tribal Plans Subject to Federal Law
Excerpt: "Congress said that in order to escape regulation by ERISA, most of the employees of an Indian tribe have to be doing governmental work, not the kinds of commercial enterprises run by the Southern Ute tribe. Dobbs, for example, worked as a geologist for the tribe's Red Willow Production Co. That will make it hard for the Dobbses to prove their case, said Tom Shipps, lawyer for the Southern Ute tribe. 'It seems it will be difficult, if not impossible, to conclude the benefit programs administered by the tribe meet that test,' Shipps said."
(The Durango Herald)

Employers Loyal to Value-Based Design in Health Programs, Survey Finds
Excerpt: "A new study confirms that employers believe the use of value-based design (VBD) in health benefit programs improves employee health and productivity. 'Value-Based Design 2009,' conducted by Buck Consultants, found that among survey respondents who currently have VBD incorporated into their health programs for employees, 79% made no changes in 2009. Additionally, more than one half of these companies (56%) anticipate no changes in these benefits for 2010."
(PLANSPONSOR.com)

Health Care Reform: Benefits for Women and Responsibilities for Employers
Excerpt: "This client alert focuses on benefits for women enacted as part of the Patient Protection and Affordable Care Act (H.R. 3590) (the Reform Act) as amended by the Health Care & Education Affordability Reconciliation Act of 2010 (H.R. 4872) (the Reconciliation Act)."
(Proskauer Rose LLP)

Laws Extend Care for Adults Under Parents' Plans
Excerpt: "Young adults will soon qualify for coverage under a parent's group health insurance policy until age 26, thanks to the new health care laws signed last month. Today, most plans cover dependents only until age 19 or 20 unless they are in college full time or a state law requires coverage until an older age. The new provision takes effect for plan years beginning on or after Sept. 23."
(San Francisco Chronicle)

Under Health Care Reform, Insured Plans Must Comply with Nondiscrimination Rules
Excerpt: "Insured group health plans now must comply with the nondiscrimination requirements for self-funded plans, including rules that the plan does not discriminate in favor of highly compensated individuals as to eligibility to participate. In addition, the benefits provided under the plan may not discriminate in favor of participants who are highly compensated individuals. Rules for nondiscrimination. Rules similar to those for self-funded plans are to be applied to insured group health plans, including rules for eligibility, benefits, and controlled groups."
(Wolters Kluwer)

The Basics of Health Care Reform (PDF)
4 pages. Excerpt: "Existing employer-sponsored group health plans are called 'grandfathered' plans and include any employer-sponsored group health plan in existence on March 23, 2010 (the day the law was signed into law). 'New' group health plans are those plans that were not in existence on the date the law became effective. Except as otherwise noted, the following requirements apply to plan years beginning on or after September 23, 2010 for existing employer-sponsored group health plans."
(Winston & Strawn LLP)

[Opinion]
Podcast: Health Insurance Issues to Consider Sooner Than 2014, 2018
Excerpt: "Steve Wojcik, vice president of public policy for the National Business Group on Health, offers his take on what employers should have top of mind between now and when the biggie components of the Patient Protection and Affordable Care Act take effect in 2014 and 2018."
(Employee Benefit Adviser; free registration required)




HIPAA covered entities, including health plans, health care clearinghouses, and covered health care providers, must comply with the HIPAA Security Rule. This regulation also requires compliance from business associates. Covered entities must create and document compliance with a HIPAA Security manual. This course will outline the security rules, safeguards and what is required for the manual.

Executive Compensation; Benefits in General

[Guidance Overview]
EEOC Proposes Rule on Age Discrimination Defense
Excerpt: "The Equal Employment Opportunity Commission (EEOC) has proposed a rule to provide guidance on the meaning of 'reasonable factors other than age' (RFOA) under the Age Discrimination in Employment Act (ADEA). The RFOA defense is one of several ADEA affirmative defenses and is particularly important to employers facing an allegation that a seemingly neutral employment action or policy had a disparate impact on older employees."
(Towers Watson)

[Guidance Overview]
Milliman's Monthly Benefit News and Developments, April 2010 (PDF)
2 pages. The newsletter provides a summary of the previous month's legislative, regulatory, and judicial information on employee benefits and upcoming key dates.
(Milliman)

[Guidance Overview]
Another Court Rules That Severance Pay is Not FICA Wages (PDF)
2 pages. Excerpt: "The IRS has the stronger position to treat severance payments as FICA wages, and at this point employers should continue to withhold applicable FICA taxes. However, to preserve a future refund claim, an employer can file protective claims based on the court's decision."
(Groom Law Group)

[Guidance Overview]
The ERISA Litigation Newsletter, April 5, 2010 (PDF)
10 pages. Excerpt: "[The newsletter begins] this month with a review of published employer stock drop decisions in the first quarter of 2010. As the article reports, there has no been no shortage of decisions. . . . The second article uses the recent decision in Hartsfield, Titus & Donnelly, LLC v. The Loomis Company, . . . as a vehicle for a discussion about disputes between ERISA plan sponsors and their third-party administrators over alleged overpayments of health benefit claims. As always, be sure to review the section on Rulings, Filings and Settlements of Interest."
(Proskauer Rose LLP)

Even With a Recovery, Job Perks May Not Return
Excerpt: "Workers have seen everything from 401(k) contributions to educational reimbursements cut by their employers during the recession. While some companies are slowly restoring some benefits, experts say workers shouldn't expect a return to pre-2007 levels any time soon. 'Those days are gone,' says Tim Prichard, head of BridgeStreet Consulting, a benefits administration consulting firm. 'Benefits across the board are no longer sacred cows.'"
(The Wall Street Journal)

Federal Government Jobs Far Outpace Private Sector Counterparts in Pay and Benefits
Excerpt: "Recent statistics suggest the federal government is becoming an increasingly more attractive place to work than the private sector. According to information from the Bureau of Labor Statistics, federal jobs outpay their private sector counterparts 83 percent of the time."
(FOX News Network, LLC)


Webcasts and Conferences

"Troubleshooting Participant Loan Issues" Web Seminar
Nationwide on May 4, 2010
presented by SunGard Relius

2010 Orange County 401k/DC Evaluation Summit
in California on May 19, 2010
presented by Xponential Growth Solutions

Roth IRA Conversion Rules and How They Impact Your Practice
in New York on April 20, 2010
presented by ASPPA Benefits Council (ABC) Of New York

Sections 409A & 457A: What's A Multinational Employer To Do?
Nationwide on April 21, 2010
presented by ABA Joint Committee on Employee Benefits


Press Releases


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