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Health & Welfare Plans Newsletter

May 13, 2010

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[Official Guidance]
Text of Interim Final Reg for Group Health Plans and Health Insurance Issuers Relating to Dependent Coverage of Children to Age 26 under the Patient Protection and Affordable Care Act (as Printed in Federal Register) (PDF)
20 pages. Excerpt: "These interim final regulations generally apply to group health plans and group health insurance issuers for plan years beginning on or after September 23, 2010. These interim final regulations generally apply to individual health insurance issuers for policy years beginning on or after September 23, 2010."
(U.S. Employee Benefits Security Administration; Internal Revenue Service; Department of Health and Human Services)

[Official Guidance]
IRS Publishes Dependent Coverage of Children Regulation as Both Proposed and Temporary Reg; Comments Requested (PDF)
The regulations published today by EBSA and HHS as Interim Final Regulations also are published as IRS Temporary Regulations. In addition, the IRS is publishing them (verbatim) as Proposed Regulations, in order to solicit comments per the usual procedures for proposed regulations. Excerpt: "Before these proposed regulations are adopted as final regulations, consideration will be given to any . . . comments . . . . Comments are specifically requested on the clarity of the proposed regulations and how they may be made easier to understand."
(Internal Revenue Service)

[Guidance Overview]
Early Retiree Reinsurance Program under Health Care Reform
Excerpt: "Employer Action Plan: Determine whether your plan is eligible for reimbursement. Discuss with your vendors what relevant services they are willing to provide related to obtaining reimbursements (determining eligible reimbursement amounts, etc.) under this Program and the cost of these services. Decide how reimbursements would be applied to lower costs for your plan . . . ."
(Seyfarth Shaw LLP)

[Guidance Overview]
'Appropriate' Equitable Relief Under ERISA
Excerpt: "Zurich Am. Ins. Co. v. O'Hara, 2010 U.S. App. LEXIS 8570 (11th Cir. Ga. Apr. 26, 2010) The Eleventh Circuit takes up the issue of 'appropriate' equitable relief in this recent opinion. The Court rejects the argument that the plan's reimbursement fails to satisfy the terms of statutory relief authorized under ERISA Section 502(a)(3)."
(Passion for Subro!)

In New Hampshire, a New Way to Manage Retiree Healthcare Costs: the 'Retiree Medical Trust'
Excerpt: "Under the plan -- which is not yet in effect -- government workers would have the chance to make tax-free contributions from their paychecks to accounts managed by their unions. The employees' money would be pooled together and invested. And both the investment returns and the monthly distributions paid to retirees for health care expenses such as insurance premiums, doctor co-pays and prescription drugs would be tax-free."
(The Pew Charitable Trusts)

Statement of Assistant Secretary of Labor Calling on Employers and Benefit Plans to Make Young Adult Coverage Available Immediately
Excerpt: "'Affordable health coverage for adult children will provide emotional and financial peace of mind to parents across this country. We encourage employers and private-sector health plans to make this important health coverage available immediately. It makes good business sense, and I thank those companies who have decided to adopt this provision earlier than the September effective date.'"
(U.S. Employee Benefits Security Administration)

Navigating the Principal 'Immediate' Health Insurance Reforms under Health Care Reform
Excerpt: "For plan years beginning before January 1, 2014, plans may establish restricted annual dollar limits on ['Essential Health Benefits'], as long as the limits are not lower than acceptable levels that are to be established by the Secretary of HHS. In defining acceptable annual dollar limits, the legislation directs the Secretary to ensure that access to necessary services is made available with only a minimal impact on premiums. For plan years beginning on or after January 1, 2014, no annual dollar limits on EHBs may be established."
(McDermott Will & Emery)

Many Patients Diagnosed with Chronic Conditions Fail to Get Initial Medication Prescriptions Filled
Excerpt: "This phenomenon -- referred to as 'prescription non-adherence' -- has been documented in various studies. Until recently, however, little data existed regarding the number of Americans who fail to get those prescriptions filled in the first place. That's changed, thanks to a new study based on an analysis of electronic prescriptions for two conditions -- high cholesterol and asthma -- by CVS Caremark and Horizon Blue Cross/Blue Shield of New Jersey."
(Human Resource Executive Online)

Obama Administration Health Care Defense Offered
Excerpt: "The administration argues that consumer decisions to forgo health insurance do 'substantially affect interstate commerce by shifting costs to health care providers and the public,' thus giving the government power to regulate via the Commerce Clause."
(Capitol News Company LLC)

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Executive Compensation; Benefits in General

New Federal Rules Target MEWA's
Excerpt: "[Health] reform legislation contains several provisions directed at Multiple Employer Welfare Arrangements ('MEWA's'). A new criminal enforcement section contains broad language prohibiting false statements. [One section] prohibits false statements about a MEWA as to: the MEWA's financial condition or solvency, the benefits provided, or the regulatory status of the MEWA under state or federal law, including specifically the exemption of the MEWA from state regulatory authorities."
(Roy Harmon via Health Plan Law)

Webcasts and Conferences

"Fundamentals of 401(k) and Other Qualified Plans" - Atlanta
in Georgia on June 16, 2010
presented by SunGard Relius

"Fundamentals of 401(k) and Other Qualified Plans" - Irvine
in California on June 16, 2010
presented by SunGard Relius

"The New 5500-EZ: At last!" Web Seminar
Nationwide on June 8, 2010
presented by SunGard Relius

Advisory Council on Employee Welfare and Pension Benefit Plans Meeting
in District of Columbia on June 29, 2010
presented by U.S. Department of Labor, Employee Benefits Security Administration (EBSA)

Press Releases

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Newly Posted Employee Benefits Jobs

Defined Contribution Operations Manager
for New York Life Retirement Plan Services
in MA

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for Milliman
in WA

Benefits Analyst II
for Milliman
in WA

Actuary needed to manage our Wisconsin office
for Summit Benefit & Actuarial Services, Inc.
in WI

Senior Plan Consultant
for BPA, A BPAS Company
in PA

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