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Health & Welfare Plans Newsletter

June 28, 2010

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This webcast will examine the just-released grandfathered health plan regulations that determine whether health plans have to comply with the full scope of PPACA, or whether certain important provisions can be avoided. You'll learn the 12 main ways grandfathered status can be lost, special rules for collectively bargained plans and whether the law applies to retiree-only plans, dental, vision and more.

[Official Guidance]
Text of Interim Final Regulations Under the Affordable Care Act's New Patient's Bill of Rights, Including Application of Preexisting Condition Exclusions, Annual/Lifetime Limits, and Rescissions (Federal Register Typeset Version) (PDF)
55 pages. Excerpt: "[For group health plans and group health insurance coverage, these] interim final regulations, except those under Public Health Service Act . . . 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 under PHS Act section 2704 . . . generally apply for plan years beginning on or after January 1, 2014, except that in the case of individuals who are under 19 years of age, these interim final regulations under PHS Act section 2704 apply for plan years beginning on or after September 23, 2010."
(Internal Revenue Service; Employee Benefits Security Administration; U.S. Department of Health & Human Services)

[Guidance Overview]
DOL Clarification of Who May Take FMLA Leave for the Birth, Bonding or Care of a "Son or Daughter"
Excerpt: "The DOL's interpretation describes several situations where the definition of in loco parentis may apply to permit an employee who is not a biological parent of a child to take FMLA leave, even if the situation does not lead to a legal relationship with the child such as through adoption."
(Michael Best & Friedrich LLP)

[Guidance Overview]
New Health Reform Rules Specify Minimum Annual Limits, Provide Model Language for Patient Protections
Excerpt: "The Affordable Care Act also requires that plans allow enrollees to select, when the plan requires it, any primary care provider that participates in the plan's network. The interim final rules note that plans must notify enrollees of this provision, and the rules provide the following model language that plans may use to comply with this requirement . . . ."
(Wolters Kluwer)

[Guidance Overview]
CMS Updates Creditable Coverage Disclosure to CMS Form
Excerpt: "EBIA Comment: Most of the changes in the Disclosure to CMS Form seem to be for clarification and are fairly minor. One wording change to be aware of - for those gathering data for completing the form - is that it now requests the date that the annual disclosure to eligible Part D individuals requirement was "provided" instead of the previous (and somewhat ambiguous) request for the date the disclosure was "completed.""
(Employee Benefits Institute of America)

[Guidance Overview]
Joint Regulations Issued on Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, and Patient Protections
Excerpt: "Plan sponsors and advisors will need to carefully study this guidance as they prepare for 2011 open enrollment. And the preamble indicates that more guidance on other health reform provisions is on the horizon (including, in a related vein, guidance on the waiver program for annual limits, the new appeals process requirements, and any notice requirements for cancellations of coverage other than in the case of rescission)."
(Employee Benefits Institute of America)

Paid Time Off Seen as Talent Attraction Tool, According to Survey
Excerpt: "A WorldatWork news release said the survey, "Paid Time Off Programs and Practices," found 70% of those firms with a paid time off (PTO)-type leave bank and 60% of those with a traditional system gave that response."

Pittsburgh, Pennsylvania, Companies Become Proactive to Keep Health Care Costs Down
Excerpt: "Here's what's new: An increasing number of employees are choosing the Internet rather than the telephone for reminders about preventive health measures, and employers are making it easier for workers to comply with medical regimens by waiving copays associated with some prescription drugs and devices. The result overall is sweeter incentives for participating in wellness programs."
(Pittsburgh Business Times)

Tricare to Allow Civilian Employers of Military Retirees to Offer Cafeteria Insurance Plans
Excerpt: "Tricare is allowing civilian employers of military retirees to offer a cafeteria-style supplemental health insurance plan so that 'workers who elect to use their Tricare Standard benefit can buy coverage conveniently and with pre-taxed dollars,' The Colorado Springs Gazette reports."
(Henry J. Kaiser Family Foundation)

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Webcasts and Conferences

"Fundamentals of 401(k) and Other Qualified Plans" - Charlotte
in North Carolina on July 28, 2010
presented by SunGard Relius

Form 5500-SF -- The Simplified Alternative to Form 5500
Nationwide on July 13, 2010
presented by SunGard Relius

The New Form 5500-EZ - At Last!
Nationwide on June 29, 2010
presented by SunGard Relius

Press Releases

ASPPA Lauds Congress for Passing Pension Funding Relief
American Society of Pension Professionals & Actuaries (ASPPA)

New Book on Defined Benefit Pension Plans
Executive Benefits Design Group

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Newly Posted Employee Benefits Jobs

Vice President, Retirement Sales
for Cammack LaRhette Consulting
in NY

Sales Director
for Goldleaf Partners
in MO

Defined Contribution Plan Administrator
for Feldman Benefit Services, Inc.
in NJ

Client Service Representative
for Decimal, Inc. (
in CA

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