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Health & Welfare Plans Newsletter

July 9, 2010

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World Congress is proud to present the World Congress 5th Annual Executive Forum on Pharmacy Benefit Management Strategies, July 12-13, 2010 in Philadelphia, PA. This year's forum identifies pertinent issues facing employers and plans, including developing Medication Therapy Management, overcoming barriers to diverse population drug challenges, Medicare Part D, changes to pharmacy in light of health reform and measuring the impact and effectiveness of existing pharmacy management programs.
Sponsored by World Congress

[Guidance Overview]
Fourth Circuit Determines That Insurer Abused Its Discretion In Terminating Employee's Long-Term Disability Benefits
Excerpt: "Based on its review of the administrative record, the Court said that MetLife's decision to terminate the benefits was not reasoned and principled, and was not supported by substantial evidence."
(Stanley D. Baum of Fellheimer & Eichen LLP)

[Guidance Overview]
Agency Regulations Address the Affordable Care Act's Rules for Group Health Plans
Excerpt: "Plan sponsors making benefit design decisions for the coming plan year must answer two questions: What new requirements apply for the next plan year? What additional requirements apply if the plan sponsor does not retain grandfathered status?"
(The Segal Group, Inc.)

What Really Makes Health Insurance Premiums Increase
Excerpt: "[T]he insurance industry trade group America's Health Insurance Plans called in a handful of reporters this week to walk through the process of how actual premiums are calculated for the individual and small group market."
(National Public Radio)

Rating Employer Health-Insurance Plan Carriers
Excerpt: "Health-plan service is more important than cost to a majority of employers, according to a first-ever ranking of employer health-insurance plan carriers. Most of the employers expressed relatively low levels of satisfaction with their carriers and half have investigated changing plans."
(Human Resource Executive Online)

Unscheduled Absence Costs Employers 8.7% of Payroll, According to Survey
Excerpt: "The total costs, direct and indirect, of all major absence categories average 35% of base payroll, ranging from 29% for exempt employees, 36% for nonexempt salaried, 39% for nonunion hourly workers and 38% for union hourly."
(Wolters Kluwer)

Most Employers Trying Reduce Workplace Stress, According to Survey
Excerpt: "In response to workplace stress, 66% of the employers have put at least four programs aimed at reducing stress in place, with employee assistance programs used most often. The survey noted other strategies, such as work-and-life balance support, on-site fitness centers and stress awareness campaigns."
(Business Insurance)

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Executive Compensation; Benefits in General

[Guidance Overview]
IRS Changes Position on Application of Section 162(m) in Acquisition Context
Excerpt: "A relatively recent development in the IRS' interpretation of section 162(m) has received little attention, notwithstanding that it will often result in an additional deduction disallowance when a public company is acquired. The issue has to do with the application of section 162(m) to the year before a public company is acquired."
(Miller & Chevalier Chartered)

[Guidance Overview]
Accounting by Health Insurance Providers for New Compensation Deductibility Requirements
3 pages. Excerpt: "The new limitation is expected to be similar to the limitation placed on companies that received TARP funds, though the new limitation applies to all employees."
(PricewaterhouseCoopers LLP)

[Guidance Overview]
Federal Banking Agencies Issue Final Guidance on Incentive Compensation (PDF)
Excerpt: "The Final Guidance is substantially similar to the proposed guidance . . . issued by the Federal Reserve in October 2009, and establishes three general principles for incentive compensation arrangements."
(Arnold & Porter LLP)

Federal Judge Finds Law Barring Federal Government from Recognizing Same-S.ex Marriage Is Unconstitutional
Excerpt: "If the rulings find their way to the Supreme Court and are upheld there, they will put same-s.ex marriage within the constitutional realm of protection, just as interracial marriage has been for decades."
(The New York Times; free registration required)

Milliman's Monthly Benefit News and Developments, July 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.

Fringe Benefits a 'Key Area' of Upcoming IRS Audits
Excerpt: "The IRS is on a mission to learn what issues are hiding in employers' records; thus, the [employment tax national research program] audits will prove to be more invasive than they would be if auditors had a specific target."
(Thompson Publishing Group Inc.)

Study Rekindles Debate Over Federal Pay and Benefits
Excerpt: "A right-leaning Washington think tank once again has added fuel to the debate over federal employee pay with a report asserting civil servants earn significantly higher salaries and more generous benefits than their private sector counterparts, while enjoying far greater job security."

Webcasts and Conferences

DOL Speaks: The 2010 Employee Benefits Conference
in Maryland on September 20, 2010
presented by ASPPA & DOL

Press Releases

U.S. Labor Department Obtains Judgment Restoring More Than $20,000 to Bedford, NH, 401(k) Retirement Plan
U.S. Department of Labor, Employee Benefits Security Administration (EBSA)

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in CA

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