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Health & Welfare Plans Newsletter

August 3, 2010

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These one-day regional seminars will provide a quick and cost-effective way for jointly-managed plans to know what they need to do now in response to unfolding reform regulations. Included is an afternoon workshop addressing the early retiree subsidy application process. Two additional workshop options are also offered -- Multiemployer Perspectives and Public/Governmental Plan Perspectives.

[Guidance Overview]
New Regulations for Preventive Services and Appeals Processes Under Health Reform
Excerpt: "A plan or issuer is considered to provide the notices in a culturally and linguistically appropriate manner if: In the case of a plan that covers fewer than 100 participants at the beginning of the year, and 25% or more of the participants are literate only in the same non-English language, the notice is provided in that language. In the case of a plan that covers 100 or more participants at the beginning of the year, and the lesser of 500 participants or 10% or more of the participants are literate only in the same non-English language, the notice is provided in that language."
(Troutman Sanders LLP)

[Guidance Overview]
Open Enrollment Communications under Health Care Reform
Excerpt: "[Health reform] includes a series of significant changes that are relevant to employer-provided group health plans. Some of these changes take effect for plan years beginning on and after September 23, 2010. As a result, plan sponsors will need to update enrollment materials and participant communications for the upcoming plan year."
(Poyner Spruill LLP)

[Guidance Overview]
Grandfathered Plan Rules Under Health Reform
Excerpt: "The [target document] Q&As summarize the most significant grandfathered plan rules from the regulations. The rules reveal a rather stringent approach taken by the governmental agencies in determining when a grandfathered plan may lose its status as such."
(Greensfelder, Hemker & Gale, P.C.)

Reminder for Employers about Planning for Current Health Care Coverage (PDF)
2 pages. Excerpt: "This Spotlight reminds employers to take a step back from looking ahead in order to focus on what they need to do now to plan for the coming year . . . ."
(The Segal Group, Inc.)

Employer Coverage of Dependent Children to Age 26 Under Health Reform (PDF)
Pages 2-8 of 20 pages. Excerpt: "The overall increase in employment-based coverage due to newly enrolled 19-to-25-year-olds in 2011 ranges from 680,000 to 2.12 million individuals, and these costs are expected to increase health insurance premiums about 0.7 percent in 2011, 1 percent in 2012, and 1 percent in 2013."
(Employee Benefit Research Institute)

Health Reform Could Accelerate Shift to High-Deductible Plans
Excerpt: "[T]he myriad ways in which these high-deductible plans can be structured likely leave them well situated in the post-reform world, benefits consultants say. Along with the plans' flexible design, they also cite other reform-related changes as being influential, such as the new limitations on another type of account, the flexible spending account."
(Workforce Management; free registration required)

Pediatric and Specialty Drugs Drive Rx Trends
Excerpt: "In its 2010 Drug Trend Report, Medco researchers found that growth in prescription drug use among children was almost four times higher than the increase seen in the general population."
(Employee Benefit News; free registration required)

Consolidated Text and Public Laws Available for Health Reform
Excerpt: "New versions of the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act (HCERA) may be useful tools when researching those laws. While not an official text, the consolidated print from the House of Representative's Office of Legislative Counsel incorporates HCERA's changes to PPACA. The public law texts of PPACA and HCERA -- the official versions of the laws as enacted in March -- also are now available."
(Mercer LLC)

Coherent and Transparent Health Care Payment: Sending the Right Signals in the Marketplace
Excerpt: "The current fee-for-service payment system rewards physicians for providing a greater volume of more costly services rather than for getting the best results for patients. An alternative is to pay each provider organization a global fee for all care -- a fixed, per-person payment based on the patient's health condition or a risk-adjusted capitation rate."
(The Commonwealth Fund)

Will Employers Undermine Health Care Reform by Dumping Sick Employees?
Excerpt: "This Essay argues that federal health care reform may induce employers to redesign their health plans to encourage employees who are likely to consume a greater-than-average amount of medical services to opt out of employer-provided coverage and instead acquire coverage on the individual market."
(Social Science Research Network)

How the Health Care Reform Law Will Impact Employers
Excerpt: "A critical first step is to understand the legislation's multi-faceted implementation schedule. With the legislation's removal of the plan sponsor's ability to control corporate costs through plan design and contribution structure, introducing health improvement initiatives also becomes essential. And, you need to keep the lines of communication open with your work force. Health care benefits remain a priority for the majority of employees, and replacing rumor and myth with facts is vital."
(Smart Business Network Inc.)

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Benefits in General; Executive Compensation

[Official Guidance]
EBSA's Index of Granted Individual Exemptions under ERISA
Excerpt: "This new online index lets people search by subject matter for individual exemptions granted from 1996 through 2010. For example, the index catalogues exemptions relating to captive reinsurance, co-investing, collateralized mortgage obligations, leases and in-kind contributions."
(U.S. Employee Benefits Security Administration)

Choose an HR Vendor Wisely
Excerpt: "The investigation of an HR services vendor for misappropriating funds earmarked for clients' medical bills, 401(k) claims and payroll shows once again why choosing the right vendors can make all the difference. Selecting consultants offers the same risks as mergers or acquisitions -- and the consequences of choosing poorly can be 'disastrous.'"
(Human Resource Executive Online)

Employee Benefits Developments, July 2010
A brief look at developments in Employee Benefits law from June and July 2010, including cases, rulings, and opinions.
(Hodgson Russ LLP)

Economic Downturn Influencing Rewards Strategy (PDF)
Excerpt: "[This article] looks at Hay Group's Changing Face of Reward research and examines how the business drivers of rewards are changing due to the impact of the global downturn and other macroeconomic trends in the global economy."
(Premium Incentive Products Magazine)

Webcasts and Conferences

401(k) Rekon Advisor Symposium - Dallas, TX
in Texas on September 14, 2010
presented by 401(k) Rekon

Information You Need to Decrease Specialty Drug Costs
Nationwide on August 26, 2010
presented by International Foundation of Employee Benefit Plans

Urgent Information on Revamping ERISA Service Provider Arrangements: New DOL Rules
Nationwide on August 4, 2010
presented by International Foundation of Employee Benefit Plans

Press Releases

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Newly Posted Employee Benefits Jobs

Onsite Participant Counselor
for Diversified Investment Advisors, Inc.
in PA

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in CA, IL, IN, MI, WA

Onsite Participant Counselor
for Diversified Investment Advisors, Inc.
in KY

Onsite Participant Counselor
for Diversified Investment Advisors, Inc.
in WI

Litigation Attorney
for Slevin & Hart, P.C.
in DC

401k Plan Administrator
for Pension Plan Services, Inc.
in IA

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