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Health & Welfare Plans Newsletter

September 15, 2010

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No matter how benefits-savvy your employees may be, today’s health care environment can confuse the most sophisticated consumer. That’s why companies large and small use BeneCom for their benefits communication. We know benefits and we understand what employees need to know to make them work – for themselves and for you. And while we’re at it, we make your life a little easier, too.

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[Guidance Overview]
IRS Guidance Illustrates When Expenses Are Paid for 'Medical Care'
Excerpt: "Two recently released IRS Information Letters illustrate the analysis that applies in determining when expenses are paid for 'medical care' under Code § 213(d) so as to be deductible or eligible for payment by a health care flexible spending account."
(Deloitte via

[Guidance Overview]
Procedures Are Open for Waiver of Annual Limit Requirements
Excerpt: "The waivers are primarily addressed toward 'limited benefit' or 'mini-med' plans, which often have annual limits below the restricted annual limits that are scheduled to become effective beginning September 23, 2010. The procedures make clear that the waivers will be available only for plan years beginning before January 1, 2014 (when annual limits are prohibited altogether on essential health benefits)."
(Deloitte via

[Guidance Overview]
DOL Wage and Hour Division Guidance Regarding Parents in the Workplace
Excerpt: "[The Department of Labor . . . recently issued guidance to employers regarding (1) employees who are entitled to take leave as a parent pursuant to [FMLA]; and (2) implementing the break time requirement for nursing mothers in [PPACA]."
(McGuireWoods LLP)

[Guidance Overview]
New Notices and Disclosures Due Under Health Care Reform
Excerpt: "Employers with group health plans must provide a host of new or expanded government reports, employee notices and other disclosures under the Patient Protection and Affordable Care Act. While some requirements are straightforward, others await regulatory guidance, which may include model notices or forms."
(Mercer LLC)

[Guidance Overview]
Guidance for External Review of Denied Appeals and New Rules for FSA, HRA and HSA Reimbursement of OTC Drugs
Excerpt: "One of the mandates under the Patient Protection and Affordable Care Act (ACA) is that non-grandfathered health plans must adopt new standards for claims and appeals and provide external review of denied appeals."
(Vorys, Sater, Seymour and Pease LLP)

[Guidance Overview]
Benefit Claims and Appeals Procedures under Health Care Reform (PDF)
8 pages.
(Thompson Hine LLP)

Health Care Reform and the Advent of Unlimited Lifetime Maximums: ISCEBS/Aegis Risk Survey Findings (PDF)
2 pages. Excerpt: "This year's survey was completed in the wake of health care reform and its removal of individual lifetime maximums - which significantly alters the underlying risk covered by medical stop loss. Although stop loss is not mandated to offer unlimited coverage, the risk is created, and according to this year's survey, 79% of respondents intend to review its coverage ? with 44% of those stating its requirement."
(International Society of Certified Employee Benefit Specialists)

Lower Taxes, Lower Premiums: The New Health Insurance Tax Credit
Excerpt: "This report takes a closer look at these premium tax credits, which will go into effect in 2014 and will help Americans with incomes up to four times the federal poverty level ($88,200 for a family of four in 2010) afford coverage."
(Families USA)

Workers' Compensation: Benefits, Coverage, and Costs, 2008 (PDF)
112 pages.
(National Academy of Social Insurance)

Non-Discrimination in Insured Health Care Plans: No More Executive Health Benefit Plans?
Excerpt: "With a probable effective date of the first plan year beginning six months form the date of enactment (Sept. 23, 2010), many insurance companies have told their clients that executive health benefit plans are no longer allowed beginning Sept. 23, 2010."
(Pension & Benefits Blog)

Florida Judge Signals He Will Likely Allow Some Parts of States' Health Law Challenge to Proceed
Excerpt: "Bloomberg: '[The U.S. District Judge] said ... he will make a decision by Oct. 14 on whether the states have jurisdiction to sue. He told lawyers he would probably dismiss part of the suit, while allowing other claims to proceed.'"
(Henry J. Kaiser Family Foundation)

Senate Amendments to Strike Health Reform Tax Reporting Provision Fail
Excerpt: "The Senate failed Tuesday to change a tax provision in the health law that even the White House said was onerous for small businesses . . . ."
(Henry J. Kaiser Family Foundation)

Reform Rule on Covering Adult Children Looms
Excerpt: "One of the first big pieces of health care reform legislation kicks in this month, when adult children up to age 26 must be covered by employed parents' health insurance, regardless of student status. Previously, only dependents in college typically remained on their parents' insurance plans after age 18, unless state law mandated coverage for older children who were not in school."
(Workforce Management; free registration required)

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Benefits in General; Executive Compensation

Employee Ownership Update for September 14, 2010
NCEO Executive Director Corey Rosen discusses the following: The NCEO has completed an extensive analysis of ESOP companies based on DOL data; unlike prior studies, this one combines data from multiple plans. The DOL has issued interim regulations for certain service providers to qualified retirement plans. The IRS is cracking down on 'ROBS' plans. A new report finds that higher CEO pay is not linked to superior shareholder returns.
(National Center for Employee Ownership)

Webcasts and Conferences

2010 Fall Tour: Advanced IRAs – Operational Issues
in Minnesota on September 22, 2010
presented by Ascensus

2010 Fall Tour: IRA Fundamentals
in Minnesota on September 21, 2010
presented by Ascensus

2010 Web/Telephone Seminar: Basic IRAs
Nationwide on October 5, 2010
presented by Ascensus

Form 8928 and Excise Tax Compliance: COBRA, HIPAA, Health Reform, and Other Rules
Nationwide on September 15, 2010
presented by EBIA / Thomson Reuters

Health Savings Accounts
Nationwide on September 30, 2010
presented by Lorman Education Services

Press Releases

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Newly Posted Employee Benefits Jobs

Pension Plan Administrator
for Thomas & Fees Pension Services
in CA

Defined Contribution Plan Administration Specialist
for Bukaty Companies Retirement Plan Services
in KS, MO

Senior New Business Specialist - Defined Benefits
for Great-West Retirement Services
in MA

Client Service Manager
for The Newport Group
in FL, NC, WI

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