Join the nation's top retirement services marketing, sales, administration and record keeping professionals at the SPARK Forum. Gain insights into the latest industry trends. Attend sessions designed specifically for TPAs, Advisors and RIAs. Participate in interactive sessions on marketing, operations, investments and distribution issues, and network with peers from national banks, insurance companies, mutual fund complexes, investment firms, third party administrators, benefit consulting organizations and financial advisory firms.
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[Guidance Overview]
HHS's New Information on Its Early Retiree Reinsurance Program Website
Excerpt: "The focus of the new information is that plan sponsors with an ERRP-approved application may now submit their lists of early retirees to the secure ERRP website. Guidance is provided on how to identify early retirees and how to format the list and submit it to HHS. Early retiree lists MUST be filed with HHS before a claim for reimbursement may be submitted. HHS reiterates that plan sponsors will be able to submit these claims in October."
(The ERISA Industry Committee)
It's Time for Plan Sponsors to Reassess Their Options Under Part D (PDF)
4 pages. Excerpt: "Healthcare reform legislation has resulted in significant changes to prescription drug plan options under Medicare Part D. A new article . . . considers why plan sponsors should reexamine their existing approaches to prescription drug coverage and take advantage of the new opportunities available since passage of the new healthcare laws."
(The Bureau of National Affairs via Milliman)
Health Care Law's Guidelines on Premiums' Use Take Shape
Excerpt: "[D]eciding which expenses insurers can include has been proving a monumental and controversial task for the National Association of Insurance Commissioners . . . . Write the 'medical loss ratio' rules too expansively, consumer advocates warn, and insurers will subvert the spirit of the law by passing off overhead and administrative expenses as activities that benefit patient health."
(The Washington Post; free registration required)
McDonald's and 29 Other Firms Get Health Care Coverage Waivers
Excerpt: "The Department of Health and Human Services, which provided a list of exemptions, said it granted waivers in late September so workers with such plans wouldn't lose coverage from employers who might choose instead to drop health insurance altogether. Without waivers, companies would have had to provide a minimum of $750,000 in coverage next year, increasing to $1.25 mil.lion in 2012, $2 mil.lion in 2013 and unlimited in 2014."
(USA TODAY)
Waivers Address Talk of Dropping Health Coverage
Excerpt: "The waivers have been issued in the last several weeks as part of a broader strategic effort to stave off threats by some health insurers to abandon markets, drop out of the business altogether or refuse to sell certain policies."
(The New York Times; free registration required)
Court Sends Retiree Health Dispute to Arbitration
Excerpt: "[A District Court] found that even though a collective bargaining agreement calling for such arbitration had expired, the newspaper company's dispute with the Newspaper Guild of St. Louis over the issue was still subject to arbitration because rights accrued under the union contract potentially were being infringed upon."
(PLANSPONSOR.com)
[Opinion]
Hewitt Comments on Claims and Appeals and External Review Processes
Excerpt: "Hewitt addressed the following issues in the letter: Existing External Review Processes; De Novo Review; Deemed Exhaustion of the Internal Claims and Appeals Process; New or Additional Evidence; Notice Requirements; Expedited Notification of Benefit Determinations Involving Urgent Care[.]"
(Hewitt Associates)
[Opinion]
ERIC Comment Letter Urges Flexibility in Operation of State-Level Exchanges Under PPACA
Excerpt: "ERIC's letter noted the strong interest of employers in how effectively the exchanges manage their health-care coverage operations and the impact of expected significant changes and developments in the areas of health-care cost containment, quality, transparency, delivery, payment reform, wellness and prevention efforts, and the adoption of health information technology."
(The ERISA Industry Committee)
[Opinion]
Reminding Ourselves What Has Gone Right with the Health Law
Excerpt: " The biggest improvements in the health insurance marketplace will not begin until 2014, but already, there are new measures that will protect consumers from dangerous holes in their coverage."
(Tom Daschle via Henry J. Kaiser Family Foundation)
[Opinion]
Insurance Is a Strange Model for Health Care
Excerpt: "[F]or something that is predictable, ongoing, needed by everyone, or necessary for the welfare of our community, an insurance model makes absolutely no sense. That's why we don't use an insurance model to provide police or fire services or to provide an education to our children. For these we use the tax model. Basic essential health care should also be in this category."
(Physicians for a National Health Program)
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