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November 17, 2010

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Thursday, November 18, 2010
So far, 2010 has brought us expanded obligations, increased penalties and more aggressive enforcement under HIPAA's Security Rules. Plans must carefully consider these new obligations and enhanced risks when ensuring that they maintain ongoing HIPAA compliance. The Webcast will focus on the impact of 2010 on HIPAA Security Rules, the most important considerations and the steps to be compliant. Register Now!

[Official Guidance]
DOL Fact Sheet: Contributory Plans Criminal Project
Excerpt: "EBSA Enforcement Efforts: To date, under the [Contributory Plans Criminal Project], EBSA has: Initiated 191 investigations; Referred 97 investigations to prosecutors; Obtained 20 indictments with 7 guilty pleas; Restored assets of $385,447."
(U.S. Department of Labor)

[Official Guidance]
Request by EBSA for Information to Help in Planning Federal External Review Process of Health Plan Denials (PDF)
3 pages. Excerpt: "This notice is a request for information (RFI) to gain market analysis information in advance of one or more future Requests for Proposals (RFP). On July 23, 2010, the Departments of Health and Human Services, Labor, and the Treasury published interim final regulations regarding, among other things, procedures for external review of health plan denials. The regulations include a provision for a Federal external review process in instances where there is no applicable State process. This RFI solicits information that will enable the Departments of Health and Human Services (HHS) and Labor (DOL) to conduct a market analysis and assist the Departments in planning and developing the Federal external review process. HHS and/or DOL may contract for services required to fulfill the statutory and regulatory requirements of the Federal external review process established under section 2719 of the Public Health Service Act, as amended by the Affordable Care Act, and its implementing regulations."
(U.S. Employee Benefits Security Administration)

[Official Guidance]
Text of Amendment to Interim Final Regs on Status as Grandfathered Health Plan Under the Patient Protection and Affordable Care Act (Federal Register Typeset Version) (PDF)
9 pages. Repeating for your convenience the excerpt BenefitsLink.com ran on November 15: 'This amendment modifies . . . the interim final regulations, which previously caused a group health plan to cease to be a grandfathered health plan if the plan entered into a new policy, certificate, or contract of insurance. The modification provides that a group health plan does not cease to be grandfathered health plan coverage merely because the plan (or its sponsor) enters into a new policy, certificate, or contract of insurance after March 23, 2010 (for example, a plan enters into a contract with a new issuer or a new policy is issued with an existing issuer). The amendment applies to such changes to group health insurance coverage that are effective on or after [November 15, 2010], the date the amendment to the interim final regulations was made available for public inspection; the amendment does not apply retroactively to such changes to group health insurance coverage that were effective before this date. For this purpose, the date the new coverage becomes effective is the operative date, not the date a contract for a new policy, certificate or contract of insurance is entered into. . . . Notwithstanding the ability to change health insurance coverage pursuant to the modification made by the amendment, if the new policy, certificate, or contract of insurance includes changes described in paragraph (g)(1) of the interim final regulations, the plan ceases to be a grandfathered health plan. . . . The amendment also provides that, to maintain status as a grandfathered health plan, a group health plan that enters into a new policy, certificate, or contract of insurance must provide to the new health insurance issuer (and the new health insurance issuer must require) documentation of plan terms (including benefits, cost sharing, employer contributions, and annual limits) under the prior health coverage sufficient to determine whether any change described in paragraph (g)(1) is being made."
(U.S. Department of Health & Human Services; U.S. Department of Labor; U.S. Department of the Treasury)

[Guidance Overview]
New Health Plan Notices Required Under Health Care Reform
Excerpt: "Some of these notices are meant to notify participants and other interested individuals of changes to their benefits under the plan, and of special enrollment opportunities related to the changes. Other notices are required in specific circumstances such as a rescission of coverage or the denial of a claim for benefits."
(Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.)

[Guidance Overview]
On Insurers' Obligations under GINA
Excerpt: "In general, Title I of GINA provides that health insurers cannot collect genetic information or discriminate based on it in connection with a group health plan. 'Genetic Information' is defined to include family medical history."
(Delaware Employment Law Blog)

[Guidance Overview]
GINA and Certification Forms
Excerpt: "As soon as possible, and no later than the effective date, employers should update their FMLA medical certification forms to include the 'safe harbor' language . . . ."
(Franczek Radelet PC)

[Guidance Overview]
Changes to Grandfathered Plan Rules
Excerpt: "Employers with fully insured plans who avoided making certain insurance policy changes (other than the 6 prohibited changes for grandfathered plans) that would reduce cost but result in a new policy being issued, may want to revisit those decisions in light of this amendment. Unfortunately, this amendment may have come too late, as a practical matter, for calendar year plans to make any changes for the 2011 plan year."
(Ford & Harrison LLP)

DOL Announces Nationwide Enforcement Actions to Protect Millions of Dollars in Worker Retirement and Health Benefits
Excerpt: "In the criminal arena, EBSA works with U.S. attorneys as well as state and local law enforcement agencies nationwide to bring criminal cases under ERISA that protect the contributions of American workers. The Contributory Plans Criminal Project is the agency's first criminal national enforcement project targeting persons who commit fraud and abuse against participants and beneficiaries of contributory employee benefit plans, including 401(k)s, and contributory health plans."
(U.S. Department of Labor)

DOL Says Some Business Owners Are Pilfering Employee Contributions to 401(k) and Health Benefits Accounts
Excerpt: "On [November 16], the department filed civil lawsuits against 24 companies and business owners alleged to have kept money withheld from paychecks that was meant for retirement or health accounts. The companies range in size, from fewer than 10 workers to more than 100 and the largest case involves more than $6 mil.lion in worker contributions."
(Gray Television, Inc.)

Best Employers for Healthy Lifestyles: 2011 Awards Program
Excerpt: "The awards, now in their seventh year, are a proven standard for exceptional employee wellness programs and recognize companies that are making health and wellness a top priority."
(National Business Group on Health)

Health Group Evaluation Data Shows Mixed Picture
Excerpt: "[A National Business Coalition on Health] news release said eValue8 was used by employers and coalitions to gather health care data from 64 health plans across the nation, representing more than 100 mil.lion Americans."
(PLANSPONSOR.com)

Video and Transcript: Health Reform Hits Main Street
Excerpt: "Confused about how the new health reform law really works? This short, animated movie -- featuring the 'YouToons' -- explains the problems with the current health care system, the changes that are happening now, and the big changes coming in 2014."
(Henry J. Kaiser Family Foundation)

OPM Delays Launch of Federal Health Claims Database
Excerpt: "In a Nov. 15 notice in the Federal Register, OPM said it would push back the deadline for the health database to Dec. 15 to accommodate more comments from the public."
(Government Executive)

Most Workers Have to Wait Longer for Health Insurance Coverage Than Congress, According to Study
Excerpt: "'The average waiting period among covered workers who face a waiting period is 2.2 months.... Thirty-one percent of covered workers face a waiting period of 3 months or more.'"
(TPM Media LLC)

Audio: What's Behind More Businesses Offering Health Insurance?
Excerpt: "A Bernstein Research survey indicates the reason is the health care overhaul legislation. The law offers immediate tax breaks for small business owners."
(National Public Radio)

Nap Time Is Catching on in the Workplace
Excerpt: "Most employers who allow napping say they do so in the name of their staffers' well-being, which research suggests is a smart idea. People who take daily 30-minute naps are 37 percent less likely to die of heart disease than those who don't nap, according to a study published in the Archives of Internal Medicine in 2007."
(Bonneville International.)

The Health Care Reform Survey, 2010 (PDF)
31 pages. Excerpt: "The primary objectives of the . . . Survey are to determine US Employers' perceptions of the Health Care Reform Law (Patient Protection and Affordable Care Act), as well as to study its potential impact on employers' future benefit strategies."
(Willis North America / Diamond)

Long-Term Care Insurance Business Struggling to Survive
Excerpt: "Insurers like Genworth Financial Inc. and Manulife Financial Corp.'s John Hancock, which dominate the market, are under pressure as a result. Even as they generate revenue from new policies, they face losses from books of older business, plus headwinds from a new competing government program."
(Business Insurance)

Generics Reduce Drug Costs, But Monitoring Lags, According to Report
Excerpt: "Health care plans have reduced pharma.ceutical costs by dispensing generics more often, but they could do a better job of monitoring whether plan members take their medication as prescribed, a report by the National Business Coalition on Health concludes."
(Business Insurance)

New Safety Reporting Website for Electronic Health Records Launches
Excerpt: "An alliance of executives from medical societies and professional liability carriers yesterday launched 'EHRevent.org, a new safety reporting system for [electronic health records] EHRs. Doctors and other health-care workers can go online and report problems and mistakes they experience as they ramp up the use of digitized records."
(Henry J. Kaiser Family Foundation)




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Benefits in General; Executive Compensation

[Guidance Overview]
New Executive Compensation and Governance Requirements in Financial Reform Legislation
Originally published July 7, 2010; Updated November 12, 2010. Excerpt: "[Within the massive text of the Dodd-Frank Wall Street Reform and Consumer Protection Act] lurk new requirements that will impact executive compensation and corporate governance practices at most public companies, not just banks. This alert highlights these key executive compensation and governance changes, with updates on agency rule making through November 12, 2010."
(K&L Gates LLP)

[Guidance Overview]
Last Chance to Correct Penalty-Free: Section 409A, Notice 2010-6, and Transition Relief in 2010
Excerpt: "Although the Notice allow correction in subsequent years, the transition relief available in 2010 offers a chance to correct a number of such failures on a penalty-free basis."
(Dorsey & Whitney LLP)

[Guidance Overview]
Preparer Tax Identification Number Update
Excerpt: "As provided in the proposed regulations, to obtain a PTIN or other prescribed identifying number, a tax return preparer must be an attorney, certified public accountant, enrolled agent, or registered tax return preparer authorized to practice before the IRS under 31 U.S.C. 330 and Circular 230."
(McKay Hochman Co., Inc.)

FASB Defers Expected Effective Date for Project on Disclosures about an Employer's Participation in a Multiemployer Plan
1 page. Excerpt: "In light of the growing concern regarding the poor funding levels of many defined benefit multiemployer pension and other postretirement benefit plans, as well as the lack of information on commitments and risks provided by employers that participate in those plans, both [FASB] and [IASB] have issued separate exposure drafts that propose significant additional disclosure requirements for participating employers."
(PricewaterhouseCoopers LLP)

Obama Deficit Panel Gets Some Competition
Excerpt: "A bipartisan group will present a deficit-reduction plan on Wednesday that goes beyond the spending cuts and tax proposals from the chairmen of President Obama's fiscal commission. It also calls for a one-year holiday from Social Security payroll taxes to encourage hiring and for a national sales tax to reduce deficits."
(The New York Times; free registration required)

DOL Announces Nationwide Enforcement Actions to Protect Millions of Dollars in Worker Retirement and Health Benefits
Excerpt: "In the criminal arena, EBSA works with U.S. attorneys as well as state and local law enforcement agencies nationwide to bring criminal cases under ERISA that protect the contributions of American workers. The Contributory Plans Criminal Project is the agency's first criminal national enforcement project targeting persons who commit fraud and abuse against participants and beneficiaries of contributory employee benefit plans, including 401(k)s, and contributory health plans."
(U.S. Department of Labor)

DOL Says Some Business Owners Are Pilfering Employee Contributions to 401(k) and Health Benefits Accounts.
Excerpt: "On [November 16], the department filed civil lawsuits against 24 companies and business owners alleged to have kept money withheld from paychecks that was meant for retirement or health accounts. The companies range in size, from fewer than 10 workers to more than 100 and the largest case involves more than $6 mil.lion in worker contributions."
(Gray Television, Inc.)


Webcasts and Conferences

401(k) Service Provider Compensation: Navigating the Required DOL and Schedule C Disclosures
Nationwide on December 14, 2010
presented by EBIA / Thomson Reuters



Newly Posted Employee Benefits Jobs

Education Consultant
for AXA Equitable
in NJ

Regional Director
for The Newport Group
in TX

Customer Service Representative for 401(k) Plans
for Houston based Employee Benefits Firm
in TX

Benefits Consultant
for DIRECTV
in CA

Relationship Manager II
for T. Rowe Price
in CA

Administration Manager/Senior Consultant
for Qualified Plan Consultants, LLC
in IA

Actuary - Part Time
for Prestigious mid-Long Island New York firm
in NY

Sales Support Specialist
for Northwestern Benefit Corporation of Georgia
in GA

Senior Account Analyst
for Freedom One Financial Group
in MI




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