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Health & Welfare Plans Newsletter

January 6, 2011

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[Guidance Overview]
Departments Revise Affordable Care Act's Grandfathering Rules to Permit Change in Insurers
Excerpt: "The amendment allows a group health plan to enter into a new insurance contract without automatically ceasing to be a grandfathered group health plan. The plan will remain grandfathered as long as the plan's benefits do not change in a way that would otherwise result in a loss of grandfathered status (e.g., any increase in coinsurance paid by participants, or certain increases in copayments or deductibles)."
(The Segal Group, Inc.)

[Guidance Overview]
IRS Provision of Further Guidance on Operation of the Small Business Health Insurance Tax Credit (PDF)
Excerpt: "The Credit is limited by the average premium for the small group market in the state (or area within the state) in which an employee enrolls for coverage."
(Groom Law Group)

[Guidance Overview]
Exclusion of a Residential Treatment Program Permitted As Long As State Mental Health Parity Rules Are Followed
Excerpt: "A health care plan that specifically excludes coverage in residential treatment programs is not compelled to provide such coverage when a state law does not include it in the list of limits establishing parity among mental health conditions and physical health conditions."
(Wolters Kluwer)

[Guidance Overview]
IRS Delay of Application of Nondiscrimination Rules to Insured Group Health Plans (PDF)
4 pages. Excerpt: "The IRS has delayed the application of the nondiscrimination requirements for fully-insured group health plans, as added by PPACA, until it issues regulations. Because the new rules for fully-insured plans will be based on the existing nondiscrimination rules for self-insured health plan, any new IRS regulations are likely to impact sponsors of both types of plans."
(Buck Consultants)

[Guidance Overview]
New IRS Mileage Reimbursement Rate Effective January 1, 2011
Excerpt: "The IRS just announced an increase in the standard mileage rates, effective January 1, 2011. The new rate will be 51 cents per mile for all business miles driven. This increase is important because California employers have a legal duty to reimburse employees for all necessary expenses incurred in performing their jobs. This includes reimbursing employees who drive their own vehicles for business purposes."
(Ballard Rosenberg Golper & Savitt, LLP)

[Guidance Overview]
IRS Guidance on Health FSA and HRA Debit Card Use for Over-the-Counter Drugs
Excerpt: "Employers who allow health FSA or HRA debit card use under their plan should begin now to communicate the changes to their employees, coordinate with their third party administrators for the FSA or HRA plans and evaluate any necessary amendments to their plan documents."
(Ford & Harrison LLP)

Program Perspectives on Life and Disability Insurance Benefits (PDF)
4 pages. Excerpt: "Fifty-six percent of all private industry employees, and 78 percent of all State and local government employees participated in employer-provided life insurance plans in March 2010. . . . Thirty-eight percent of private industry employees participated in short-term disability insurance plans, and 31 percent had long-term disability insurance protection."
(U.S. Bureau of Labor Statistics)

Blues Plan Offers Dental Option in Connecticut
Excerpt: "Anthem Blue Cross and Blue Shield is now offering its new Dental Prime and Complete programs on both a voluntary and employer-paid basis with three core plan designs to 40,000 small businesses and 79 chambers of commerce throughout Connecticut."
(Employee Benefit News; one-time free registration required)

U.S. Health Insurers Face Uncertain Environment of Regulatory, Political and Economic Factors
Excerpt: "[A new report, 'U.S. Health care Insurers: Outlook Remains Negative,'] points to provisions of the health care reform law that become effective in 2011, such as minimum medical loss ratio . . . regulations and changes to Medicare Advantage reimbursement levels, as having the potential to significantly affect the financial results of health care insurers."
(Employee Benefit News; one-time free registration required)

Washington's Health Care Power Brokers
12 slides. Excerpt: "With the 112th Congress preparing to spar with the Obama Administration over health reform, EBN has compiled a list of the 12 most influential players within the Beltway."
(Employee Benefit News; one-time free registration required)

Self-Insurance and the Potential Effects of Health Reform on the Small-Group Market (PDF)
14 pages. Excerpt: "As mandated in PPACA, monitoring state insurance markets for potential and actual adverse selection on the exchanges and collecting information about self-insured plans' stop-loss arrangements could help policymakers to understand the effects of employers' decisions to self-insure and the number of people and firms that could be affected by clarifying definitions of self-insured."
(National Health Policy Forum)

$1B paid under Early Retiree Reinsurance Program, According to HHS
Excerpt: "The Department of Health and Human Services said it has paid out about $1 bil.lion for a federal program that partially reimburses employers and other organizations for health care claims incurred by early retirees and their dependents."
(Business Insurance)

Health Spending Represents Record Chunk of GDP for 2009
Excerpt: "Health spending rose to a record 17.6% of the U.S. economy in 2009, as the overall economy shrank and higher federal Medicaid spending helped to push up health costs."
(The Wall Street Journal)

U.S. Health Care Expenditures Up Only 4 Percent in 2009, Perhaps Effect of Recession
Excerpt: "Although health insurance premiums rose slightly faster than they did a year earlier, overall spending on private health insurance decelerated as the number of people with such coverage fell by 6.3 mil.lion. And the out-of-pocket amount Americans spent on health care barely increased, the figures show."
(The Washington Post; one-time registration required)

Health Care Workers Take Challenge to Lose Weight, Get Healthy
Excerpt: "A smattering of studies have documented weight problems in doctors, nurses and other health workers. One 2008 study in the Journal of the American Academy of Nurse Practitioners found that more than half of the nearly 5,000 nurses surveyed were overweight or obese. Most said they lacked motivation to make lifestyle changes. 'The irony of health care is that hospitals are just starting to realize the benefits of keeping employees healthy,' . . . ."
(St. Petersburg Times)

[Opinion]
NAIRO White Paper on External Review Questionable
Excerpt: "Under the NAIRO white paper, the IRO [independent review organization] would only offer 'recommendations' not final decisions. (Apparently, the IRO's errors and omissions carriers do not cover ERISA fiduciary claims.) Unfortunately, this position does not square with the regulatory guidance."
(Roy Harmon III via Health Plan Law)

[Opinion]
Reforming Medicare: The Affordable Care Act versus the Rivlin/Ryan Proposal
Excerpt: "Evaluating the fiscal impact of either reform requires baseline estimates of Medicare's spending path and of the potential impact of the reform, and an educated guess about the likelihood that the ACA will actually be implemented."
(National Center for Policy Analysis)




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Benefits in General; Executive Compensation

2011 Treasury and DOL Regulatory Agendas for Employee Benefits (PDF)
4 pages. Excerpt: "Projects added since the previously published agendas are shown in bold [on the target page chart]; there are 22 new initiatives."
(Sutherland Asbill & Brennan LLP)

Strained States Turning to Laws to Curb Labor Unions
Excerpt: "State officials from both parties are wrestling with ways to curb the salaries and pensions of government employees, which typically make up a significant percentage of state budgets."
(The New York Times; one-time registration required)


Webcasts and Conferences

2011 Benefits Boot Camp
in Georgia on April 12, 2011
presented by Worldwide Employee Benefits Network (WEB) - Atlanta Chapter

Legislative and Regulatory Update
in California on January 18, 2011
presented by Western Pension & Benefits Conference, San Diego Chapter

Understanding Health FSA Reimbursements: A Seminar Based on Your Scenarios!
Nationwide on February 3, 2011
presented by EBIA / Thomson Reuters


Press Releases


Newly Posted Employee Benefits Jobs

Pension Administrators
for Northern NJ Mid-Size Pension Consulting Firm
in NJ

Pension Analyst/Actuarial Student
for Hooker & Holcombe, Inc.
in CT

Client Service Manager
for New York Life - Retirement Plan Services
in MA

Pension Administrator
for Alliance Pension Consultants
in IL




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