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June 23, 2011 Get Retirement News  |  Advertise  |  Unsubscribe  |  Past Issues  |  Search

[Official Guidance]
Text of Amendment to Interim Final Rules Relating to Group Health Plans and Health Insurance Issuers on Internal Claims and Appeals and External Review Processes (PDF)
"These rules are intended to respond to feedback from a wide range of stakeholders on the interim final regulations and to assist plans and issuers in coming into full compliance with the law through an orderly and expeditious implementation process." (U.S. Internal Revenue Service / Employee Benefits Security Administration / Centers for Medicare & Medicaid Services)


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[Guidance Overview]
Federal Court Permits Aetna ERISA Class Action to Proceed in Providers' Overpayment Disputes
"The court dismissed provider's RICO claims and granted Aetna's motion to enforce a settlement agreement and release from one provider and motion to compel arbitration and to dismiss two provider's claims." (Daily Markets)

Obama Administration Narrows Rules for Patient Health Care Appeals
"Specifically, the rule says that patients are allowed to appeal if an insurer declines to pay for care on the basis of a medical judgment. However, patients cannot appeal when the dispute is based, for instance, on mistakes involving diagnosis coding or disagreements about whether a patient should see a medical specialist outside the insurer's network of doctors." (The Washington Post; free registration required)

Number of Americans with Employer-Sponsored Health Insurance Drops Significantly Over Last Decade
"Two new reports . . . by the nonpartisan Robert Wood Johnson Foundation (RWJF) show there has been a significant erosion in employer-sponsored insurance (ESI) over the last decade, but that the Affordable Care Act (ACA) is expected to help reverse the trend among small employers." (Robert Wood Johnson Foundation)

CMS Official Grilled on Medicare Secondary Payer Program at House Hearing
"Deborah Taylor, director of that office, testified about the program she described serves as a 'payer of last resort' when another insurer has the primary responsibility to pay for care of a Medicare beneficiary." (The Henry J. Kaiser Family Foundation)

Economics Favor Retaining Health Coverage in Large Employer Plans, According to Benfield Report
"The Benfield report concluded, 'In addition to concerns over competing for valuable (and increasingly scarce) human capital talent, the math behind the decision is likely behind our finding that only 7% of jumbo employers are considering dropping active employee health care coverage in 2015 and beyond. An additional 7% of jumbo employers are considering dropping health care coverage, but will provide employee vouchers or supplemental compensation.'" (Wolters Kluwer Law & Business)

Health-Care Spending Waste: The International Edition
"Most Canadians and UK-ers say the top dollar/pound-waster is lack of responsibility by individuals for their own health. Consumers in the U.S. and six other countries put redundant paperwork at the top of the list." (The Wall Street Journal)

Employers Look to Comparative Effectiveness Research to Inform Health Benefits Decisions
"In particular, employers will be looking to the Patient-Centered Outcomes Research Institute . . . as their most trusted source of this information . . . ." (PLANSPONSOR.COM)

Employee Sues over Gender Change Benefits Denial
"Reuters reports that Alec Esquivel, a 41-year-old law clerk at the Oregon Court of Appeals who was born a woman, sued the state and its public employee benefits board claiming discrimination based on gender identity in what the news report said is the first lawsuit of this kind." (PLANSPONSOR.COM)

The Effects of Health Reform on Small Businesses and Their Workers
"We find generally positive effects of the ACA on small employers and their workers. Employers with fewer than 50 workers will experience substantial savings on health costs; employers with 50 to 100 workers will see a very small cost increase." (Urban Institute)

Consulting Firm Evaluates Impact of Health Reform on Employer-Sponsored Insurance
"A new report by Avalere . . . analyzes projections of employer-sponsored insurance . . . under the Affordable Care Act . . ., 'assesses the likelihood of erosion in the ESI market and explores how employer response will vary depending on firm composition, sector, and size.'" (The Henry J. Kaiser Family Foundation)

NIH Program Connects EHR Systems with Online Health Resource
"Because MedlinePlus Connect allows EHR systems to identify patient-specific education materials, the program could help eligible health care providers meet one of the requirements of the meaningful use incentive program . . . ." (California HealthCare Foundation by The Advisory Board Company)

Benefits in General; Executive Compensation

[Guidance Overview]
GSA Increases Miscellaneous Expense Allowance for Relocations
"The GSA announced on June 16 that effective July 18, it will increase the lump sum it will pay for the miscellaneous expense allowance . . ., the figure by which it reimburses miscellaneous relocation-related expenses for which employees do not provide documentation." (Thompson Publishing Group)

Frequency of Shareholder Say on Pay: A Form 8-K Reminder
"We want to remind readers of the obligation to disclose in an 8-K/A the company's decision regarding how frequently it will offer the advisory Say on Pay vote, unless the company has already disclosed that decision in the initial 8-K filed after the annual meeting." (Michael S. Melbinger via Winston & Strawn LLP)

PSCA Releases Survey of Non-Qualified Plans
"The survey found non-qualified plans continue to be more common among large companies, with fewer than 10% of small companies (fewer than 500 employees) offering a non-qualified plan versus 70% of companies with 25,000 or more employees." (PLANSPONSOR.COM)

Press Releases

US Department of Labor’s ERISA Advisory Council to Hold July Meeting
(U.S. Department of Labor, Employee Benefits Security Administration (EBSA))

How IRAs Are Invested, by Gender and Age
(Employee Benefit Research Institute (EBRI))

ING Rolls Out New Banking Channel and 401(k) Payroll Strategy to Grow Distributor-Sold Business
(ING Retirement)

Employee Benefits Jobs

Senior Counsel, Vice President
for State Street Corporation in MA

Relationship Manager
for The Standard in NC

ITS Relationship Manager 3
for Wells Fargo in NY

Compliance Consultant/Manager
for Milliman, Inc. in TX

401(k) Specialist
for Freedom One Financial Group in MI

Retirement Consultant
for Freedom One Financial Group in MI

Relationship Manager - Institutional Wealth Management
for BOK Financial in TX

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Webcasts and Conferences

401(k) Fees: What You Need to Know in 2011 Live Webcast
Nationwide on August 9, 2011 presented by Knowledge Group

401(k) Rekon Advisor Symposium-Indianapolis
in Indiana on July 21, 2011 presented by 401(k) Rekon

Success through Innovation Forum: Trends in Absence Management
Nationwide on July 13, 2011 presented by Liberty Mutual


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Jeanette Hull, News Editor
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager
Copyright 2011 BenefitsLink.com, Inc., but feel free to forward this newsletter in its entirety.

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