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

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Benefits Manager (Job ID 25553)
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[Guidance Overview]
Group Health Plan Requirement to Deliver Summary Documents Beginning in 2012
"If you are an employer sponsoring and/or administering a group health plan, you need to know about three basic requirements that will apply to you or your underlying group health insurance policies under these proposed rules . . . ." (McKenna Long & Aldridge LLP)

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[Guidance Overview]
Agencies Issue Proposed Regs on Summary of Health Benefits (PDF)
"The new summary of benefit requirement applies to insured and self-funded ERISA group health plans, including grandfathered plans, as well as to non-ERISA group health plans. The new rules also apply to individual health insurance coverage. The Departments request comment as to whether the requirement should apply to expatriate health insurance coverage." (Groom Law Group)

[Guidance Overview]
HHS Annual Limit Waiver Program to Close; No Waiver Application Required for Certain HRAs (PDF)
"[The Supplemental Guidance addresses the HRA wavier program only, which ceases to apply with respect to plan years beginning on or after January 1, 2014. Thus, there are still open issues remaining to be resolved as to whether the annual limits will apply to stand-alone HRAs at that time. This issue remains to be addressed in regulations." (Alston & Bird LLP)

[Guidance Overview]
No Reinstatement After 12 Weeks of California Family Rights Act Leave
"The decision is important regarding CFRA/FMLA leave, but it does not address reasonable accommodation obligations under the ADA/Fair Employment and Housing Act. So, employers still need to consider reinstatement following extended leave when an employee has a covered disability and takes more leave than allowed under CFRA/FMLA." (Shaw Valenza LLP)

[Guidance Overview]
HHS's Preliminary Determinations Regarding State Compliance with External Review Standards
"Employers sponsoring insured group health plans may look to their insurers for compliance with the new external review requirements, and, as a result, the HHS determinations should create no compliance concerns for these employers directly." (Thomson Reuters/EBIA)

[Guidance Overview]
Payments to Caregivers Are Deductible as Qualified Long-Term Care Expenses
"The most important thing for employers and administrators to remember about the tax court's decision is what it does not say. Specifically, although qualified long-term care services can be deductible on an individual's tax return, health FSAs cannot reimburse them on a tax-free basis. Similarly, most HRAs may not reimburse qualified long-term care services. . . . In contrast, HSAs can reimburse long-term care services tax-free." (Thomson Reuters/EBIA)

[Guidance Overview]
Plan Administrator Cannot Terminate Benefits Based on Limitation Not Included in SPD
"It is worth noting that this case was argued before the U.S. Supreme Court's decision in Cigna v. Amara. . . . In that case, the Supreme Court identified estoppel as an appropriate remedy for faulty SPD disclosures but suggested that a plan participant has to show 'detrimental reliance' (i.e., that he or she was harmed by relying on the SPD) in order to prevail." (Thomson Reuters/EBIA)

Wrap Documents: A Simple and Cost-Effective Means of Complying with ERISA's Plan Document and SPD Requirements
"In addition to easing compliance with ERISA's plan document and SPD requirements, wrap documents can also be used by an employer to consolidate employee welfare benefits plans into a single plan (commonly referred to as an 'umbrella' or 'mega-wrap' plan)." (Lewis and Roca LLP)

Stand-Alone HRAs Exempted from Annual Minimum Dollar Limits
"The class exemption issued Friday applies to all stand-alone HRAs that were in effect prior to Sept. 23, 2010. As a result, plan sponsors will not have to apply for waivers from the annual minimum dollar limit of $750,000 in 2011, $1.25 mil.lion in 2012 and $2 mil.lion in 2013." (Business Insurance)

Employers Pass Along High Costs of Specialty Drugs by Making Patients Pay a Percentage of Cost Instead of a Co-Pay
"The idea of paying differing amounts for types of prescription drugs is not new. Employers and insurers have long used 'tiers' to set the amounts patients pay for generic drugs, brand-name products and 'non-preferred' brand-name drugs." (Henry J. Kaiser Family Foundation)

Recent Guidance Clarifies ERRP Claim Submissions and Use of Reimbursements
"Plan sponsors participating in the early retiree reinsurance program (ERRP) must meet a maintenance of contribution (MOC) requirement if they use program reimbursements to offset increases in their costs for plan benefits." (Mercer LLC)

Health Care Reform Will Increase Costs, Access, and Care Quality, According to Survey
"In Buck Consultants' Health Care Organizations Health Care Reform Readiness Survey, many health care organizations anticipate that patients will benefit the most from the Patient Protection and Affordable Care Act (ACA), while employer health plans and the hospital system itself will experience challenges[.]" (Wolters Kluwer Law & Business / CCH)

Benefits in General; Executive Compensation

[Guidance Overview]
New York State Tax Guidance on Same-S.ex Marriage (PDF)
"It is also important for an employer to understand whether its insured health plan is required to recognize a same-s.ex marriage. An insured health plan is only subject to the New York requirement to recognize a same-s.ex marriage if the insurance policy is subject to New York law. If the insurance policy is governed by another state law, that state's law will govern whether the same-s.ex marriage must be recognized." (Patterson BelknapWebb & Tyler LLP)

[Guidance Overview]
Relief Granted for Disabled Auto Workers Denied Severance Benefits
"NUMMI employees who meet the following criteria may be eligible to participate in a claims process over the coming months: disabled under state and federal laws, on leave from work due to their own disability at any time between October 1, 2009 and April 1, 2010, and denied all or any part of the NUMMI severance pay." (U.S. Equal Employment Opportunity Commission)

The Principal 2011 Ten Best Companies for Employee Financial Security
"'These winning companies are taking a comprehensive approach to workplace benefits in order to reduce financial and physical stress of employees at all levels and demographics,' said Dallas Salisbury, Principal 10 Best judge and president and CEO, Employee Benefit Research Institute." (PLANSPONSOR.COM)

Observers Leery of Postal Service Plan to Opt Out of Federal Health and Retirement Programs
"According to draft documents summarizing the changes, government-run benefit programs do not address the Postal Service's 'unique demographic and program needs,' nor do they allow the agency to control costs and provide compensation and benefits comparable to the private sector." (Government Executive)

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