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BenefitsLink Health & Welfare Plans Newsletter
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[Guidance Overview]
CMS Updates Medicare Secondary Payer Reporting Guidance for HRAs
"CMS has issued an Alert that changes the reporting rules for health reimbursement arrangements (HRAs) under the Medicare Secondary Payer (MSP) mandatory reporting requirements. CMS views HRAs as group health plans that are subject to MSP coordination of benefit requirements, as well as the MSP reporting requirements."
(Towers Watson)
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MCOs are under Siege: Litigation becoming Frequent and Costly [Advert.]
Managed care organizations (MCOs) have long been seen as “deep pockets” and favorable targets for litigation. Defending these lawsuits requires meticulous litigation planning. Experienced litigators will share their strategies -- register now!
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[Guidance Overview]
OPM Extends FMLA Benefits for Military Families
"The new regulations, which took effect Oct. 1, will make it easier for federal employees to juggle work, home and military responsibilities, officials at the federal Office of Personnel Management say."
(SmartHR)
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The Cost of Uniform Coverage Summaries
"Health reform's uniform summary of benefits and coverage (SBC) will cost insurers and third party administrators (TPAs) about $160 mil.lion over the next three years to develop, update, and provide the SBC and glossary to applicants and enrollees, its agency drafters estimate."
(SmartHR)
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HHS Suspends CLASS Program Indefinitely
"In suspending the CLASS program, HHS cited actuarial and solvency impediments as the reason why they had 'not identified a way to make CLASS work at this time.'"
(Faegre & Benson LLP)
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Obama Administration Pulls Plug On CLASS, the Long-Term Care Program
"After looking at a variety of options, the Obama administration determined the CLASS Act program could not simultaneously meet three important criteria: be self-sustaining, financially sound for 75 years and affordable to consumers."
(The Henry J. Kaiser Family Foundation)
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No COBRA Notice for Family of Employee Terminated After Workplace Altercation
"Given the loss of health care coverage and the emotionally charged nature of an employment termination for alleged gross misconduct, a covered employee and family members have an incentive to ask a court to decide what the facts are and whether those facts establish gross misconduct. The fees and costs will vary with the case but can be considerable -- even a successful gross-misconduct defense can be expensive."
(Thomson Reuters/EBIA)
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Benefits in General; Executive Compensation
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[Guidance Overview]
One-Person Individually-Negotiated Employment Agreement Not an ERISA Plan
"With regard to the employee's demands under the ERISA plans, the Court ruled that the state law remedies would be preempted; however, if the employee's demands were simply for payment of amounts that were pegged to what would have been paid under the ERISA plans, the state law remedies would not be preempted. The case was sent back to the district court for further proceeding in accordance with the Court's decision."
(Deloitte via BenefitsLink.com)
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Significant New Developments for Benefit Plan Fiduciaries (PDF)
"Because most benefit plans are structured as 'calendar-year plans', fall is traditionally the busiest season for plan fiduciaries who must deal with issues relating to annual enrollment (typically held in the fall) and comply with various year-end plan filing and employee notification requirements (such as annual notices dealing with automatic enrollment or default investment options)."
(Orrick, Herrington & Sutcliffe LLP)
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Legal and Practical Considerations for ESOP Fiduciary Liability Insurance
Individuals serving as trustees or other fiduciaries of an ESOP face enormous personal exposure under ERISA for breach of fiduciary duty. Indemnification may not be possible or practical, but commercial liability insurance continues to be a viable supplement or alternative to indemnification for transferring fiduciary risk away from the fiduciaries. This issue brief discusses the legal issues involved, plus practical tips for buying fiduciary insurance.
(National Center for Employee Ownership)
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Press Releases
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