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American Health Care Congress and Exhibition [Advert.]
Bringing together the health care community to discuss strategies aimed at more efficient and effective operation of our health system post-reform. December 5-6, 2011, Anaheim, CA.
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[Guidance Overview]
Summary of Benefits and Coverage Requirements Delayed; FAQs on Mental Health Parity Issued (PDF)
"The latest round of guidance includes several items of interest for employers: (1) a delay of the applicability date for the Summary of Benefits and Coverage . . . requirements under PPACA; (2) clarifications regarding the nonquantitative treatment limitations and copayment variations prohibited for mental health/substance use disorder benefits under MHPAEA, and (3) information on permissible copayment variations for mental health/substance use disorder benefits."
(Sutherland Asbill & Brennan LLP)
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[Guidance Overview]
ERISA Plan Reimbursement Limited by Equitable Principles, Third Circuit Holds
"The Third Circuit answered a question left open in Sereboff v. Mid Atlantic Medical Services, Inc.: whether 'appropriate equitable relief' under ERISA Section 502(a)(3) means that a plan's recovery from a participant is limited by the equitable defenses and principles, such as unjust enrichment, typically available in equity."
(Practical Law Company)
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[Guidance Overview]
HHS Rolls Out HIPAA Audit Program
"The Pilot Audit Program will include only HIPAA-covered entities, i.e., health care providers, health plans and health care clearinghouses, and not their business associates, but OCR stated that business associates would be included in future audits."
(McDermott Will & Emery)
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[Guidance Overview]
Failure to Disclose Time Limit for Filing Suit Resulted in Extended Deadline
"This case reinforces the importance of thorough disclosure and adherence to ERISA's claims procedure requirements. In particular, if a plan imposes a time limit for filing suit under ERISA, this limit should be set forth in the benefit denial notice, as well as in SPDs and other communications, if the plan hopes to enforce it."
(Thomson Reuters/EBIA)
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[Guidance Overview]
IRS Agrees That Se.x Reassignment Surgery and Related Hormone Therapy Were for Medical Care
"The IRS had disallowed the deduction, based on an IRS Chief Counsel Advice memorandum (CCA) expressing the view that hormone therapy and se.x reassignment surgery did not treat a medically recognized disease or promote the proper function of the body . . . . With this AOD, the IRS has acquiesced in the Tax Court's position and indicated it will no longer take the position reflected in the CCA."
(Thomson Reuters/EBIA)
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Wellness Efforts Often not Meeting Employee Needs
"A new survey from Aon Hewitt, The Futures Company and the National Business Group on Health, reveals consumers want their employers to do more to help them improve their health and get the most from their employer-provided health and wellness plans."
(PLANSPONSOR.COM)
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Health Insurers Fear Consequences of Individual Mandate Being Struck Down
"For insurers, the death of the mandate alone -- one of many plausible outcomes in the blockbuster case -- is the nightmare scenario, one Republican healthcare lobbyist told The Hill. 'They're terrified they're going to be left holding the bag,' the lobbyist said . . . ."
(The Henry J. Kaiser Family Foundation)
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Multiemployer Plans Look to Value-Based Health Care
"A new survey released by the International Foundation of Employee Benefit Plans finds that in the last year, the number of multiemployer and public employer plans that consider their health and wellness offerings to be a part of a broader VBHC strategy more than doubled from 16% to 37%."
(Employee Benefit News)
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Early Retiree Reinsurance Program Funds 80% Used Up
"Of the total paid out so far, $387.2 mil.lion was distributed to the United Auto Workers Retiree Medical Benefits Trust. The trust is a voluntary employees' beneficiary association set up by the UAW under a 2007 collective bargaining agreement between General Motors Corp., Ford Motor Co. and Chrysler L.L.C. and the UAW."
(Business Insurance)
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Get a Legal Check-Up Before Lauching a Wellness Program
"Wellness programs fall into two broad categories: participation-based and standard-based. Both types may focus on raising health awareness, educating employees and/or encouraging lifestyle and behavior change. And both may even offer incentives."
(GoLocalProv)
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Protecting Consumers from Unreasonable Health Insurance Rate Increases
"Starting September 1, 2011, in every State and for the first time ever, insurance companies are required to publicly justify their actions if they want to raise rates by 10 percent or more. . . . Today, we're announcing our first decision as part of this rate review process, including the decision that one insurance company's plan to raise rates in Pennsylvania was unreasonable . . . ."
(HealthCare.gov)
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Benefits in General; Executive Compensation
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[Guidance Overview]
ISS 2012 Updates to Proxy Voting Guidelines
"The key change in the ISS 2012 updates is that, going forward, the first time a post-IPO company presents an equity plan for Section 162(m) approval, ISS will give the plan a full equity plan evaluation."
(Morgan, Lewis & Bockius LLP)
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Stock Ownership Guidelines Hard-Wired Into the Plan?
"I wanted to point out to readers a company that recently incorporated its stock ownership guidelines into its stock incentive plan document, which I had not seen previously. The amended Motricity, Inc. 2010 Long Term Incentive Plan, approved by stockholders on October 28, 2011, contains the following paragraph . . . ."
(Michael S. Melbinger via Winston & Strawn LLP)
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Nonqualified Deferred Compensation Plans: Plan Decisions and Changing Tax Conditions
"This white paper will: Look at which individuals are potentially affected by proposed tax changes; Examine four key factors that need to be considered when comparing the effect of taxes on deferred compensation versus paying taxes currently; Provide scenarios of how tax rate changes might impact NQDC plan deferrals over time."
(Principal Life Insurance Company)
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Press Releases
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