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BenefitsLink Health & Welfare Plans Newsletter
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[Guidance Overview]
FAQs Clarify Parity Requirements for Mental Health and Substance Use Disorder Benefits
"[DOL released a set of [FAQs] responding to questions raised regarding how the new parity requirements apply to nonquantitative treatment limitations, such as medical management standards, formulary designs, standards for provider admission to the network, and methods to determine reasonable and customary fees."
(Deloitte via BenefitsLink.com)
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[Guidance Overview]
DOL's Proposed New Rules Affecting Multiple Employer Welfare Arrangements
"Under the proposed rule, MEWAs that provide medical care benefits (but are not group health plans) are now required to register with the Secretary of Labor prior to operating in any state in the United States. The rule defines what constitutes 'operating' in a state; addresses how a MEWA may register . . .; describes what information must be included; and addresses the penalties for noncompliance (which include criminal penalties for intentional misrepresentation)."
(Littler Mendelson P.C.)
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Coverage of Bariatric Surgery Is Thin for Obese Kids
"As obesity among young people continues to rise, a growing number of clinicians and researchers say that weight-loss surgery may be their best chance to take off significant weight and either correct or avoid conditions like diabetes and heart disease, which often go hand-in-hand with obesity. But although health plans frequently cover bariatric surgery in adults, insurance coverage for the procedure in patients under age 18 is spotty."
(The Henry J. Kaiser Family Foundation)
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HHS Website: HIPAA Privacy & Security Audit Program
"The audit program serves as a new part of OCR's health information privacy and security compliance program. OCR will use the audit program to assess HIPAA compliance efforts by a range of covered entities[.]"
(U.S. Department of Health & Human Services)
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Dealing with Depression Difficult in Workplace
"'Stress and depression are very hot issues with employers,' said Christine Wilson, chief executive of the Mid-America Coalition on Health Care, which in 2000 began an initiative with a couple dozen large employers to understand and deal with depression."
(The Kansas City Star)
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[Opinion]
How Obamacare Targets Consumer-Directed Health Plans
"The MLR issue hinges on the requirement within Obamacare that forces insurers to spend no more than 20 percent of each insurance premium on non-health care costs in the small group and individual market, and 15 percent in the large-employer market. Shorthand: It's basically a hard cap for insurers' profits, which is odd, not just because such a thing is fundamentally un-American, but because insurers are not very profitable to begin with — averaging about 4 percent in profit."
(The Heartland Institute)
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Benefits in General; Executive Compensation
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[Guidance Overview]
The ERISA Litigation Newsletter, December 2011
The newsletter includes the following: Third Circuit Finds 'Inequitable' The Enforceability of a Clear ERISA Welfare Plan Reimbursement Provision That Deprived a Participant of a Full Recovery; District Court Dismisses ERISA § 502(a)(2) Claim Based on Plaintiffs' Failure to Make Pre-Suit Demand; Application of ERISA Section 510 to Internal Workplace Complaints: A Review of Circuit Court Decisions; and, Rulings, Filings, and Settlements of Interest.
(Proskauer Rose LLP)
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[Guidance Overview]
New York's Same Se.x Marriage Law Has Broad Implications for Employee Benefit Plans
"Despite the broad application of DOMA, and perhaps to some extent because of it, states have begun to consider and in some cases enact laws that extend marriage rights to same se.x couples. By extension, these laws effectively require employers within those states to provide certain benefits to same se.x couples to the extent that these laws are not found to be preempted under ERISA or otherwise in conflict with federal law."
(Porter Wright Morris & Arthur LLP)
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Getting Executive Compensation Ready for 2012: Starting with ISS Guidelines (PDF)
"This Client Alert addresses some of the key implications for publicly traded U.S. companies, and is followed by our article titled 'Candor for Compensation Committees' which is reproduced from the latest edition of Board Member magazine because the article highlights actions that compensation committees should be taking this winter in order to be ready for the 2012 proxy season."
(Paul Hastings LLP)
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2012 Resolutions for Employee Benefits and Executive Compensation
"This article identifies three key employee benefits and executive compensation items that employers should resolve to focus on in 2012: 1) Review compensation plans and practices for compliance with Section 162(m) of the IRC; 2) Plan for summaries of benefits and coverage for group health plans; and 3) Prepare to comply with DOL fee disclosure requirements."
(Practical Law Company)
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Press Releases
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