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December 27, 2011 Get Retirement News  |  Advertise  |  Unsubscribe  |  Past Issues  |  Search

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[Guidance Overview]
New HHS Rules Regarding Medical Loss Ratio Requirements (PDF)
"It is anticipated that mini-med plans will no longer be allowed as of 2014 due to the prohibition under health care reform of annual and lifetime dollar limits. However, to satisfy the MLR requirements for 2012 and 2013, insurers may have to reduce administrative expenses or raise benefit levels to comply with the MLR requirements. This could result in employers needing to modify their benefit strategy for mini-med plans sooner than 2014." (Buck Consultants, LLC)


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[Guidance Overview]
Further Guidance Issued on Nonquantitative Treatment Limitations under Mental Health Parity and Addiction Equity Act (PDF)
"A plan sponsor that wants to impose a special copayment on mental health or substance use disorder benefits has to make certain that at least two-thirds of all medical/surgical benefits in the classification are subject to a copayment and that the specialist copayment applies to more than 50% of all medical/surgical benefits paid within that classification that are subject to a copayment." (Buck Consultants, LLC)

[Guidance Overview]
Court Sides with NFL Pension Board for Denial of Disability Benefits
"[The judge] noted the terms of the Bert Bell/Pete Rozelle NFL Player Retirement Plan say if the voting members of the board are deadlocked on whether a player meets the requirements for disability benefits, the plan provides that it may submit that medical questions to a medical advisory physician (MAP) for a final and binding determination." (PLANSPONSOR.COM)

[Guidance Overview]
HHS Proposed Framework for Meeting Essential Health Benefits Requirement under Affordable Care Act
"Generally, the bulletin explains that the HHS will propose that EHBs be defined by a benchmark plan selected by each state, which could be modified as needed so long as the value of coverage is not reduced." (Littler Mendelson P.C.)

[Guidance Overview]
San Francisco's New Rules on Health Reimbursement Arrangements
"The City and County of San Francisco Labor Standards Enforcement department has published the full law, highlighting the most recent changes, as well as sample contribution and separation of employment forms." (Business Insurance)


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EEOC Staff Members Offer Informal Views on GINA but Decline to Elaborate on Wellness Incentives
"Hardship distribution requests involving genetic information may not arise all that often, but employers will be interested in staff members' view that the inadvertent acquisition exception is available in these circumstances, even without the safe harbor disclaimer." (Thomson Reuters/EBIA)

Empire Blue Cross Blue Shield to Accelerate Phase-Out of Some Small Group Health Insurance Products
"The decision is being greeted with relief by brokers and small businesses. An estimated 20,000 companies, covering as many as 250,000 workers and their family members, use the plans being discontinued by Empire." (Workforce Management)

Progress-Based Incentives Reward Employees for Making Meaningful Progress Toward Health Goals
"Incentive strategies generally fall into three categories: participation-based incentives, outcomes-based incentives and a newly suggested approach, progress-based incentives." (Society for Human Resource Management)

Michigan County Opts Out of State's Offer to Limit Health Care Costs
"Ogemaw County Commissioners have opted out of a new state public health insurance plan that aims to limit the amount employers contribute to employee health care. . . . [The chairman of the county's budget and finance committee] said county employees will continue to contribute 10 percent of their health insurance costs next year." (Ogemaw County Herald)

Middle Market Employers Eye Health Benefits Cuts in 2012
"About 65% of executives polled in a recent industry survey identified the cost of benefits most often as having the biggest impact on compensation decisions over the past year. Decision makers (37%) said they plan to increase employees' share of health and welfare costs, according to the 'Verisight and McGladrey 2011/2012 Compensation, Retirement and Benefits Trends Survey.'" (Financial Planning and SourceMedia, Inc.)

GAO Report Says Many Insurers Might Already Satisfy Medical Loss Ratio Rules
"Final data on MLRs for 2011 will not be available until required reports are filed with HHS in June 2012, so it remains to be seen how many insurers will meet the actual MLR standards in 2011. Employers and advisors starting to plan for rebates to be provided in 2012 by insurers that do not meet the standards should nevertheless find this report of interest for the background it provides." (Thomson Reuters/EBIA)

Benefits in General; Executive Compensation

[Guidance Overview]
ISS Issues Technical Paper on Evaluating Pay for Performance and Updated Burn Rate Tables (PDF)
"Under its Burn Rate Policy, ISS recommends against stock plan proposals if a company's three-year average burn rate exceeds its industry group's mean by more than one standard deviation or two percent of weighted common shares outstanding, if higher." (Frederic W. Cook & Co., Inc.)

[Guidance Overview]
DOL Releases Form 5500 for 2011 Plan Year
"Given the numerous changes made to the 2009 and 2010 Form 5500, it is not surprising that the changes this year were fairly limited. In fact, most of the changes took the form of clarifications and enhancements to the Instructions. But plan administrators and service providers nonetheless should familiarize themselves with the revisions to ensure that their 2011 Form 5500 filings are complete and accurate." (Thomson Reuters/EBIA)

Philadelphia Tells Its Large Contractors to Extend Benefits to Life Partners
"Companies that score a big contract with the City of Philadelphia will soon be forced to amend their employee benefit plans to comply with the City's requirement that the benefits offered to the spouses of employees also must be offered to same-s.ex life partners of employees." (Ballard Spahr LLP)

Probe Finds No Wrongdoing at SAG Plans: No Misconduct at Pension or Health Plans
"'Based on the results of the investigation, we can assure you that the fiscal integrity of the SAG-PPHP remains sound and your benefits are secure,' [a letter to plan participants] said. 'In plain English, your pension plan is safe; your health plan is safe.'" (Chicago Tribune)

Screen Actors Guild Whistleblower Alleges $5-$10M Benefit Theft
"The Labor Department has yet to comment on whether it has begun an investigation. Lawyers for the SAG, which controls about $2.5 bil.lion in plan assets, are denying all charges." (National Legal & Policy Center)

Press Releases



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