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BenefitsLink Health & Welfare Plans Newsletter
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[Guidance Overview]
IRS Updates Form 8928 for Self-Reporting of Excise Taxes Owed for PPACA Failures
"PPACA created several new reporting and compliance standards for plans and employers. The [chart in this document] lists some of those new requirements and their effective dates. Failure to meet any of these must be reported on Form 8928 starting in 2012 as of the due date of the employer's federal income tax return. In general, the penalty assessed under Code § 4980D is $100 per day, per affected participant for as long as the plan is non-compliant."
(Faegre Baker Daniels)
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[Guidance Overview]
Audits Heat Up HIPAA Liability: What to Do Now to Mitigate Risk
"In November 2011, the Office for Civil Rights (OCR) began audits to assess compliance with the HIPAA Privacy, Breach Notice, and Security Rules. The OCR compliance audits will be conducted by KPMG LLP and generally will consist of an initial document request, an onsite visit by the auditors, and then negotiation of an audit report."
(Poyner Spruill)
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[Guidance Overview]
Effect of New Michigan Health Insurance Claims Assessment Act on Group Health Plans
"Employer plan sponsors with Michigan employees should discuss payment of the HICA tax with their medical, dental, vision, prescription drug and wellness TPAs. Plan sponsors may want to review their service agreements with their TPAs to determine whether the plan sponsor has any obligation to reimburse the TPAs for the tax."
(McDermott Will & Emery)
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[Guidance Overview]
IRS Addresses Effect of Indian Health Services Eligibility on HSA Eligibility
"This Notice finally answers an HSA eligibility question that was especially troubling because, as with certain veterans benefits, the right to obtain medical services from an IHS facility is determined by status (e.g., membership in a federally recognized Indian tribe), and not by choice. The IRS approach resembles the one used to determine HSA eligibility for those eligible for VA medical benefits — a solution that some of us anticipated as the best fit."
(Thomson Reuters/EBIA)
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White House Might Compromise on Contraception Decision
The White House may be open to compromising on a new rule that requires religious schools and hospitals to provide employees with access to free birth control, a senior strategist for President Obama said on Tuesday morning.
(The New York Times; free registration required)
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How to Manage Pharmacy Benefits Plans: Getting the Plan Design Right
"As pharmacy plan costs have risen and the economy has deteriorated, many employers have made significant changes in their pharmacy benefits plan designs. Two key plan design trends have emerged during the past 5 years, which were validated in the findings of our 2011 Prescription Drug Benefit Survey Report: 1. A shift from 2-tier to 3-tier cost sharing to encourage plan members to switch to lower-cost generic drugs and formulary brand drugs. 2. A shift from flat-dollar co-pays to co-insurance to minimize cost-shifting to the employer as drug costs rise."
(Buck Blog)
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Senate Medical Loss Ratio Bill Aims to Give Agents and Brokers Some Relief
"U.S. Senator Mary L. Landrieu, D-La., chair of the Senate Committee on Small Business and Entrepreneurship, and Sen. Johnny Isakson, R-Ga., have introduced S. 2068, the Access to Independent Health Insurance Advisors Act, a companion bill and a shot in the arm for a medical loss ratio bill in the House that has many supporters but has gained no traction."
(ProducersWEB.com)
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Health Insurance, Health Care and Labor Supply by Older Adults (PDF)
"Early workforce exits are publicly costly due to foregone payroll taxes and disability benefit payments, but also costly to workers, whose SSDI benefits are typically lower than their earnings, and who lose the additional contributions to retirement benefits and Social Security earnings credits associated with paid work. Despite a large literature that has shown the importance of health status and disability on work and retirement decisions of older workers, relatively little is known about the role of health care utilization in preventing or delaying workforce exit."
(University of Michigan Retirement Research Center)
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[Opinion]
The Income Divide in Health Care: How the ACA Will Help Restore Fairness to the U.S. Health System
"[U]ninsured lower-income adults were more likely than insured adults in the same income group to cite factors other than medical emergencies as reasons for going to the emergency room. These included needing a prescription drug, not having a regular doctor, or saying that other places cost too much. The Affordable Care Act will substantially narrow these inequities through an extensive set of affordable coverage options starting in 2014."
(The Commonwealth Fund)
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Benefits in General; Executive Compensation
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Avoiding Litigation Over Unexercised Expired Stock Options
"Regardless of the outcome of [recent] cases, the moral(s) of the story for companies are as follows: (1) Address option expiration issues and blackout period in the plan or award agreement. Even Code Section 409A allows an option period to be extended during a blackout period. (2) Clearly communicate the expiration and other terms of equity awards with terminating employees. (3) Take extra care in drafting the plan and agreement terms governing employment termination, vesting, forfeiture and expiration."
(Winston & Strawn LLP)
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Press Releases
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