[Official Guidance]
Final IRS/EBSA/HHS Regs on Required Summary of Benefits and Uniform Glossary for Health Plan Participants (PDF)
"The requirements to provide an SBC, notice of modification, and uniform glossary . . . apply for disclosures to participants and beneficiaries who enroll or re-enroll in group health coverage through an open enrollment period (including re-enrollees and late enrollees) beginning on the first day of the first open enrollment period that begins on or after September 23, 2012. For disclosures to participants and beneficiaries who enroll in group health plan coverage other than through an open enrollment period (including individuals who are newly eligible for coverage and special enrollees), the requirements . . . apply beginning on the first day of the first plan year that begins on or after September 23, 2012. For disclosures to plans, and to individuals and dependents in the individual market, these requirements are applicable to health insurance issuers beginning on September 23, 2012."
(U.S. Internal Revenue Service, U.S. Employee Benefits Security Administration, U.S. Department of Health & Human Services)
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[Official Guidance]
'Fact Sheet' from HHS on Final Regs on Summary of Benefits and Coverage and Uniform Glossary for Health Plan Participants
"Recent studies, including one from Consumers Union, the nonprofit publisher of Consumer Reports, show that forms like the ones announced today help consumers better understand their insurance coverage and its value, making it easier to find the coverage that is best for them. Consumers in these studies took particular note of the coverage examples, a new plan comparison tool for health insurance consumers included in the SBC, which allowed them to compare how a health plan's coverage works for certain medical scenarios."
(U.S. Department of Health & Human Services)
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[Official Guidance]
Health Reform to Require Insurers to Use Plain Language in Describing Health Plan Benefits, Coverage
"People in the market for health insurance will soon have clear, understandable and straightforward information on what health plans will cover, what limitations or conditions will apply, and what they will pay for services thanks to the Affordable Care Act — the health reform law — according to final regulations published today. . . . The new explanations, which will be available beginning, or soon after, September 23, 2012 will be a critical resource for the roughly 150 mil.lion Americans with private health insurance today."
(U.S. Department of Health & Human Services)
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[Guidance Overview]
Circuit Court Says Individuals Cannot Disclaim Entitlement to Medicare Part A
"To be sure, no one has to take the Medicare Part A benefits. But the benefits are available if you want them. There is no statutory avenue for those who are 65 or older and receiving Social Security benefits to disclaim their legal entitlement to Medicare Part A benefits."
(Physicians for a National Health Program)
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[Guidance Overview]
Health Care Compliance Form 8928 Excise Tax Self-Reporting Requirements
"Sections 4980B, 4980D, 4908E, and 4980G of the Internal Revenue Code impose excise taxes for various failures of health care coverage requirements. For example, Section 4980B excise taxes apply to COBRA failures, and Section 4980D excise taxes apply for failure to comply with Code Chapter 100, group health plan requirements. The list of 4980D triggers has grown substantially since enactment of the Genetic Information Nondiscrimination Act (GINA) and the Patient Protection and Affordable Care Act (PPACA)."
(Employee Benefits Law Report)
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[Guidance Overview]
IRS Updates Model HSA Trust and Custodial Account Forms
"These bare-bones model agreements serve as a good starting point for HSA trustees and custodians. Nonusers may also find them helpful to identify the minimum requirements for a qualifying HSA trust or custodial agreement."
(Thomson Reuters/EBIA)
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Small Firms' Actions in Two Areas, and Exchange Premium and Enrollment Impact
"We estimate that Affordable Care Act regulations restricting employers' ability to offer grandfathered plans will result in lower premiums on plans available through the exchanges and will have small negative effects on enrollment in the exchanges. Our results suggest that these regulations are essential to keeping premiums on the Small Business Health Options Program (SHOP) exchanges affordable. Our analysis also found that Affordable Care Act regulations limiting self-insurance will reduce enrollment in the exchanges somewhat, without substantially affecting exchange premiums."
(Health Affairs)
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Implementing the PPACA: A 2012 State To-Do List for Exchanges, Private Coverage, and Medicaid (PDF)
"[This paper] recommends a series of tasks and issues to consider in 2012 in order to move forward with the implementation of the Affordable Care Act in the states. Specifically, it explores the following: Setting Up an Exchange; Getting People Enrolled Efficiently; Ensuring Coverage Is Affordable and Comprehensive; Monitoring Implementation of Reforms Effective Now; Educating Consumers on Their Current and Future Coverage Options and Rights."
(Families USA)
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Urban Institute's ACA Implementation Monitoring and Tracking Series
"The Urban Institute is undertaking a comprehensive monitoring and tracking project to examine the implementation process and effects of the Affordable Care Act (ACA) in 10 states. Designed to help states, researchers and policy-makers learn from the process as it unfolds, the Urban Institute is documenting changes to the implementation of national health reform in Alabama, Colorado, Maryland, Michigan, Minnesota, New Mexico, New York, Oregon, Rhode Island and Virginia."
(Robert Wood Johnson Foundation)
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Consumers Hit by Higher Out-of-Network Medical Costs
"Consumers have long complained about the cost of going outside their health plan's network, but [one consumer] encountered a new twist: a growing number of insurers have changed the way they calculate reimbursements to shift more of the expense to patients."
(Kaiser Health News)
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Campaign to Regulate Health Insurance Premiums Launched in San Francisco
"The 800-word measure would require health insurance companies to publicly justify their rate increase requests, make the company CEOs affirm that financial data under penalty of perjury, and make the rate increases subject to approval by California's Insurance Commissioner."
(San Francisco Bay Guardian Online)
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Small Firms' Actions in Two Areas, and Exchange Premium and Enrollment Impact
"The authors conclude that federal regulators acted prudently by restricting employers' ability to offer grandfathered plans while maintaining their option to self-insure. The current policy 'strikes a good balance between mitigating adverse selection and achieving high insurance enrollment,' the authors conclude."
(The Commonwealth Fund)
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How Choices in Exchange Design for States Could Affect Insurance Premiums and Levels of Coverage
"With support from The Commonwealth Fund, researchers from the Urban Institute simulated the implications of various design choices, including whether to: merge the small-group and individual insurance markets or keep them separate; eliminate age rating; remove the small-employer tax credit; and define 'small group' as an employer with 100 or fewer workers or one with 50 or fewer workers."
(The Commonwealth Fund)
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Making the SHOP Exchanges Work
"The Affordable Care Act's Small Business Health Options Program (SHOP) was designed to address this problem by creating state-based insurance marketplaces, or exchanges, for small employers. The SHOP exchanges, set to open in January 2014, will make it easier for small employers to offer an array of comprehensive, affordable plans to their workers."
(The Commonwealth Fund)
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Benefits in General; Executive Compensation
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[Guidance Overview]
2011 Decisions of Interest in ERISA Cases (PDF)
Pages 6-7 of 8 pages. Court Denies Plaintiffs' Attorneys' Claim for Fees in ERISA Action and Second Circuit Adopts Presumption of Prudence Standard in ERISA Stock Drop Litigation.
(Schulte Roth & Zabel)
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[Guidance Overview]
New York's Marriage Equality Act and its Effect on Welfare and Pension Benefits (PDF)
Page 5 of 8 pages. 'Almost without exception, the Act provides that same-s.ex couples must be able to marry in New York, that the marriages of same-s.ex and opposite-se.x couples must be treated equally in all respects under the law, and that marriages must be valid regardless of whether the parties to the marriage are of the same or opposite se.x."
(Schulte Roth & Zabel)
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[Guidance Overview]
Top 10 ERISA Developments of 2011
"In sum, 2011 altered the legal landscape for plan sponsors, plan fiduciaries, third-party administrators, service providers, and plan participants. Although the precise consequences of the top ERISA developments of 2011 remain to be seen, they are certain to present new risks and challenges in 2012 and beyond."
(Jenner & Block)
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Chrysler's Hourly Employees to Get Bonuses Friday
"Chrysler reported its first net profit of $183 mil.lion — its first in 15 years — last week. For the first time since 2005, it also posted an operating profit of almost $2 bil.lion. The company's annual earnings were actually much higher, but Marchionne decided to pay back Chrysler's loans from the U.S. and Canadian governments early."
(The Detroit News)
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Present Law and Background Relating to the Interaction of Federal Income Tax Rules and Financial Accounting Rules
"The House Committee on Ways and Means [scheduled] a public hearing for February 8, 2012, on the interaction of tax and financial accounting on tax reform. This document, prepared by the staff of the Joint Committee on Taxation, provides an overview of earnings per share computations and the financial accounting rules for deferred taxes and uncertain tax positions. The document also provides examples of financial accounting for income taxes."
(The Joint Committee on Taxation)
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Relocation Benefits Are on the Move
"New trends in relocation are growing out of economic necessity as companies find new ways to move their talent while protecting both the employee and the company from the volatility of the real estate market."
(Workforce)
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Press Releases
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