CAWG (Change Agent Work Group)

Mid-Level Employee Benefits Associates
for Mid-Size Washington, DC Firm in DC

401(k) Plan Manager
for PenServ Plan Service, Inc. in SC

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Final Rules on Group Health Plans and Health Insurance Issuers Relating to Coverage of Preventive Services Under the PPACA (PDF)
Published today in the Federal Register. "Nothing in these final regulations precludes employers or others from expressing their opposition, if any, to the use of contraceptives, requires anyone to use contraceptives, or requires health care providers to prescribe contraceptives if doing so is against their religious beliefs.... This approach is consistent with the First Amendment and Religious Freedom Restoration Act. The Supreme Court has held that the First Amendment right to free exercise of religion is not violated by a law that is not specifically targeted at religiously motivated conduct and that applies equally to conduct without regard to whether it is religiously motivated—a so-called neutral law of general applicability.... Likewise, this approach complies with the Religious Freedom Restoration Act, which generally requires a federal law to not substantially burden religious exercise, or, if it does substantially burden religious exercise, to be the least restrictive means to further a compelling government interest." (U.S. Internal Revenue Service / U.S. Employee Benefits Security Administration / U.S. Department of Health and Human Services)

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HHS/DOL/IRS FAQs Addressing Automatic Enrollment, Employer Shared Responsibility, and Waiting Periods Under the Affordable Care Act
"[T]he FAQs fail to address at least one very import set of rules, relating to non-discrimination standards for fully-insured group health plans, that could have a major impact on plan design and coverage. It will do little good for an employer to successfully navigate the assessable penalty and waiting period rules only to find that it has failed the applicable non-discrimination standards." (Mintz Levin)

Functions of the Health Care Exchanges for 2014
"[This article discusses] the role of the new exchanges, beginning in 2014, for employees who don't have employer-sponsored coverage or unaffordable employer-sponsored coverage. The basic concept of the exchange is to facilitate the interaction between insurance companies and consumers using a common platform for comparison of qualified health plans." (Faegre Baker Daniels)

Final Regulations Address Summary of Benefits and Coverage
"In preparing SBCs for your plans, you will want to look at the prescribed form, the instructions for completing the form, the sample completed form, and other materials that the government has prepared for these purposes. If your plans operate on a calendar year, you should consider developing your SBCs this spring and summer to ease the burdens during the traditionally hectic weeks leading up to annual enrollment. It is also worth watching for additional guidance on practical questions that emerge as group health plan sponsors and insurers start to implement the new requirements." (Ballard Spahr LLP)

New Guidance on Distribution of Medical Loss Ratio Rebates Creates Issues for Group Health Plan Sponsors (PDF)
"This advisory discusses the obligations of plan sponsors receiving rebates. The applicable requirements differ based on the type of plan. Thus, this advisory separately addresses rules for plans subject to ERISA, state and local governmental plans, and church plans. Special rules for terminated plans are also discussed." (Alston & Bird LLP)

ML Strategies Health Care Reform Update, February 13, 2012 (PDF)
Read this week's update on health care reform legislation, regulations, and initiatives. (ML Strategies)

The 2011 Consumer Health Mindset: Views, Behaviors and Solutions (PDF)
"Aon Hewitt partnered with the National Business Group on Health . . . and The Futures Company to conduct our annual consumer health care study. This study explores perspectives, attitudes, and behaviors that employees and dependents hold toward the current and changing health care landscape and can be correlated with employers' efforts to promote health and productivity within their workforces." (Aon Hewitt)

Making Health the CFO's Business: Findings From the Integrated Benefits Institute's 2011 CFO Survey
"CFOs appear poised to recognize the established links between workforce health, productivity and financial performance. A large share of the 313 CFOs surveyed described poor health as having a significant impact on financial success through factors — such as opportunity costs, sick leave and turnover — that influence productivity." (Integrated Benefits Institute)

How to Manage Pharmacy Benefits Plans Part 3: As Pharma Consolidates, Even Smaller Employers Can Negotiate
"Just 3 years ago, there were few opportunities for employers with 10,000 or fewer covered lives to negotiate with the PBMs. Today, the intense competition among the PBMs for employer business has opened up the possibilities to these employers to strike better arrangements. Competitive bidding by, and follow-on negotiations with, PBMs have enabled larger [employers] to achieve even greater savings that before. As a result, virtually all financial and non-financial terms are negotiable." (Buck Consultants)

Employer and Worker Contributions to Health Savings Accounts and Health Reimbursement Arrangements, 2006–2011 (PDF)
"This report presents findings from the 2011 EBRI/MGA Consumer Engagement in Health Care Survey, as well as earlier surveys, examining the availability of health reimbursement arrangement (HRA) and health savings account (HSA)-eligible plans (consumer-driven health plans, or CDHPs). It also looks at employer and individual contribution behavior." (EBRI.org)

Fifty-Four Mil.lion Additional Americans Are Receiving Preventive Services Coverage Without Cost-Sharing Under the Affordable Care Act
"Based primarily on guidelines from the U.S. Preventive Services Task Force, this includes services such as colonoscopy screening for colon cancer, Pap smears and mammograms for women, well-child visits, flu shots for all children and adults, and many more." (U.S. Department of Health and Human Services)

When It Comes to Disease Management, Science Defies Logic
"Disease management guided by science targets the people who need it most, rather than rely on the faulty assumption that all patients with a particular disease are equal." (Employee Benefit News)

With a Growth in Consumer-Directed Plans, HSAs Rocket in Usage
"Among 600,000 [Bank of America] accounts, HSAs are the fastest growing, approaching 200,000 user accounts and more than $300 mil.lion in account balances." (Employee Benefit News)

Guidance on Summary of Benefits and Coverage Requirements and FAQs on Automatic Enrollment, Employer Shared Responsibility, and Waiting Periods
"The SBC requirements apply to disclosures made to those enrolling or re-enrolling in group health plan coverage through an open enrollment period beginning on or after September 23, 2012. (For enrollments occurring outside of open enrollment, the requirements apply beginning on the first day of the first plan year that begins on or after September 23, 2012 — i.e., January 1, 2013 for a calendar-year plan.)" (Thomson Reuters/EBIA)

DOL's Model FMLA Forms Now Approved Through 2015
"Now that the DOL's model FMLA forms are in effect for the foreseeable future, employers should work with their employment counsel to review and amend their FMLA forms to include the suggestions above and to streamline forms to fit your operational needs." (FMLA Insights)

Amicus Brief of the American Legislative Exchange Council to U.S. Supreme Court; Urging Court to Find Individual Mandate Unconstitutional (PDF)
"ALEC believes that the Supreme Court should affirm the judgment of the 11th Circuit Court of Appeal's in this case [finding the mandatory purchase of health insurance by individuals to be unconstitutional]." (American Legislative Exchange Council)

NIPA Expands TPA Business Owner Services to Include 401(k) Sales Champion Workshop©
(National Institute of Pension Administrators)

Kemper Corporation Initiates Rebranding with Total Compensation Statements from Benefit Software Inc.
(Benefit Software Inc.)

Benchmarking Survey to Identify 403(b) Plan Trends and Best Practices
(Principal Financial Group)

Prudential Investments Expands Defined Contribution Mutual Fund Business; Names New Director of Sales
(Prudential Financial, Inc.)

Saint Luke's Health System Recognized by IBI and NBCH for Health & Productivity Leadership in Transforming Benefits Program
(Integrated Benefits Institute and National Business Coalition on Health)

Flexible Benefit Service Corporation Introduces Health Advocate to Help Clients Navigate Health Insurance Landscape
(Flexible Benefit Service Corporation (Flex))