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BenefitsLink Health & Welfare Plans Newsletter
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[Guidance Overview]
Agencies Issue Guidance on Automatic Enrollment, Employer Mandate, and Waiting Periods
"This interim guidance may be helpful to employers that are trying to project the financial effect that some of the ACA provisions will have on them in 2014 and beyond. However, because the FAQs are not binding and employers cannot rely on them, additional guidance will be necessary before employers can confirm their final strategies for compliance."
(Spencer Fane Britt & Browne LLP)
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Possible Application of Rule by Supreme Court Might Prolong Health Care Fight
"[T]here is a path the Supreme Court could take when it hears the case that could delay for years any resolution of a main point of contention. The core of the law is a requirement that most people buy health insurance by 2014 or face a tax penalty. But looming over the case is a federal policy that restricts the timing of lawsuits connected to the assessment and collection of 'any tax.'"
(USA TODAY)
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Expert Projects 2013 HSA Figures
"Private consultant Roy Ramthun, who led the U.S. Treasury Department's implementation of the HSA program after it was enacted in 2003 and is an expert on consumer-driven health care, projects that the maximum HSA contribution will expand to $3,200 for individuals with self-only coverage and $6,450 for those with family coverage in 2013."
(BenefitsPro.com)
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One Reason American Health Care Costs More: Obesity
"The OECD [released] new projections on international obesity rates and, for the United States, it's not pretty: We nabbed the dubious honor of the most overweight country. By 2020, the OECD predicts approximately 75 percent of Americans will be overweight or obese."
(Ezra Klein's Wonkblog)
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Feds Jump-Start Health Insurance Co-Ops with Loans
"Seven organizations will receive a total of $639 mil.lion in federal low-interest loans to launch new, consumer-governed health insurance plans in eight states, the federal government announced[.]"
(Kaiser Health News)
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U.S. Health Care Costs Grew 5.28% in 2011
"A further breakdown of S&P data shows that healthcare costs covered by commercial insurance plans grew by 7.11% in 2011, while Medicare claim costs rose by 2.51%, despite the government plans' older and sicker population."
(HealthLeaders Media)
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Healthcare Blue Book: The Free Guide to Fair Healthcare Pricing
"The Healthcare Blue Book is a free consumer guide to help you determine fair prices in your area for healthcare services. If you pay for your own healthcare, have a high deductible or need a service your insurance does not fully cover, we can help. The Blue Book will help you find fair prices for surgery, hospital stays, doctor visits, medical tests and much more."
(Healthcare Blue Book)
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ERRP Reimbursement Requests Exceed $5 Bil.lion Funding Limit
"The Early Retiree Reinsurance Program (ERRP) announced on February 17, 2012, that it has received requests for reimbursement that exceed the $5 bil.lion in funding appropriated for the program under health care reform. These requests will be held in the order in which they were received, pending funds that may become available if ERRP recoups overpayments (for example, from adjustments to initial claim amounts)."
(Practical Law Company)
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The Care Coordination Imperative: Responding to the Needs of People with Chronic Diseases
"Nearly half of all Americans live with at least one chronic condition, and care for these patients is complex, often involving a number of clinical, occupational, and social services. One study found that the typical primary care doctor has the potential to interact with as many as 229 other doctors, in 117 different practices. Another recent study found that the probability that a physician visit would result in a referral to another physician increased from 4.8 percent in 1999 to 9.3 percent in 2009, a 94 percent increase. The absolute number of ambulatory care visits that resulted in a referral more than doubled in this 10-year period."
(The Commonwealth Fund)
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Overuse of Health Care Services in the United States: An Understudied Problem
"Overuse of health care services contributes to poor-quality care and drives up medical costs. Because of challenges in identifying and documenting overuse, however, the concept has been little studied in U.S. health care. Commonwealth Fund-supported researchers conducted a literature review to better understand the scope of overuse and spot trends over time."
(The Commonwealth Fund)
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When G.ay Employees Can Enroll Spouses for Health Insurance
"If you work for a company that provides your health benefits, you typically need to wait until the annual 'open enrollment' period to add a family member or a dependent to your plan. There are exceptions, of course. If you get married or have a child, for instance, you can add them to your plan right away. But a reader recently raised an important question: How do these rules apply to les.bian and g.ay couples, since their marriages are not recognized by the federal government? If g.ay employees marry, will they be able to immediately add their new spouse to their health coverage?"
(The New York Times; free registration required)
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[Opinion]
American Academy of Actuaries Letter to CMS on Medical Loss Ratio Annual Reporting Form (PDF)
"Our comments are limited to the instructions for Line 2.6 of Part 2 of the form, as shown on page 20 of the draft form instructions, and quoted below (emphasis added): 'Line 2.6 - Direct contract reserve current year. Report the amount of reserves required when due to the gross premium structure, the future benefits exceed the future net premium. Contract reserves are in addition to claim liabilities and claim reserves. The only contract reserves that are allowed to be used in the calculation are those used for the purpose of leveling the emerging cost due to advancing demographic age under an issue age priced contract.'"
(American Academy of Actuaries)
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Benefits in General; Executive Compensation
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[Guidance Overview]
SEC Clarifies How to Describe Say-On-Pay Vote in Proxies
"As companies prepare their 2012 proxy statements, the SEC has clarified how they should describe the advisory vote to approve executive compensation on their proxy cards and voting instruction forms. In a Feb. 13, 2012, Compliance and Disclosure Interpretation, the SEC staff provides examples of acceptable and unacceptable disclosures. The interpretation supplements the guidance on compliant resolutions in the SEC's final say-on-pay rules."
(Mercer)
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[Guidance Overview]
No-Hire Policy After Corporate Spin-Off Doesn't Violate ERISA, 7th Circuit Rules
"A two-year no-hire policy between parties to a corporate spinoff was created to promote workforce stability, not to interfere with benefits, the 7th Circuit has ruled. Though the policy prevented employees from collecting a pension and then joining the new company, the court rejected claims under ERISA Section 510, which bars actions that interfere with plan rights."
(Mercer)
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Press Releases
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