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BenefitsLink Health & Welfare Plans Newsletter
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[Guidance Overview]
Overview of Final Guidance on Summary of Benefits and Coverage (PDF)
"Plan sponsors will need to coordinate the distribution of the SBCs with their upcoming open enrollment material. It is important to note that with respect to a participant already enrolled in the plan, an SBC must only be provided for the option in which the participant is enrolled. Whether 'passive' enrollments (where employees are not required to make an election) satisfy the requirements for automatic reenrollment is not clear. Inclusion of the SBCs in SPDs and open enrollment guides should be considered now, in order to meet the requirements most efficiently."
(Buck Consultants)
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[Guidance Overview]
Medical Loss Ratio Rebates: ERISA Plan Assets?
"The first set of rebates will be due in August, 2012, based upon insurers' calculations of their medical loss ratio for 2011. Plan sponsors should review applicable insurance policies and plan documents, and consider the plan asset issues before then to ensure that they will know what to do with any MLR rebates that they receive."
(Spencer Fane)
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[Guidance Overview]
HHS's Intended Approach for Determining Actuarial Value for Individual and Small Group Coverage
"We suspect the devil will be in the details as HHS's methodology is translated into proposed (and then final) regulations. For example, when the calculator tool is used by an insurer to determine the AV of an HDHP offering, how will the insurer know what HSA contributions an employer will make? Presumably, some coordination or minimum contribution levels will need to be established to ensure the combined offering satisfies the applicable metal level."
(Thomson Reuters/EBIA)
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Small Companies Working to Make Health Coverage Pay
"[I]n certain industries, health insurance is already essential to attract good employees. That forces entrepreneurs to figure out ways to afford coverage. [One employer] has been providing fully paid insurance with no copays or deductibles for 33 years. He says he does it because it makes good business sense."
(Star Tribune)
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Looking Ahead to the Supreme Court's Health Care Reform Hearings in March
"Almost three years to the day after the ACA was enacted, it will become the most significant piece of legislation reviewed by the Court since the Voting Rights Act in the 1960s. In anticipation of the major news coverage that will surely ensue, this post outlines the legal issues at stake, and takes a look at how the Court's voting might line up."
(E is for ERISA)
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Under The Affordable Care Act, 105 Mil.lion Americans No Longer Face Lifetime Limits on Health Benefits
"Overall, we estimated that 70 mil.lion persons in large employer plans, 25 mil.lion persons in small employer plans, and 10 mil.lion persons with individually purchased health insurance had lifetime limits on their health benefits prior to the passage of the Affordable Care Act .... These 105 mil.lion Americans now enjoy improved coverage without lifetime limits."
(U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation)
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Health Saving Account Contribution Guidance Raises Concerns for Employers
"Employers who contribute to employees' health savings accounts or health reimbursement arrangements may not get full credit for that amount when running a key 'actuarial value' test that is part of the health care reform law, federal regulators said in a bulletin."
(Business Insurance; free registration possibly required)
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When Are Health Insurance Premiums Tax-Deductible?
"You can always deduct your premiums as medical expenses on Schedule A, Itemized Deductions. The downside is you have to itemize, and the total of your medical expenses has to exceed 7.5% of your income before you get any tax benefit. It would be better if you could receive the health insurance premiums as a tax-free benefit, similar to when you were an employee."
(Fox Business)
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Employers Boosting Values of Wellness Incentives: Survey
"Employers are boosting the values of incentives they offer employees to encourage them to take action to improve their health ... [J]ust under 73% of employers used incentives in 2011 as part of their health improvement programs.... Incentives used by employers include cash, gift cards and contributions to health savings accounts."
(Business Insurance; free registration possibly required)
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[Opinion]
Determining the Level of Payments in Health Care
"Unilateral, administrative price-setting shares with an all-payer system the advantage of simplicity in claims processing and, thus, lower administrative costs. Both methods furnish the ideal platform for common claims forms and electronic billing."
(The New York Times; free registration required)
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[Opinion]
ObamaCare's Supreme Mistake: Mandatory Purchase of Health Insurance
"The US Supreme Court this month hears arguments on the constitutional challenges to the ObamaCare law — with the top challenge centering on the mandate that every American buy health insurance. Increasingly, and not just for constitutional reasons, that mandate looks to be the law's downfall."
(Galen Institute)
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Benefits in General; Executive Compensation
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What Does Maryland's Same-S.ex Marriage Law Mean for Employers?
"Employers in Maryland have 10 months to adjust their employee benefit policies, plan documents and plan language regarding dependents before a law legalizing same-s.ex marriage goes into effect.... The new law contains protections for churches and religious groups and officials."
(Thompson / SmartHR Manager)
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Press Releases
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