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March 15, 2012 Get Retirement News  |  Advertise  |  Unsubscribe  |  Past Issues  |  Search

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Manager - Compliance and Retirement Plan Administration
for Verisight, Inc in IA

Plan Administrator
for Nationwide Insurance in OH

Director, Defined Contribution Product Development
for Prudential in NJ

Client Relations & Employee Education Specialist
for Gordon Asset Management, LLC in NC

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[Guidance Overview]
HIPAA Privacy Violations Cost Insurer $1.5 Mil.lion
"HHS announced that Blue Cross Blue Shield of Tennessee ... agreed to pay $1.5 mil.lion to settle possible violations of the HIPAA privacy and security rules. This is the first enforcement action which resulted from a breach report required by the Health Information Technology for Economic and Clinical Health (HITECH) Act Breach Notification Rule." (Practical Law Company)

DATAIR! More Choices Better Guidance Less Cost   [Advert.]

Sponsored by DATAIR Employee Benefit Systems, Inc.

FSA, DCAP, Full-Flex, HRA, HSA, 132(f)
Documents, SPDs, Amendments, Administrative Forms

[Guidance Overview]
HHS Final Regs on Insurance Exchanges Address Eligibility and Establishment Rules
"The regulations include specific content, form and timing requirements for notices sent by an Exchange to individuals and employers (for example, contact information for available customer service resources). HHS indicated that it is planning to develop model Exchange-issued notices, which should be in writing and provided electronically when possible; and include the date the notice was sent and the reason for any intended action." (Practical Law Company)

[Guidance Overview]
The Small Business Health Options Program (SHOP) Allows Employers to Choose Level of Coverage
"Starting in 2014, small employers purchasing coverage through SHOP might be eligible for a tax credit of up to 50 percent of their premium payments if they have 25 or fewer employees, pay employees an average annual wage of less than $50,000, offer all full-time employees coverage and pay at least 50 percent of the premium." (Society for Human Resource Management)

Summarizing Benefits and Coverage
"Compliance with the new federal rules requiring organizations to provide expanded healthcare disclosures to workers has been postponed [until the open-enrollment period beginning on or after Sept. 23, 2012]. HR leaders should use the extra time to ensure internal staff works with vendors, prepares and reviews drafts, and creates a final Summary of Benefits and Coverage to include with open-enrollment materials, beginning this fall." (Human Resource Executive Online)

Health Reform Might Spur New Types of Employee Lawsuits
"Recent legal challenges have focused on constitutional issues, but health care reform is expected to create new reasons for benefits and employment-law litigation, according to a reform expert. Reform rules fraught with legal risk include: (1) pay-or-play requirements, (2) claims appeals and external review, (3) essential benefits; and (4) retiree medical rules. Another area of concern is that scenarios will arise under reform that will generate discrimination complaints." (SmartHR Manager)

Final Regs on Health Insurance Exchanges Direct Insurers to Justify Rates
"The final rule does ... direct exchanges to implement some strict standards on insurers, such as requiring the qualified health plans to justify their proposed rate increases and, if they choose to, more closely scrutinize these rate increase justifications[.]" (FierceHealthPayer)

Health Reform Law to Slightly Lower Number of Employer Plan Enrollees
"The health care reform law will have only a modest impact on the number of people covered in employer plans, but it will significantly reduce the number of uninsured, according to [CBO]." (Business Insurance; free registration required)

AARP Supports Health Care Reform Law Against Challenges to Its Constitutionality
"AARP's brief describes the effects on the national economy as well as on public health caused by the millions of uninsured and underinsured people who cannot afford medical diagnosis and treatment, and accumulate crushing medical debt or are forced to file bankrup.tcy because of the debt. In addition, older Americans with employer-based insurance experience 'job lock' which means they are unable to retire or pursue self-employment as they often cannot obtain or afford health insurance on the private, individual market for them or covered family members." (AARP Foundation)

Who Will Have Health Insurance in the Future? An Updated Projection
"Private health insurance will become increasingly unaffordable to low-to-middle-income Americans unless major changes are made in the US health care system." (Annals of Family Medicine)

Challenges to Health Care Reform in the Supreme Court: A Primer for the Upcoming Oral Arguments
"The immediate issues, in the order the court will hear them, begin with the question of whether the so-called 'individual mandate' — which requires that almost all Americans without coverage buy individual health insurance policies or pay fines -- is ripe for adjudication now. Or must the case be deferred until 2015 because of the 1867 Anti-Injunction Act, which bars federal courts from ruling on the constitutionality of tax laws before payments are due?" (Kaiser Health News)

Video: Policy and Political Implications of the Supreme Court Case on the Affordable Care Act
"This webcast features a Kaiser Family Foundation briefing held on March 14, 2012, examining the policy and political implications of the pending U.S. Supreme Court case on the Affordable Care Act (ACA). At the briefing, the Foundation released new polling data on the public's views about the case as well as their more general views about the health reform law." (The Henry J. Kaiser Family Foundation)

U.S. Senate Passes Bill Boosting Commuter Subsidy
"The maximum tax-free subsidy that employers, including the federal government, can pay for their workers to use public transit in their commuting would nearly double to $240 a month under a provision in the transportation bill the Senate passed [March 14, 2012]." (The Washington Post; free registration required)

Chronology of Obama Health Care Law Legal Battle
"The Supreme Court will hear arguments on March 26-28 over the fate of President Barack Obama's healthcare law, a battle with legal, political and financial implications for the U.S. healthcare system's biggest overhaul in nearly 50 years.... Here is a chronology of the key events in the legal battle over the law that seeks to provide health insurance to more than 30 mil.lion previously uninsured Americans[.]" (Reuters)

Final HHS Rule on the Implementation of Health Insurance Exchange Markets
"The most significant change from the proposed rules allows additional flexibility for states regarding eligibility determinations ... Changes made to the proposed rules also allow states to determine a role for agents and brokers, including the use of online brokers[.]" (Bloomberg BNA)

Five Costly Health Care Plan Compliance Slips
"Smaller companies without a substantial, experienced human-resources team may risk overlooking some fundamental requirements for complying with health-care-related laws and regulations.... Even something as simple as maintaining a required plan document ... can fall through the cracks.... 'many [plan sponsors] think they are in compliance because they have insurance contracts. In 99% of the cases, that is not enough to meet ERISA's standards for plan documents[.]'" (CFO)

First Annual Specialty Drug Benefit Report
"Coinciding with the increased spending for specialty medications is a need for plan sponsors to better understand the appropriate use of specialty pharmaceuticals as well as effective tools to manage specialty pharmaceuticals.... Total healthcare costs and specialty drug costs were the most important reported outcome across health plans and employers. More clinically-oriented outcomes, including medication adherence, disease progression, and quality-of-life, were much less frequently identified as the most important outcome for both employers and for health plans." (Pharmacy Benefit Management Institute; free registration required for full report)

Compromise Could Clear Way for Massachusetts Bill Seeking Paid Sick Days
"Advocates for a bill requiring Bay State businesses to offer paid sick days to their workers hope new compromise legislation exempting the state's smallest companies will break a years-long logjam, but critics of the bill say it will cost nearly 12,000 jobs." (Lowell Sun)

Ohio 26- and 27-Year-Olds Do Not Qualify for State-Mandated Health Care Coverage When Employer Plan is Uninsured
"Most Ohioans with private health insurance work for companies that are exempt from a state law that lets workers keep adult children on their health plans until they turn 28." (The Columbus Dispatch)

The ACA and Fluoridation: The Power of Political Symbols
"Of course there are substantive and legitimate differences over the Affordable Care Act ... However, for many Americans, especially those who oppose the law, the ACA derives its power as an issue, like fluoridation did many years ago, because it has become a symbol of their broader fears and concerns.... The largest share of those who oppose the law (38%) say they oppose it because of what it represents to them about the direction of the country and Washington." (The Henry J. Kaiser Family Foundation)

Benefits in General; Executive Compensation

CEO Pay Characteristics Relative to Shareholder Dissent (PDF)
"With the advent of 'say on pay' in the U.S. last year, much focus has been placed on the role of total shareholder return (TSR) in determining shareholder support or opposition to the non-binding management resolution. Yet, while TSR is widely seen as the most critical driver of votes, CEO pay magnitude also plays role, as evidenced by [an] analysis of voting data for 2011." (ISS Corporate Services)

2012 Top Five Total Rewards Priorities Survey (PDF)
"This year's survey showed a dramatic shift in focus as employers pointed to concerns about talent. When asked to identify the most significant challenge facing their organization over the next three years, employers identified the shortage, motivation and retention of talent." (Deloitte/ISCEBS)

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Lois Baker, J.D., President
Holly Horton, Business Manager

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