[Official Guidance]
Text of New Proposed Reg on Mandatory No-Cost Coverage of Contraception and Sterilization by Religious Employers Not Otherwise Exempt
"For ... religious organizations that sponsor self-insured plans, the Departments intend to propose that a third-party administrator of the group health plan or some other independent entity assume [the] responsibility [for the provision of contraceptive coverage without cost sharing to participants and beneficiaries covered under the plan]. The Departments suggest multiple options for how contraceptive coverage in this circumstance could be arranged and financed in recognition of the variation in how such self-insured plans are structured and different religious organizations' perspectives on what constitutes objectionable cooperation with the provision of contraceptive coverage. The Departments seek input on these options, particularly how to enable religious organizations to avoid such objectionable cooperation when it comes to the funding of contraceptive coverage[.]"
(Employee Benefits Security Administration / Internal Revenue Service / Centers for Medicare & Medicaid Services)
|
|
[Official Guidance]
CMS Notice on the Early Retiree Reinsurance Program
"This notice establishes a timeframe by which plan sponsors participating in the Early Retiree Reinsurance Program (ERRP) are expected to use ERRP reimbursement funds. Sponsors are expected to use such funds as soon as possible, but not later than December 31, 2014."
(Centers for Medicare & Medicaid Services)
|
[Guidance Overview]
The HHS Final Rule to Implement Health Insurance Exchange Markets
"Although the final rule has a more immediate impact on individuals and small businesses, it also has implications for large employers, human resources and public policy experts told Bloomberg BNA. 'This matters to large employers in a less explicit manner, but it is important because states will have the option of opening their exchanges in 2017 to large employers[.]'"
(Bloomberg BNA)
|
[Guidance Overview]
HHS Final Exchange Establishment and Eligibility Regs, Including Guidance for Participation in SHOPs
"The preamble suggests that we should expect even more guidance as the deadlines for Exchanges approach, including rules on federally facilitated Exchanges, verification by Exchanges that an individual requesting premium tax credit or cost-sharing reductions is enrolled in eligible employer-sponsored coverage, and the finalization of a number of interim final rules included with this release. HHS has also released a comprehensive regulatory impact analysis assessing the costs and benefits of Exchanges, which indicates that the proposed regulations on standards related to reinsurance, risk corridors, and risk adjustment are to be finalized separately."
(Thomson Reuters/EBIA)
|
[Guidance Overview]
U.S. Court of Appeals for Ninth Circuit Rules Timing Critical for Filing ERISA Claims
"California's 9th Circuit Court of Appeals recently determined [that] the statute of limitations for filing an ERISA lawsuit ... for the denial of an ERISA-protected benefits claim is four years ... [The Court] elected to apply California's statute of limitations for contract disputes, which is four years, as an expiration date for insurance claims. The four year statute of limitations applies to all ERISA claims whenever a limitations period is not included in the plan itself."
(Donahue and Horrow, LLP)
|
[Guidance Overview]
Learn Elements of ERISA Plan Status to Help Avoid State Law Claims
"A former employee's ... attempt to call COBRA coverage a 'privately paid' policy, rather than an ERISA plan, in order to maintain state-law claims against a group health insurer [failed] .... The [9th Circuit Court of Appeals] didn't buy that argument based upon the evidence the insurer provided that the plan met ERISA standards.... But [the court noted that] there is a "safe harbor" regulation that exempts plans that would otherwise be ERISA plans from ERISA's reach[.]"
(Thompson / SmartHR Manager)
|
|
|
The FTC and Rising Health Care Costs
"[Federal Trade Commission] Chairman Jon Leibowitz ... says 'If you want to do something about controlling costs in health care, you have to challenge anticompetitive hospital mergers.'"
(America's Health Insurance Plans)
|
|
|
|
|
Employee Assistance Programs Now Cover Host of Issues and Problems
"An employee assistance program ... can reduce tardiness and absences. The services can also help to change behaviors to reduce accidents, health care claims and worker disputes. Long ago, EAPs focused on drug- and alcohol-abuse problems. Now, the scope of services is much broader."
(The Commercial Appeal)
|
Health Insurers Set Plans in Case Mandate Is Quashed
"Their worst-case scenario: The court knocks out the law's mandate that most Americans carry insurance or pay a fee but leaves in place requirements that insurers sell policies to all applicants. The result, they say, would be spiraling insurance premiums, because sick people would buy insurance and nothing would stop healthy people from waiting to buy it until they needed it."
(The Wall Street Journal)
|
Data Breach Leads to First HITECH Enforcement Settlement
"Though the settlement is the first relating to HITECH's breach reporting requirements, there likely are more enforcement actions in the pipeline.... HHS has received, on average, 17 breach reports each month. Six of those reports involved breaches involving PHI of more than one mil.lion patients. HHS has initiated audits on many (if not all) of the significant reported breaches to date[.]"
(Ballard Sphar LLP)
|
Health Care Reform Debate Returns with Intensity
"[On March 26, 2012], the Supreme Court will begin three days of oral arguments about whether the law's requirement that individuals buy insurance is unconstitutional. Both sides are gearing up for a political carnival outside the court building in Washington, as well as an extended debate that will play out on the cable news networks for the entire week."
(The New York Times; free registration required)
|
Mandate-Based Health Reform and the Labor Market: Evidence from the Massachusetts Reform
"We model the labor market impact of the three key provisions of the recent Massachusetts and national 'mandate-based' health reforms: individual and employer mandates and expansions in publicly-subsidized coverage. Using our model, we characterize the compensating differential for employer-sponsored health insurance (ESHI) — the causal change in wages associated with gaining ESHI. We also characterize the welfare impact of the labor market distortion induced by health reform."
(The National Bureau of Economic Research; paid subscription or individual purchase required to retrieve full text)
|
|
|
|
|
Healthy Employees Can Cut Costs for Employer, Experts Say
"Employers are seeing the cost benefits of having healthier employees, and are getting on the bandwagon. There are so many options and opportunities for employers to help employees available locally, right outside their door. Lifestyle-related chronic disease, like heart disease, cancer and diabetes, are the leading cause of disability in the United States. Because they are lifestyle-related, they are preventable[.]"
(thetimes-tribune.com)
|
|
|
Site-Specific Approaches Help Drive Wellness Improvement
"The targeted health risks and desired outcomes should be determined upfront. One key is to make sure your health risk assessment (HRA) is capturing data you can use. Another is not to 'ignore the other 80 percent' of employees who are low-risk.... 'Make sure they continue in their current status' or improve."
(SmartHR Manager)
|
|
|
GOP Plans for Medicare, Health Reform Repeal Draw Scrutiny
"Political observers are noting challenges for Republican lawmakers in upcoming budget, health law and Medicare debates. And some Democrats in the Senate are being pressured on the issue of keeping one of the health law's safeguards for slowing Medicare's costs."
(Kaiser Health News)
|
Health Care Reform: 4 Inconvenient Truths for the Administration
"A Congressional Budget Office report issued this week says that 3 mil.lion to 5 mil.lion people could move from employer-based health care plans to government-based programs as the Affordable Care Act takes effect. And in the worst-case scenario, it could be as many as 20 mil.lion. For Obama, it's an inconvenient truth at a really inconvenient time — coming less than two weeks before the Supreme Court begins oral arguments on the law and just as the administration touts the law's early benefits on its second anniversary."
(Politico)
|
U.S. Supreme Court to Release Audio Recordings and Transcripts of Health Care Arguments
"The usual high court practice is to release audio recordings at the end of each week of arguments. In the court's announcement Friday, it said it would post the audio recordings and transcripts from the morning sessions March 26–28 by about 2 p.m. A recording and transcript of the March 28 afternoon session is likely to be available by 4 p.m. The recordings and transcripts will be available at the court's web site: www.supremecourt.gov."
(Reuters)
|
Millions Could Receive Insurance Rebates in 2012, Despite Industry Opposition
"Millions of Americans stand to receive insurance company rebates by the end of the summer, as a result of a new requirement in the federal health care overhaul that strictly governs how insurers spend their cash. The insurance industry, along with a slew of state officials, have been fighting the policy. Based on rules that were issued at the end of last year, Washington will require insurers to spend between 80 and 85 percent of premium dollars on medical care. Insurance companies that violate the rule will be required to effectively refund their customers."
(Fox News)
|
We Haven't Changed Our View -- We've Always Been Uncertain About Effect of Health Care Reform on Coverage, Says Congressional Budget Office
"Some of the commentary on those reports has suggested that CBO and JCT have changed their estimates of the effects of the ACA to a significant degree. That's not our perspective. Assessing the impact of broad changes in the nation's health insurance system, like those in the ACA, requires assumptions and projections about a wide array of technical, behavioral, and economic factors. CBO and JCT, in consultation with outside experts, have devoted a great deal of care and effort to analyzing health care legislation in the past few years — but our estimates are still very uncertain."
(Congressional Budget Office)
|
Major Trends in the U.S. Health Economy Since 1950
"Rapid advances in medical science and technology, substantial gains in health outcomes attributable to medical care, and budget-busting increases in health care expenditures fueled by private and public insurance have marked the past six decades of health care in the United States.... Third-party payment has grown partly because of expensive interventions that expose individuals to large financial risk and partly because employers' contributions to employee health insurance are not considered part of employees' taxable income.... A shift from individual to group insurance has also contributed to the spread of coverage by reducing marketing and administrative costs and, thanks to compulsory participation within firms, limiting the risk of adverse selection for insurance companies."
(The New England Journal of Medicine)
|
[Opinion]
How Would ObamaRomneycare Change American Health Care? For Most, Not at All
"In particular, those receiving good health benefits from employers would keep them. The act is aimed, instead, at Americans who fall through the cracks, either going without coverage or relying on the miserably malfunctioning individual, 'non-group' insurance market."
(The New York Times; free registration required)
|
[Opinion]
Employment Is Not the Coverage Answer
"Imagine the job market fully recovered from the economic downturn by next year ... What would happen to employer-sponsored insurance coverage? Not what many would hope, according to ... a new analysis of job-based health benefits."
(Modern Healthcare )
|
|
Benefits in General; Executive Compensation
|
[Guidance Overview]
USERRA Rights Can Apply Even if Employee Refuses Position for Other Reasons
"The Eleventh Circuit held that [the Alabama agency] violated USERRA and owed [the employee] $25,000 in damages for lost wages and benefits because [he]: Properly informed his employer of his deployment; Was absent for less than two years; Filed for reemployment as soon as he returned from duty."
(Practical Law Company)
|
Americans See Progress, As Women and Men Willingly Make Trade-Offs to Balance Work and Family Life
"More than half (56 percent) of American men and women [recently polled] consider gender diversity to have a positive impact on the economic health of the country, and 36 percent of men and 39 percent of women cite 'a flexible work schedule to pursue outside interests and spend time with your family' as their first or second most important reason for working."
(Wolters Kluwer Law & Business / CCH)
|
|
Press Releases
|
