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BenefitsLink Health & Welfare Plans Newsletter
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401(k) Investment Lineup Summit [Advert.]

Ensure your 401(k) plan can adapt to changing economic & financial currents and participants can reach their goals. Practical 1 day seminars - SF 4/17, Dallas 4/19, Chicago 4/24, NY 4/26. FREE registration for qualified plan sponsors. More info.
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[Guidance Overview]
HHS Issues Final Regulations on Health Insurance Exchanges
"These final regulations offer states substantial discretion in the design and operation of an Exchange, and include standards for the establishment and operation of an Exchange and other rules."
(Price Waterhouse Cooper)
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[Guidance Overview]
Added Guidance on Summaries of Benefits and Coverage
"The FAQs offer some flexibility with regard to formatting and content that plan sponsors will welcome, but plan sponsors will still need to be mindful of the space constraints imposed by the SBC requirements and the need to present information that can be easily understood."
(Ballard Spahr LLP)
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[Guidance Overview]
Summary of Benefit Coverage Rules: The Devil Is in the Details
"During the February 28, 2012 ALI-ABA Video Broadcast program on Health Plans some representatives from the government provided ... their personal insights on how the Summary of Benefits and Coverage [SBC] rules and templates should operate. Earlier this week the DOL posted FAQ VIII ... regarding the SBC that provided additional flexibility for employers. This [article highlights] some of the important information learned during such program and from FAQ VIII."
(Bloomberg BNA)
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[Guidance Overview]
Agencies Seek Input for Future Religious Exemption Rule
"One possible approach [for religious organizations with self- insured health plans to comply with the contraception/sterilization coverage mandate] is to allow a third-party administrator 'to use revenue that is not already obligated to plan sponsors such as drug rebates, service fees, disease management program fees, or other sources. These funds may inure to the third- party administrator rather than the plan or its sponsor and drug rebates, for example, could be larger if contraceptive coverage were provided.' Another possibility under consideration is to have the third-party administrator receive a credit or rebate on the amount that it pays under the Affordable Care Act's reinsurance program."
(Littler)
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Small Businesses, Confused by Costs, Wavering on Health Coverage
"If [the group health plan of Lake Michigan Mailers in Kalamazoo, Michigan] doesn't meet the requirements [of health care reform becoming applicable in 2014], [company President David] Rhoa calculates it will be cheaper to pay the penalties, which he estimates at $42,000, than to buy a more comprehensive plan. He'd prefer to keep offering the benefits the company can afford. If he drops coverage, workers may get subsidies to buy their own plans in insurance exchanges. 'I'll end up paying a fine and irritating my employees at the same time[.]'"
(Bloomberg BusinessWeek)
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March Madness at the Court — Sweet Sixteen Players? No, Nifty Nine
"Important as the unconstitutionality of the health care law may be, whether in part or in toto, an even much larger issue potentially is at stake, which the Court as a whole, or one or more of the several opinions which its Justices may file (concurring, concurring in part, dissenting or whatever), might confront — namely, how big is too big a role of the Federal government? The issue divides the political parties and the electorate at large at this time, and it obviously directly affects one's view of the health care reform legislation. But, in a larger sense, it affects the entire fabric of our society."
(Alvin D. Lurie, Esq. on BenefitsLink.com)
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Health Law Transforming U.S. as Court Threat Looms
"For two years, even as a debate has raged over what Republicans deride as 'Obamacare,' the new health-care law has begun benefiting consumers and refashioning a $2.6 tril.lion industry. Insurers, hospitals and doctors are forming alliances and adopting new procedures, preparing for a reshaped market that will debut when — or if — the law aimed at covering at least 30 mil.lion uninsured Americans is fully implemented in 2018."
(Bloomberg BusinessWeek)
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Obama's Health Care Law in Court: An Overview
"The Supreme Court is getting ready to hear its biggest case in decades — or at least its longest. Next week, three days and six hours of hearings may determine whether President Obama's landmark health care law lives or dies."
(NPR)
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What Happens Without Individual Mandate?
"Analyses from the Congressional Budget Office, the RAND Corporation and others have shown that average premiums on the state insurance exchanges would be 10%–20% higher or more if the individual mandate were not part of the law. But does that mean you would pay 10% more? No. Our analysis shows that the premium for any individual would rise only by about 2%."
(RAND)
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Implementing the Affordable Care Act: State Action on Early Market Reforms
"This issue brief examines new state action on a subset of these 'early market reforms.' The analysis finds that 49 states and the District of Columbia have passed new legislation, issued a new regulation, issued new subregulatory guidance, or are actively reviewing insurer policy forms for compliance with these protections."
(The Commonwealth Fund)
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Utah Health Insurers Scrutinized for Double-Digit Price Hikes
"Two Utah health insurance companies have come under scrutiny for sharp price increases — one as high as 19 percent.... The price hikes are the first to be flagged by the Utah Department of Insurance since it began vetting increases of 10 percent or higher, a requirement of federal health reform."
(The Salt Lake Tribune)
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The Early Retiree Reinsurance Program — Go Forth and Spend
"On March 13, 2012, the Centers for Medicare & Medicaid Services (“CMS”) issued a notice that establishes a timeframe under which plan sponsors participating in the ERRP are expected to use ERRP reimbursement proceeds. The notice provides that sponsors are expected to use these funds as soon as possible, but not later than December 31, 2014."
(Porter Wright Morris & Arthur LLP)
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HIPAA/HITECH Enforcement Action Alert
"In 2009, BlueCross reported the theft of 57 unencrypted computer hard drives containing the protected health information (PHI) of more than one million customers from a former BlueCross call center in Chattanooga.... In spite of [numerous] physical safeguards, HHS determined that the [protected health information] contained on the hard drives was not protected well enough."
(Morgan Lewis)
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The State of Value-Based Insurance Design (PDF)
"The University of Michigan's Center for Value-Based Insurance Design ... was created in 2005 to lead the development of innovative health benefit designs that balance cost and quality.... The 2011 V-BID Center Symposium, held November 16, 2011, [saw m]ore than 350 professionals from various disciplines gathered to listen to a number of speakers and discuss collaboration among those in various V-BID-related specialties; these included healthcare executives, employers, government officials, plan designers, benefits consultants, and more.... [Tom Daschle] delivered the keynote speech."
(The American Journal of Managed Care)
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High Court and the ACA: Three Days, Four Issues
"In an extraordinary three-day event beginning Monday March 26, the Supreme Court will work its way through arguments on four contentious issues arising from court challenges to the ACA. Here's the schedule for the arguments[.]"
(Wolters Kluwer Law & Business / CCH)
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Young Adults Particularly Likely to Gain Stable Health Insurance Coverage as Result of Affordable Care Act
"New analysis ... shows that privately insured young adults ages 19 to 25 were over twice as likely as older adults to lose private insurance coverage prior to the Affordable Care Act.... because they are more likely to experience the types of life transitions that ... often resulted in a loss of insurance coverage.... Starting in 2014, there will be even more health coverage options available to young adults when the Affordable Insurance Exchanges, premium tax credits, and Medicaid expansion all begin."
(U.S. Department of Health & Human Services, Assistant Secretary for Planning and Evaluation)
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[Opinion]
Economists Address the Supreme Court on the Health Law
"Today's Myth Buster is brought to you by 215 economists ... [who] have filed an amicus brief with the U.S. Supreme Court in connection with its consideration of the Affordable Care Act, known familiarly as ObamaCare. In ... the brief, these folks bust a number of long-standing liberal myths that are built into any discussion of health care[.]"
(National Center for Policy Analysis)
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[Opinion]
The Issue of a Constitutionally Limited Government
"[T]he Court must articulate the constitutional vision and principles we've so long abandoned, as the 11th Circuit Court of Appeals did when it ruled that Congress, in enacting [the Affordable Care Act], had unleashed effectively unlimited regulatory power, tantamount to the general police power the Framers left to the states, and in so doing had upset the balance between the federal and state governments that the Framers established for the purpose of securing our liberties."
(Cato Institute)
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[Opinion]
Obamacare, Two Years Later
"This week marks two years since of the passage of the Patient Protection and Affordable Care Act, and if the Obama administration has chosen to all but ignore the second anniversary of Obamacare, the rest of us should pause and reflect on just what a monumental failure of policy the health-care-reform law has been.... {R}egardless of whether the Court upholds Obamacare or strikes it down, in whole or in part, we should understand that, simply as a matter of health-care reform, Obamacare is a costly and dangerous failure."
(Cato Institute)
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[Opinion]
Why the Individual Mandate Is Inseparable from Obamacare
"The Court has scheduled ninety minutes of oral argument for the 'severability' issue, and the possible outcomes are legion.... If the Court takes the wrong approach on severability, it could leave the nation with a stripped-down law that did not command, and never could have commanded, congressional support at the time of passage. That judicially constructed law, moreover, could well leave us with an underfunded health care system that could unravel in spectacular fashion, pushing the private health insurance industry to the brink of collapse."
(Cato Institute)
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Benefits in General; Executive Compensation
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10th Annual MetLife Study of Employee Benefits Trends (PDF)
"One of the Study's most significant findings is the strong relationship between satisfaction with benefits and job satisfaction.... [T]his correlation creates compelling evidence for the power of benefits to drive a universal set of business objectives -- employee attraction, retention and productivity."
(MetLife)
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Press Releases
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