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BenefitsLink Health & Welfare Plans Newsletter
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[Guidance Overview]
Dismissal of ERISA Action Against Health Plan TPAs
"[The judge] held that although pleaded as such, the breach of fiduciary duty claims [against Aetna for allegedly wrongfully refusing to pay for chiropractic expenses] were in actuality claims for benefits, and that such claims could be brought only against the benefit plans themselves or the named plan administrator. Since none of the defendants was a plan administrator, but merely rendered 'third-party administrator' or claims processing services, they could not be sued under ERISA."
(Epstein Becker Green)
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Ohio Spent $96 Mil.lion on Unused Paid Time Off in 2010-11
"The payouts are late-career incentives for hardworking employees who have jobs where it's difficult to take time off, such as prisons or health care centers, said ... a spokeswoman for the Ohio Civil Service Employee Association, which represents 30,000 workers."
(MarionStar.com)
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Higher Insurance Costs Loom for Employees Who Fail to Meet Health Goals
"Companies desperate to cut the cost of health insurance — which has risen 145 percent in Iowa on average since 1999 — are moving toward rewarding and punishing employees based on how healthy they are, or whether they meet wellness goals. That's a shift from rewarding employees for participating in wellness programs, benefits experts say."
(DesMoinesRegister.com)
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How Much of the Health Reform Law Will Stand If the Individual Mandate Is Stricken?
"Chief Justice Roberts asked questions that were critical of both sides, making his final disposition unclear. On the one hand, he asked questions that appeared to support the states' case. The individual mandate was the central motivator during legislative efforts to get votes he said, supporting the 'intent of Congress' arguments. Ancillary provisions were added in some cases to acquire votes for the measure's principal core elements, he said. On the other hand, Roberts acknowledged there are PPACA provisions unrelated to the individual mandate, and that it would be quite a step to declare clearly constitutional parts of the law unconstitutional."
(Thompson)
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Justices Grapple with What Parts of PPACA Should Be Retained, If Insurance Mandate Found Unconstitutional
"Paul Clement, arguing on behalf of the 26 states challenging the law, urged the Court to invalidate the entire law. Deputy Solicitor General Edwin Kneedler, speaking on behalf of the government, urged the Court to remove only two other provisions — guaranteed issue and community rating — and keep the rest of the law, including the Health Insurance Exchanges, intact. H. Bartow Farr, assigned by the Court to advocate on behalf of the view that, if the mandate is unconstitutional, the rest of the law, including the guaranteed issue and community rating provisions, should remain intact."
(Wolters Kluwer Law & Business / CCH)
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Justices Wrestle with Whether Health Care Overhaul Should Be All or Nothing
"The law imposes new taxes on medical-device makers, calls for the establishment of insurance exchanges, permits parents to carry adult children on their health policies until the age of 26, and even requires restaurants to post the calorie content of menu items. It also greatly expands Medicaid, the joint program of the federal and state governments, to provide health insurance to individuals and families who currently earn too much to qualify for the program but not enough to afford health insurance. The Obama administration contends many of these programs can stand on their own, without the insurance mandate, and has urged the court to keep them in place."
(The Philadelphia Inquirer)
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Health Insurers Push Back on Consumer Rebate Letter
"[T]he industry and the Obama administration are at odds over proposed language in the letter that goes with the checks as well as who gets notification. The administration may require insurers to send notices about rebate rules even to customers who aren't getting a rebate."
(Kaiser Health News)
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International Perspectives on Patient Engagement: Results from the 2011 Commonwealth Fund Survey
"An international survey of adults with complex health care needs found wide variations in the degree to which patients are engaged in their own care, from self-managing a health condition to actively participating in treatment decisions. Across countries, engaged patients reported fewer medical errors, higher care ratings, and more positive views of the health system as a whole."
(The Commonwealth Fund)
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[Opinion]
How Did the Challenge to the Affordable Care Act Ever Make It to the U.S. Supreme Court?
"The media played a major role, fanning political passions by quoting every challenge — including the absurd claim that the bill called for 'death panels.' As Rachel Maddow observed Monday night: this case was 'built up as the Super Bowl of American partisan politics.' Thus, the Supreme Court was left with little choice: it had to hear 'The Case of the Century.'"
(The Health Care Blog)
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[Opinion]
Civics Lessons from the Supreme Court
"Americans who chose to listen to, or read the transcripts of, three days of oral argument at the Supreme Court this week were treated to a challenging civics lesson on federalism, liberty and the limits and potential of government authority. Three points in particular struck [the editorial board at the Washington Post]."
(The Washington Post; free registration required)
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[Opinion]
Why the Supreme Court Justices Won't Be Crudely Political When They Rule on Obamacare
"Indeed, as commentators consider what kind of decision the court will hand down in June, they have been increasingly tempted to apply a simple 'it's all politics' template: Liberal justice[s] will favor the individual mandate, conservatives will oppose it, case closed. But that's hardly ever the right way to look at the court, and it's certainly wrong now."
(Brookings)
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Benefits in General; Executive Compensation
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[Guidance Overview]
New Foreign Financial Asset Reporting Requirement with Deadline of April 17, 2012
"The Foreign Account Tax Compliance Act (FATCA) requires certain U.S. taxpayers holding foreign financial assets, including an interest under a foreign pension or deferred compensation plan and foreign equity awards, to report those interests beginning with this tax filing season. Taxpayers who fail to meet their obligation to file Form 8938 are subject to significant penalties.... Note that FATCA reporting requirements are separate from FBAR reporting of foreign financial accounts[.]"
(McDermott)
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[Guidance Overview]
Should Section 457(f) Apply to Deferred Compensation Plan of For-Profit Subsidiary of Tax-Exempt Organization?
"[T]he provisions of Code Section 457 (and the related Treasury Regulations, which [are not cited] here) as well as a Private Letter Ruling generally support the conclusions that no part of Code Section 457, including Section 457(f), should apply to the for-profit subsidiary of a tax-exempt entity. But it takes more than a few steps, and a modicum of hand wringing, to reach that conclusion. Wouldn't it be great if the forthcoming regulations were to confirm this explicitly? Perhaps they will."
(Verrill Dana)
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[Guidance Overview]
Presentation on Code Section 409A: Revisiting the Basics (PDF)
Topics discussed included: Arrangements subject to, and excluded from, Section 409A requirements; Section 409A election timing rules; Section 409A payment restrictions and related exceptions; A brief summary of available relief for Section 409A compliance errors.
(Morgan Lewis)
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Press Releases
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