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BenefitsLink Health & Welfare Plans Newsletter
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[Guidance Overview]
EBSA Issues Field Assistance Bulletin on Apprenticeship Funds' Graduation and Marketing Expenses
"EBSA stated that with few exceptions, apprenticeship or other training programs are considered employee welfare benefit plans subject to ERISA. The apprenticeship and training program fiduciaries must abide by the general fiduciary standards in Part 4 of ERISA.... [they] must be able to justify plan expenses as appropriate means of carrying out the plan's mission of training workers."
(International Foundation of Employee Benefit Plans)
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Federal Judge Takes U.S. Attorney to Task Over Obama's Comments on Supreme Court's Jurisdiction to Review Health Care Law
"During oral arguments in Houston in a separate challenge to another aspect of the federal health care law, U.S. 5th Circuit Court of Appeals Judge Jerry Smith said Obama's comments troubled a number of people who have read them as a challenge to the authority of federal courts.... Judge Smith ordered [Justice Department attorney Dana] Kaersvang to submit a letter to the appeals court by Thursday stating the position of U.S. Attorney General Eric Holder and the Justice Department on the concept of judicial review."
(The Washington Post; free registration required)
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Catholic University in Ohio to End Contraceptive Coverage
"The controversy [over federally mandated coverage for contraceptives, sterilizations and abortifacient drugs] prompted Xavier President Michael Graham, a Jesuit priest, to review the health insurance plan offered to the university's 935 employees. Graham announced this week in a letter to the faculty that the plan will cease to cover contraception on July 1."
(Reuters)
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Many Medical Tests and Procedures Aren't Needed, Doctors Say
"The lists will be publicized by Consumers Union's Consumer Reports, AARP and other consumer groups ... Many of the examples on the initial lists, such as imaging scans, focus on services and situations that have long drawn concern about overuse."
(The Wall Street Journal)
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Can Health Care Reform Survive Without the Individual Mandate?
"Some experts estimate that removing the individual mandate will raise premiums an estimated 30% and diminish the number of newly insured by two-thirds (from 27 mil.lion additional people insured to just over 16 mil.lion). [Here are] a few examples of why[.]"
(William Gallagher Associates)
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And Then There Were Two: Express Scripts Completes Medco Acquisition
"The three biggest [pharmacy benefit management companies] were reduced to two Monday when Express Scripts Inc., completed its $29.1 bil.lion acquisition of Medco Health Solutions Inc.... The deal went through once the Federal Trade Commission said ... it would not block the move, but that decision was controversial and will not end a legal fight, if independent pharmacists have any say."
(The Philadelphia Inquirer)
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Beyond the Affordable Care Act: An Economic Analysis of a Unified System of Health Care for Minnesota
"[This study] modeled a comprehensive plan covering medical, mental health and dental benefits, eliminating deductibles and coinsurance, while using only minimal copays on specialists, hospitalizations, procedures, and diagnostic tests, with coverage for all Minnesota residents.... Total state health spending [could] be reduced by nearly 9% under a unified single-payer plan ... while eliminating uninsurance in the state ... despite covering the remaining 262,000 Minnesotans who would still be uninsured under the ACA."
(Growth & Justice)
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Effects of Employer Health Costs on the Trend and Distribution of Wages Subject to Social Security Payroll Tax
"The increasing cost of employer contributions for employee health insurance reduces the percentage of compensation that is subject to the payroll tax. Rising insurance contributions can also have a more subtle effect on the Social Security tax base because they influence the distribution of money wages.... [T]he effect of health cost trends [in 1996-2008] exerted a disproportionate downward pressure on money wages below the taxable maximum, reducing the percentage of compensation subject to the payroll tax.... The main long-term impact of reform on the taxable wage base is likely to be through its effect on the trend in underlying health care costs."
(Boston College, Center for Retirement Research)
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Supplemental Group Health Insurance Benefit Strategies for Retirees
"As employers consider alternatives to offering retirees traditional group Medicare insurance, they may evaluate more than one supplemental insurance solution. Employers often compare an Employer Group Waiver Plan (EGWP) solution with a private Medicare exchange ... Both solutions offer some clear benefits[.]"
(Extend Health)
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Wrap-Up on Constitutional Challenges to the ACA
"As volatile as the oral argument was at times, and as plainly as a few of the Justices displayed their apparent support of, or skepticism about, the ACA's constitutionality, the deliberations and drafting process may temper some of the more polarized views displayed in open court."
(E for ERISA)
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Health Exchanges Already Offering Large Companies Cost Control
"While state insurance exchanges are mandated by healthcare reform to be up and running by 2014, some private health insurance exchanges that target corporations are already doing business, suggesting that healthcare benefits may follow retirement benefits' shift to a defined-contribution model."
(Treasury & Risk)
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[Opinion]
Text of Comments by American Academy of Actuaries on HHS-Proposed 'Actuarial Value Calculator' (PDF)
"The Health Practice Council submitted a comment letter to the Center for Consumer Information and Insurance Oversight (CCIIO) providing responses to questions ... on the structure of a proposed actuarial value calculator (for purposes of the ACA). The letter addresses cost-sharing inputs for the calculator, incorporation of induced demand, number of geographic pricing tiers, and incorporation of multiple network tiers."
(American Academy of Actuaries)
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Benefits in General; Executive Compensation
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[Guidance Overview]
EEOC Clarifies 'Reasonable Factors Other Than Age' Standard
"Although the EEOC purports to agree that Title VII's business necessity defense is inapplicable in an ADEA case — and that the RFOA defense is less strict than the business necessity defense — the EEOC's articulation of the above-listed RFOA factors could have the practical effect of requiring employers to meet the more demanding business necessity showing."
(Ballard Spahr)
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Contrary to Predictions, Boomers Are Retiring in Droves (PDF)
"The study reports that 59% of the first Boomers to turn 65 are at least partially retired -- 45% are completely retired and 14% are retired, but working part-time. Of those still working, 37% say they'll retire in the next year and on average plan to do so by the time they're 68. Half (51%) of those who are retired say they retired earlier than they had expected. Of those who retired early, four-in-ten say they did so for health reasons."
(MetLife Mature Market Institute)
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Press Releases
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