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May 14, 2012 Get Retirement News  |  Advertise  |  Unsubscribe  |  Past Issues  |  Search

Employee Benefits Jobs

DC Plan Administrator
for Capital Retirement Plan Services, Inc. in PA

Pension Administrator
for Flynn Shojinaga & Associates in CA

IRT Relationship Manager 3
for Wells Fargo in FL, GA

Plan Services Consultant
for AUL/OneAmerica Financial Partners in IN

Director, Business Process Management
for Prudential in IA, PA

Director, Retirement Plan Consultants
for Prudential in CT, NJ, PA

Vice President, Plan Compliance Services
for Prudential in CT, NJ, PA

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Webcasts and Conferences

"Participant Disclosures: Working with the New DOL Rules" Web Seminar
Nationwide on May 17, 2012 presented by SunGard Relius

"Fundamentals of 401(k) and Other Qualified Plans" - Denver
in Colorado on June 13, 2012 presented by SunGard Relius

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[Official Guidance]
Text of Part IX of FAQs About Affordable Care Act Implementation; Additional Guidance on Summary of Benefits and Coverage
14 new "Frequently Asked Questions," issued May 11, 2012. Excerpt: "Are there any additional safe harbors for electronic delivery of SBCs? [Answer:] Yes. The Departments have adopted the following additional safe harbor. SBCs may be provided electronically to participants and beneficiaries in connection with their online enrollment or online renewal of coverage under the plan. SBCs also may be provided electronically to participants and beneficiaries who request an SBC online." The FAQs also state that "[D]uring this first year of applicability, the Departments will not impose penalties on plans and issuers that are working diligently and in good faith to comply." (U.S. Department of Labor; U.S. Department of Health and Human Services; U.S. Department of the Treasury)

Outcomes-Driven Health Care & Benefit Design - July 24-26 - Chicago   [Advert.]

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[Official Guidance]
Text of Revised Summary of Benefits and Coverage Template and Related Documents
Q&A 14 in Part IX of "FAQs About ACA Implementation" explains the changes: "In the diabetes treatment scenario, the version originally posted contained a typographical error, listing the allowed amount for insulin as $11.92, rather than $119.20 -- a difference that impacts the total cost of care for diabetes in the coverage example calculations. To correct this error, the Departments have posted updated versions of the SBC template, the sample completed SBC, and the guide for coverage examples calculations - diabetes scenario. The updated SBC template and sample completed SBC also include sample taglines for obtaining translated documents ... as well as updated Sample Care Costs amounts for the diabetes coverage example, due to more accurate rounding in making these calculations. Finally, the updated versions include some appearance modifications (such as changes in bolding, underlining, shading, capitalization, margin justification, use of hyphens, and row and column sizing) to ensure the document is accessible to individuals with disabilities, consistent with section 508 of the Rehabilitation Act. Plans and issuers may use either version, or may make similar modifications to their own SBCs, without violating the appearance requirements for an SBC. The updated versions of these documents are labeled 'corrected on May 11, 2012' in the lower right corner of the first page and are available at and These three documents replace the prior versions issued contemporaneously with the final regulations in February 2012." (U.S. Department of Labor; U.S. Department of Health and Human Services; U.S. Department of the Treasury)

[Official Guidance]
Text of Final HHS Regs for Medical Loss Ratio Requirements (PDF)
"[T]his final rule establishes a simple, straightforward notice requirement for health insur.ance issuers that meet or exceed the [Medical Loss Ratio, or 'MLR'] standards established by the Affordable Care Act, but only requires the notice for the 2011 MLR reporting year, the first year that the MLR rules are in effect, and does not require issuers to include information about the current or prior year MLR. The notice will direct enrollees to the HHS Web site for specific information about issuers' MLRs." (Centers for Medicare & Medicaid Services)

[Guidance Overview]
Preauthorization of Surgical Procedure Not Covered by the Plan Was Not a Fiduciary Breach
"This case is another example of how participants may be left without a remedy for harm caused by the actions of a plan fiduciary. The U.S. Supreme Court's decision last year in Cigna v. Amara ... suggested that courts may be more inventive in using equitable principles to fashion remedies for fiduciary breaches. However, this court found no breach of fiduciary duty and therefore did not address the issue of remedies." (Thomson Reuters/EBIA)

[Guidance Overview]
COBRA Notice Deadline Runs from Employment Termination Date
"This case illustrates COBRA's general rule that the deadline for providing an election notice runs from the date of termination, even if plan coverage extends beyond that date. The statute does provide an alternative, however. If the plan so provides, the notice period (and the maximum coverage period) may instead run from the date that coverage is lost. Given the court's silence on this point, we assume the plan in question was not written to take advantage of this delayed notice rule. The case also contains a helpful discussion of the factors that a court may consider in deciding whether to award attorney's fees or unreimbursed medical expenses incurred during the violation period." (Thomson Reuters/EBIA)

[Guidance Overview]
Connecticut's Group Health Plan Would Lose Governmental Plan Status by Covering Employees of Non-Profit Contractors
"[T]he DOL concluded that a group health plan sponsored by the State of Connecticut for state employees, retirees, and dependents would lose its ERISA exception as a governmental plan if it extended eligibility to employees of nonprofit entities providing public services through state contracts or funding.... [T]he 175,000 nonprofit employees estimated to become eligible under the new law (compared to 100,000 state employees and retirees currently in the plan) would far exceed the 'de minimis' number of private employees permitted under prior DOL guidance addressing the governmental plan exception." (Thomson Reuters/EBIA)

America's Employers Controlling Health Care Costs and Improving Employee Lifestyles with Wellness Initiatives
"Seven in 10 American employers offer wellness initiatives such as flu shots, health screenings, and weight management programs ... according to the [International Foundation of Employee Benefit Plans] survey ... The survey suggests a definite decrease in health care costs when wellness initiatives are offered, according to the 21.6 percent who have analyzed return on investment (ROI). Of the organizations that are analyzing ROI, 83 percent indicated a positive return. For every dollar spent on wellness initiatives, most organizations see between $1 to $3 decreases in their overall health care costs." (Wolters Kluwer Law & Business / CCH)

Should You Purchase Long-Term Care Insur.ance?
"Buying a long-term-care insur.ance policy can be a way of making sure your future physical needs will be met. Policies designed in partnership with state governments also give individuals and their families a way to protect savings in the event of burdensome care costs that stretch on for years. Critics, however, say insurers are using scare tactics to sell their products, which come with a hefty price. For most people, these critics say, long-term-care policies are either unnecessary or cost more than their benefits are worth. They believe that a great many people would be better off essentially self-insuring or relying on government-funded programs." (The Wall Street Journal)

Workplace Wellness Programs: Trends, Changes in the Law Starting in 2014, and Issues to Watch
"Employer wellness programs must comply with a number of federal and state requirements, such as the Americans with Disabilities Act of 1990, the Genetic Information Nondiscrimination Act of 2008, and the Health Insur.ance Portability and Accountability Act of 1996 (HIPAA). The issues discussed in this brief relate mostly to HIPAA provisions that prohibit employer health benefit plans from discriminating against individuals based on any factor connected with their health status." (Health Affairs)

Paid Sick Leave is 'Basic Human Right,' Senator Says
"Senate HELP Committee Chairman Tom Harkin (D-IA) held a hearing this week on the Healthy Families Act ... which would require employers to offer 56 hours of paid sick leave. Republicans ... argued that it would be counterproductive and make it harder for employers who choose to provide paid leave to continue to do so, particularly in the current economy. [The chairman], however, disagreed, characterizing 'paid leave [as] a basic human right' and he argued that 'we need a one-size-fits-all-approach that ... sets a floor that we won't let people go below.'" (HR Policy Association)

U.S. House Bill Would Expand 'Reasonable Accommodation' Obligations by Employers to Include Pregnancy and Childbirth
"Democrats [in the U.S. House of Representatives] introduced legislation that would place an affirmative duty on employers to provide 'reasonable accommodations' to pregnant employees and applicants unless doing so would cause an 'undue burden' for the employer. Employers are already prohibited from discriminating on the basis of pregnancy under the Pregnancy Discrimination Act. The 'Pregnant Workers Fairness Act' (H.R. 5647) would impose new requirements based on the robust accommodation obligations under the Americans with Disabilities Act (ADA), which do not apply to pregnancy because it is not considered a disability under the ADA." (HR Policy Association)

The Small Business Tax Credit in the ACA Is Good Business Sense
"[The] analysis found that more than 3.2 mil.lion small businesses, employing 19.3 mil.lion workers across the nation, will be eligible for this tax credit when they file their 2011 taxes. In total, these small businesses are eligible for more than $15.4 bil.lion in credits for the 2011 tax year alone, an average of $800 per employee." (Families USA)

Techniques Used by Obamacare Could Support Proposed Taxation of Employer-Provided Health Care Benefits
"On November 4, 2011, [two Congressmen] sent a letter to the Congressional Supercommittee on federal debt reduction, urging the committee 'to oppose new taxes on employer-sponsored health benefits.' ... The letter argues that [imposing taxes on] employer-sponsored insur.ance ... is unfair, because it disproportionately affects those who, by virtue of being older or living in the Northeast, face higher health costs ... Obamacare's 'Cadillac tax' on high-value health plans worked out a number of these issues. Let's go through them[.]" (Forbes)

Why Employer-Paid Health Insur.ance Drives Up Health Care Costs
"Stanford Nobelist Kenneth Arrow famously described third-party insur.ance as one of the principal flaws in America's health-care market. That is to say, because patients don't pay for their health care directly, they're insensitive to the cost and value of that care. But the 155 mil.lion Americans with employer-sponsored insur.ance in fact have fourth-party insur.ance. Not only do they not directly pay for their care, but they don't directly pay for their third-party insur.ance." (Forbes)

Benefits in General; Executive Compensation

[Guidance Overview]
Tax Treatment of Executive Compensation Clawbacks
Addresses tax issues raised by clawbacks and their solutions. Topics are: (1) repayment of same year's compensation; (2) repayment of prior year's compensation; (3) retroactive clawbacks; (4) bad boy clawbacks; (5) retirees and other former employees; (6) Section 409A; (7) employer stock; (8) FICA taxes; and (9) practical conclusions. (Ivins, Phillips & Barker)

10th Annual Study of Employee Benefits Trends
"A key finding this year is that 60% of surveyed employers recognize the precarious economic climate, rather than reducing business focus on employee benefits, actually creates opportunity for benefits to drive human capital. In addition, the Study found employees are less committed to their employers, but at the same time, highly dependent on their workplace benefits." (MetLife)

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