EmployeeBenefitsJobs.com logo BenefitsLink.com logo

BenefitsLink Health & Welfare Plans Newsletter

June 12, 2012 Get Retirement News  |  Advertise  |  Unsubscribe  |  Past Issues  |  Search

Employee Benefits Jobs

Retirement Plan Consultant and Administrator
for Beasley & Company in ANY STATE

Administrative Analyst
for University of California Office of the President in CA

Institutional Trust Sales Representative
for BMO Harris Bank in NY

Senior Legal Consultant
for Mercer in DC

VPCOO
for Third Party Administration Firm in Midwest

Post Your Job on EmployeeBenefitsJobs.com

View All Jobs

RSS feed for jobs RSS Feed: All Jobs


Webcasts and Conferences

Advanced Pension Conference
in Illinois on September 5, 2012 presented by SunGard

Littler's Employee Benefits Summit 2012
in Illinois on June 20, 2012 presented by Littler Mendelson

Just for ERPAs Workshop
in Illinois on September 4, 2012 presented by SunGard


We also publish the BenefitsLink Retirement Plans Newsletter (free): Subscribe

[Guidance Overview]

Mandate Requiring Coverage of Women's Preventive Health Care Services Goes Into Effect August 1, 2012
"According to [HHS], group health plans may use reasonable medical management techniques for women's preventive care to determine any coverage limitations when the applicable recommendations or guidelines do not specify the frequency, method, treatment or setting for a covered service. In addition, plans may use reasonable medical management techniques to control costs, for example, by continuing to charge cost-sharing for brand-name drugs if a safe and effective generic version is available and requiring cost-sharing for preventive services received from out-of-network providers." (McKenna Long & Aldridge LLP)


DATAIR! More Choices – Better Guidance – Less Cost   [Advert.]

Sponsored by DATAIR Employee Benefit Systems, Inc.

FSA, DCAP, Full-Flex, HRA, HSA, 132(f)
Documents, SPDs, Amendments, Administrative Forms
(888) 328-2474   Sales@DATAIR.com   www.DATAIR.com


2012 Employer Healthcare Trends: Cost Control Strategies (PDF)
"Confused by the pending legislation, employers are fearful of rising insur.ance costs and are hesitant to make any significant changes to their current plans. However, despite the potential changes coming to the US healthcare market, they have no choice but to continue managing these costs for their companies.... [This paper discusses] three methods that have been growing in popularity over the past several years, each of which has proven successful in containing insur.ance premiums and overall costs[.]" (CPEhr)

Continued Coverage of 26 Year Olds under ACA - Good News or Bad?
"They are entitled to be covered on their parent's health insur.ance, as part of the Affordable Care Act reforms. The Commonwealth Fund can find only good things to say about all this. Chris Jacobs probes their study more carefully and finds three items missing from the organization's press release: crowd out, regressive benefits for the better off and higher premiums for everyone else[.]" (John Goodman's Health Policy Blog)

Insur.ance Companies Show No Turning Back on Health Care Reform
"Three of the top five U.S. health insurers sent a signal that many of the changes wrought by the 2010 health-care overhaul are here to stay, even if the Supreme Court decides the law itself must go. UnitedHealth Group Inc., Aetna Inc. and Humana Inc. said this week they would save some of the law's most popular provisions, including letting young adults stay on parents' plans. Employers seeking to contain the cost of care will also press to keep other provisions, said Mike Tuffin, who represented insurers ... while the law was being negotiated." (Bloomberg)

Employers Concerned about PPACA's Affect on Behavioral Health Costs
"According to the DMEC 2012 Behavioral Risk Survey, 47.7 percent of respondents believe behavioral risk is an important emerging area of concern. Also, 40 percent indicated they include a behavioral component in their integrated or coordinated disability/absence management program. The survey indicates adoption of behavioral health programs could be impacted by the uncertainty surrounding healthcare reform." (Disability Management Employer Coalition)


7th Annual Congress on On-Site Employee Health Clinics   [Advert.]

Sponsored by Global Media Dynamics, LLC

Strategically building & expanding on-site health clinics -- incorporating innovative strategies to reduce costs and ensure employee satisfaction. July 19–20, 2012, Boston, MA


ML Strategies Health Care Reform Update, June 11, 2012 (PDF)
Weekly update on developments in federal and state health care reform legislation and regulations. Includes summaries of recent regulatory activity by HHS, CCIIO, IRS and CMS. (Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.)

Will Insurers Continue Health Care Reform Even If ACA Is Overturned?
"'The insurers feel the law created price controls on them, and they foresee a tremendous potential benefit in striking the law,' says [a health care attorney]. While he declines to speculate whether other insurers will follow the [UnitedHealthcare] lead, 'if enough other insurers do join this pledge, it might suggest to the Supreme Court that it's not that big a deal if it decides to strike down the law' because key consumer-protection provisions would effectively remain in place." (CFO.com)

What Do Consumers Want To Know About Health Insur.ance? (PDF)
"This project ... analyze[d] a convenience sample of approximately 1,650 emails sent to ... Consumer Reports between March 2010 and November 2011.... [C]onsumers understand the importance of health insur.ance and want to do the right thing by getting insur.ance, but they feel overwhelmed by the choices and are uncertain where to get reliable information to make their decisions. Many were unsure how to even begin choosing a health plan." (Consumers Union)

Actuarial Value Under the ACA: Plan Valuation with the Consumer in Mind (PDF)
"While a reliable and standardized measure of actuarial value can help consumers navigate their health plan choices, it is important to consider the limits of actuarial value. Actuarial value does not help consumers identify which plans might be best at controlling costs or delivering high quality care. Neither does it predict the total expenses that a particular individual will pay. Nonetheless, actuarial value can provide a useful summary measure of plan value that can help inform consumer choice of health plans." (Consumers Union)

Federal Employees Health Plan Experiences Lack of Competition, Raising Cost Concerns for Exchange Plans
"[This report examines] the availability of plans and enrollment levels in the Federal Employees Health Benefits Program [which resembles the ACA Exchanges, and] found that although plans were widely available, enrollment was concentrated in plans owned by just a few organizations, typically Blue Cross/Blue Shield plans. Enrollment was more concentrated in rural areas, which may reflect historical patterns of enrollment or lack of provider networks. Average biweekly premiums for an individual were lowest ($58.48) in counties where competition was extremely high, rising to $65.13 where competition was extremely low." (Health Affairs)

Former Medicare Chief: Even If Health Law Survives Court Challenge, Congress Could Delay Timetable
"Thomas Scully, who ran Medicare and Medicaid under President George W. Bush (2001–2003), believes that the 2014 implementation of the Affordable Care Act will have to be delayed, even if the Supreme Court upholds it. Next year, Congress will have to negotiate a major deficit reduction deal, and could find savings by postponing the law." [Interview - video and transcript - at link.] (Kaiser Health News)

California Health Insurers Want to Hike Premiums for Small Employers
"Some California health insurers are proposing to raise small-business rates more than 10% next month, drawing scrutiny from state regulators.... In April, insur.ance department officials objected to other small-business rate hikes as high as 21% by Aetna and called them 'excessive.' But Aetna went ahead with the higher charges. [An] Aetna spokeswoman ... said its rates 'are based on actuarially sound data and a reasonable projection of future cost.'" (Los Angeles Times)

Proposed IRS Regs Implement Comparative Effectiveness Research Fees
"The [proposed regulation] includes a special rule for a plan sponsor that maintains multiple self-insured plans with the same plan year under which the plan sponsor is permitted to treat the plans as a single plan and pay a single fee. Thus, a self-funded plan that is paired with a medical expense reimbursement plan (MERP) or health reimbursement arrangement (HRA) may be treated as one self-insured plan subject to a single fee provided that both plans share the same plan year. But if the MERP or HRA is paired or integrated with a fully-insured group health plan, each plan would be subject to a separate CER fee." (Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.)

Design and Implementation Considerations of ACA Risk Mitigation Programs (PDF)
"[T]he analysis focused on loss ratios—medical claims divided by premiums—to assess the adequacy of premium income, both with and without the [ACA] risk mitigation programs.... Risk mitigation programs appear to reduce financial risks to health plans. At the same time, overly restrictive premium rate limitations can lead to high federal risk corridor payments." (Society of Actuaries)

No Change in the 10% Federal Rate Review Threshold
"CCIIO ... noted that medical costs have not risen any faster since the initial 10 percent threshold was implemented, which 'would appear to argue against any increase in the threshold for reviewing rate increases.' ... This spring marked states' first opportunity to submit state-specific threshold proposals for the federal rate review program. Only two states, Alaska and Wisconsin, submitted requests ... CCIIO denied both of the requests on June 1, 2012." (Epstein, Becker & Green, P.C.)

Deloitte Health Care Reform Memo, June 11, 2012
Describes recent developments in various health plan and health insur.ance matters at the federal and state levels. This issue includes a discussion of the 2012 Survey of U.S. Health Consumers, the Health Care Cost Reduction Act of 2012 (repeal of the medical device tax), and Medicare and Medicaid eligibility and funding issues. (Deloitte Center for Health Solutions)

Text of Comments by the Actuarial Value Subgroup of the American Academy of Actuaries on IRS Notice 2012-31, 'Minimum Value of an Employer-Sponsored Health Plan' (PDF)
"[While] the subgroup does not expect non-core benefits to have a large effect on the MV calculations ..., the methods for including non-core benefits in the MV calculation must be considered carefully, otherwise unintended conclusions could result. And importantly, information regarding the degree to which non-core benefits are included in the data underlying the MV calculator needs to be made available to actuaries performing MV calculations... Plans not meeting safe harbor requirements potentially could meet MV requirements through use of the MV calculator or through separate actuarial certification." (American Academy of Actuaries, Actuarial Value Subgroup)

[Opinion]

5 Ways to Solve Health Care
"Even if ObamaCare is fully implemented, as many as 23 mil.lion Americans would still lack health insur.ance by 2020. What then should we do to reform health care? Here are five ideas[.]" (Cato Institute)

[Opinion]

UnitedHealthcare's Spurious Generosity with Extending ACA Benefits
"[UnitedHealthcare] has remained silent on some of the more important requirements not yet in effect that could be overturned by the Supreme Court decision. Insuring preexisting conditions for adults in addition to children, guaranteeing issue of coverage to all individuals regardless of projected costs, and setting premiums based on community rating—driving up premiums for lower-cost, healthier patients—are more significant measures that could impair their competitiveness if they acted unilaterally. We won't see these policy changes unless ACA is upheld and all insurers are required to comply." (Physicians for a National Health Program)

[Opinion]

Emphasis on Individual Mandate Is Misplaced: Other ACA Features Are Far Worse
"The ACA is a classic illustration of placing a persuasive title on a controversial statute to conceal its deep internal weaknesses. There is no way that one can "protect patients" by restricting, either through private employers or public exchanges, the choices they have in the type of plans they can join. It would be impossible for the statute to make health care more affordable when it piles major mandates on private plans, which could make them too costly to operate at all. Measured against these epic concerns, the individual mandate is one of the least offensive provisions contained in the statute." (HealthAffairs Blog)

Benefits in General; Executive Compensation

[Guidance Overview]

Section 409A Basics: When is a Payment Date Close Enough?
"Treasury Regulations contain two special rules that allow some wiggle room (perhaps more than one might think) to an employer in establishing the payment dates or in actually making a payment. These provisions reflect the recognition on the part of the drafters that it may not be possible or practicable to make a payment precisely on the intended date and minor delays in payment will not materially affect the income taxation of the payments." (Verrill Dana LLP)

Section 409A Transitional Relief Deadline Approaching
"The December 31, 2012, deadline is quickly approaching for amending affected deferred compensation arrangements to comply with the Code Section 409A documentation requirements that apply for payments that are contingent on execution (and, where applicable, nonrevocation) of a release of claims. The affected arrangements could potentially include equity, nonqualified retirement, and severance or employment arrangements." (Morgan, Lewis & Bockius LLP)

Two Significant Developments in Limits on Executive Comp
"Last week ... the shareholders of Chesapeake Energy Corporation overwhelmingly rejected the company's shareholder say on pay resolution—by an 80% vote, one of the highest rejection rates to date. Perhaps more significantly, however, the shareholders also voiced their displeasure with compensation (among other) issues by voting against two sitting directors at a level of nearly 75%.... Also last week, the Board of Governors of the Federal Reserve System (the 'Fed'), the Office of the Comptroller of the Currency (OCC), and the [FDIC] jointly issued proposed rules that would require all financial institutions to comply with the complicated and severe bank capital standards known as 'Basel III.'" (Winston & Strawn LLP)

Fox Rothschild 'For Your Benefit' Newsletter - June, 2012
Newsletter on current legal issues impacting employee benefits and executive compensation. This issue includes: COBRA Audits—Another Worry for Employers; What To Do About Those Underfunded Defined Benefit Plans? The Price of Fiduciary Failure—$36.9 Mil.lion; and FSA Cap Update—Limited Relief Announced (Fox Rothschild LLP)

Press Releases



BenefitsLink.com, Inc.
1298 Minnesota Avenue, Suite H
Winter Park, Florida 32789
Phone (407) 644-4146
Fax (407) 644-2151

David Rhett Baker, J.D., Editor and Publisher
Lois Baker, J.D., President
Holly Horton, Business Manager

Copyright © 2012 BenefitsLink.com, Inc. All rights reserved.

All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of that content. You may not alter or remove any trademark, copyright or other notice from copies of the content.

Links to Web sites other than those owned by BenefitsLink.com, Inc. are offered as a service to readers. The editorial staff of BenefitsLink.com, Inc. was not involved in their production and is not responsible for their content.

More useful links: