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BenefitsLink Health & Welfare Plans Newsletter
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Supreme Court's Decision on Health Care Law Unlikely to Be the Last Word
"The problems of high medical costs, widespread waste, and tens of millions of people without insur.ance will require Congress and the president to keep looking for answers, whether or not the Affordable Care Act passes the test of constitutionality. With a decision by the court expected this month, here is a look at potential outcomes[.]"
(The Washington Post; free registration required)
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Do Plan Changes Confuse Your Employees? [Advert.]

No matter how savvy your employees, today’s benefits world can confuse the most sophisticated consumer. That’s why more organizations use BeneCom for benefits communication. We know what employees need to make their benefits work for them - and you.
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SPD Disclosures Provided Adequate Notice of Coverage Required by Women's Health and Cancer Rights Act
"Under WHCRA, group health plans and health insurers must provide a notice, at the time of enrollment and annually, of the availability of required medical and surgical benefits with respect to a mastectomy. Although the enrollment notice must include, among other things, a description of treatments and any deductibles or co-insur.ance limitations, the annual notice requirement may be satisfied by providing a shorter notice that informs participants of the availability of benefits for the treatment of mastectomy-related services and explains how to obtain more information. The annual notice may, as this case illustrates, be furnished by itself or provided in an SPD (if the plan distributes SPDs annually)."
(Thomson Reuters/EBIA)
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'Keep the ACA,' Say Half of Small Businesses
"[O]nly one-third of small business owners would like to see [the Supreme Court] overturn [the ACA]. On the other hand, half would like to see it upheld with, at most, only minor changes. This support grows after learning more details about its key provisions."
(Physicians for a National Health Program)
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Churning Under the ACA, and State Policy Options for Mitigation
"[Churning,] the involuntary movement of consumers from one health plan or system of coverage to another ... makes programs more complicated and costly to administer and interrupts continuity of coverage and care.... This paper ... takes into account affordable offers of employer-sponsored insur.ance (ESI), which disqualify consumers from all insur.ance affordability programs except Medicaid and the Children's Health Insur.ance Program (CHIP)."
(Robert Wood Johnson Foundation)
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Definition and Implementation of 'Essential Health Benefits' and 'Actuarial Value' Critical in Meeting ACA's Goals
"[I]nsurance reforms, guided by requirements for minimum or 'essential health benefits,' insur.ance plan actuarial value and other tools provided by the ACA, are and will remain a work in progress. This analysis suggests the way these tools—working together and reevaluated over time—can most effectively ensure that ACA implementation progresses toward the goals of adequate and affordable insur.ance protection, especially for the highest-need, highest cost patients."
(Urban Institute)
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Washington State's Experience Might Show What Happens If Insur.ance Mandate is Overturned
"In 1993, Washington state passed a law guaranteeing all residents access to private health-care insur.ance, regardless of their health, and requiring them to purchase coverage. The state legislature, however, repealed that last provision two years later. With the guaran.teed-access provisions still standing, the state saw premiums rise and enrollment drop, as residents purchased coverage only when they needed it. Health insurers fled the state and, by 1999, it was impossible to buy an individual plan in Washington—no company was selling. Washington is among a handful of states that have pursued universal access to health insur.ance. The challenges they have faced could give some clues about the federal overhaul's fate should the individual mandate get struck down."
(OregonLive.com)
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The Future of the Affordable Care Act
"By the end of this month, the United States Supreme Court is expected to render its decision regarding the constitutionality of President Obama's health care reform law.... While the outcome of the decision is unknown, five scenarios are likely, ranging from upholding the entire law to declaring the entire law unconstitutional. [This Report reviews] these possible outcomes and their likely impact on stakeholders and Congress."
(SNR Denton)
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State by State Enrollment in the Pre-Existing Condition Insur.ance Plan, as of April 30, 2012
"[This] temporary program ... designed as a bridge for people with pre-existing conditions who cannot obtain health insur.ance coverage in today's private insur.ance market.... The PCIP program is administered by either the state or the federal government: 23 states and the District of Columbia elected to have their PCIP program administered by the federal government while 27 states have chosen to run their own programs.... The chart below details the date when each state began providing benefits to people accepted into the program and the number of people enrolled in the program by each state as April 30, 2012."
(Healthcare.gov)
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[Opinion]
The Irrelevance of the Supreme Court Decision on Obamacare
"Even though this is the month that the Supreme Court is supposed to rule on the constitutionality of Obamacare, it is striking this fact rarely that ever comes up in discussions with healthcare providers.... The array of disruptive innovation activity is breathtaking. Much of this is taking place in what [the author calls] the DIY Health Reform at the behest of commercial plans and employers.... For example, more than 80% of the newly formed [Accountable Care Organizations] are driven solely by private sector efforts."
(The Health Care Blog)
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[Opinion]
Five Devastating Effects Obamacare Will Have on Young Adults
"Here's a list of five ways young adults will be hurt by the law: Premium increases ... Loss of coverage ... Government takeover of student loans ... Less money for education ... Crushing fiscal burden."
(The Heritage Foundation)
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Benefits in General; Executive Compensation
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Say-on-Pay Tempers Shareholder Proposals for Second Year
"Although the number of shareholder resolutions filed so far in 2012 is up slightly from 2011 ... the say-on-pay vote continues to be the preferred mechanism for sending shareholder messages to companies.... [A]s of May 21 of this year, 160 Fortune 200 companies had held their annual meetings, and the number of shareholder proposals received per company increased from 1.4 in all of 2011 to 1.5 so far in 2012."
(HR Policy Association)
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Employers Often Can Designate FMLA Leave in Longer Increments Than the Actual Leave Taken
"We have a policy that requires employees to use paid leave at the same time as FMLA leave. However, paid leave can be taken only in one-half day or full day increments. If an employee needs two hours of FMLA leave (e.g., to receive medical treatment), can an employer require that the employee use paid leave and FMLA leave in increments provided for under the employer's policy? In other words, can the employer require the employee to use one-half day of paid leave and one-half day of FMLA leave?"
(FMLA Insights)
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Philadelphia Paid Sick Leave Law Takes Effect July 1
[F]ull-time workers at employers with 11 or more employees will accrue 56 hours of paid sick time each calendar year, while employees of a smaller business will accrue 32 hours of paid sick time. Employers, of course, may select a higher limit. The law mandates that employees accrue a minimum of one hour of paid sick leave for every 40 hours worked in Philadelphia."
(Ballard Spahr)
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Two Approaches to Internal Markets
This excerpt from the July-August 2012 Employee Ownership Report, available for the next two months (and then replaced by a new article), discusses alternative approaches to providing an internal market allowing employees to buy and sell shares to each other.
(National Center for Employee Ownership)
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Employee Ownership Update for June 15, 2012
NCEO Executive Director Loren Rodgers discusses the 2012 Employee Ownership 100, a decision requiring a net loss in a stock drop lawsuit, Apple CEO Tim Cook's decision to give up his restricted stock dividends and have them paid on employee-held stock, a lost employee stake at Ireland's Eircom, a new director at the CEPI, and a half-price offer on the NCEO's Know Your ESOP Quiz.
(National Center for Employee Ownership)
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Press Releases
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