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July 23, 2012 Get Retirement News  |  Advertise  |  Unsubscribe  |  Past Issues  |  Search

Employee Benefits Jobs

Supervisor Participant Services
for Ascensus in PA

Plan Accounting Manager
for Pension Corporation of America in OH

Conversion Payroll Specialist
for Charles Schwab & Co., Inc. in OH

Director of Sales Support and Implementation
for July Business Services in TX

Plan Services Coordinator
for MidAmerica Administrative & Retirement Solutions, Inc. in FL

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Webcasts and Conferences

Fiduciary Responsibility: What You Need to Know
Nationwide on November 15, 2012 presented by TRI-AD

What Every Woman Should Know About Retirement Savings and How to Make It Last Forum
in Illinois on July 28, 2012 presented by U.S. Department of Labor, Employee Benefits Security Administration (EBSA)

Smoking Discrimination in the Workplace: On and Off the Clock
Nationwide on August 15, 2012 presented by Lorman Education Services

The Rising Cost of Commuting: Developing a Transportation Benefits Plan
Nationwide on August 23, 2012 presented by Lorman Education Services


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[Opinion]

OCR Releases HIPAA Audit Protocol
"The protocol covers 165 areas of performance evaluation, including 88 related to the Privacy Rule and Breach Notification Rule and 77 related to the Security Rule. With respect to the Privacy Rule, the audit protocol addresses the following specific areas: Notice of privacy practices Rights to request privacy protection; Access of individuals to protected health information; Administrative requirements Uses and disclosures of protected health information; Amendment of protected health information; and Accounting of disclosures. The protocol also shows that the OCR audits are focused on technical safeguards under the Security Rule, such as the use of encryption technology, and requirements related to the Breach Notification Rule, including risk assessment processes and the content and timeliness of notifications." (Morgan, Lewis & Bockius LLP)


Understanding the Impact of Health Care Reform on Employers   [Advert.]

Sponsored by Lorman and BenefitsLink.com

This seminar will give you the information you need to move forward in addressing the issues, and insight into upcoming changes. Learn about the latest developments including what is currently being enforced. Discounted pricing for BenefitsLink readers.


The Latest Health Care-Related Legislation - July 23, 2012
Descriptive list of the latest health care-related legislation introduced in the U.S. House and Senate, including links to text of proposed bills. (AHIP Coverage)

Meet a New Breed of Medical Professional: The Health Coach
"Health coaches are a new kind of health professional, and it's their job to help people make those easy-to-say, hard-to-do behavioral changes that promote good health—getting enough exercise, eating a balanced diet, managing stress.... Health coaches are still rare in the medical profession. But they are becoming more popular as chronic and often preventable diseases like Type 2 diabetes consume more and more health care dollars." (Kaiser Health News)

Effect of the Supreme Court Ruling on Stop-Loss Insur.ance (PDF)
"Large employers with single-parent captives that insure stop-loss with attachment points over $100,000 are not likely to be affected by PPACA unless the employer decides to discontinue offering medical benefits to their employees and let them fend for themselves on the state exchanges.... The real issue with stop-loss is with smaller employers that have or are considering captive arrangements to create a stop-loss pool.... A catalyst for these employers to seek such arrangements is the effect that PPACA might have on the risk profile of the small group and the insured larger group marketplace." (Milliman and captive.com)

Insurers Say New Insur.ance Coverage Summaries Could Drive Up Costs
"Health insur.ance trade group America's Health Insur.ance Plans estimates the initial cost at $188 mil.lion and annual cost at $194 mil.lion—roughly more than $1 per year for each of the 180 mil.lion enrollees. The estimates were considerably higher than the government's, which put the 2012 cost at $73 mil.lion and the 2013 cost at $58 mil.lion." (American Medical Association)

Health Plans Helping to Reduce Preventable Hospital Readmissions
"There is an increasing amount of evidence showing that the programs and services health plans have implemented are helping to reduce preventable hospital readmissions for patients compared to FFS Medicare. Reducing preventable hospital readmissions will improve the quality of care for patients and help control the soaring cost of medical care." (AHIP Coverage)

Coalition of Six Health Care Organizations Offers Guidance for a Reasonably Designed, Employer-Sponsored Wellness Program Using Outcomes-Based Incentives (PDF)
"[The organizations'] primary goal in providing this guidance is to help employers to implement programs that engage their workforce, improve employee health, and potentially reduce health care and other related costs over time while also protecting employees from discrimination and unaffordable coverage. [These organizations] believe that the fundamental goal of any wellness program should be to provide opportunities for individuals to improve their health and wellness. A wellness program should not be used in a way that threatens an employee's ability to maintain health insur.ance because any resulting decrease in access to care would be in direct conflict with the primary objective of improving employee health." (American Cancer Society, American Heart Association, American Diabetes Association, and Three Other Health Care Organizations)

OPM Identifies Medically Underserved Areas for 2013
"[The Federal Employees Health Benefits (FEHB) law] mandates special consideration for enrollees of certain FEHB plans who receive covered health services in States with critical shortages of primary care physicians.... [F]or calendar year 2013, the following 14 states are considered as Medically Underserved Areas under the FEHB Program: Alabama, Arizona, Idaho, Illinois, Louisiana, Mississippi, Missouri, Montana, New Mexico, North Dakota, Oklahoma, South Carolina, South Dakota, and Wyoming. Alaska and Kentucky were designated as a Medically Underserved Area in 2012, but will not be so designated for 2013. South Carolina is being added as a Medically Underserved Area for the 2013 calendar year." (U.S. Office of Personnel Management)

[Opinion]

The Logical Argument for Why Employers Will Drop Coverage
"Analysts at the health care consulting firm Truven Health Analytics recently released a 'study' that some observers are suggesting could undermine the case that employers will drop health insur.ance coverage thanks to Obamacare... There's only one problem with this analysis, and it's a huge one: At no point does it consider the thousands of dollars of federal insur.ance subsidies that most workers will be eligible to receive if their firms drop coverage—yet up to 63 percent of non-elderly Americans will be eligible for taxpayer-funded insur.ance under Obamacare." (U.S. Senator Jim DeMint (R-SC))

[Opinion]

How to Cure U.S. Health Care
"Can Americans get the same—or better—health outcomes for less money? They almost certainly can, but it is not clear that they will. European nations limit the growth of health-care spending through technocratic controls. Usually, a central government agency makes decisions about treatments and drugs that fall within a universal mandate governing coverage. The United States, with no true central system in the offing, can't do the same." (Sacramento Bee)

[Opinion]

A Formula for Cutting Health Costs
"At a recent conference for health leaders from the United States and abroad at the native-owned Southcentral Foundation in Anchorage, the Alaskans described techniques that could be adopted by almost any health care organization willing to transform its culture. Such a transformation would require upfront financing for training, data processing and the like, but the investment should rapidly pay off in reduced costs." (The New York Times; free registration required)

[Opinion]

Health Savings Accounts Continue to Grow
"[I]n the real world Health Savings Accounts continue to grow as the future of health care financing.... Yet, in spite of all this, HSAs may be on the ropes in Washington.... [One author] talks about his own experience with an HSA, and how it prompted him to ask questions about the cost of the services he was getting. No one seemed to know and said they had never been asked before—'That, in a nutshell, is what is wrong with our health insur.ance and health care systems: Consumers are completely divorced from costs. Massive inflation has been the result.'" (John Goodman's Health Policy Blog)

[Opinion]

Essential Health Benefit Definition Built On Expensive Mandated Benefit Plan Likely To Be Expensive For Employers, States & Individuals
"The current approach of the HHS to determining the services and benefits for non-grandfathered individual and small group market insured plans and covered state and federal benefit programs will be skewed toward the benefit rich plan design of federal and state employee health plans and benefit mandate-laden small group insur.ance plans even though the majority of employer sponsored health plans are self-insured plans that contain more limited benefit packages." (Solutions Law Press)

Benefits in General; Executive Compensation

[Guidance Overview]

New Developments on Equity Incentive Plans in China
"Circular 7 does not substantially change the operating procedures stipulated in Circular 78. However, the expansion of application coverage and the provisions on the subsequent reporting requirements reflect the Chinese authorities' intention to strengthen foreign exchange control of the participation in equity incentive schemes of overseas listed companies by domestic individuals. Overseas listed companies offered or planning to offer equity in China should review their public filing schedules to make sure they are in compliance with Circular 7." (Nixon Peabody LLP)

Executives Who Left Company Were Entitled to Payment Under Equity Comp Plan After Wrong Person Decided Claims
"The plans gave an Executive Compensation Committee (ECC) authority to interpret and administer the plans. Two former executives terminated employment when company assets were sold and they declined to accept continued employment at transfer locations. The company's Senior Vice President of Administrative Services, Authorized Representative and Fiduciary to the Benefit Plan Committee, who was not a member of the ECC, determined that the former executives did not terminate employment due to retirement or involuntarily without cause. The Court of Appeals found that the Senior Vice Presidents' decision was not entitled to any deference because the plans gave discretionary authority only to the ECC and the ECC did not decide the claims nor delegate authority to the Senior Vice President." (Haynes and Boone, LLP)

Board of Newly Combined Actors' Unions Pushes to Merge Health and Pension Plans
"Actors have complained in recent years about having their benefits splintered between the two unions, making it harder for them to qualify for health insur.ance. The issue helped fuel support for merging [the Screen Actors Guild and the American Federation of Television and Radio Artists]. However, combining the separate plans is a complex process and must ultimately be approved by trustees of each plan, which is administered by representatives from the unions and from the major Hollywood studios." (Los Angeles Times)

Duped Plaintiff Gets Full Insur.ance Policy's Death Benefit: Fourth Circuit Recognizes Equitable Estoppel and Surcharge as 'Make Whole' Relief Under ERISA
"[T]the Court of Appeals for the Fourth Circuit in McCravy v. Metropolitan Life Insur.ance Company relied on the U.S. Supreme Court's majority opinion in CIGNA Corp v. Amara to expand the relief available under ERISA section 502(a)(3) to include the remedies of surcharge and estoppel. Specifically, the court held on rehearing that, if applicable, these remedies would allow a putative beneficiary of a life insur.ance policy to recover the full amount of the policy proceeds, rather than only a premium refund, where the plan administrator led her to believe inaccurately that she had coverage. In so holding, the Fourth Circuit reversed its own earlier decision in the case, and cast doubt on the continued viability of other decisions both within and outside of the Fourth Circuit, which had construed section 502(a)(3) narrowly to bar "make whole" relief." (Littler Mendelson LLC)

Government Extends Some Benefits to Federal Employees' Same-S.ex Partners
"Same-s.ex domestic partners of feds now are automatically considered an 'insurable interest' for survivor annuities. Federal employees in good health can opt to provide an insurable interest annuity, which is different from a spousal survivor annuity, to certain family members.... Other changes include ... extending to same-s.ex couples child care subsidies available to low-income civil servants. A proposed rule ... would allow the children of a federal employee and same-s.ex partner to receive health benefits under the Federal Employees Health Benefits Program, including dental and vision insur.ance. Same-s.ex partners are not eligible for health care benefits under FEHBP or spousal survivor retirement benefits." (Government Executive)

[Opinion]

It's Time to Keep Public Employee Benefits in Check in Baltimore
"In Baltimore County, the cost of health care alone has escalated to the point where it is rapidly approaching an unsustainable threshold. Consider that for a county employee who selects family coverage, Baltimore County contributes between $15,950 and $20,554 annually, depending upon the selected plan. Baltimore County not only covers the health care of its current employees, but retirees as well. The cost of health care benefits alone for general government, library, community college and school system employees is more than $280 mil.lion a year, roughly 10 percent of the county's total budget. By comparison, the county spends an equivalent amount to fund its entire police and fire operations. Such an expenditure for health care is simply not sustainable." (Baltimore Sun)

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