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August 20, 2012 Get Retirement News  |  Advertise  |  Unsubscribe  |  Past Issues  |  Search

Employee Benefits Jobs

Taft Harley Relationship Manager
for New York Life Retirement Plan Services in MA

Part Time Retirement Planning Consultant
for Diversified in MD

Client Service Specialist
for Charles Schwab in OH

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Webcasts and Conferences

Controlled Groups
in Minnesota on September 18, 2012 presented by ASPPA ABC Greater Twin Cities

Seven Steps for Creating and Maintaining an Effective Corporate Wellness Program
Nationwide on September 13, 2012 presented by Thompson Publishing Group

Mastering Health Reform’s Taxation and Reporting Issues for Employers: A Two-Part Webinar Series
Nationwide on September 20, 2012 presented by Thompson Publishing Group

Consumer-Directed Health Care: A Strategy for Making Plans More Cost-effective
Nationwide on August 22, 2012 presented by Thompson Publishing Group

Taxation Under Health Reform: What Employers Need to Know
Nationwide on September 20, 2012 presented by Thompson Publishing Group

Tackling the Top Reporting Concerns Under Health Reform: A Guide for Employers
Nationwide on September 27, 2012 presented by Thompson Publishing Group

"Cross-Tested/Safe Harbor 401(k) Plan Design and Troubleshooting" Workshop - Boston
in Massachusetts on September 20, 2012 presented by SunGard Relius

"Cross-Tested/Safe Harbor 401(k) Plan Design and Troubleshooting" Workshop - Minneapolis
in Minnesota on September 20, 2012 presented by SunGard Relius

"Cross-Tested/Safe Harbor 401(k) Plan Design and Troubleshooting" Workshop - Kansas City
in Missouri on September 21, 2012 presented by SunGard Relius

"Cross-Tested/Safe Harbor 401(k) Plan Design and Troubleshooting" Workshop - Pittsburgh
in Pennsylvania on September 21, 2012 presented by SunGard Relius


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[Official Guidance]

Text of Technical Guidance: Content of Notices of Adverse Benefit Determinations for Beneficiaries in Non-Federal Governmental Health Plans (PDF)
"Section 2719 of the Public Health Service Act ... requires that non-grandfathered group health plans and health insur.ance issuers offering non-grandfathered group or individual health insur.ance coverage have an effective internal claims and appeals process.... This document sets forth an enforcement safe harbor with respect to the content of the adverse benefit determinations and final internal adverse benefit determinations issued to participants and beneficiaries in group health plans that are non-federal governmental plans (and health insur.ance coverage offered in connection with such plans).... HHS will not enforce the requirement that non-federal governmental plans provide notice of the ERISA private right of action. Similarly, HHS will not enforce the requirement that non-federal governmental plans provide contact information for the EBSA or a State Department of Insur.ance. This safe harbor is applicable as long as [certain notices are provided by the plan]." (Center for Consumer Information & Insur.ance Oversight)


Executive Forum on Creating A Culture of Health - October 8-9, Chicago   [Advert.]

Sponsored by World Congress

Shifting organizational norms and behaviors to embody a true Culture of Health results in an exponential rise in employee health, engagement and performance. Gain perspectives to restructure resources and chart next steps in transforming your workforce.


Court Rules in Favor of Orange County, California: Retiree Medical Benefits Can Be Modified
"[C]ounty officials ... had estimated savings of $1 bil.lion from a 2006 deal negotiated with the Orange County Employees Association that capped retiree medical benefits. Following that deal, the Retired Employees Association of Orange County (REAOC) sued the county, and the issue of whether retiree medical coverage was akin to a pension promise had been tied up in the courts ever since. On Thursday, federal Judge Andrew Guilford helped the county budget avoid that torpedo, deciding that retiree medical benefits could be capped and that the county was no longer required to subsidize retiree medical benefit rates by pooling them with active employees." (Voice of Orange County)

Businesses Experiment with Wellness Programs to Cut Costs, Increase Productivity
"As employers look to trim health care costs and increase the productivity of their workforces, an increasing number of them are experimenting with wellness programs that reward workers for healthy lifestyle choices or penalize unhealthy ones. A [recent] survey ... found that 61 percent of firms said they found such initiatives to be among the three most effective tactics for keeping a lid on health care costs. And among firms that offered financial rewards for healthy behavior, the median compensation amount will rise to $450 in 2013, up from $300 in 2012." (The Washington Post; free registration required)

HHS Releases Final Approval Process Blueprint for Exchanges in States
"Although most states have received some form of Exchange establishment grants, only a small number have filed declaration letters, to date.... But the impending November deadline for submitting declaration letters and the January 1, 2013 deadline for receiving approval from HHS make it likely that a federally facilitated Exchange will operate in many states for 2014. Employers and advisors will watch with great interest as the Exchanges get underway -- small employers may choose to participate in SHOPs, and larger employers will need to consider implications of the employer shared responsibility (play or pay penalty)." (Thomson Reuters / EBIA)

Waiting for HHS's EHB Rule Is Like Being Engaged to Be Engaged
"As states and plan sponsors await further guidance from HHS in the form of a proposed or interim final rule on essential health benefits (EHB) for individual and small-group plans sold in health insur.ance exchanges, one major question mark that remains is prescription drug coverage. All that plans have at this point is a bulletin from Dec. 2011 indicating HHS's intent to propose four benchmark plans and a one-drug per-class minimum for formulary coverage (which may not even be HHS's intent at this point, insiders say). And what comes next, which could be any day now, won't even be a final rule." (AISHealth.com)


The Rising Cost of Commuting: Developing a Transportation Benefits Plan   [Advert.]

Sponsored by Lorman and BenefitsLink.com

Learn how to help your employees pay for their rising commuting expenses, with tax-free dollars. Join us to discuss solutions to the rising costs of commuting. Discounted pricing for BenefitsLink readers.


Not All Rosy in Britain's Health Care System
"The studies compared the healthcare systems of 14 advanced countries, and on the 20 measures of comparison, Britain's centralized National Health Service performed well in 13, indifferently in two and badly in five.... This hardly seems like a cause for national rejoicing, yet according to the report, the British were the most satisfied with their healthcare of all the populations surveyed.... So, how is it that the population most confident that it will receive treatment of the highest possible standard, featuring the latest medical advances, actually has the worst survival rates in precisely those diseases that require the most up-to-date treatments? One explanation is ignorance." (Los Angeles Times)

Reissued HHS Bulletin Clarifies Eligibility for Contraceptives Coverage Safe Harbor
"The reissued bulletin provides additional background regarding one of the four requirements for the safe harbor. Under this requirement, as restated in the August 2012 bulletin, from any point on or after February 10, 2012, an organization's group health plan must consistently not have provided all (or the same subset of) the contraceptive coverage otherwise required, because of the organization's religious beliefs. The August 2012 bulletin provides an exception from this requirement under which a group health plan will not be considered to have provided all or the same subset of contraceptive coverage otherwise required if: (1) It took some action to try to exclude or limit the contraceptive coverage [and] (2) That action was unsuccessful as of February 10, 2012." (Practical Law Company)

According to GAO, Estimates on Post-ACA Decline in Employer-Provided Coverage Vary
"The GAO found that the microsimulation model studies generally predicted little change in prevalence of employer-sponsored coverage in the near term.... Among the 19 employer surveys examined, 16 reported estimates of employers dropping coverage for all employee types. Among these 16, 11 indicated that 10 percent or fewer employers were likely to drop coverage in the near term, but estimates ranged from 2 to 20 percent." (Wolters Kluwer Law & Business)

Contraceptive Mandate Enforcement Stay Revised
"Compliance with the contraceptive coverage mandate under health reform is stayed until Aug. 1, 2013 for employers that fit into a slightly expanded enforcement safe harbor ... [E]nforcement stays go to non-exempted, non-grandfathered organizations that: (1) Operate and are organized as a non-profit entity. (2) Historically don't provide contraceptive coverage, because of religious beliefs. (3) Communicate to participants that the contraceptive coverage will not be provided in the plan year starting on or after Aug. 1, 2012. (4) Certify that they meet the above criteria." (Thompson SmartHR Manager)

Health Plan Decisions Needed on Grandfathered Status for 2013
"As the 2013 annual enrollment period approaches for many calendar-year group health plans, sponsors of 'grandfathered' health plans—those that were already in existence when the Affordable Care Act ... was enacted in March 2010 and that have not undergone significant changes since then—will once again have to assess whether the plan can and/or should try to retain such status for 2013." (Spencer Fane)

Will You Benefit from a Medical Loss Rebate?
"[R]eceipt of the rebate is a positive event, yet with it comes fiduciary responsibilities for employers sponsoring health plans and tax considerations for individual recipients. Sponsors of health insur.ance plans are now faced with decisions regarding: implications of the rebate constituting a plan asset when otherwise there is no trust, properly using and allocating the rebate, and properly responding to inquiries from plan participants regarding the individual tax implications of the rebate." (EisnerAmper LLP)

Choice of Law In ERISA Disputes—How State Law May Affect Outcomes On Judicial Review
"This unpublished Fifth Circuit opinion addresses several sets of opposing principles in choice of law as applied in the ERISA context.... Though the outcome in this case was for the plan, the choice of law framework provides an opportunity to evaluate some important fundamental issues that precede a substantive ruling on the merits. In many cases, once the issue reaches the merits a plan administrator's discretionary authority and the presumptions that attach to its findings will be determinative. Thus, the preliminary question of applicable law may be very important where state law differs." [Jimenez v. Sun Life Assur. Co., 2012 U.S. App. LEXIS 17108 (5th Cir. La. Aug. 15, 2012)] (Health Plan Law blog by Attorney Roy F. Harmon III)

Long-Term Care Insur.ance Research Brief
"This Research Brief describes the long-term care insur.ance industry; in particular, it covers who buys the product, how much it costs, what the market looks like, and foreign experience." (Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services)

[Opinion]

Comments to IRS on Possible Modification of Use-It-or-Lose-It Rule for Health FSAs (PDF)
"The National Business Group on Health ... strongly support[s] elimination of the use-or-lose rule or, in the alternative, allowing additional flexibility with respect to operation of the rule for health FSAs ... The current use-or-lose rule limits employees' ability to make full use of their health FSAs by setting an arbitrary time limit on employees' use of health FSA funds. The use-or-lose rule also creates an incentive for employees to 'spend down' their health FSA balances at the end of the plan year (or grace period, if applicable), which runs counter to the goal of controlling and planning health care expenses." (National Business Group on Health)

[Opinion]

A Health Mandate Business Might Like
"A recent study found that an astonishing 86 percent of all full-time employees in the U.S.—that's six of every seven workers—are now either overweight or have a chronic (but usually preventable) health condition that significantly raises their health costs. And as the health of employees keep declining, their employer-paid premiums keep rising—113 percent since just 2001.... The simple truth is that the only way to get health costs under control is for employers to stop handing out unlimited health benefits with no strings attached." (Politico)

[Opinion]

Comments on Potential Modification of 'Use-It-or-Lose-It' Rule (PDF)
"[The Council believes] the current rule discourages Health FSA participation and, for those that do participate, it incents inefficient health care purchasing decisions.... Many employees do not participate in Health FSAs given the possibility of forfeiting unused funds, while some employees that do participate in Health FSAs may find themselves having to make unnecessary health-related purchases (e.g., extra eyeglasses) at the end of the year (or grace period, if applicable) in order to avoid forfeiture of such amounts." (American Benefits Council)

Benefits in General; Executive Compensation

Year-End Amendment Deadline Under Code Section 409A
"[Any] deferred compensation arrangement under which payments subject to Section 409A are contingent on the execution of a release of claims must be amended by December 31, 2012, to comply with the requirements of Section 409A (by adopting one of ... two alternative provisions ...). Of course, only arrangements that are subject to Section 409A (and for which no exemption applies) are affected by these requirements. There is thus no need to modify arrangements for the payment of amounts that are exempt from Section 409A under either the 'short-term deferral' rule ... or the 'severance pay. exception[.]" (Spencer Fane)

The Importance of State Anti-Discrimination Laws on Employer Accommodation and the Movement of Their Employees Onto Social Security Disability Insur.ance
"The rate of application for Social Security Disability Insur.ance (SSDI) benefits, as well as the number of beneficiaries has been increasing for the past several decades, threatening the solvency of the SSDI program.... Using the Health and Retirement Study data linked to Social Security administrative records and a state fixed effects model, [this study finds] that the provision of workplace accommodation reduces the probability of application for SSDI following disability onset. We estimate that receipt of an accommodation reduces a worker's probability of applying for SSDI by 30 percent over five years and 21 percent over 10 years." (University of Michigan Retirement Research Center)

Murder Victim's Mother May Rely on Post-Amara Equitable Remedies
"Here we have the latest episode in the sprawling saga of equitable remedies under ERISA. The question, as always, is whether a participant is entitled to something for which the plan document does not expressly provide. This time, the answer appears to be 'yes.' ... [In a recent case, McCravy v. Metropolitan Life Insur.ance Company, the] Fourth Circuit reversed its earlier decision (on surcharge and all of Ms. McCravy's other equitable theories) and remanded the entire case to the trial court.... [T]he trial-court judge has already made clear how he would decide these issues absent the restrictions on equitable remedies that applied before Amara." (Spencer Fane)



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