Defined Contribution Consultant/Analyst
for AON Hewitt in NJ

Pension Analyst
for Third Party Administrator in MI

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"ERISA Workshop 2012" - Dallas
in Texas on October 24, 2012 presented by SunGard Relius

"ERISA Workshop 2012" - Houston
in Texas on October 25, 2012 presented by SunGard Relius

"ERISA Workshop 2012" - Nashville
in Tennessee on October 25, 2012 presented by SunGard Relius

"ERISA Workshop 2012" - New Orleans
in Louisiana on October 26, 2012 presented by SunGard Relius

 

[Guidance Overview]

90-Day ACA Waiting Period Rule Guidance Affects Multiemployer Plans
"Multiemployer plans use many different rules to determine eligibility for [health] coverage. It appears that quarterly, semi-annual, and rolling eligibility periods may be permissible. However, it is possible that an annual eligibility period may not be consistent with the rule if the lag period before coverage starts is longer than one month." (The Segal Group, Inc.)

[Advert.]

Summaries of Benefits and Coverage Now Available!

Wolters Kluwer Law & Business – ftwilliam.com now offers the newly required Summaries of Benefits and Coverage (SBC). Contact us for a demo and if you have more than just a few plans, ask us about our batch printing option.

The 'HIPAA Police' Are Here
"After several years during which the Department of Health and Human Services ... operated essentially in 'complaint-driven' mode with respect to enforcement of the HIPAA Privacy and Security Rules, recent activity suggests a trend toward stricter HIPAA enforcement.... The recent increase in enforcement efforts may be partially attributable to the fact that the available civil penalties increased dramatically as a result of the [HITECH] Act ... These steep penalties and settlements should serve as a reminder of how important it is to comply with the HIPAA Privacy and Security Rules." (Spencer Fane)

The High Cost of Out-of-Pocket Expenses at the End of Life
"On average, people with Medicare coverage paid $38,688 for medical care in the last five years of life. There was enormous variation, with 25 percent of participants spending an average $101,791 out-of-pocket for medical services and 25 percent spending an average $5,163 during this period. One-quarter of older adults incurred out-of-pocket medical expenses that exceeded the total value of their assets during this five-year period.... What’s behind these costs? Although it is a fairly comprehensive program, Medicare doesn’t cover everything. Besides long-term care, traditional Medicare also does not pay for companions or homemakers who help older people get dressed, eat, bathe and cook; dental services; hearing aids and eyeglasses." (The New York Times)

Military Leave Treated Differently for Purposes of COBRA and USERRA
"Both COBRA and USERRA provide that employees on active duty must be allowed to continue their health plan coverage for a period of time (generally 18 months for COBRA and 24 months for USERRA). In addition, USERRA requires employers to reinstate health coverage that terminates during military service upon the employee's return.... While employees on active duty are treated for USERRA purposes as if they are on furlough or leave, the same employees may be treated as terminated for COBRA purposes." [Dorris v. TXD Services, LP, 2012 WL 3149106 (E.D. Ark. 2012)] (Thomson Reuters / EBIA)

Individual Mandate Could Lead to Penalty on 6 Million Americans, Says CBO
"On the one hand, the CBO reports that the penalty is likely to hit almost six (5.9) million legal American residents. On the other hand, the tax won't rise to that level until 2016, and it is now expected to bring in almost seven (6.9) billion dollars in revenue for that year, three billion more than originally anticipated." (Wolters Kluwer Law & Business)

Uninsured Rate Fell or Held Steady in Almost Every State Last Year
"[A] substantial number of states made progress in reducing the number of people without health insurance coverage. In 18 states, the number of residents without health insurance coverage fell. As noted, the percentage of the population without health insurance coverage fell in 20 states. In 34 states, the percentage of 18- to 24-year-olds with private coverage increased; the number of residents in this age group with private coverage increased in 35 states." (Center on Budget and Policy Priorities)

What Do Polls Really Tell U.S. About the Public's View of the Affordable Care Act?
"[P]ublic disapproval of the ACA outweighs approval by a gap averaging around 5 to 10 points. But very few polls ask why people disapprove. The answers to that question change the picture dramatically." (HealthAffairs Blog)

Employee Microsegmentation: Driving Behavior Change to Control Health Costs
"[D]espite making significant investments in employee wellness, too few employers are seeing their workers move toward healthier lifestyles. To foster the kind of behavior change that can affect health, employers need to see the world through employees' eyes and use approaches that are more relevant to who workers are as people." (Towers Watson)

[Opinion]

The Sensible Solution for Pre-Existing Condition Exclusions
"The one problem remaining is in the individual market—which represents less than 10 percent of the total private insurance market—is that the same rules that protect consumers from unreasonable pre-existing condition exclusions in the group market do not currently apply to the individual market. An individual can keep continuous insurance coverage in the individual market for years and still face unjust exclusions when switching plans." (The Heritage Foundation)

Who Has Benefits in Private Industry in 2012? (PDF)
"Health, retirement, and paid leave benefits made up more than three-fifths of private industry employer-provided benefit costs in June 2012.... For example, paid holidays are offered to 77 percent of private industry workers overall and about 90 percent of full-time and high-wage workers. Medical care and retirement benefit availability show similar patterns." (Securities and Exchange Commission, via The SPARK Institute)

Employee Satisfaction Linked to Benefits Choices
"[W]hile fewer than half of employees are very satisfied with their company's employee benefits package, more than 70% who are confident in their benefits selections are very satisfied. Fewer than 4 in 10 employers (37%) say their benefits communications are effective in helping employees make the right choices about benefits." (Treasury & Risk)

Public Sector Plan Fiduciary Risk-Management Strategies (PDF)
"[T]he 2008 stock market decline and its direct and indirect consequences for public sector benefit plans may have fundamentally and permanently changed the way those plans are viewed, structured and managed.... [E]very action of plan sponsors, trustees and staff of public sector retirement and health plans is under the public's microscope." (The Segal Group, Inc.)

Setting CEO Compensation (PDF)
"Committees must evaluate several factors when making decisions on CEO compensation.... (1) Company Performance ... (2) Individual Performance ... (3) Alignment with Pay Decisions for Other Executives ... (4) Market Data and Expected Trends ... (5) External Messaging ... [and] (6) Internal Messaging." (Meridian Compensation Partners, LLC)

Inconsistent UK Government Policy on Executive Pay Giving Private Companies a Competitive Edge
"The [UK] government's focus on using shareholders to oversee executive pay is compromised by failure to apply the changes to all types of organisations ... Partnerships, private companies, the UK divisions of multinationals, private equity and hedge fund firms and all represent a larger proportion of the senior executive labour market but it isn't clear that the government's standards will apply to them. It's entirely likely that, if not, some executives will opt out of the scrutiny that comes from working in a listed company. The extent to which this fractures the market, we will have to wait and see." (Mercer)