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October 4, 2012 Get Retirement News  |  Advertise  |  Unsubscribe  |  Past Issues  |  Search

Employee Benefits Jobs

Installation Coordinator
for Ascensus in PA

Director, Employee Benefit Services
for e3 Financial in CA

Attorney
for Hill Ward Henderson in FL

Compliance Testing and Form 5500 Analyst
for OneAmerica Financial Partners in IN

Defined Benefit Pension Plan Administrator
for The Angell Pension Group, Inc. in ANY STATE

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Webcasts and Conferences

SBCs for Employer Health Plans Revisited: Compliance for Major Medical, HRAs, and Other Plans
Nationwide on October 24, 2012 presented by Thomson Reuters / EBIA

Advanced COBRA: Top Compliance and Litigation Traps
Nationwide on September 27, 2012 presented by Thomson Reuters / EBIA

Health Care Reform Fees for Employers and Insurers: Understanding PCOR, Reinsurance, and Health Insurer Fees
Nationwide on October 30, 2012 presented by Thomson Reuters / EBIA

Economic Outlook and the Impact of the Upcoming Presidential Election
in California on October 16, 2012 presented by Western Pension & Benefits Council - San Diego Chapter

"ERISA Workshop 2012" - Portland
in Oregon on November 1, 2012 presented by SunGard Relius

"ERISA Workshop 2012" - San Francisco
in California on November 2, 2012 presented by SunGard Relius

Choosing A Retirement Solution For Your Small Business Workshop
in Rhode Island on November 7, 2012 presented by U.S. Department of Labor, Employee Benefits Security Administration (EBSA)


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[Guidance Overview]

IRS Regs Provide Details on Use of 90-Day Waiting Period for Health Plans
"[R]ules that delay health plan eligibility for 6 months or 12 months are no longer viable. And while a plan may place other conditions on eligibility, these conditions may not be a subterfuge for getting around the regulations." (Warner Norcross & Judd LLP)


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[Guidance Overview]

Two IRS Notices Address 'Full-Time' Employee Definition, 90-Day Waiting Period Requirement
"Notice 2012-58 will be of particular interest to employers with part-time or seasonal employees. Be forewarned, its application can be complex and may require some mental gymnastics to understand and apply. It is important to keep in mind that Notice 2012-58 is a safe harbor and plan sponsors do not have to follow it." (ERISAdiagnostics, Inc.)

How Obamacare Affects Health Plan Premiums
"Health plans under Obamacare cost more because they're delivering more benefits. Customers are paying more—and getting something back in return. These benefits are, however, pretty tiny when you think of the big, expensive hospitalizations or surgeries that insurers tend to cover. That means they do a pretty lousy job explaining any longer term trends in insurance costs." (The Washington Post; free registration required)

HHS Contends Bible Publisher Not a 'Religious Employer'
"The Obama administration is claiming that a dedicated Christian publisher of Bibles and ministry material is insufficiently religious to qualify for an exemption to the contraception mandate in the president's health-care overhaul. According to a federal lawsuit filed Tuesday in the District of Columbia by Tyndale House Publishers, the company has been refused a 'religious employer' exemption because the Health and Human Services Department categorically maintains that any for-profit publisher is not a 'religious employer.'" (Washington Times)

Federal Employee Health Benefit Program Enrollees: The Check Is Not in the Mail
"Federal employees enrolled in the government's health care program, however, should not expect to see an extra bump in their paychecks. The Office of Personnel Management, which administers the Federal Employees Health Benefits Program, will use any rebates it receives from insurance carriers participating in the program to adjust premium rates for the next year[.]" (GovExec.com)

2013 Health Plan Open Enrollment Season Foreshadows Significant Structural Changes in 2014 and Beyond
"In response to continued cost escalation, the rapidly changing provider marketplace and the many provisions of health care reform, employers are working to deliver greater value for each dollar spent on health care. This will translate into new plan options, new approaches to care delivery and a marked shift to narrow provider networks. While these changes may not be immediately evident in 2012 and 2013, employees should be on the lookout next year for new health care plan designs that encourage them to make more informed decisions or bear a greater financial burden as a consequence." (Wolters Kluwer Law & Business)

Transition to 2014: Will the ACA Curb COBRA's Bite?
"Certainly the need for continued participation in the employer plan would be reduced if, in fact, individuals would have access to good quality affordable coverage through the exchanges to be established by 2014. This notwithstanding, it is essential to scrupulously comply with requirements of COBRA." (Wolters Kluwer Law & Business)

States Take First Step on Path to 'Essential Health Benefits'
"So far, 20 states and the District of Columbia have at least made a preliminary benchmark plan decision, and 15 of these states and DC have chosen a small employer plan.... [This article looks] at where states have landed; implications of states' decisions so far; what states can do if they want to encourage more value-based benefit design; why so many states are active in this particular health reform decision; and how these decisions were made." (HealthAffairs Blog)

Who's Considered 'Full-Time' Under Health Care Reform?
"[Employers] cannot wait until 2014 to identify your full-time employees. Rather, you must implement a program in 2013 to identify them and make sure they are offered coverage during your 2013 open enrollment period for the 2014 plan year. If your health plan does not operate on a calendar year, you must make sure that newly eligible individuals are covered under your plan by January 1, 2014. That may mean making them eligible at the beginning of the plan year that starts in 2013, or having a special enrollment period in late 2013." (Warner Norcross & Judd LLP)

Sustainable Provider Payment Arrangements (PDF)
"Managed care faced a significant backlash in the late 1990s as many providers that accepted risk experienced financial difficulty, if not ruin.... [I]nsurers and their employer clients are again looking for ways to shift some financial risk back to providers as a way to ... achieve better care delivery. [This paper examines] the shortcomings of provider payment during the 1990s and consider[s] ... payment arrangements that may make provider risk sharing sustainable in the future." (Milliman)

Eleventh Circuit Affirms Employee Wellness Program Complies With ADA
"While employers should still be cautious about making sure their wellness programs are voluntary, they may be able to rely on the Eleventh Circuit's 'safe harbor' analysis if they ensure that their wellness programs are incorporated into their health plan documents and are communicated as a part of their health plans." (Faegre Baker Daniels)

6.3% Health Premium Increase Is Projected for 2013
"Employers have seen some stabilization in employment levels, less severe impact of high cost claims, a general movement towards consumer-driven plans and greater clarity around the average cost impact associated with health care reform. As a result, 2012 premiums were offset to reflect the better than expected historical experience." (Society for Human Resource Management)

[Opinion]

Raising Medicare Age: Supreme Court Decision Makes the Proposal More Problematic
"Raising the Medicare age from 65 to 67 would save the federal government money only by shifting costs to the private sector ... Total health care costs would rise, not fall." (Center on Budget and Policy Priorities)

[Opinion]

An Alternative Approach to Health Reform: Vouchers For All
"Health care rights have been unstable for a number of reasons, but two in particular put the ACA at risk. First, the Act gives a right to coverage, not care.... Second, the ACA retains the two-tiered system of health care in this country in which the well-to-do can rely on private insurance while the less-well-off have to rely on a publicly-funded program." (HealthAffairs Blog)

Benefits in General; Executive Compensation

NYSE Amends Proposed Rules on Independence of Compensation Committee Advisers
"The amendment accelerates the effectiveness of the requirements relating only to compensation committee oversight, which were originally scheduled to be effective by (a) the first annual meeting after January 15, 2014, or (b) October 31, 2014—July 1, 2013. This means that any necessary committee charter amendments will need to be in place a bit earlier than we thought last week. (NASDAQ's proposed rules already provided for earlier effective dates.)" (Winston & Strawn LLP)

NYSE Corrects Effective Dates for Compliance with New Compensation Committee and Compensation Adviser Independence Standards
"The amended proposed listing standards clarify that, subject to approval by the Securities and Exchange Commission, compliance with the provisions relating to compensation adviser access and compensation adviser independence will be required effective July 1, 2013, but that compliance with the provisions relating to the independence of compensation committee members will not be required until the earlier of the first annual meeting after January 15, 2014, or October 31, 2014." (Vorys, Sater, Seymour and Pease LLP)

Text of DOL Inspector General Report: Changes Are Still Needed in the ERISA Audit Process to Increase Protections for Employee Benefit Plan Participants (PDF)
"Despite EBSA's significant efforts to improve oversight and audit quality, protections and assurances have decreased over time for participants and beneficiaries.... The percentage of plans electing limited scope audits has grown from about 46 percent in 1987 to approximately 70 percent in 2010.... While the use of limited scope audits is a major obstacle in providing audit protections for plan participants, EBSA could have done more within the existing law to improve audit quality.... We recommended the Assistant Secretary for Employee Benefits Security continue to seek repeal of the limited scope audit exemption and obtain authority over plan auditors. We also recommended that in the interim, EBSA: (1) use existing authority to clarify and strengthen limited scope audit regulations and evaluate the ERISA Council recommendations, (2) make better use of available enforcement tools over IQPAs, (3) improve procedures in audit quality reviews, and (4) perform a reassessment of audit quality." (U.S. Department of Labor, Office of the Inspector General)

Text of EBSA Response to Inspector General Performance Audit (PDF)
"[EBSA has been and continues to be] concerned about what appears to be failures among some plan auditors to comply with their professional standards and with ERISA's reporting and disclosure requirements.... [EBSA has] long advocated statutory reform because several statutory provisions of ERISA limit the Secretary's ability to combat audit quality deficiencies.... EBSA continually evaluates the effectiveness of its existing regulations and the appropriateness of amendments to them.... EBSA has a comparatively small enforcement staff relative to the size of the employee benefit universe ... The agency continues to work diligently to assess audit quality within all segments of the IQPA population as a part of its multi-tiered inspection program." (Employee Benefits Security Administration)

Ohio District Court Holds That Wisconsin FMLA Substitution Law Is ERISA-Preempted
"[The Wisconsin] FMLA's substitution provision permitted employees to substitute 'paid or unpaid leave of any other type provided by the employer' for portions of family leave or medical leave.... [The court] determined that WFMLA's substitution provision, to the extent it is used to require payment of STD plan benefits, is expressly preempted under ERISA Section 514(a) and conflict preempted due to its interference with ERISA Section 502(a)'s civil enforcement provisions." (Bloomberg BNA)

Bill Would Require Reasonable Accommodations for Pregnancy
"The Pregnant Workers Fairness Act ... is modeled after the ADA and borrows some of its language.... [It] would require employers to 'make reasonable accommodations to the known limitations related to the pregnancy, childbirth, or related medical conditions of a job applicant or employee, unless such covered entity can demonstrate that the accommodation would impose an undue hardship on the operation of the business of such covered entity.' Employers also wouldn't be able to force pregnant employees to take leave, if another accommodation was available." (Thompson SmartHR Manager)

Employer Sued for Failing to Return Employee to Equivalent Position After FMLA Ended
"[E]mployers often get into trouble when they don't fully consider how the duties of the new position will be viewed by the employee in terms of prestige, authority and especially earning potential. One common example is a sales position.... Selling a different trinket, or assigning them to different accounts that arguably provide for less earning potential or cause them to work with 'lower profile' clients in your industry may very well be enough ... to create genuine risk of a viable FMLA interference or retaliation claim." (FMLA Insights)

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