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Ninth Circuit Says Fiduciary Exception to Attorney-Client Privilege Applies to Insurers
"The Ninth Circuit rejected the Third Circuit approach that the fiduciary exception was inapplicable to insurance companies ... and sided with numerous district courts that have found the fiduciary exception to apply to insurers. The Ninth Circuit reasoned that the rationale for excepting ERISA fiduciaries from the attorney-client privilege applied equally to insurance companies, because 'the obligation of an ERISA fiduciary does not differ depending on whether that fiduciary is a trustee or an insurer.'" [Stephan v. UNUM Life Ins. Co. of America, No. 10-16840 (9th Cir., Sept. 12, 2012)]
(Seyfarth Shaw LLP)
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One in Four Milwaukee-Area Small Employers Expect to Drop Group Health Coverage in 2013
"Approximately one in four Milwaukee-area employers with between 20 and 99 employees say they are either 'likely' or 'very likely' to drop their company's health plan in 2014 and let employees purchase individual insurance through state-run exchanges. That is a significant increase from the 16 percent of small employers who said they were likely to drop their health plan last year."
(HCTrends)
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Fixing California's Retiree Health Care Underfunding
"When OPEB is unfunded (which ... is the case in most California communities), costs in coming years are set to accelerate rapidly -- likely more rapidly than pension costs. When a worker retires and begins to draw benefits, his pension comes out of the pension fund, whereas his health benefits continue to come directly out of the operating budget. Thus, for as long as governments fund OPEB on a pay-as-you-go basis, they will experience the combined force of the baby-boom retirement wave and rising health-care costs. In a prefunded system, the effect is filtered."
(California Public Policy Center)
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Payment Reform Has Best Chance To Improve Quality and Cut Costs, Insurers Say
"Payment reform has the best chance of achieving quality improvements and cost reductions for the U.S. health care system, and the federal government needs to align its public health care programs with innovations created in the private market, health insurers said at a conference Oct. 25 sponsored by the U.S. Chamber of Commerce.... [N]ew programs undertaken by some Blue Cross Blue Shield [plans] move away from traditional fee-for-service reimbursements to providers. The fee-for-service payment system, which is used in Medicare, is widely criticized as creating incentives for high volumes of medical services that have led to unsustainable cost increases and uncoordinated care and do not always improve health care quality."
(Bloomberg BNA)
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Jobs Without Benefits: The Health Insurance Crisis Faced by Small Businesses and Their Workers
"The share of U.S. workers in small firms who were offered, eligible for, and covered by health insurance through their jobs has declined over the past decade. Less than half of workers in companies with fewer than 50 employees were both offered and eligible for health insurance through their jobs in 2010, down from 58 percent in 2003. In contrast, about 90 percent of workers in companies with 100 or more employees were offered and eligible for their employer's health plans in both 2003 and 2010."
(The Commonwealth Fund)
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Hurricanes and 401(k) Hardship Distributions: The Post-Sandy Clean-Up
"Generally speaking, hardship distributions may be available to an employee to cover the costs of repair or recovery from a natural disaster, provided the plan permits it and they have no other available financial options. It is not designed to be the first source of money. Instead, it should be the option of last resort. Bear in mind, there can be negative tax implications from the distribution."
(Fox Rothschild LLP)
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Seeking Lower Health Costs, Wal-Mart to Pay Workers' Costs at Six 'Centers of Excellence'
"Wal-Mart, the nation's largest private employer, is getting in on the concept of 'Centers of excellence,' a method of steering referrals to providers who perform more efficiently in a bid to bend the health cost curve. With the generous coverage, the company creates good press and may counter its reputation as being skimpy on workers' benefits. The company has defended itself in a long line of court cases, a few of which are outlined below."
(Thompson SmartHR Manager)
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Creating a Health-Promoting Work Environment
"Lifestyle-related (and therefore preventable) illnesses make up approximately 80 percent of the burden of health care costs for companies and 90 percent of all health care costs, according to one study. Health and wellness incentives have long been considered a luxury only large corporations can afford, not a strategic imperative for all businesses to keep ever-increasing health care costs at bay, say the authors of a study published in the Harvard Business Review. That view is rapidly changing."
(The Huffington Post)
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Incentivizing Good Health: A Mid-Sized Firm's Success Story
"Wellness Lessons Learned at Confluence: (1) Don't scare away employees most at risk for health problems; lower entry barriers to include sedentary workers. (2) Financial rewards work best when they are closely linked to out-of-pocket health care costs. (3) Craft a program that leverages off a company's own workplace culture. (4) Appearances can be deceptive, especially regarding health. A person's vital metrics don't lie. (5) Find a capable wellness partner to work with."
(Society for Human Resource Management)
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Alternative Health Benefits: 'Like Bringing Your Pet to Work'?
"Many employers, still focused largely on trying to contain health-care costs, spend most of their time focused on benefit design, says [Raymond Fabius, chief medical officer for Truven Health Analytics]. Another group is moving toward the position that containing those costs partly involves managing workers' health. Then there is a small cadre that feel that health costs are really not a cost but an investment in work-force productivity. 'And it's a subset of those that are engaged in broad-based efforts to elevate employees' health and wellness, including [complementary and alternative medicine] efforts,' he says."
(CFO)
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How Health Care Changed While You Were Watching the Election
"[M]any of the most significant stories in health care from the past two months haven't come from the campaign trail -- where candidates have mostly rehashed their existing policies -- but from the private sector, as employers and providers have made aggressive, and sometimes unexpected, deals and changes. [They include:] Top Employers Move to Defined Contribution ... Wal-Mart, More Providers Ramp Up Direct Contracting ... Mass. Hospitals Make Shift Toward Global Payment."
(CaliforniaHealthline)
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GDP + 0: Prospects and Challenges of Bending the Health Care Cost Curve
"This summer, Massachusetts legislated ... limits on health care spending growth -- defined as not to exceed overall growth in Gross State Product (GSP) in 2013-2017 and GSP growth minus 0.5 percent for 2018-2022.... What if Massachusetts-like spending restraints were imposed nationally? National health care expenditures ..., which constitute about 18 percent of the nation's GDP, have been growing about 2 percent faster than the growth of U.S. GDP for most of the past 22 years[.]"
(Altarum Institute)
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U.S. Solicitor General Has No Objection to New Court Challenge to ACA
"The Obama Administration told the Supreme Court on Wednesday afternoon that it does not object to the Court clearing the way for new constitutional challenges to two key 'mandates' written into the new federal health care law. In a new filing, U.S. Solicitor General Donald B. Verrilli, Jr., chose not to challenge an opportunity for Liberty University of Lynchburg, Va., to try to press its claims in the Fourth Circuit Court based in Richmond. The Court had asked a month ago for the government's views."
(SCOTUSblog)
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[Opinion]
How The Health Law Might Be Changed By The Next President
"On the presidential campaign trail, Republican Mitt Romney has repeatedly called for repeal of the 2010 health law and President Barack Obama has vowed to implement it.... Here is a look at how Obama and Romney might change the health law in the years ahead based on interviews with health policy experts."
(Kaiser Health News)
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Benefits in General; Executive Compensation
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[Official Guidance]
IRS Gives Additional Time to Taxpayers and Preparers Affected by Hurricane Sandy; File and Pay by Nov. 7
"The Internal Revenue Service ... announced it is granting taxpayers and tax preparers affected by Hurricane Sandy until Nov. 7 to file returns and accompanying payments normally due today. The relief applies to taxpayers and tax preparers in an area affected by Hurricane Sandy or otherwise impacted by the storm that hit the Mid-Atlantic and Northeastern United States this week.... IRS expects to grant additional filing and payment relief as qualifying disaster declarations are issued by the Federal Emergency Management Agency (FEMA). Details will be posted on the Tax Relief in Disaster Situations page on IRS.gov."
(Internal Revenue Service)
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NYSE and NASDAQ Proposed Compensation Committee and Advisers Independence Rules
"The NYSE and NASDAQ proposed rules are expected to be released by the SEC for public comment following an initial review period and are scheduled to be adopted by the SEC by June 27, 2013. Accordingly, these new rules may not be applicable in the 2013 proxy season for calendar year companies, but, as discussed in more detail [in this article], certain of NASDAQ's proposed rules relating to compensation committee responsibility and authority would become effective immediately upon SEC approval."
(Morgan, Lewis & Bockius LLP)
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CFOs Identify Cost of Benefits As Hindrance to Company Growth
"According to the survey, the biggest barrier to employee and company financial growth is the cost of employee benefits, with 56 percent identifying healthcare and pensions as the prime culprits. Furthermore, as the cost of healthcare grows, 77 percent of those surveyed anticipate company and employee contributions to increase over the next year. Yet benefits such as life insurance and disability are expected to remain mostly unchanged."
(Grant Thornton)
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Sixth Circuit Finds ERISA Section 510 Does Not Protect Unsolicited Internal Complaint (PDF)
[CORRECTED LINK] The question in this case is whether [ERISA section] 510 extends its protections to an employee's unsolicited, internal complaint to his employer that it has violated ERISA.... The Sixth Circuit has not yet had occasion to address the issue.... [T]he Court concludes that in this case Section 510 does not protect the plaintiff's unsolicited, internal complaint -- an email to his employer threatening to report its ERISA violations to state and federal authorities -- because it was unconnected to any 'inquiry or proceeding'.... A fuller explanation is that 'an employee's grievance is within Section 510's scope whether or not the employer solicited information,' provided that the employee himself solicited information. Without the asking for information, there is no 'inquiry'." [Sexton v. Panel Processing, Inc., No. 12-10946 (6th Cir., Oct. 30, 2012)]
(U.S. Court of Appeals for the Sixth Circuit)
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