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for The Newport Group in NC

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ERISA Advisory Council to Hold Final 2012 Meeting Nov. 26-27
in District of Columbia on November 26, 2012 presented by U.S. Department of Labor, Employee Benefits Security Administration (EBSA)

HSAs, HRAs, and Health FSAs: Understanding the Differences to Find the Best Fit
Nationwide on November 15, 2012 presented by Thomson Reuters / EBIA

 

Bible Publisher Wins Stay of Contraceptive Coverage Mandate
"A federal [judge in the district court for the District of Columbia] on Friday said a Bible publisher doesn't have to offer health insurance coverage for contraceptives if it has moral objections [under the Religious Freedom Restoration Act], blocking the Obama administration from imposing its contraceptive care mandate on the business for now.... The administration argued that allowing employers to be exempted from the contraceptive mandate would harm women's health and could lead to a patchwork of company coverage. But Judge Walton pointed to tens of millions of people who already belong to plans exempted from the new mandate." (Washington Times)

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Text of Court Opinion Granting Temporary Injunction Against Enforcement of Mandatory Contraceptive Coverage Against Bible Publisher (PDF)
"By requiring the plaintiffs to provide for certain contraceptive care, the plaintiffs allege that the defendants have violated their rights under the [Religious Freedom Restoration Act, 42 U.S.C. Section 2000bb-1 (2006), or 'RFRA'] ... The RFRA forbids the government from 'substantially burden[ing] a person's exercise of religion even if the burden results from a rule of general applicability' unless the government can 'demonstrate[] that application of the burden to the person (1) is in furtherance of a compelling governmental interest; and (2) is the least restrictive means of furthering that compelling governmental interest.'" (U.S. District Court for the District of Columbia)

Economist Stuart Altman Tasked With Huge Challenge of Bringing Down Massachusetts Health Costs
"Massachusetts is the first state to say that health care costs must stop increasing faster than that of most other goods and services. Prof. Stuart Altman, a Brandeis economist who advised President Richard Nixon on health policy and President Bill Clinton on Medicare, has responsibility for helping the state achieve that goal." (Kaiser Health News)

A Middle Way: What States Should Build Instead of Obamacare's Health Insurance Exchanges
"Should ... states act as agents of the Obama administration, and set up state-based versions of Obamacare's subsidized health insurance exchanges? Or should they say no, leaving implementation of the law in the hands of HHS Secretary Kathleen Sebelius? In this article, [the author presents] a third possibility: that states set up their own markets for health insurance, markets that drive down the cost of insurance by ignoring Obamacare's tangled web of mandates, regulations, and taxes." (Forbes)

Post-Election ACA Implementation: What Employers Should Be Thinking About for 2013
"2013 is clearly a critical planning year for employers and plan sponsors. Cost containment and compliance have to be the main focus. With respect to compliance, deliberate focus must be on PPACA's many requirements that either are currently in effect or which will become effective soon[.]" (Proskauer Rose LLP)

To Be or Not To Be: Court Holds Self-Funded Health Plan's TPA 'To Be' an ERISA Fiduciary
"[A] Michigan federal trial court recently held that a third-party administrator of two self-funded employer health plans was an ERISA fiduciary. As a result, the TPA was held liable for breaching its fiduciary duty by not disclosing certain of its fees that had been charged to the plans.... This court's decision hinged on its finding that the amounts sent to the TPA were ERISA plan assets, notwithstanding the fact that the ASAs specifically stated that these amounts were not plan assets. " [Borroughs Corp. v. Blue Cross Blue Shield of Michigan, Nos. 11-12565, 11-12557 (E.D. Mich. Sept 17, 2012)] (Spencer Fane)

How Does Your Company's Benefit Program Stack Up Against Your Competitors'?
"Employers may or may not be looking to attract new employees in today's economy, but they certainly need to retain the good ones they have and create a culture that inspires team members to give discretionary effort and do more than the minimum required. Quality employer-sponsored health benefits remain highly valued by employees." (United Benefit Advisors)

Women's Risk of Health Insurance Loss Due to Divorce
"[E]stimates suggest that roughly 115,000 American women lose private health insurance annually in the months following divorce and that roughly 65,000 of these women become uninsured. The loss of insurance coverage ... is not just a short-term disruption. Women's rates of insurance coverage remain depressed for more than two years after divorce." (Journal of Health and Social Behavior)

2012 Aflac WorkForces Report Addresses Health Benefits, Communications Issues
[Excerpt from the 'About the Study' page:] "The Aflac WorkForces Report is an annual employee benefits study examining the forces impacting the trends, attitudes, and utilization of employee benefits. Surveying both American workers and business decision-makers, the Aflac WorkForces Report reconciles the perceptions and realities of benefits in the workplace. The insights aim to help businesses make informed decisions about benefits to better protect their employees and their bottom line." [Also, from the 'Executive Summary' page:] "Despite having insurance, results indicate that workers do not feel adequately protected or prepared for the financial impact of unexpected illnesses or injuries." (Aflac)

Democrats: Leave Federal Employee Health Plan Out of Deficit Deal
"While some plans have called for cuts in civil servants' compensation, including changes to the Federal Employees Health Benefits Program, Democrats in Congress said federal workers should not be targeted to reduce the nation's debt.... [The] Simpson-Bowles budget plan, commissioned by President Obama and released in December 2010, recommended turning FEHBP into a 'defined contribution premium support plan that offers federal employees a fixed subsidy that grows by no more than [gross domestic product] plus 1 percent each year.' The commission estimated that plan would save the government $18 billion during a 10-year period." (GovExec.com)

Employers Weigh Options Under Healthcare Reform
"The so-called 'employer mandate' takes effect Jan. 1, 2014, meaning employers who currently offer health care coverage but need to make changes in order to comply with the law, or who want to drop health care and pay a penalty instead, have just a few months to put those plans in place. The situation is even more critical for employers who currently do not provide health care benefits but will be required to do so, or face penalties, under the new law. For all, the decision goes beyond a simple cost analysis." (Treasury & Risk)

State-by-State Enrollment in the Pre-Existing Condition Insurance Plan, as of September 30, 2012
"The [Pre-Existing Condition Insurance Plan] program began accepting applications for enrollment July, 2010 (July 1, 2010 for the federal program, dates for state programs varied). The chart [at the linked article] details the date when each state began providing benefits to people accepted into the program and the number of people enrolled in the program by each state as of September 30, 2012." (Healthcare.gov)

Plan Sponsor, Not Insurer, Is Plan Administrator Responsible for Responding to Requests for Plan Documents
"While some of the plan administrator's responsibilities may be contractually assigned to third parties such as insurers or TPAs, it is the designated plan administrator -- or the plan sponsor in the absence of a designation -- that ultimately is liable. Consequently, a plan sponsor should carefully and consistently identify the ERISA plan administrator in plan documents and participant communications, and also ensure that it has access to the necessary documents." [McCollum v. Blue Shield of California Life & Health Ins. Co., 2012 WL 5389711 (N.D. Cal. 2012)] (Thomson Reuters / EBIA)

States Given Additional 4-Week Extension of Deadline to File Exchange Application
"As the dust settles from the 2012 election season, this extension may be the first of many offers of flexibility from HHS to the states as they develop their Exchange strategies for 2014. At this point, HHS still intends to meet the January 1, 2013 approval/conditional approval deadline for a state-based Exchange. Exchanges are to be operational in every state on January 1, 2014 (the initial open enrollment period will begin on October 1, 2013)." (Thomson Reuters / EBIA)

Play-or-Pay Under the Affordable Care Act 2014 (PDF)
12 presentation slides addressing the ACA individual and employer mandates, with flow charts for compliance, and the current status of state- and federally-operated exchanges. (Chao & Company, Ltd.)

[Opinion]

State Decisions on Health Exchanges Are Early Indicators for ObamaCare's Post-Election Health
"[C]reating a functional health benefits exchange under the ACA faces key impediments: The ACA is a classic example of a limited, but theoretically good, idea mutating into a politically-driven passage to overregulation, income redistribution and increased dependence on Washington. Most states will either refuse to set up their own exchange or prove unable to do so for political and technical reasons." (National Center for Policy Analysis)

[Guidance Overview]

Overview of 2012 Year-End Amendments for Retirement and Cafeteria Plans
"There are no interim amendments needed for ongoing DC plans in 2012.... All defined benefit plans must adopt a [Section] 436 interim amendment by the last day of the 2012 plan year (IRS Notice 2011-96).... There are currently no amendments required in 2012 for ongoing 457(b) plans.... An amendment is technically not needed [for cafeteria plans] in 2012, but one may be needed in 2013 ... [if the plan] includes a health care flexible spending account (health FSA) with a limit over $2,500[.]" (SunGard Relius)

Beware of Section 409A Traps in Employment Agreements
"[F]ailure to comply with section 409A results in expensive tax issues not for the employer, but for the executive, including income tax on any amounts deferred under the agreement retroactive to the first year the agreement violated section 409A, interest on the unpaid taxes, and an excise tax payable by the executive (not payable by the employer) of 20% of the income recognized. [This article discusses] some of the more common section 409A compliance issues as they relate to employment agreements." (EisnerAmper LLP)

ISS Releases 2013 Policy Updates
"Acknowledging the comments received during ISS' 2012 comment period, ISS will be taking a case-by-case approach in determining whether pledging rises to a level of serious concern for shareholders. Also in response to comments, ISS is including significant pledging of company stock as a failure of risk oversight and thus considered a governance failure whereby directors should be held accountable.... Realizable pay is being added to the research report for large capitalization companies." (Dodd-Frank.com, a blog by Leonard, Street and Deinard)

ISS Releases Final Policies for 2013 -- Share Pledging Addressed
"In the 2013 Update, ISS indicates, by footnote, that 'under extraordinary circumstances,' ... hedging of company stock and significant pledging of company stock by directors and/or executives could be considered a failure of risk oversight that could lead ISS to vote AGAINST or WITHHOLD from directors individually, committee members, or the entire board." (Winston & Strawn LLP)

Postal Service Posts Record Loss, Wants Pension Cash Freed Up
"The Postal Service had a record loss of nearly $16 billion in fiscal 2012 ... [T]he agency said $11.1 billion of its losses were related to two payments to prefund its retiree health benefits. The Postal Service again said that solvency is within its reach, but this requires congressional action, including the elimination of the prefunding requirement." (FierceGovernment)

After the Storm: Employers' Obligations After Sandy
"Between the devastation caused by the storm itself, power outages, and transportation shutdowns, employers were forced to close business or operate on a significantly reduced basis for days, and, in some cases, weeks. Nevertheless, companies must still satisfy certain obligations as employers. While situations vary considerably from employer to employer, here is a summary of key issues and employer obligations post Sandy[.]" (Orrick)

IRS Announces Tax Relief for Leave Donations to Aid Hurricane Sandy Victims
"The IRS has previously provided relief for leave-based donation programs in two other instances -- in the aftermath of the September 11, 2001 terrorist attacks (see our article) and for victims of Hurricane Katrina (see our article). The special relief granted in this notice automatically expires on December 31, 2013." (Thomson Reuters / EBIA)

Tegrit Group Expands Michigan Office!
Tegrit Group

HealthPass New York Selects bswift as Exchange Technology Partner: bswift�s Proven Exchange Platform to Power HealthPass� Multi-Carrier Private Exchange
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bswift Releases White Paper on Exchange Technology: Top 10 Factors to Consider
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