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[Official Guidance]
Text of Proposed HHS Regs Under ACA on Essential Health Benefits and Actuarial Value (PDF)
"This proposed rule details standards for health insurance issuers consistent with title I of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 ... Specifically, this proposed rule outlines Exchange and issuer standards related to coverage of essential health benefits and actuarial value. This proposed rule also proposes a timeline for qualified health plans to be accredited in Federally-facilitated Exchanges and an amendment which provides an application process for the recognition of additional accrediting entities for purposes of certification of qualified health plans."
(U.S. Department of Health and Human Services)
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[Official Guidance]
Text of Proposed Regs on HIPAA and ACA Standards Applicable to Wellness Programs (PDF)
"[B]ecause the Departments believe that the provisions of these proposed regulations would be authorized under either HIPAA or the Affordable Care Act, the Departments are proposing in this rulemaking to apply the same set of standards to both grandfathered and non-grandfathered health plans ... Like the 2006 regulations, these proposed regulations would continue to limit the total amount of the reward for health-contingent wellness programs with respect to a plan, whether offered alone or coupled with the reward for other health-contingent wellness programs."
(Employee Benefits Security Administration, Internal Revenue Service, Department of Health and Human Services)
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[Official Guidance]
Text of Proposed HHS Regs Under ACA on Guaranteed Availability, Ratings for Age and Other Factors (PDF)
"This proposed rule would implement the Affordable Care Act's policies related to fair health insurance premiums, guaranteed availability, guaranteed renewability, risk pools, and catastrophic plans. The proposed rule would clarify the approach used to enforce the applicable requirements of the Affordable Care Act with respect to health insurance issuers and group health plans that are non-federal governmental plans. This proposed rule would also amend the standards for health insurance issuers and states regarding reporting, utilization, and collection of data under section 2794 of the Public Health Service Act[.]"
(U.S. Department of Health and Human Services)
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[Guidance Overview]
How to Prepare for 2014 and the New Employer Shared Responsibility Rules and Waiting Period Limitation
"Employers may rely on the new guidance through the end of 2014. Employers will not be required to comply with any subsequent guidance that is more restrictive until January 1, 2015 at the earliest. This is good news because it provides employers a measure of certainty about how to prepare for the 2014 employer shared responsibility mandate -- particularly those employers concerned about what must be done to avoid significant penalties for failing to provide coverage, or for providing unaffordable coverage."
(DrinkerBiddle)
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Obama Administration Regs Fill in Health Law Details
"The new rules issued by the Health and Human Services Administration spell out how a centerpiece of the law -- its requirement that insurers cover even sick or old applicants -- will work. They also sketch out what minimum package of benefits must be included in health plans sold on state exchanges.... A rule on health insurance market reforms spells out how the health law's "guaranteed issue" and "community rating" requirements will work in practice. Those rules ban insurer discrimination against customers with pre-existing health problems and limit how much insurers can vary premium prices on the basis of age, tobacco use, family size and geography."
(NationalJournal)
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Can the IRS Handle All That Obamacare Requires?
"IRS officials have promised they'll have everything ready in time, but the sheer scope of the workload has prompted fears that it's all just too much for the agency to handle and could cause error and fraud to skyrocket."
(Politico)
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Cleveland-Area Employees Paying More for Health Coverage at Work
"Cleveland-area employees will contribute an average of $2,500 out of their paychecks next year for health insurance premiums -- that's 56 percent more than they paid toward coverage in 2007 ... premiums for single and family coverage will average $10,638 for employees in Northeast Ohio. The employee will pay about $2,500 of that out of their paycheck and the employer will pick up the rest."
(Cleveland Plain Dealer)
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Advocates of Medical Marijuana Face Another Hurdle: Health Insurance Coverage
"Massachusetts became the latest state to allow the use of marijuana for medical purposes, joining 17 others and the District of Columbia. But for patients who use marijuana to help alleviate chronic pain and nausea and stimulate appetite, legalization is only part of the battle. Health insurance rarely if ever covers its use; some patients spend hundreds of dollars a month or more on the drug."
(Kaiser Health News)
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Judge Rejects Hobby Lobby's Case Against Obamacare Mandatory Contraceptive Coverage
"In his ruling denying Hobby Lobby's request for an injunction, [U.S. District Judge Joe] Heaton said that while churches and other religious organizations have been granted constitutional protection from the birth-control provisions, 'Hobby Lobby and Mardel are not religious organizations.' 'Plaintiffs have not cited, and the court has not found, any case concluding that secular, for-profit corporations such as Hobby Lobby and Mardel have a constitutional right to the free exercise of religion,' the ruling said."
(Fox News)
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Ad Campaign Seeks to Get Lawmakers to Lower ACA Taxes
"[B]usiness groups plan an advertising campaign to get lawmakers to ease new taxes in the [ACA]. Stop the HIT, a Washington-based coalition of trade groups, will start the effort ... Changes to the taxes will be 'on the table' as part of talks to cut the U.S. budget deficit ... The campaign's goal is to change the taxes that PPACA imposes on insurance companies and employers who provide the highest level of coverage. The law puts about $84 billion in new taxes and fees on the insurance industry[.]"
(Employee Benefit News)
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Profiles of Health Care Systems in the United States and 14 Other Countries
"Each overview covers health insurance, public and private financing, health system organization, quality of care, health disparities, efficiency and integration, care coordination, use of health information technology, use of evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views."
(The Commonwealth Fund)
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Health and Welfare Plans Audits on the Rise -- Are You Ready?
"While audits of qualified retirement plans have become commonplace, audits of health and welfare plans have historically been much less common. Only a select group of 'lucky' employers was subjected to health and welfare plan audits, and the scope of those audits was somewhat limited. Unfortunately, it appears that trend is ending. We are seeing a notable increase in the frequency of health and welfare plan audits, and the scope of these audits is becoming much broader. Employers have rights, and the agencies have rules the auditors are required to follow."
(Porter Wright Morris & Arthur LLP)
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New Health Care Flexible Spending Account Rules for 2013 But Use-It-or-Lose-It Rule Still on the Books
"There are two ways you can get around the new $2,500 cap. If you hold two or more jobs (with unrelated employers), you can elect up to $2,500 under each employer's FSA plan. The other way is if you're married and you both work for employers that provide FSAs. Each of two spouses can elect up to $2,500, for a total $5,000 -- even if they work for the same employer.... Last summer the Treasury Department asked for comments on fixes to -- or outright elimination of -- the use-it-or-lose-it rule in light of the new $2,500 cap.... Unfortunately, there's been no word from Treasury in time for the current open enrollment period."
(Forbes)
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HHS Extends Deadline for States to Declare Intent to Operate State-Based Exchanges
"[T]he extension means continued uncertainty for employers in those states that have not declared what type of exchange they will operate. To the extent these employers are evaluating whether to continue offering health coverage, they must do so, for the near future at least, with an incomplete picture of what the exchanges in their states will ultimately look like."
(Practical Law Company)
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[Opinion]
Cheer Up, Papa John's -- Obamacare Gave You a Good Deal
"The health-care law's treatment of larger employers is almost laughably complicated. If you've got fewer than 50 employees, nothing is asked of you, and if you're willing to provide insurance for your employees, you get a giant tax credit, at least for awhile. But if you're a business with more than 50 full-time employees, matters become considerably more complex. If you've got more than 50 full-time employees and you already offer them health insurance, you can stop reading now. You're in the clear. If you've got more than 50 full-time employees and you don't offer them coverage and you don't pay them enough to buy coverage on their own without using subsidies, then you have to pay $2,000 for each employee, except for your first 30 employees."
(The Washington Post; free registration required)
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[Opinion]
Under Obamacare, How Likely Is the Company to Hire That 50th Worker?
"While restaurants, with traditionally low profit margins and large numbers of low-skilled, low-wage workers, are exceptionally vulnerable to ObamaCare's costs, other business are being hit too. For example, Boston Scientific has announced that it will now lay off up to 1,400 workers and shift some jobs to China. And Dana Holdings, an auto-parts manufacturer with more than 25,000 employees, says it to is exploring ObamaCare-related layoffs"
(Cato Institute)
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[Opinion]
Deloitte Health Care Reform Memo, November 19, 2012
"The equipping of consumers, policymakers, and industry leaders to manage the pace of change in this industry is perhaps our most significant need. In most communities, health care means local physicians, local hospitals and facilities, and insurance either obtained through a public program or employer, if eligible and affordable. But the health care system is much more, and its pace of change often challenging to incumbent stakeholders."
(Deloitte)
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Benefits in General; Executive Compensation
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ISS Policy Updates for 2013: Golden Parachutes and Realizable Pay
"ISS' consideration of realizable pay may mitigate or exacerbate CEO pay-for-performance concerns.... [T]he SEC had expressed concern about companies' 'realized pay' disclosures because there was not common a definition for that term, which made comparisons difficult for investors and (fears the SEC) potentially misleading. An ISS-created standard might solve that problem."
(Winston & Strawn LLP)
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Plaintiffs' Law Firms May Be Gaining Steam With Say-On-Pay Suits
"[P]laintiffs' firms have orchestrated a new strategy to hold companies liable: suits to enjoin the shareholder vote because the proxy statement fails to provide adequate disclosure concerning executive compensation proposals. Such suits have met with some success -- with two court orders enjoining shareholder meetings and five settlements prior to companies' annual meetings."
(Pillsbury Winthrop Shaw Pittman LLP)
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ISS Releases 2013 Policy Updates (PDF)
"For 2013, ISS will update its peer group selection approach for purposes of running its pay-for-performance assessment of Russell 3000 companies and will add a realizable pay analysis to the qualitative review conducted on large-cap companies identified as "high concern" on the quantitative screen."
(Frederic W. Cook & Co., Inc.)
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Has the Executive Benefits Pendulum Swung Too Far?
Excerpt: "A series exploring the value of providing executive benefit plans.... In recent years, executive benefits have undergone significant changes and faced intense scrutiny. This has been daunting for executives and companies alike. Today, both face enormous challenges and uncertainties." Articles include [1] Introduction - Has the Pendulum Swung Too Far? [2] Non-qualified Benefits Lead to Prudent Long-Term Management; [3] Regardless of Tax Rate Changes, Deferred Compensation Will Remain Important; [4] Beyond Deferred Compensation; [5] Deferred Comp Matches: Why They Make Sense; [6] A Guide to Executive Benefit Technology; and [7] Total Plan Management.
(The Todd Organization)
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Health vs. Wealth: Are Employees Making the Right Benefits Choices?
"'The rising cost of health care is leading companies to shift more cost to employees, as well as to offer employees a robust menu of voluntary benefits to address key financial risks,' said Stephen Pelletier, president of Prudential Group Insurance ... 'When it comes to making these decisions companies are providing more information and decision tools than ever to help employees make choices that meet both their shorter-term health and longer-term wealth protection needs.'"
(Prudential)
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Press Releases
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