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BenefitsLink Health & Welfare Plans Newsletter

November 29, 2012          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

Senior Advisory Consulting Analyst
for Mercer in FL

Benefits Plan Manager/Account Executive (Taft-Hartley TPA)
for BeneSys Administrators in CA

Daily Valuation Specialist
for Benetech, Inc. in CA

Retirement Plan Administrator
for Tri-State Plan Administration, Inc. in OH

Plan Administrator
for Capital Retirement Plan Services in FL

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Webcasts and Conferences

The Impact of HITECH on HIPAA Privacy and Security Compliance
Nationwide on December 17, 2012 presented by Thompson Interactive

View All Webcasts and Conferences

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[Guidance Overview]

HHS Guidance Addresses Methods for De-identifying HIPAA Protected Health Information
"HHS released guidance and a related webpage on the two methods for de-identifying protected health information (PHI) under the HIPAA Privacy Rule, the Expert Determination method and the Safe Harbor method. The guidance explains and answers questions about both methods and is intended to assist covered entities, which includes health plans, in understanding: [1] What de-identification is. [2] The process by which de-identified information is created. [3] The options available for performing de-identification. [4] [A] glossary of relevant terms." (Practical Law Company)


DATAIR's FlexPlus System Makes Administration Profitable

Sponsored by DATAIR Employee Benefit Systems, Inc.

Proposals, Testing, Claims Processing, Debit Cards and more!
Plus CafeDocs/SPDs and 5500s/SARs
(888) 328-2474Sales@DATAIR.comwww.DATAIR.com

[Guidance Overview]

Guidance Issued on Essential Health Benefits and Other Individual and Small Group Market Reforms
"The regulations provide that the annual limit on cost-sharing (which includes all deductibles, copayments, co-insurance and similar employee charges applicable to EHB) will be set at the annual high deductible health plan limit for out-of-pocket expenses. For 2013, this limit will be $6,250 for self-only coverage and $12,500 for other tiers of coverage. Deductibles will be subject to a separate limit that, in 2014, will be $2,000 for self-only coverage and $4,000 for other tiers." (Ballard Spahr)

[Guidance Overview]

Proposed Regs Increase Maximum Rewards Allowed by Wellness Programs
"[T]he preamble to the wellness program regulations provides interesting data regarding wellness programs currently in existence. According to surveys conducted by consulting firms and research studies, most wellness programs are participatory and not health-contingent. In addition, those surveys indicate that the usual health-contingent wellness program reward percentage ranges from 3% to 11% of the cost of group health plan coverage. Thus, it is unclear whether an increase in the maximum reward from 20% to 30% of the cost of group health plan coverage will result greater usage of health-contingent wellness programs." (Sidley Austin LLP)

Why Your Company Should Care About Wellness Programs
"[E]mployers are, indeed, very concerned about the cost of health care -- so much so that it appears to impact strategic business decisions, like the size of the workforce. Employers indicate they have tried several strategies to control health care costs (for example, reducing expensive In many ways health is the ultimate outcome or the final state -- and wellness is the strategy used to get there. plan options, shifting costs to employees, and reducing the number of employees who are eligible for benefits), but recognize that there is a potential downside to these strategies." (ADP Research Institute; free registration required to download full report)

Most People Now Say Federal Government Should Not Guarantee Health Care for All
"Fifty-four percent of U.S. residents asked said healthcare isn't the government's responsibility while 44 percent said it was, the first time in Gallup trends since 2000 that a majority expressed such a view, results released Wednesday indicated. Poll results also indicated respondents remain as divided about Affordable Care Act as they have been for the past few years, with 48 percent expressing approval and 45 percent expressing disapproval." (InsuranceNewsNet)


Last-Minute Compliance Issues for Reporting Health Care Benefits on Form W-2 for 2012 - December 13

Sponsored by Lorman and BenefitsLink.com

This live audio conference discuss which employers are subject to the requirement and who must receive benefits information, the types of benefits that must be reported, and how these benefits must be valued for purposes of reporting. Discounted pricing for BenefitsLink readers.

Arizona Governor Rejects State-Run Health Exchange
"[Arizona Governor Jan] Brewer's decision ... means the federal government will set up an online marketplace for the state, offering subsidized private health coverage to the middle class. The governor reiterated her unwavering opposition to the health care overhaul, and said there were too many costs and questions associated with a state-run exchange." (The New York Times; free registration required)

Small Employer Self-Insurance Under the ACA
"The [ACA] changes the small-group insurance market substantially beginning in 2014, but most changes do not apply to self-insured plans. This exemption provides an opening for small employers with healthier workers to avoid broader sharing of health care risk, isolating higher-cost groups in the fully insured market.... Average single premiums would be up to 25 percent higher, if stop-loss insurance with no additional risk to employers than fully insuring is allowed -- an option available in most states absent further government action. Regulation of stop-loss at the federal or state level can, however, prevent such adverse selection and increase stability in small-group insurance coverage." (The Commonwealth Fund)

Proposed Anthem Blue Cross Rate Hike Could Mean Refund Checks for California Consumers
"Anthem Blue Cross could owe big refund checks to 730,000 Californians if its proposed rate hikes of up to 25% are deemed excessive thanks to an initiative voters will consider on the 2014 ballot. The ballot measure requires health insurance companies to get approval before raising rates and allows that refunds be ordered on rates that are considered excessive after November 6, 2012." (Consumer Watchdog)

Who Defines 'Fraud, Waste, and Abuse'? (PDF)
"This document contains a sample of the various definitions of the terms 'Fraud, Waste, and Abuse' from government agencies and health plans. There are more. The lack of a concrete definition in law should give pause as cost containment initiatives increase. Here are a few questions to consider: Who decides what definition to use for these terms? What will the definitions mean for patient care? What procedures will be defined as fraud, as waste, as abuse -- and for whom?" (Citizens' Council for Health Freedom)

Amicus Brief of Insurance and Employer Organizations in Petition for Certiorari on Availability of Equitable Relief to ERISA Disability Plan(PDF)
"Question presented: Whether the [9th Circuit] court of appeals erred in holding that when an ERISA plan seeks to recover overpaid benefits from a plan participant, 'equitable relief' is available and 'appropriate' under ERISA's remedial provision, 29 U.S.C. section 1132(a)(3), only if the participant still possesses the specific funds in question, or their specifically identifiable proceeds." [First Unum Life Insurance Co. v. Bilyeu, et al, (Petition for Writ of Certiorari to the U.S. Court of Appeals for the Ninth Circuit, No. 12-526)] (American Benefits Council, America's Health Insurance Plans, American Council of Life Insurers)

Benefits in General; Executive Compensation

[Guidance Overview]

ISS Issues Final 2013 Proxy Voting Policies
"ISS's current policy is to vote on a case-by-case basis on proposals to approve golden parachute compensation, consistent with its policies on problematic pay practices related to severance. The ISS final 2013 policy eliminates the previous 'grandfather' status of existing change-in-control arrangements with named officers.... ISS originally proposed adding hedging and pledging as an additional problematic pay practice under its pay-for-performance analysis. However, based on comments received, ISS determined that the negative vote recommendation should be directed toward election of directors rather than a company say-on-pay proposal." (Wilson Sonsini Goodrich & Rosati)

Most Consumers Lack Confidence in Ability to Pay Costs of Long-Term Care
"[M]ost consumers lack confidence in covering their long-term care costs in retirement and ... already low confidence levels appear to diminish further with age. While only 28 percent of Generation Xers are confident in meeting long-term care costs, that level of optimism declines to 24 percent among Baby Boomers. The trend of decreasing confidence with age was detected across all demographics surveyed, including gender, income and marital status." (Insured Retirement Institute)

Health Care Costs Are Largest Retirement Worry for Investors
"The top retirement concerns among investors aged 21-50 are health care costs (76%), rising taxes (67%), Social Security availability (63%), inflation (61%), long-term care (58%), living too long and running out of money (52%), and housing values (52%). Only 16% of investors expect to receive full Social Security benefits as currently promised. The remaining 84% expect to receive no Social Security benefits (36%) or some form of reduced benefits when they retire (48%)." (TD Ameritrade via InsuranceNewsNet)

Press Releases

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