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December 6, 2012          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

Retirement Services Consultant
for CUNA Mutual Group in WI

Plan Administrator
for Chemung Canal Trust Company in NY

Sr. Retirement Services Consultant
for CUNA Mutual Group in WI

Sr. 401(k)/DC Plan Admin Specialist
for CUNA Mutual Group in WI

Sr Account Executive - Retirement Services
for Principal Financial Group in MA

Plan Administrator
for The Newport Group, Inc. in FL, TX, VA

Daily Valuation Administrator
for Heritage Pension Advisors, LLC in MA

Retirement Education Specialist
for The Newport Group, Inc. in NC

Senior Account Manager/Employee Benefits
for Beneflex Insurance Services, Inc. in CA

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Webcasts and Conferences

Health Care Reform After the Election
in California on December 11, 2012 presented by Seyfarth Shaw LLP

View All Webcasts and Conferences

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[Guidance Overview]

Health Insurers and Self-Insured Plans Get Final IRS Regs on Fees to Fund Patient-Centered Outcomes Research Institute
"[T]he fees imposed on an issuer of a specified health insurance policy and those imposed on a plan sponsor of an applicable self-insured health plan is two dollars (one dollar in the case of policy years ending before October 1, 2013) multiplied by the average number of lives covered under the policy or plan.... [T]he rule provides that a specified health insurance policy does not include any insurance policy to the extent it provides for an employee assistance program (EAP), disease management program, or wellness program, if the program does not provide significant benefits in the nature of medical care or treatment." (Littler Mendelson LLC)


Summaries of Benefits and Coverage Now Available!

Sponsored by ftwilliam.com

Wolters Kluwer Law & Business – ftwilliam.com now offers the newly required Summaries of Benefits and Coverage (SBC). Contact us for a demo and if you have more than just a few plans, ask us about our batch printing option.

Health Care Payment Reform Could Save $200 Billion to $600 Billion During Next Decade But Implementation Challenges Substantial
"Americans could realize net savings in health care costs of around $200 billion to $600 billion cumulatively over the next 10 years if concerted action is taken to reform care provider payment incentives, including moving away from the traditional fee-for-service model ... U.S. physicians say that care costs could be cut by an average of 18 percent without any impact on quality, and 59 percent of physicians report there are meaningful differences in the quality of care provided by doctors in their local areas -- although only 44 percent of consumers are aware of them." (UnitedHealth Group)

Farewell to Fee-For-Service? A 'Real World' Strategy for Health Care Payment Reform (PDF)
"The federal government projects that national health spending will rise from $2.8 trillion to $4.8 trillion over the coming decade -- accounting for nearly 20 percent of the U.S. economy.... [This Working Paper] assesses the spectrum of options for reforming payments; publishes results of a new national survey of physicians' views about payment reform; and shares new UnitedHealth Group data and 'real world' implementation experience about what it will take to genuinely unleash the potential of payment reform." (UnitedHealth Center for Health Reform & Modernization)

Alternative Health Care Providers Push for Inclusion As 'Essential Health Benefits'
"The chiropractors were out in force, lobbying for months to get their services included in every state's package of essential health benefits that will be guaranteed under the new health care law.... The acupuncturists were modest by comparison, ultimately focusing on a few states, like California, where they had the best odds of being included.... Both efforts seem to have shown results." (The New York Times; free registration required)

Olive Garden Restaurant Chain Decides Not to Move Employees to Part-Time Status to Avoid ACA
"The company, based in Orlando, Fla., is set to announce Thursday that none of its current full-time employees will have their status changed as a result of the new regulations. The move will come just two days after the company lowered its profit outlook for the year, citing failed promotions and negative publicity from its tests that used more part-time employees. The tests were aimed at keeping down costs tied to new health care regulations, which will require large companies to provide insurance to full-time workers starting in 2014." (The Washington Post; free registration required)


Executive Forum on Rewarding Healthy Behaviors - January 30-31, 2013 - San Diego

Sponsored by World Congress

The pre-eminent event for innovative workplace wellness and preventive health management initiatives designed to promote health behavior change within health insured populations. Evidence-based success strategies to contain healthcare costs.

Trends and ACA Changes for Workplace Wellness Programs
"The [ACA] will, as of 2014, expand employers' ability to reward employees who meet health status goals by participating in wellness programs -- and, in effect, to require employees who don't meet these goals to pay more for their employer-sponsored health coverage. Some consumer advocates argue that this ability to differentiate in health coverage costs among employees is unfair and will amount to employers' policing workers' health. This brief explains trends in wellness programs, details changes in the law starting in 2014, and highlights issues to watch." (Robert Wood Johnson Foundation)

HHS, OPM Issue Proposed Regs on Multistate Health Plans, Risk Standard Expansion
"To reduce incentives for health insurers to avoid enrolling people with pre-existing conditions, the permanent risk adjustment program would assist health plans that cover individuals with relatively high health care costs and would help ensure that those who are sick have access to coverage they need, CMS said." (Bloomberg BNA)

MLR Rules Saved Consumers $1.5 Billion But That's Bad News for Insurers
"The health-care law has a rule requiring insurers to spend at least 80 percent of health-care premiums on medical care. The good news: It's saved consumers $1.5 billion in one year! The not-so-good news: Some insurers are operating at a loss." (The Washington Post; free registration required)

Drug Store Trips as a Medical Expense?
"For millions of Americans, Dec. 31 is the deadline to make use of the pre-tax earnings set aside for medical expenses in flexible-spending accounts ... Since the money ... can't be rolled over from year to year, many employees scramble to stock up on first-aid kits and new glasses to avoid losing the balance. But there are better ways.... The transportation costs of getting to and from the doctor or pharmacy qualify. In fact, employees can also get reimbursed for parking, tolls and up to 23 cents a mile." (MarketWatch.com)

Cleveland Clinic's Incredible Vision for the Future of Health Care
"For costs to come down, hospitals need to embrace innovation in how they do business, and start to change some of the behaviors that have made healthcare more and more expensive without making it any better for patients.... 98 percent of the people that request a same day appointment at the Cleveland Clinic get one, and there were over one million such appointments last year. Focusing on costs doesn't have to come at the expense of the patient." (Business Insider)

The Case for Replacing a Traditional PPO with a CDHP [Consumer-Driven Health Plan] (PDF)
"A case study ... found that 91% of employees with families and 65% of employees overall would have spent less in a plan year under a CDHP design than with the Preferred Provider Organization (PPO) plan offered. Families would average $140 per month in premium and out-of-pocket savings, while employees overall would save $55 per month." (Change Healthcare)

Analysis of the ACA Annual Tax on Health Insurers, Allocated by State
"The [ACA] will impose taxes beginning in 2014 on insurance companies that offer fully-insured coverage. The taxes will be assessed on earned health insurance premiums, with certain exclusions.... On average across all states ... additional premiums to be paid over the ten-year period would increase by [1] $2,171 for single contracts and $5,140 for family contracts in the individual market; [2] $2,794 for single contracts and $6,883 for family contracts in the small-group market; and [3] $2,636 for single contracts and $7,186 for family contracts in the large-group market." (Oliver Wyman, for America's Health Insurance Plans)


Regulation of Premiums May Be Needed for Consumers to Benefit from Health Insurers' Administrative Savings
"[A recent] report notes that many insurance companies reduced administrative costs in 2011, but retained those savings as profits rather than reduce premiums for customers. Despite insurance companies' failure to pass on all administrative savings, the 80-20 rule did result in $1.45 billion in savings for consumers, largely in the form of rebates." (Consumer Watchdog)

Video Illustrates Impact of ACA's $100 Billion Health Insurance Tax
"To further raise awareness of the new $100 billion health insurance tax included in the Affordable Care Act (ACA), [this video] highlights the impact this tax will have on people purchasing coverage in the individual market, small businesses, and Medicare Advantage beneficiaries. The new video follows the release of a state-by-state analysis from Oliver Wyman that estimates the impact this tax will have on policyholders in all 50 states." (America's Health Insurance Plans (AHIP))


Medical Loss Ratio Caps Are Bad Public Policy, and Here's Why
"The MLR caps any expense that does not go directly to pay for medical care or is not included on a pre-approved list of 'activities that improve health care quality.' As a result, this regulation places an arbitrary cap on what health plans can spend on a variety of programs and services that improve the quality and safety of patient care, help patients navigate a complicated delivery system, and help control soaring medical costs." (America's Health Insurance Plans (AHIP))


Business Owners on the Cost of Obamacare
"[F]orget President Obama's 'if you like your plan, you can keep it' promise. Two government agencies have estimated that more than 11 million people will no longer have their employer-sponsored health coverage once Obamacare is fully implemented. Other studies have put that number much higher. With employers dumping employees into government-run insurance exchanges or Medicaid (which are still unsettled proposals), the future of health insurance will be taxpayers footing the bill. This is a huge money problem on top of the skyrocketing entitlement programs that already exist." (The Heritage Foundation)


It's Not Profit That's Destroying Our Health Care; It's the Private Insurance Business Model
"Many Europeans use private health insurance companies, a few of them for-profit. These Europeans enjoy better care for more people at lower cost than we do.... It is not profits but the business model that places the financial interests of our health insurance industry in opposition to the medical interests of its clients. Neither removing profits, nor enhancing competition, nor deregulation will increase health care quality or make health care more accessible." (Physicians for a National Health Program)


The Crown Jewel of Obamacare Failures
"As employers learn more about the requirements of the new law they are more likely to run away from it. We can't know until it happens how many employers will drop coverage, but the 30% estimated by McKinsey [in a 2011 study] may be the minimum. That could mean 50 million or more people who used to get employer coverage no longer will." (John Goodman's Health Policy Blog)


Inside Baseball: Getting the Federal Health Insurance Exchange Right
"In order for the feds to administer the new insurance exchanges, they have proposed a fee of 3.5% of premium on each insurance policy sold in the exchanges (page 224 [of the 'Draft Notice of Benefit and Payment Parameters for 2014']).... Under the new health care law's Minimum Loss Ratio (MLR) provisions, insurance companies are limited to no more than 20% of premiums for expenses in the small group and individual markets. The feds just increased those expense ratios by 18%." (The Health Care Blog)

Benefits in General; Executive Compensation

Accelerating Incentive Pay From 2013 to December 2012 -- Executive Compensation Planning for the Fiscal Cliff
"[Accelerating] payments of incentive compensation into 2012, rather than pay them in 2013 ... may sound tempting to executives given all of the headlines of the fiscal cliff and potentially higher tax rates on high-wage earners. Still, a lot can happen between now and December 31st. To determine the appropriate tax planning strategy, employers should take the following steps: (1) Have a Discussion With Key Executives ... (2) Consider Plan Documentation and Code Section 409A Challenges ... (3) Determine When to Act ... Public Company Employers Probably Should Not Accelerate Payments." (Porter Wright Morris & Arthur LLP)

New Company Benefit? Consider Matching Contributions to a Section 529 College Savings Plan
"Dun & Bradstreet Credibility Corp. ... announced this week a 'multiple match' program for employees who contribute to a 529 college savings plan. The company will match dollar for dollar up to $2,500 per year in total contributions made by salaried employees and up to $1,000 per year for hourly workers, beginning with any contributions made in 2012. (The 529 matching payments are taxable, but the company says it will contribute enough additional money to cover the taxes itself, so that employees wind up with the full dollar-for-dollar value.)" (MarketWatch)

IRS Issues Proposed Regs on High-Earners' Additional Medicare Tax
"Unlike Social Security, the amount of compensation subject to the 1.45 percent Medicare FICA tax is uncapped.... The additional tax differs from the standard Medicare tax in that there is no employer portion to correspond to the additional amount owed by the employee.... The proposed rules clarify that calculating wages for purposes of withholding the additional Medicare tax is no different than calculating wages for FICA generally." (Society for Human Resource Management)

Mercer Workplace Survey, 2012 (PDF)
"Facing an unconvincing economic recovery, workers are nonetheless extending their new commitment to retirement savings both inside and outside their workplace retirement plans. 401(k) and other retirement savings are on the way up again. Feeling vulnerable and out of time, older workers especially are funding their 401(k)s more generously.... Participants are also finding the overall benefits landscape more difficult to navigate this year than last with perceived complexity up and quality of information down, a striking reversal of historic experience. At the same time, this insured population of workers is ever more skeptical of national health care reform and what it will mean to them and their personal circumstances." (Mercer)

Press Releases

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