Retirement Planning Consultant
for Diversified in IN

Defined Benefit Plan Administrator
for Growing Westchester County NY Actuarial and Administration Firm in NY

Client Service Representative
for Associated Pension Consultants in CA

ERISA Compliance Reviewer
for Employee Fiduciary, LLC in AL, FL

Assistant Relationship Manager
for Lincoln Trust Company in CO

ERISA Associate
for Schwartz, Steinsapir, Dohrmann & Sommers LLP in CA

401(k) Conversion Specialist/Customer Service
for Vesdata in WI

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National Health Policy Conference
in District of Columbia on February 4, 2013 presented by AcademyHealth

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NIPA (National Institute of Pension Administrators)

 

[Guidance Overview]

HHS Updates 'Common Questions' on Early Retiree Reimbursement Program Website
"The new common questions clarify that a plan sponsor may use the ERRP funds it receives during a given plan year to retroactively offset health benefit or health benefit premium cost increases it already experienced during that same plan year. A plan sponsor may do this either by actually applying the ERRP funds during that same year or by retroactively applying the ERRP funds during the subsequent plan year." (Wolters Kluwer Law & Business)

[Advert.]

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[Guidance Overview]

HHS Issues Proposed Regs on ACA Transitional Reinsurance Program
"If states establish their own reinsurance programs, they have the option of requiring additional reinsurance contributions, although those additional contributions will apply to insurers only and not to self-insured plans.... [S]elf-insured group health plans and insurers must make reinsurance payments annually on a calendar year (rather than plan year) basis." (HighRoads)

[Guidance Overview]

Another Day, Another (Health Care Reform) Dollar: The ACA's Transitional Reinsurance Program
"Fees to support this transitional reinsurance program will be assessed against both insured and self-funded group health plans. The total amount of fees to be collected over the three-year period is $25 billion. Of this amount, $20 billion will fund the reinsurance program, while the other $5 billion will be paid to the U.S. Treasury. The ... $5 billion payable to the Treasury equals the amount appropriated by the ACA to fund the Early Retiree Reinsurance Program, which began in 2010. That program ... exhausted its $5 billion appropriation well before its scheduled end date of January 1, 2014." (Spencer Fane)

[Guidance Overview]

Untangling New Form W-2 Reporting Requirements for Professional Employer Organizations
"Unfortunately, the IRS has not yet addressed how the ACA Form W-2 reporting requirements apply to Professional Employer Organizations (PEOs). Specifically, where health care is offered at the PEO-level and at the client-level, it's not clear which entity has the obligation to report, and how many employees to be counted to determine whether the IRS transitional rule applies.... [S]ome legal commentators and consultants believe that subsequent ACA Form W-2 regulations will model the FMLA and Title VII approach. But these laws, while similar in subject matter, are not controlling, and though they may give some insight into how the regulations will approach ACA Form W-2 reporting for PEOs, they should not be the basis of compliance." (Ford & Harrison LLP)

Cutting the High Cost of End-of-Life Care
"One out of every four Medicare dollars, more than $125 billion, is spent on services for the 5% of beneficiaries in their last year of life. Yet even with Medicare or private insurance, you're likely to face a big bill: A recent Mount Sinai School of Medicine study found that out-of-pocket expenses for Medicare recipients during the five years before their death averaged about $39,000 for individuals, $51,000 for couples, and up to $66,000 for people with long-term illnesses like Alzheimer's." (CNNMoney.com)

[Advert.]

Nat'l Health Benefits Conf & Expo (HBCE) Jan.29-30, 2013 -- Clearwater Beach, FL

Speakers wrote the books on wellness, onsite clinics, disease management, obesity and health reform. Hear from public employers, universities, Boeing, FirstEnergy, JetBlue, Mayo Clinic, many more. Low cost, high quality! >HBCE.com Ph: 941-484-1430 info@HBCE.com

53% of Consumers 'Oblivious' to Costs of Health Care
"'[S]urveys show that about 53% of consumers are oblivious to costs and tend to go along with whatever is suggested. Only one in 10 is inclined to be price sensitive,' [says Paul H. Keckley, PhD, executive director of the Deloitte Center for Health Solutions.] 'That is a pretty bad starting point for reducing healthcare costs, especially if the incentives in the system are for doing more, which leads doctors and providers to recommend tests and surgeries that shouldn't be done, or even medications that don't work.'" (HealthLeaders Media)

Experts Say There's Still Time to Set Up State Exchanges
"Some states say it was tardy, shoddy guidance from the Obama administration that forced them to punt on running a state-based health insurance exchange. But many exchange experts aren't buying it, saying plenty of other states have forged ahead and that those that waited until the eleventh hour still can. In fact, one prominent consultant said he can get the exchange basics up and running in 90 days." (Politico)

Significant Changes to California Pregnancy Leave Take Effect December 30
"California employers with five or more employees are covered by [pregnancy disability leave, or 'PDL'].... [H]ere are the five most significant changes: 1. Health Benefits Continuation During PDL Is Separate and Distinct from Coverage During CFRA/FMLA.... 2. An Employer That Fails to Reinstate an Employee to a Comparable Position Must Now Notify the Employee of Available Positions for 60 Days Following the Scheduled Date of Reinstatement ... 3. [A]n employee's entitlement to PDL varies based on the number of hours typically worked in a week.... 4. Employers may not discriminate, harass, or take other adverse actions on the basis of 'perceived pregnancy.'" (Wilson Sonsini Goodrich & Rosati)

'Global Payments' -- Shifting How Health Care Is Paid For
"Massachusetts, a model for President Obama's 2010 national healthcare law, may offer another template for national leaders looking to control health spending.... In the last three years, commercial insurers in the state have moved nearly 1 million patients into health plans that reward doctors and hospitals that control costs while improving quality.... The building block of the Massachusetts experiment is a contract between insurers and groups of doctors known as a global payment. In such contracts, physicians receive a budget to care for a cohort of patients. If doctors can care for their patients more economically, they keep a portion of the savings. If patient care exceeds the budget, they pay a penalty." (Los Angeles Times)

Best Practices for Employers in Administering FMLA Leave
"Medical certification, recertification and second/third opinions continue to be among the best tools to combat FMLA abuse.... An honest belief that an employee is abusing FMLA leave -- in most cases and states (except California!) -- is a strong defense to an FMLA claim, so long as the employer conducts a complete and exhaustive investigation of the facts involved." (FMLA Insights)

Eleven Governors Seek Meeting with Obama to Discuss New Health Care Law
"The governors made several suggestions that included asking that states be allowed to determine their own Medicaid eligibility levels and still receive all the federal funds.... The governors also said they want to be able to leverage their private health insurance markets to reduce dependency on entitlement programs." (The Washington Post; free registration required)

Healthcare Benefit Innovations Continue
"The [ACA] ... has helped spur employers to be more proactive in controlling costs ... The cost-shifting trend may be culminating in the growing number of companies that are switching to a 'defined-contribution' approach to healthcare by giving employees a fixed amount each year to go and purchase their own coverage. Forty-five percent of employers say they currently use or plan to use this approach ... More than half of the survey respondents (56 percent) said they would consider a private exchange ... for their active or retired employees." (Human Resource Executive Online)

Aetna CEO Sees Obamacare Doubling Some Premiums
"Health insurance premiums may as much as double for some small businesses and individual buyers in the U.S. when the Affordable Care Act's major provisions start in 2014 ... While subsidies in the law will shield some people, other consumers who make too much for assistance are in for 'premium rate shock,' [said] Mark Bertolini, who runs the third-biggest U.S. health-insurance company[.]" (Bloomberg BusinessWeek)

Private Health Exchanges: A Second Look Before Leaping
"[E]mployers will essentially be giving up control of plan design in exchange for ease of administration. Whether that trade makes sense for any particular employer is a question each has to answer on its own." (Benefits Bryan Cave)

How Does Employment -- or Unemployment -- Affect Health?
"Steady employment can provide the income, benefits, and stability necessary for good health.... Employers can institute a variety of strategies -- including workplace wellness programs, job safety training, and education initiatives -- to keep employees healthy and help their bottom line." (Robert Wood Johnson Foundation)

Spending for Private Health Insurance in the United States (PDF)
"Employees have been required to shoulder an increasing portion of rising premiums through their explicit contributions, hitting 27 percent in 2011. They are also increasingly likely to face a deductible, and average deductible levels have been rising quickly.... Average premiums in the non-group market are lower than in the employer-based market and have been increasing a little less rapidly. Deductibles, on the other hand, are considerably higher in the non-group market, consistent with a growing prevalence of plans eligible for health savings accounts." (National Institute for Health Care Management)

Addressing the Underlying Drivers of Growth in Health Care Costs
"According to National Health Expenditure data released by the U.S. Department of Health and Human Services, from 2000-2010 the growth in premiums tracked almost directly with the growth in benefits -- a trend that has been consistent for decades. The NHE data also shows that medical prices accounted for nearly 3/4 of the increase in personal health care spending." (America's Health Insurance Plans (AHIP))

[Opinion]

Deadline Approaching for States to Decide on Obamacare Exchanges
"[December 13 is] the deadline for states to declare their intentions about setting up their own health insurance exchanges for residents to purchase insurance under the new regime. If a state does not set up an exchange, the federal government will come in and set it up ... Why leave it up to the federal government? Well, to begin with, it's an extremely costly undertaking.... We are being reminded every day that Obamacare is still a work in progress, and a lot can still go wrong and likely will. These are the problems you face when you try to overhaul one-sixth of the economy in one piece of legislation." (The Heritage Foundation)

[Opinion]

Health Insurance Market Regulations Under the Affordable Care Act: Protections for Consumers and Small Businesses
"In 2010, more than one-third of adults ages 19 to 64 who tried to buy a health plan in the individual market over a three-year period, an estimated 9 million people, were either turned down because of a preexisting condition, charged a higher price, or had a condition excluded from their coverage. In just over a year from now, none of these practices will be allowed." (The Commonwealth Fund)

[Opinion]

Don't Raise the Eligibility Age for Medicare
"Medicare provides the bedrock of health security for more than 47 million Americans today and must be preserved and strengthened for seniors, their kids and grandkids, and future generations. Proposals to increase the Medicare eligibility age simply shift costs onto beneficiaries and do nothing to lower health care costs." (AARP)

[Official Guidance]

IRS Eliminates Form 5500 Proposed Penalty Notices
"Beginning January 1, 2013 the IRS will discontinue sending these notices: CP 213N, Proposed Penalty Notice for Late Filing of Form 5500, Annual Return/Report of Employee Benefit Plan CP 213I, Proposed Penalty Notice for Incomplete Filing of Form 5500 The IRS is eliminating proposed penalty notices under the Form 5500 program in an effort to reduce processing costs, reduce notices and comply with notice and systems standards. Filers will continue to receive CP 283, Penalty Charged on Your 5500 Return, if a Form 5500 is filed late or is incomplete." (Internal Revenue Service)

EBSA Renews Charter for ERISA Advisory Council
"Not more than eight members of the [Advisory Council on Employee Welfare and Pension Benefit Plans, sometimes called the 'ERISA Advisory Council'] shall be of the same political party. Three of the members shall be representatives of employee organizations (at least one of whom shall be a representative of any organization members of which are participants in a multiemployer plan); three of the members shall be representatives of employers (at least one of whom shall be a representative of employers maintaining or contributing to multiemployer plans); three members shall be representatives appointed from the general public (one of whom shall be a person representing those receiving benefits from a pension plan); and there shall be one representative each from the fields of insurance, corporate trust, actuarial counseling, investment counseling, investment management, and accounting." (Internal Revenue Service)

Consumer�s Medical Resource� President And Founder Asked To Serve As NCEBBD Committee Member
Consumer's Medical Resource, Inc.

PBGC Director Joshua Gotbaum to Testify on Multiemployer Pension System
U.S. House Committee on Education and the Workforce

Great-West Financial Unveils New Retirement Income Control Panel Delivering Custom Retirement Strategies
Great-West Retirement Services

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