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December 17, 2012          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

IRT Relationship Manager 3
for Wells Fargo in TX

Regional Sales Manager
for The Newport Group in IL

DC/401(k) Administrator
for Gelman Pension Consulting, Inc. in NY

Assoc Disability Ben Examiner
for The Standard in NY

Senior Tax Manager - Employee Benefits
for Postlethwaite & Netterville in LA

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Webcasts and Conferences

Employers at the Intersection of Public and Private Exchanges Webinar
Nationwide on January 22, 2013 presented by Employee Benefit News

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DOL Begins Auditing Group Health Plans for ACA, GINA and Wellness Program Compliance
"EBSA has updated its audit protocols to include a review of plans' compliance with the Patient Protection and Affordable Care Act (PPACA), the Genetic Information Nondiscrimination Act (GINA), and wellness programs, in addition to the laundry list of other federal benefits laws pertaining to group health plans. An uptick in PPACA enforcement appears to be underway, and many plan sponsors have received EBSA audit notices." (Jackson Lewis LLP)


Agenda Debut: Health & Benefits Leadership Conference

Sponsored by Health & Benefits Leadership Conference

While other events focus on the administrative & legal aspects, we bring you thought leaders & senior execs at major employers to inspire & give you real solutions to enhance your overall HR strategy. April 22-24. Aria, Las Vegas. BenefitsConf.com

Employers Offering More Financial Incentives to Get Healthy
"According to a [recent] survey ... nearly half of large employers with health-management programs included financial stakes for workers in 2012, up from just a third in 2011. A smaller, but growing, share of employers is taking a step further and tying such incentives to concrete outcomes, such as cholesterol levels, body mass index, blood pressure and smoking status. [Another] survey ... found that, for 2013, 29% of employers were planning to link financial incentives in their wellness programs to achieving specific health goals." (The Wall Street Journal)

Despite ACA Mandate, Tobacco Cessation Not Always Covered
"The Affordable Care Act decrees that insurers cover a list of preventive services, including smoking cessation attempts. But that doesn't mean physicians will always get paid for helping patients kick the habit.... [Mila Kofman, a research professor at Georgetown University's Health Policy Institute in Washington] analyzed 39 contracts between patients and insurers for individual, small group and government employee policies in six states. Thirty-six contracts included language indicating that preventive services would be paid for in full, but 26 of those contracts said smoking cessation was not covered. Four contracts excluded individual counseling, and 10 didn't include telephone counseling. Seven covered counseling for tobacco cessation but required patients to pay a portion." (American Medical Association)

Some Questions and Answers for Employees About Grandfathered Health Plans
"Consumers should know the status of their plans since that may determine whether they are eligible for certain protections and benefits created by the health law. For example, an employee at a large company may wonder why his job-based insurance doesn't include the free preventive services he's heard about. Or someone who purchases her own coverage may wonder whether she will be eligible for broader benefits when new insurance marketplaces open next fall. To answer those questions, you must understand the status of your plan and how grandfathering works." (Kaiser Health News)

Most States Punt Health Exchanges to Federal Government
"The option to have the federal government run the state markets was seen as a backstop when the Affordable Care Act was signed. Administration officials have repeatedly said they hoped most states would run the markets themselves because they know their insurance markets best. Only states with small populations such as Delaware or Montana would seek federal help, thought most experts. Instead, the majority of states will rely on the federal government." (National Public Radio)


Employer Health & Human Capital Congress - February 21-22, 2013 - Orlando, FL

Sponsored by World Congress

With deadlines looming, and Private Exchanges potentially shifting the employer-health care marketplace, focus on strategy planning and benchmarking. Talk directly to your counterparts in similar industries about next steps in these uncertain times.

Federal Government to Control Most Health Insurance Exchanges
"More than half of the state exchanges to be created under the 2010 U.S. health-care overhaul are expected to be run by the federal government, offering insurers and consumers uniform criteria in at least those areas.... Four states, Delaware, Illinois, Iowa and North Carolina, plan to contribute some services to a federally built exchange in a partnership with the Obama administration ... Those states may take on functions such as plan selection and customer assistance, while the federal government builds the websites and other infrastructure." (Treasury & Risk)

Which States Are Going with Insurance Exchanges -- and Does It Matter?
"[H]owever you do the math, the result is clear: the federal government will be involved in at least half of the new insurance exchanges come next October.... [T]he federal government's outsized role comes because many conservative governors -- who are strong supporters of states' rights -- said no to running state-based insurance exchanges.... [S]ome states are sitting out because of protest against the ACA, while others are concerned that the exchanges represent an unfunded mandate." (The Advisory Board Company)

Setup for State-Run Health Insurance Exchanges Is Massive Job with Crucial Deadline
"Officials in the states that did receive approval this past week to run their own health insurance exchanges describe the effort as a huge undertaking, with much work still to be done.... States must build Web sites that will tell consumers whether they are eligible for subsidized coverage and detail the cost of a plan's premiums, based on factors such as age and sex. They must also create consumer support programs to work with Americans who might be purchasing insurance coverage for the first time." (The Washington Post; free registration required)

Domino's Pizza Founder Sues Government Over Obamacare Contraceptive Mandate
"The founder of Domino's Pizza is suing the federal government over mandatory contraception coverage in the health care law. Tom Monaghan, a devout Roman Catholic, says contraception isn't health care but a 'gravely immoral' practice." (The New York Times; free registration required)

Health Benefits: The Biggest of All Tax Exclusions
"One of the biggest tax exclusion in the U.S. is the exclusion that allows workers who get job-based (or 'employer paid') health insurance coverage not to pay taxes on the value of those policies and employers to deduct the cost as a business expense. The exclusion costs the Treasury an estimated $246 billion annually, according to Congress' Joint Committee on Taxation, dwarfing the second-largest break, the mortgage interest deduction, which costs an estimated $98 billion." (Zane Benefits)

IRS Finalizes Regs for Comparative Effectiveness Research Fee on Health Plans (PDF)
"If a person is covered under both an insured medical program and a self-insured HRA, the insurer pays the fee with respect to the insured program, but the sponsor must pay the fee with respect to HRA coverage, even if that coverage is integrated with the medical coverage, and even if both coverages are part of the same ERISA plan. However, the fee is based solely on the number of employees or retirees enrolled under the HRA, not their dependents too." (Lockton, Inc.)

Appeal to D.C. Circuit Court May Put Pressure on Contraceptive Coverage Mandate
"Judges on the D.C. Circuit Court, the first appeals court to hear a case against the new federal health care law's mandate for free birth control and other reproductive health services ... left the impression [at an oral hearing] that they would not push for an early court ruling on the constitutionality of that requirement, even while showing some sympathy for the plight of religious colleges that complain it will interfere with their faith beliefs." (SCOTUSblog)

Most HSA Owners Don't Know About Preventive Care Coverage
"In the case of office visits, 18.1 percent of respondents understood the cost-sharing arrangement, meaning that they knew preventive office visits were exempt from the deductible but nonpreventive office visits were not exempt from cost sharing. For medical tests, 10.4 percent correctly understood the cost-sharing arrangement." (America's Health Insurance Plans (AHIP))

Philippine Legislators Approve Divisive Contraceptives Bill Despite Objections by Catholic Church
"Philippine legislators passed a landmark bill Monday that would provide government funding for contraceptives and sexuality classes in schools despite strong opposition by the dominant Roman Catholic Church and its followers, some of whom threatened to ask the Supreme Court to block the legislation." (The Washington Post; free registration required)


The Practical Reasons To Not Set Up State-Run Health Insurance Exchanges
"Much to the surprise of the administration 32 states have declined to participate. The reasons for a majority of states to refuse to participate has less to do with opposition to Obamacare than practical politics.... . At this point any governor signing up to run a [health insurance exchange] is signing himself and his administration up for an unmitigated headache as the rules are nebulous, the costs open ended, and the potential to torque constituents when they confront Department of Motor Vehicle style customer service when trying to buy health insurance. Eventually the governor and the legislature will have to answer to the voters for that headache." (RedState)


Time for California to Start a Health Insurance Rate Hike Revolution
"California's insurance commissioner has no authority to reject excessive increases to premium rates. And given that California is a leader in the healthcare industry, as many states and sometimes even the federal government often follow its regulatory lead, this is a big deal. Maybe if California's health officials could actually throw down the gauntlet at these brazen insurance companies, requiring them to justify the rate increases and even block any unnecessary ones, the trend would spread throughout the country." (FierceHealthPayer)

Benefits in General; Executive Compensation

McGraw Wentworth Benefit Advisor, December 2012 (PDF)
"This final issue of [the] Benefit Advisor for 2012 reviews the important developments that affected employee benefit programs this year. It also reviews the year-end housekeeping issues that organizations should revisit annually." (McGraw Wentworth)

AARP Returns to Hard Line Against Benefit Cutbacks
"AARP now appears to have veered back to a hard-line position of opposing any cutbacks in Medicare or Social Security and is seeking to keep those programs off the bargaining table altogether.... If the Chamber of Commerce is the lead voice of business leaders on the right in opposing increased taxes in the deficit talks, AARP plays a similar role on the left in opposing benefit cuts. It hopes to meet or make contact with the office of every member of Congress before a deal is done." (The New York Times; free registration required)

Seventh Circuit Affirms Penalties for Employer's Failure to Produce Requested Plan Documents
"The court noted that documents such as the internal guidelines requested in this case may not always be subject to ERISA's disclosure requirements. But citing a document as the basis for a claim denial elevates the document to the status of a plan document that must be provided upon request." [Mondry v. American Family Mut. Ins. Co., 2012 WL 5938681 (7th Cir. 2012)] (Thomson Reuters / EBIA)

Cypen & Cypen Newsletter for December 13, 2012
Covers employee benefit developments with an emphasis on governmental plans. Topics in this issue include: Switch From DB To DC May Not Be Best Solution; A Six-point Plan To Address Accelerated Exodus From DB Plans; Why Saving for Retirement May Be Good for Women's Health; and Health Care Costs Loom as Largest Investors' Retirement Worry. (Cypen & Cypen)

Press Releases

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