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[Guidance Overview]
Final Regs Issued on PCORI Fees Payable by Health Insurers and Self-Insured Health Plan Sponsors
"The Regulations permit a plan sponsor that provides health coverage under two or more self-insured plans to treat them as one plan when calculating the PCORI fee, so long as the programs have the same plan year. For example, if a plan sponsor maintained both a self-insured major medical plan and a self-insured prescription drug plan and an individual benefited under both arrangements, that individual could be counted as only one covered life for purposes of determining the PCORI fee."
(McGuire Woods LLP)
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[Guidance Overview]
IRS Releases Final Regs Imposing PCORI Fee on Sponsors of Fully Insured and Self-Insured Health Plans (PDF)
"If a plan sponsor only maintains a health FSA (that is not an excepted benefit) or HRA, the plan sponsor may treat each participant's health FSA or HRA as covering a single covered life (and not include any spouse, dependent, or other beneficiary of the participant). If a plan sponsor maintains a health FSA or HRA and another applicable self-insured health plan (other than a health FSA or HRA), the plan sponsor may treat the two arrangements as a single plan."
(Aon Hewitt)
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Top 5 Priorities for Employer-Sponsored Health Plans
"Here's the short list of what employer health plan sponsors need to keep top-of-mind going into the New Year ... 1. Prepare for the health reform law's 2014 requirements.... 2. Evaluate the level of benefits provided.... 3. Examine whether private health exchanges have a place in the health benefits strategy.... 4. Ramp up health management programs for long-term savings... 5. Rethink where and how care is delivered."
(Mercer)
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Health Exchanges to Be Run by Only 18 States as Most Governors Pass
"Idaho, Nevada and Utah were among the states that submitted blueprint applications to the Obama administration by the Dec. 14 deadline to create exchanges for residents to shop for insurance as part of the [ACA] ... Governors who opted out said they balked at the federal regulations they would have to adhere to and long-term costs they would have to bear."
(Bloomberg)
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California Issues Amended Pregnancy Regulations, Extends Protections to 'Perceived' Pregnancy
"Amendments to California's pregnancy anti-discrimination regulations will extend coverage to 'perceived pregnancy,' defined as 'being regarded or treated by an employer or other covered entity as being pregnant or having a related medical condition.' With no additional guidance as to who is included in this protected class (which may include those who are not pregnant, but, because of a perception that they are, suffer adverse employment actions), it remains to be seen how the Department of Fair Employment and Housing Fair Employment and Housing Commission or California courts will interpret this term."
(Jackson Lewis LLP)
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[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
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Doctors Join Hospitals -- Prices Soar
"North Carolina patients pay more for many tests and procedures if their physician is employed by a hospital ... whether the health care offered is a heart stress test or a routine visit to a doctor's office. And it's part of a national shift that experts say is raising costs but not quality: Hospitals are increasingly buying doctors' practices, then sending bills for routine services that are significantly higher than those charged by independent doctors."
(The News and Observer)
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How Raising Age for Medicare Would Affect Seniors
"If Medicare raises its eligibility age, the medical costs for seniors ages 65 and 66 don't disappear -- they're simply shifted somewhere else.... [I]f Medicare's eligibility age were increased in 2014, the $5.7 billion in net savings to the federal government would be offset by an estimated net increase of $3.7 billion in out-of-pocket costs for 65- and 66-year-olds, and a rise of $4.5 billion in employer retiree health-care costs."
(CBS MoneyWatch)
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Findings from the 2012 EBRI/MGA Consumer Engagement in Health Care Survey
"10 percent of the population was enrolled in a CDHP, up from 7 percent in 2011.... Overall, 18.6 million adults ages 21-64 with private insurance, representing 15.4 percent of that market, were either in a CDHP or were in an HDHP that was eligible for an HSA.... [A]dults in a CDHP and those in an HDHP were more likely than those in a traditional plan to exhibit a number of cost-conscious behaviors."
(EBRI)
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Deloitte Health Care Reform Memo, December 17, 2012
"The two exchanges most frequently cited as prototypes are in Utah and Massachusetts -- two states with decidedly different demography, provider density, utilization and cost characteristics [A chart outlining the differences follows.] ... While implementing Section 1311 of the ACA is the focus for most states, commercial health insurers along with financial partners have started developing private health insurance exchanges to sell group and individual coverage in the states. The distinctions between the two are significant[.] [A chart outlining the differences follows.]"
(Deloitte)
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Benefits in General; Executive Compensation
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New Appointments and Leadership Announced for 2013 ERISA Advisory Council
Current members Karen Kay Barnes and Neal Schelberg will serve as the chair and vice chair, respectively, of the council. New members and the areas they represent are: Josh Cohen (Investment counseling); Christina R. Cutlip (Employers); Ronald Gebhardtsbauer (Actuarial consulting); Paul M. Secunda (General public); and James I. Singer (Employee organizations).
(Employee Benefits Security Administration)
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Reinhart Employee Benefits Update, December 2012 (PDF)
Articles include: Select Compliance Deadlines and Reminders; PBGC Announces Section 4062(e) Enforcement Pilot Programs; IRS Permits Governmental Plans to Elect Cycle E; IRS Issues Final Regulations Amending the Prohibited Payment Option Under Single-Employer Defined Benefit Plan of Plan Sponsor in Bankruptcy; New Guidance Released on Wellness Programs; Center for Medicare and Medicaid Services (CMS) Releases Health Insurance Market Reform Rules; and HHS Releases Proposed Rule Relating to Essential Health Benefits Actuarial Value and Accreditation Standards.
(Reinhart Boerner Van Deuren s.c.)
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Press Releases
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