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December 26, 2012          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

Senior Compliance Analyst
for T. Rowe Price in CO

Senior Benefits Specialist - Retirement
for Freeport-McMoRan Copper & Gold Inc. in AZ

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Webcasts and Conferences

Prep for Compliance Testing Season: Fixing Plan Errors
Nationwide on January 10, 2013 presented by ASC (Actuarial Systems Corporation)

2013 FORUM East, "Making HealthCare Consumerism Work"
Nationwide on May 9, 2013 presented by The Institute for HealthCare Consumerism

Nationwide on December 5, 2013 presented by The Institute for HealthCare Consumerism

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[Guidance Overview]

Proposed Rule Would Require Plan Sponsors to Pay ACA's Transitional Reinsurance Program Fees
"[HHS] proposes to make self-insured plan sponsors directly responsible for payment of the transitional reinsurance fee, although self-insured plans could use a third party administrator (TPA) to transfer the fee to HHS. As HHS is now proposing a national contribution rate of $5.25 per person per month (i.e., $63 per person per year), this approach will result in direct, significant costs to self-insured plans." (The Segal Company)


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

Sponsored by Health Benefits Conference & Expo (HBCE)

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

[Guidance Overview]

Ten Critical Considerations for Health Insurance Plans Evaluating Participation in Public Exchange Markets (PDF)
"Health insurance plans need to fully prepare and understand the impact that the public exchanges may have on their business. Whether or not a health plan participates, the logjam that blocked reform progress for several months appears to have been cleared ... [and] brings new terminology and issues to light, which are critical to understand before making decisions on whether or not to participate in the public exchanges. This paper provides 10 critical considerations based on the preliminary rule recommendations published in the last half of November." (Milliman)

Health Care Co-Ops: Opportunities and Challenges
"[Under the ACA] the federal government will provide funds in the form of loans (not grants) as seed money for qualifying groups to start healthcare CO-OPs. The CO-OPs are meant to serve as nonprofit issuers of health insurance, governed by the plan's membership... [T]he effective date for new CO-OPs to have their operational details in place is October 1, 2013, if they want to take part in the state exchanges as of January 1, 2014.... Approved CO-OPs must make many decisions and act quickly to put their administration processes in place. For example, they must: [1] Choose between building their own organizations from scratch and contracting with outside vendors; [2] Design their benefit plans, including pricing Enlist physicians, hospitals, and other provider entities for working with prospective CO-OP plan members; [3] Plan their marketing strategies[.] It's a lot to do in a few months' time." (Milliman)

ACA Presents Many Unknowns for California Officials
"As California positions itself at the vanguard of the national healthcare overhaul, state officials are unable to say for sure how much their implementation of the federal Affordable Care Act will cost taxpayers. The program, intended to insure millions of Americans who are now without health coverage, takes states into uncharted territory." (Los Angeles Times)

Resolve to Create a Healthy Workforce in 2013
"Many companies provide wellness programs because they sincerely care about their employees. But these programs also can affect a company's bottom line.... [F]or every dollar spent on an employee wellness program, medical costs decreased by about $3.27 and costs related to employee absenteeism dropped by $2.73. Researchers concluded that nearly 25 percent of all employer-employee medical costs are related to issues that can be addressed by employer-based wellness programs." (The Bakersfield Californian)


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.

How Individuals Will Get Health Coverage Under the ACA (PDF)
"This month's Visualizing Health Policy provides a step-by-step guide through the options and requirements for health coverage under the Affordable Care Act beginning in 2014, including coverage through an employer, coverage through a health insurance exchange, and coverage through Medicaid." (Kaiser Family Foundation)

Partial List of Taxes and Fees Under the ACA
"For the vast majority of people, the health care law won't mean sending more money to the Internal Revenue Service. But the wealthiest 2 percent of Americans will take the biggest hit, starting next year. And roughly 20 million people eventually will benefit from tax credits that start in 2014 to help them pay insurance premiums. [Here is a] look at some of the major taxes and fees, estimated to raise nearly $700 billion over 10 years." (The New York Times; free registration required)

Health Care Tax Hikes for 2013 May Be Just a Start
"It's hard to see how lawmakers can avoid touching health insurance if they want to eliminate loopholes and curtail deductions so as to raise revenue and lower tax rates. Congress probably wouldn't do away with the health care tax break, but limit it in some form. Such limits could be keyed to the cost of a particular health insurance plan, the income level of taxpayers or a combination." (The New York Times; free registration required)

Certain Plan Designs Will Cost More Under the PCORI Fees
"[A]n employer that sponsors a fully insured high deductible health plan paired with a self-funded HRA will essentially be required to pay the fee twice on the same lives.... Employers who sponsor self-funded HRAs with fully insured medical plans may wish to consider other plan designs to avoid this fee, such as self-funding the high deductible health plan or moving to a plan design that uses HSAs instead of HRAs." (Leonard, Street and Deinard LLP)


The Battle of the Narrative: How Ordinary Americans Can Fight Obamacare
"As the problems of ObamaCare inevitably emerge, the big question will be whether they will be blamed on the residual free-market elements of our health system or on the new government controls. This will be the battle of the 'narrative.'" (Forbes)

Benefits in General; Executive Compensation

Top Ten Myths of 'Say on Pay'
"Some of the factors running through several of the 'Ten Myths' are: Many shareholder say on pay votes FOR or AGAINST, are really votes in favor of or against the recent performance of the company's stock, rather than its compensation package.... [S]ome shareholders are more focused on political issues than stock price performance -- never mind their fiduciary duties.... Anyone who cannot grasp the fact that stock options are performance-based compensation ought to be disqualified from voting[.]" (Winston & Strawn LLP)

Status of Employee Benefits Under DOMA: An Update (PDF)
"Pending the Supreme Court's decision, the application of DOMA in the states of the Second Circuit (Connecticut, New York, and Vermont) is not clear. Although the DOJ will no longer defend DOMA, the law still stands. While it appears that employers in the Second Circuit should continue to impute income for benefits provided to legally married [same-gender] spouses, they must consult with counsel for all the legal implications of the decision." (Buck Consultants)

Be Careful How You Word Your Claims Procedure
"The language of the plan's claims procedure provided as follows: 'In the case of a claim that is not appealed to the Claims Committee in a timely manner by the claimant, the decision of the Claims Administrator shall be the final and conclusive administrative proceeding under the Plan, and the decision of the Claims Administrator shall be given legal deference . . . in any subsequent legal proceeding.' ... According to the court, the provision clearly provided that an adverse claim decision that was not appealed is final and conclusive and the equivalent of an appealed decision. Therefore, the retiree had properly exhausted the plan's claims procedure and could proceed with his action." [Ross v. Weyerhaeuser, No. CIV-11-422-FHS (E.D. Okla., Nov. 27, 2012)] (Leonard, Street and Deinard LLP)

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David Rhett Baker, J.D., Editor and Publisher
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