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February 6, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
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401k Plan Administrator
for Doherty Employer Services in MN

Legal Assistant / Paralegal
for Peeples & Hilburn, P.C. in TX

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Webcasts and Conferences

COBRA Compliance for Group Health Plans
in Washington on April 11, 2013 presented by Thomson Reuters / EBIA

HIPAA Privacy & Security
in Washington on April 11, 2013 presented by Thomson Reuters / EBIA

Health Care Reform
in Washington on April 12, 2013 presented by Thomson Reuters / EBIA

ERISA Compliance for Health & Welfare Plans
in Washington on April 10, 2013 presented by Thomson Reuters / EBIA

Cafeteria Plans
in Washington on April 9, 2013 presented by Thomson Reuters / EBIA

A Prudent Process for Investment Manager Selection Webinar
Nationwide on February 20, 2013 presented by Multnomah Group

EBIA’s Full-Day Health Care Reform Seminar: A Webcast Re-Presentation
Nationwide on May 8, 2013 presented by Thomson Reuters / EBIA

HSAs, HRAs, and Consumer-Driven Health Care
in Washington on April 10, 2013 presented by Thomson Reuters / EBIA

US Equity as Compensation for a Global Workforce: Issues and Pitfalls (NY CLE Program)
in New York on February 14, 2013 presented by WEB (Worldwide Employee Benefits Network ), New York Chapter

Section 436 - Now and Future Webcast
Nationwide on February 27, 2013 presented by American Society of Pension Professionals & Actuaries (ASPPA)

View All Webcasts and Conferences


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[Guidance Overview]

A Short Q&A on Employer Shared Responsibility (PDF)
"What is Shared Responsibility? ... Who has Shared Responsibility? ... What is the Shared Responsibility of employers that do not offer health coverage? ... What is the Shared Responsibility of employers that do offer health coverage? ... What is a cost-sharing reduction? ... What is a premium tax credit? ... What Does It Mean to Employ 50 or More Full-Time Employees?" (Want Kobayashi Austin, LLC)


[Advert.]

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[Guidance Overview]

Expanded Contraception Coverage Exemption for Religious Organizations Proposed by HHS and IRS
"Under the new proposal, the government agencies would expand the definition of exempt religious employers, but also would enable women covered by these employers' plans to obtain the contraceptive coverage as a preventive health benefit at no additional cost, either to them or their employer. The new rules expand the religious employer exemption by eliminating the requirements that an employer's purpose must include the inculcation of religious values, and that it must employ primarily persons who share its religious tenets." (Ballard Spahr)

[Guidance Overview]

Proposed Contraceptive Coverage Rules Would Involve Insurers and TPAs
"For purposes of the accommodations, an eligible organization is one that: [1] Opposes providing coverage for some or all of the required contraceptive services due to religious objections. [2] Is organized and operates as a nonprofit entity. [3] Holds itself out as a religious organization. [4] Self-certifies that it satisfies the first three criteria, under a process to be addressed in future guidance. The definition of eligible organization does not include for-profit secular employers." (Practical Law Company)

Some Part-Timers to Fall Within Health Care Coverage Mandate
"The gap between part-time and full-time insured workers looms large, as the [ACA] ... requires that employers with 50 or more full-time employee equivalents provide affordable coverage to any employee working 30 or more hours per week, or 130 hours per month, beginning in 2014. 'Potentially, this provision could create a spike in part-time employees eligible for benefits starting in 2014,' [said an] ADP spokesman ... 'The eligibility percentage remains a critical question because even small changes to this number can have a material impact on an employer's benefit costs. For this reason, we expect employers to manage and monitor part-time eligibility closely.'" (Society for Human Resource Management)

IRS to Base Insurance Affordability on Single Coverage
"In 2012, according to an annual survey by the Kaiser Family Foundation, total premiums for employer-sponsored health insurance averaged $5,615 a year for single coverage and $15,745 for family coverage. The employee's share of the premium averaged $951 for individual coverage and more than four times as much, $4,316, for family coverage. Under the [IRS] rule, such costs would be considered affordable for a family making $35,000 a year, even though the family would have to spend 12 percent of its income for full coverage under the employer's plan." (The New York Times; free registration required)

CBO Predicts Bright Short Term But Unsustainable Health Costs As Baby Boomers Retire
"Even though health spending has slowed in recent years for reasons analysts do not fully understand, the sheer volume of new Medicare and Medicaid recipients means costs will rise. The number of people eligible for Social Security retirement benefits will be 40% higher in 10 years than in 2012[.]" (Los Angeles Times)

CBO Chart of ACA's Effect on Health Insurance Coverage, February 2013 Baseline (PDF)
Chart shows estimates of the effect of the ACA on the number of persons covered by Medicaid/CHIP, employers, Exchanges, and nongroup coverage, as well as total uninsured, for each year from 2013 through 2023. (Congressional Budget Office)

Three Ways CBO Expects Health Spending to Change
"Why will 3 million fewer Americans receive employer-sponsored insurance? You can thank the American Tax Payer Relief Act, which preserved low tax rates for those with incomes below $450,000. That change will 'reduce the relative attractiveness of employment-based insurance for low-income workers and for their employers,' the CBO projects. In other words, providing health insurance as a tax-free form of income becomes less attractive when marginal tax rates are lower -- and when a publicly-subsidized option becomes available." (The Washington Post; free registration required)

Health Insurance Expansion Eroding Under ACA, According to CBO
"The number of Americans projected to gain insurance from the U.S. health-care law is eroding, by at least 5 million people, as the Obama administration struggles to implement the $1.3 trillion overhaul amid Republican opposition. About 27 million people are expected to gain coverage by 2017, according to ... the Congressional Budget Office.... [As] many as 8 million people will lose health-care plans now offered through their employers, the CBO estimates." (Bloomberg)

Patients' Share of Health Spending Shrinks
"Out-of-pocket spending -- what consumers spend on their own health care -- has fallen by more than half over the past four decades. Third-party payers -- such as private health insurers, Medicaid and Medicare -- now cover 73.7 percent of all health care spending in the United States. Back in 1970, that number stood at 41.7 percent." (The Washington Post; free registration required)

Patients with Lower 'Activation' Associated with Higher Costs; Healthcare Providers Should Know Their Patients' 'Scores'
"In a bid to improve health outcomes and lower costs, many health care delivery systems are seeking to make patients more active participants in treatment decisions and the management of their care -- a strategy often referred to as 'patient activation.' A Commonwealth Fund-supported study of a large care delivery system in Minnesota found that patients with the highest level of patient activation had significantly lower costs than those who were the least activated." (The Commonwealth Fund)

Florida Blue and Other Health Insurers Prepare for ACA Regulations
"The plans [which insurance] companies offer will be highly regulated through government-run exchanges that are still getting their final regulatory touches [starting in 2014]. Insurance companies across the country, whether national profit-making players like WellPoint and UnitedHealth Group or nonprofit Blue Cross plans ..., are undergoing radical change as a result. After years of focusing on selling plans to employers, rather than individual consumers, the insurers must alter course." (The New York Times; free registration required)

State Exchanges Face Challenges In Offering Standardized Choices Alongside Innovative Value-Based Insurance
"Value-based insurance is a relatively new approach to health insurance in which financial barriers, such as copayments, are lowered for clinical services that are considered high value, while consumer cost sharing may be increased for services considered to be of uncertain value. Such plans are complex and do not easily fit into the simplified, consumer-friendly comparison tools that many state health insurance exchanges are formulating for use in 2014.... In the postreform environment, policy-makers must find ways to present complex value-based insurance plans in a way that consumers and employers can more readily understand." (Robert Wood Johnson Foundation)

CMS Releases Long-Awaited Sunshine Act Final Rule
"CMS finalized several provisions to simplify the reporting of research payments, including eliminating the proposed requirement that applicable manufacturers report research payments as direct or indirect and implementing a process by which research-related payments will be reported and published separately from other payments and transfers of value made to covered recipients. In addition, CMS has made modifications related to reporting indirect payments provided through a third party, reporting the value of food and beverages provided in group settings, delayed publication, dispute resolution, and attestation, among others." (Sidley Austin LLP)

Rise in Electronic Claims Submission Speeds Up Receipt, Processing Time
"Health insurance plans processed 93 percent of claims within 14 days of receipt, and 98 percent of all claims within 30 days, according to [a recent survey]. The rise in electronic claims processing systems has expedited receipt and processing of claims submitted by health care providers. Notably, between 2002 and 2011, the percent of claims submitted and processed electronically nearly doubled from 44 percent in 2002 to 94 percent in 2011. Furthermore, health plans received 66 percent of claims within two weeks of the service date, up from 58 percent in 2009 and 45 percent in 2002." (America's Health Insurance Plans (AHIP))

Survey of Connecticut Employers Providing Paid Sick Leave
"Of the 156 businesses that responded to the survey, 86 -- or 55 percent -- had started providing sick leave to comply with the new law. Prior to the law taking effect in January 2012, 31 of the businesses surveyed had scaled backed on employee benefits or reduced paid leave (or both) to account for the cost of the new law. Twelve had cut back employee hours, and another six reduced employee wages. Nineteen businesses raised consumer prices, six laid off employees, and three converted part-time positions to full-time positions. Sixteen businesses indicated they had decided to limit or restrict their expansion within the state." (Employment Policies Institute)

DOL Marks 20th Anniversary of Family and Medical Leave Act
"The [DOL] marked the 20th anniversary of the signing of the [FMLA] by issuing a final rule implementing two important expansions of FMLA protections. The first expansion provides families of eligible veterans with the same job-protected FMLA leave currently available to families of military service members and it also enables more military families to take leave for activities that arise when a service member is deployed. The second expansion modifies existing rules so that airline personnel and flight crews are better able to make use of the FMLA's protections." (Employee Benefits Security Administration)

[Opinion]

John Goodman: Why I Am More Egalitarian Than Most Liberals on Health Care
"One thing that adds to so much confusion is that people on the left have a huge investment in seeing themselves as more altruistic and more caring than everybody else. Paul Krugman, for example, refers to the Republican Party as the party of Scrooge and sees most elections as Dickensian morality plays -- even though research shows that right-of-center folks are actually more generous than folks on the left, on the average. Today, [I, John Goodman,] ask you to put aside such foolish thoughts and seriously consider the titular issue of this post." (John Goodman's Health Policy Blog)

[Opinion]

Even in Vermont, Healthcare Reform Proves a High Mountain to Conquer
"Vermont planned to use the ACA as a launching pad of sorts for its move to single-payer, and was already well into designing its federally mandated health insurance exchange, Vermont Health Connect, when Obama was re-elected in November 2012. So that means it has been smooth sailing for Vermont and its single-payer healthcare pilgrimage, right? Well, not exactly." (HealthLeaders InterStudy)

[Opinion]

The Vanishing Case of Obamacare
"Remember all the reasons advanced for the Affordable Care Act? It was going to control private sector health care costs. It was going to control the government's health care costs. It was going to be funded by efficiencies found in Medicare. Each of these arguments has fallen, one by one." (John Goodman's Health Policy Blog)

[Opinion]

Obamacare's Priceless Warm Glow
"What benefits do broad-based expansions of health insurance, like ObamaCare, actually provide? ... [T]here has been only one -- one!--scientifically rigorous study of that question. The Oregon Health Insurance Experiment found Medicaid coverage confers modest improvements in self-reported health and financial security. The first batch of that study's results appeared more than a year after Congress enacted ObamaCare. And there remains to this day absolutely zero evidence that Medicaid or other broad-based expansions of health insurance buy us the most health and financial security per dollar spent." (Cato Institute)

[Opinion]

Five Health Care Takeaways from CBO's Report
"Health care entitlement spending is bypassing all other spending. ... Obamacare still costs well over a trillion dollars.... CBO anticipates a delay in Obamacare exchange operation.... More Americans lose employment-based insurance.... Medicare cost projections are unrealistic." (The Heritage Foundation)

[Opinion]

FMLA Turns 20; DOL Celebrates with Curious Survey Results About the Use of FMLA
"In light of the many difficulties employers face administering the FMLA, ... a recent Department of Labor FMLA survey ... makes a whopper of a conclusion: The study shows that employers generally find it easy to comply with the law, and misuse of the FMLA by workers is rare.... Interestingly, the DOL's survey results are vastly different than the findings of a survey conducted by SHRM just a few years back [which found that] 63% of HR professionals found it 'very difficult' or 'somewhat difficult' to comply with the FMLA." (FMLA Insights)

Benefits in General; Executive Compensation

[Guidance Overview]

2012 Q&As: SEC Meeting with ABA Joint Committee on Employee Benefits (PDF)
9 pages. Topics include: Use of Non-GAAP Measures in Executive Summary to Compensation Discussion and Analysis; Stock Option Modification in Connection With Termination of Employment; Reporting for NEOs; Bonus Payable in Stock; Reporting of Equity Incentive Plan Awards with Multi-Year Performance Periods. (Joint Committee on Employee Benefits, American Bar Association)

[Guidance Overview]

Deadline Approaching for Reporting 2012 ISO Exercises and ESPP Transfers
"If a company is required to file 250 or more of either form with the IRS, such filing must be done electronically. Otherwise, paper filing with the IRS is acceptable. For example, if a company is required to file 300 Form 3921s and 100 Form 3922s, the Form 3921s will need to be filed with the IRS electronically but the Form 3922 may be filed with the IRS in paper form." (Goodwin Procter LLP)

Press Releases

Randy Fuss Earns Registered Corporate Coach™ Designation
CPI Qualified Plan Consultants, Inc.

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