Financial Advisor
for MFP Strategies in PA

Retirement Plan Education and Communication Specialist
for MFP Strategies in PA

Retirement Plan Relationship Manager
for MFP Strategies in PA

Actuary
for MassMutual Financial Group in MA

Plan Administrator
for Nationwide Financial in OH

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How to Avoid Hiring Pitfalls - Live FutureOffice Network Smartcast webinar
Nationwide on February 19, 2013 presented by Davidson Marketing Group -- FutureOffice Network

Quality, Affordability and Accessibility - Health Care Reform Webinar
Nationwide on February 15, 2013 presented by Davidson Marketing Group -- FutureOffice Network

ERISA Litigation Update
in California on February 19, 2013 presented by Western Pension & Benefits Council - San Diego Chapter

Health Care Reform
in Pennsylvania on May 3, 2013 presented by Thomson Reuters / EBIA

COBRA Compliance for Group Health Plans
in Pennsylvania on May 2, 2013 presented by Thomson Reuters / EBIA

HIPAA Privacy & Security
in Pennsylvania on May 2, 2013 presented by Thomson Reuters / EBIA

HSAs, HRAs, and Consumer-Driven Health Care
in Pennsylvania on May 1, 2013 presented by Thomson Reuters / EBIA

ERISA Compliance for Health & Welfare Plans
in Pennsylvania on May 1, 2013 presented by Thomson Reuters / EBIA

Cafeteria Plans
in Pennsylvania on April 30, 2013 presented by Thomson Reuters / EBIA

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[Guidance Overview]

The Omnibus HIPAA Rule: A New Era of Federal Privacy Regulation
"[An] impermissible use or disclosure of protected health information is presumed to be a reportable breach unless the covered entity or business associate, as applicable, demonstrates through a documented risk assessment that there is a low probability that PHI has been compromised.... Suggesting that the original standard did not set a high bar in spite of the plain meaning of the phrase 'significant risk,' OCR characterizes the new standard as a clarification as opposed to what appears to be a reversal of its prior position." (Sidley Austin LLP)

[Advert.]

10 more days left for lowest rate on newest Benefits Conference

Dozens of employer case studies presented by senior executives at major employers. 8 thought-proving general sessions. 30 concurrent sessions spanning 7 tracks. Earn 14.5 HRCI credits. Pay only $745 through Monday, Feb. 18. Benefitsconf.com

[Guidance Overview]

PCORI Fees for Self-Insured Plans Due July 31, 2013, for Calendar Year Plans
"the plan sponsor is responsible for paying the PCORI fee from a source other than plan assets. However, recent DOL guidance permits the independent joint board of trustees appointed to sponsor a multiemployer plan to pay the PCORI fee using plan assets. Additionally, the DOL stated that there may be rare circumstances where sponsors of plans that are not multiemployer plans would also be able to pay the PCORI fee using plan assets, such as [certain VEBAs] that provides retiree-only health benefits[.]" (Jenner & Block)

[Guidance Overview]

Final FMLA Regulations Issued by DOL
"[The final DOL regulation] [1] Adds a new category of exigency leave for parental care; [2] Increases the maximum number of days from five to 15 calendar days for exigency leave to bond with a military member on rest and recuperation leave; ... [3] Clarifies the scope of exigency leave to family members of those in the regular armed forces; [4] Retains the physical impossibility rule, which provides that, where it is physically impossible for an employee to commence or end work midway through a shift, the entire period that the employee is forced to be absent is counted against the employee's FMLA leave entitlement; [5] Retains, but clarifies, the existing regulation regarding the appropriate increments to calculate intermittent and reduced-schedule leave." (Morgan Lewis)

[Guidance Overview]

Final FMLA Regulations Require Employer Action
"Because the regulations have modified the circumstances under which qualifying exigency leave must be offered to employees with family members in the military and modified veteran eligibility determinations, it is necessary for employers subject to the federal FMLA to amend their policies and forms to comply with the changes. Employers will need to post the new FMLA poster in place of the prior version. Employers who reference FMLA in their employee handbooks may need to revise their employee handbooks to incorporate the new terms of the FMLA." (Michael Best & Friedrich LLP)

Federally Facilitated Exchanges: Issues and Challenges Ahead
"A number of issues arise because of the existence of both state and federal regulation of health plans. The Affordable Care Act created a number of new federal regulations on health insurance and gave states funding to expand certain oversight responsibilities. Now, in operating the federally facilitated exchanges, the federal government will have to be cognizant of the variety of state insurance laws and regulations." (Robert Wood Johnson Foundation)

[Advert.]

Summit on Consumer Engagement through Health Plan Innovation - March 13-15, Lake Mary, FL

Insights from industry leading Plans, Providers and Employers on how Payers can develop new ways to expand their market share and retain their existing membership while cutting costs and maintaining excellent consumer relations. Promo Code BLINK3 for $300 off.

HHS Denies Mississippi's Bid To Run Its Own Exchange
"[HHS] rejected Mississippi's plan ... making Mississippi the only state to have its exchange blueprint nixed by the federal government. Instead, Mississippi will have a federal exchange like the more than two dozen other states that have balked at implementing the health law. The decision follows more than a month of delay from the federal government over the future of Mississippi's proposal to run its own exchange." (Kaiser Health News)

The Effects of Mental Health Parity on Spending and Utilization for Bipolar, Major Depression, and Adjustment Disorders
"Parity implemented under managed care improved financial protection and differentially affected spending and psychotherapy utilization across groups. There was some evidence that resources were preferentially preserved for diagnoses that are typically more severe or chronic and reduced for diagnoses expected to be less so." (The American Journal of Psychiatry)

Enhanced Support For Shared Decision Making Reduced Costs Of Care For Patients With Preference-Sensitive Conditions
"[S]upport for shared decision making can generate savings.... [A] 'remote' model of support -- combining telephonic coaching with decision aids, for example -- may constitute a relatively low-cost and effective intervention that could reach broader populations without the need for the direct involvement of regular medical care team members." (HealthAffairs; purchase required to view full article)

New Federal Regs Shake Up Private Health Exchange Market
"[E]mployers have increasingly been using HRAs ... for the purpose of providing funds with which employees can buy individual insurance policies through private health-insurance exchanges.... The new guidance by HHS, DOL, and [Treasury Department] effectively prohibits employers with at least 50 full-time employees from taking that approach. They could still do it, but the funds would have no tax advantages. Not only that, the employer would not be deemed as offering a qualified plan under the Affordable Care Act (ACA) and therefore would be assessed an annual $2,000 or $3,000 per-employee penalty." (CFO.com)

HHS 'Family Penalty' Call Passes Buck
"The Obama administration's decision not to subsidize family health insurance for workers who have individual coverage on the job effectively drops that same tough call into the laps of employers. They can pay for the coverage and threaten the bottom line. Or they can in turn pass the problem on to the families." (Politico)

[Opinion]

Premium Subsidies: What You Need to Know
"Subsidies do NOT lower the underlying premium... Millions of Americans are not eligible for subsidies and, for those that are eligible, the subsidy amount declines significantly as incomes rise... Many individuals who receive subsidies will still pay more for their premiums than they do today... As premiums increase, many younger, healthier people may wait to purchase coverage until they need it -- driving up costs for everyone else." (America's Health Insurance Plans (AHIP))

[Opinion]

HHS Proposal Falls Short In Meeting Church Concerns, Catholic Bishops Say
"'Throughout the past year, we have been assured by the Administration that we will not have to refer, pay for, or negotiate for the mandated coverage. We remain eager for the Administration to fulfill that pledge and to find acceptable solutions -- we will affirm any genuine progress that is made, and we will redouble our efforts to overcome obstacles or setbacks,' said Cardinal Timothy Dolan of New York[.]" (U.S. Conference of Catholic Bishops)

Executive Performance Metrics and Their Link to Value
"Executive compensation design has moved towards [long-term incentive (LTI)] components in an attempt to align management interests with those of long-term shareholders; further, those LTIs are now largely performance-based. Among companies using performance-based LTIs, most (53%) use a mix of TSR and financial measures in their equity LTI plans; others (28%) use financial measures only; and a smaller minority (15%) use TSR only. This use rate puts a premium on getting the financial measures right[.]" (Farient Advisors)

Second Circuit Narrows ERISA Exhaustion Requirement When Plan Document Is Ambiguous on Need to Follow Claims Procedures
"[The Court] focused on the Plan's claims procedure language, paying special attention to the repeated usage of the phrase '[a] benefit claim' [and] drew a distinction between claims seeking retirement benefits versus inquiries seeking clarification of future benefits.... The Second Circuit then adopted precedent from the Seventh and Eleventh Circuits, whereby a plaintiff who reasonably interprets plan terms not to require exhaustion and, as a result, does not exhaust his or her administrative remedies, may proceed to directly to federal court." [Kirkendall v. Halliburton, Inc. (2nd Cir., Jan. 29, 2013) (McDermott Will & Emery)

Groom Law Group Expands its Fiduciary Responsibility Practice: David Kaleda Joins Firm
Groom Law Group

PayerFusion Expands Reach of Health Plan Administration Services Across the USA
PayerFusion Holdings LLC

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