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BenefitsLink Health & Welfare Plans Newsletter

February 13, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

Manager Retirement Administration
for Freeport-McMoRan Copper & Gold Inc. in AZ

ERISA & Benefits Counsel, Employee Benefits
for USI Insurance in CA

Processing Specialist
for Company in New York City in NY

Sr. 401K - DC Plan Admin Specialist
for CUNA Mutual Group in WI

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Webcasts and Conferences

Plan Administrator Skills Workshop
in Texas on March 8, 2013 presented by SouthWest Benefits Association

S Corporation ESOPs - Legal Issues
Nationwide on March 12, 2013 presented by National Center for Employee Ownership

S Corporation ESOPs - Administrative Issues
Nationwide on March 19, 2013 presented by National Center for Employee Ownership

S Corporation ESOPs - Valuation Issues
Nationwide on March 26, 2013 presented by National Center for Employee Ownership

End-to-End Approval and Acceptance Processes: From Boards to Participants
Nationwide on March 27, 2013 presented by National Center for Employee Ownership

View All Webcasts and Conferences

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[Guidance Overview]

Employer 'Play or Pay' Details of Health Reform (PDF)
"IRS controlled group rules determine whether an employer is a large employer for 'play or pay' rules. However, it calculates penalties based on individual employers. If three related employers are grouped together to determine whether the employer is subject to 'play or pay,' then the penalty will be calculated separately for each of the three employers." (McGraw Wentworth)


DATAIR! 5500 Filing for Welfare, Flex & Pension Plans

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[Guidance Overview]

The ACA's 'Play or Pay' Mandate for Employers: How It Works
"Sole proprietors, partners in partnerships, 2% S corporation shareholders, employees who work outside the United States and leased employees (as defined in Code section 414(n)(2)) are generally not employees for purposes of the Play or Pay mandate. However, individuals who serve in dual roles -- such as an individual who provides services as an employee and serves on the board as a director -- are employees with respect to their hours of service in the role of employee." (Perkins Coie LLP)

[Guidance Overview]

HHS Makes Significant Changes to HIPAA Breach Notification Rules
"In the preamble to the Final Rule, HHS Office of Civil Rights explains that the Final Rule 'modifies and clarifies the definition of breach and the risk assessment approach' contained in the 2010 Interim Final Rule. Most commentators agree that is a bit of an understatement." (Verrill Dana LLP)

[Guidance Overview]

Proposed Rules Clarify Definition of Religious Employer Under ACA's Contraceptive Coverage Requirement
"For self-insured group health plans, the eligible organization would notify the third party administrator, which in turn would work with a health insurance issuer to provide separate, individual health insurance policies at no cost for participants. The Departments believe that the costs of both the health insurance issuer and third party administrator would be offset by adjustments in the Exchange user fees that insurers pay. The Departments intend that insurers and third party administrators would work to ensure a seamless enrollment process. The proposed rules lay out how the costs of both the insurer and the third party administrator would be covered, without any charge to either the religious organization or the enrollees." (Wolters Kluwer Law & Business)

7th Circuit Grants Indiana Employer Relief from Contraceptives Mandate
"By a 2-1 vote, a panel of the 7th U.S. Circuit Court of Appeals in Chicago issued an injunction pending appeal in favor of the Grote family, whose Grote Industries makes vehicle safety systems and has more than 1,100 full-time workers. Members of the Grote family are Catholic, and opposed including coverage for various contraception and sterilization procedures in a group health insurance plan for their privately-held company[.]" (Reuters)


Summit on Ancillary Products and Voluntary Benefits - March 13-15, Lake Mary, FL

Sponsored by World Congress

This Summit is a must attend for health plans, insurance carriers and brokers looking for the most current insights, innovations and solutions available in the ancillary and voluntary benefits sector. Promo Code BLINK3 good for $300 off registration fee.

[Guidance Overview]

HHS Regs Address Premium Stabilization, Premium Assistance, Cost-Sharing Reductions and User Fees for Exchanges (PDF)
"These latest regulations from CMS and DHHS cover many issues on how the Exchanges will operate. The premium stabilization programs minimize the impact of the dramatic individual and small group market changes in 2014. These programs will help insurance carriers manage the uncertainty of premium setting in a changing market. Employers will need to include funds for the reinsurance program in their 2014 budgets. More details were provided on how the Exchanges will manage premium assistance and cost-sharing reductions. Again, these details do not directly impact employers. However, employers who choose to discontinue health coverage need to understand the complex Exchange market." (McGraw Wentworth)

ACA Rules Mean Health Care Will Cost More for Some Young Idahoans
"Idaho is one of the cheapest states for buying health insurance, partly because its insurers can factor characteristics like age into a person's premiums.... Insurers in Idaho can -- and do -- charge their oldest members more than five times as much as their youngest members for the same coverage. Starting Jan. 1, they won't be allowed to do that for new plans. Instead, they'll be limited to charging three times as much." (IdahoStatesman.com)

Tax Help Comes with Health Insurance Advice
"The individual effects and consequences of the nation's healthcare overhaul in 2014 are far from certain, but insurance companies, tax consultants and other financial planners are starting to offer cost estimates for next year and describe the penalties for inaction. For many consumers, their 2012 tax returns will offer some of the first clues on what financial aid may be available and what coverage may cost." (Los Angeles Times)

The Decade-Long Slowdown in U.S. Healthcare Spending
"Over the past decade, the growth of total U.S. medical spending has actually slowed by about half, falling from an annual rate of more than 8 percent in 2003 to 4 percent in 2012 ... [T]hese numbers do suggest that doctors and insurers have at least begun to get a handle on expenses. While some of the slowdown can be credited to patients cutting back during the recession, the trend started before the economy fell apart and has lasted into the recovery. But here's a red flag: The rate hasn't dropped much in the last few years. Instead, it's stayed roughly even, ranging between 3.5 percent and 5 percent a year since 2010." (The Atlantic)

Sharp Slowdown in U.S. Health Care Costs Eases Deficit
"Health experts say they do not yet fully understand what is driving the lower spending trajectory. But there is a growing consensus that changes in how doctors and hospitals deliver health care ... are playing a role. Still, experts sharply disagree on where spending might be in future years, a question with major ramifications for the federal deficit, family budgets and the overall economy." (Reuters, via The New York Times; free registration required)

A 2013 Hip Replacement Looks a Lot Like a 1954 Buick
"Health care today suffers from the same sickness that plagued the auto industry a half-century ago ... even the health care 'dealer' has no idea what the price of his product is.... Claiming to speak on behalf of their 62-year-old grandmother, [researchers] called the top-ranked orthopedic hospitals in the United States as well as the 2 largest hospitals in each state asking for complete price information for an elective hip replacement, including the fee for the hospital and the fee for the orthopedic surgeon.... Of the 20 top-ranked hospitals, more than half (55%) could not provide a single 'bundled price' for the procedure. And a substantial portion (40%) could not even provide a complete estimate after the hospital and physician practices were contacted separately." (JAMA Internal Medicine)

Raising the Age of Medicare Eligibility: Historic Trends in Public Polling and Current Nuances (PDF)
"This Data Note analyzes ... historic trends and gives a current snapshot of public opinion on the proposal, with a special focus on how views differ by age, and the partisan divide that pervades public opinion on healthcare. The analysis then investigates how different arguments sway views on raising the age of Medicare eligibility in order to better understand the nuances of public opinion." (Kaiser Family Foundation)


Five Questions the President Should Answer About His Health Care Law
"[W]hile the President may give ObamaCare a glowing review in his State of the Union address, the American people who have to pay for and live with ObamaCare have a few questions that deserve some answers: Mr. President, [1] why are my health insurance premiums going up? ... [2] why am I losing the health insurance I have and like? ... [3] why have many employers stopped hiring new workers and/or shifted full-time workers to part-time status? ... [4] am I going to pay higher taxes as a result of ObamaCare? ... [5] why is this law so difficult to understand and comply with?" (U.S. House Ways and Means Committee)


Obamacare's Assault on Dr. Carson's Health Savings Accounts
"Obama Care has launched an all-out assault on the very savings programs that Dr. [Benjamin] Carson supports to save our medical care system. Dr. Carson proposed a much broader form of health saving account. We should be assigned a health savings account at birth, whose principal sum would grow over the years and need not be expended by a particular date.... With universal coverage by health savings accounts, a private competitive market in medical care would emerge to supplement or even replace the bloated bureaucratic health insurance programs of insurance companies and federal and state governments." (Forbes)


Health Insurance Agents in Limbo
"Navigator funding differs from the commissions agents now receive from insurers. Navigators are not allowed to receive funds from any health insurer to enroll any individual using the exchange. Instead, the PPACA requires Exchanges to 'establish a program under which it awards grants' to navigators, and further requires these grants to be 'made from the operational funds of the Exchange and not Federal funds received by the State to establish the Exchange.'" (Citizens' Council for Health Freedom)


Obamacare Does Not Lower Health Care Spending
"[S]pending is estimated to decrease for Medicare and Medicaid in 2020 by $200 billion but Obamacare spends an extra $187 billion more than would have been spent in the absence of the law. Thus, whatever 'savings' were projected have been gobbled up by Obamacare and its massive new spending." (The Heritage Foundation)


Who Needs to Know What a Hip Replacement Costs?
"Almost everyone seems to be fixated on the concept that if we make health care pricing transparent, we will be able to place every individual in charge of getting the health care that they need while eliminating excessive prices and unnecessary care. The massive shift taking place to higher deductibles and other consumer-driven cost sharing is based on this principle." (Physicians for a National Health Program)


How to Win Friends and Influence Millennials: Health Exchanges Edition
"To compound our already-stratospheric opinion of ourselves, we know that the Millennials are a coveted market for health exchange insurers. Face it: you want us. Bad. That's because we're relatively healthy, loyal to brands we like that we see as having a positive impact (70% identify as being brand loyal), and we could actually be the first generation to recommend our health insurance plan to others. So, culling from Millennial research, surveys, and conversations with fellow Millennials, here are a few morsels of unsolicited advice on how to win us over." (The Health Care Blog)

Benefits in General; Executive Compensation

Defending Section 162(m) Executive Compensation Derivative Suits in the U.S.
"Decisions regarding executive compensation fall squarely within the discretion of a public company's board of directors. Recently, however, plaintiffs' firms have been trying to invade the board's purview by bringing shareholder derivative actions challenging such decisions.... At least thirteen such cases were filed in 2011 and 2012, seven of which were filed in Delaware.... So far this year, the plaintiffs' firm at the forefront of this movement has issued at least twelve press releases announcing investigations of companies and their boards in connection with executive compensation." (Dechert LLP)

When Outsourcing Benefits Administration, Focus on the Employee Experience
"As companies turn to business administration outsourcing (BAO) for more and varied functions, the vendors' presence becomes more apparent to the employee end-user. Companies that in the past may have partnered with BAO providers for behind-the-scenes functions -- such as open enrollment support or summary plan description creation -- are increasingly using the vendors as employees' major point of contact for all things benefits-related.... Employers should not forget that employees still need a personal touch -- they often seek guidance from someone with their best interests in mind, someone within their own organization." (Society for Human Resource Management)

Press Releases

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