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February 18, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

Senior Manager - Operations
for J.P. Morgan in KS, MO

Retirement Plan Specialist (Defined Benefit)
for Transamerica in MA

Sr. Investment Analyst
for Gallagher Retirement Services in IL

Investment Analyst
for Gallagher Retirement Services in IL

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Webcasts and Conferences

Retirement Plan Insights Seminar
in Pennsylvania on May 7, 2013 presented by McKay Hochman Co., Inc.

Retirement Plan Insights Seminar
in Illinois on June 11, 2013 presented by McKay Hochman Co., Inc.

Multiple Employer Plans (MEPs) Webcast
Nationwide on March 20, 2013 presented by American Society of Pension Professionals & Actuaries (ASPPA)

DOL Audits of Health and Welfare Plans: Be Prepared to Show Compliance With Health Care Reform and Other Laws
Nationwide on February 14, 2013 presented by Thomson Reuters / EBIA

EPCRS and Beyond: Protecting Your Clients and Your Practice!
Nationwide on March 21, 2013 presented by ASCi

Health Care Reform Impact on Globally Mobile Employees Webinar
Nationwide on February 27, 2013 presented by Baker & McKenzie

The Definition of "Compensation" - How It Impacts Your Benefit Plans Webinar
Nationwide on April 24, 2013 presented by Baker & McKenzie

View All Webcasts and Conferences

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[Official Guidance]

Text of CMS Proposed Regs on Medical Loss Ratio Requirements for Medicare Advantage and Medicare Prescription Drug Benefit Programs
"This proposed rule would implement medical loss ratio (MLR) requirements for the Medicare Advantage Program and the Medicare Prescription Drug Benefit Program under the [ACA].... An MLR is expressed as a percentage, generally representing the percentage of revenue used for patient care, rather than for such other items as administrative expenses or profit.... MA organizations and Part D sponsors are required to report their MLR, and are subject to financial and other penalties for a failure to meet a new statutory requirement that they have an MLR of at least 85 percent.... This proposed rule sets forth CMS' proposed approach to implement these new MLR requirements for the MA and Part D programs." (Centers for Medicare & Medicaid Services)


Register Today! 401(k) Investment Lineup: SF 4/16 - Dallas 4/18 - CHI 4/23 - NY 4/25

Sponsored by Pensions & Investments

Free registration for qualified plan sponsors. Sponsored by Pensions & Investments - learn how to design a 401(k) offering that helps your participants generate lifetime retirement income.

[Guidance Overview]

The New HIPAA Omnibus Rule and Your Group Health Plan's Liability
"The proposed rules provided for major changes, such as direct liability for business associates and a tiered penalty structure for noncompliance. This advisory sets forth some of the most significant changes in the final rules, the impact of the final rules on group health plans, best practices for compliance with the rules, and how the final rules correspond with state privacy laws." (Mintz Levin)

[Guidance Overview]

Final HIPAA Regs Require Changes for Employers
"Employers with self-insured group health plans, including medical, dental, vision, health flexible spending accounts or health reimbursement arrangements and certain employee assistance programs, as well as those sponsoring on-site medical clinics or using data warehousing in conjunction with their group health plans, will have HIPAA obligations. In general, employers with insured group health plans that don't have access to protected health information will have only limited HIPAA obligations." (PricewaterhouseCoopers)

ACA Challenges and Implementation Issues Facing Employers
"If the final HHS regulations don't provide a good faith compliance standard for self-insured plans to follow, then employers may end up having to comply with the prohibition on annual and lifetime limits for each state's EHB standards, significantly eroding ERISA and substantially increasing implementation costs. According to participants at the meeting, protecting ERISA preemption and simplifying compliance should be a major [HR Policy Association] focus." (HR Policy Association)

Properly Designed CDHP Plans Improve Total Medical Cost Without Compromising Care or Shifting Costs
"According to [a recent] study, when compared to customers in traditional PPO and HMO plans, those in a CDHP: Lowered their health risks ... Reduced total medical costs ... [Were] more engaged in health improvement ... Were more likely to compare cost and quality ... Were more savvy consumers of health care ... Received higher levels of care:" (InsuranceNewsNet.com)


The Only Conference Series 100% Dedicated to Innovative Health and Benefit Management

Sponsored by IHC

The IHC FORUM East helps employers, TPAs, benefit brokers, consultants and regional health plan providers learn to implement health care consumerism strategies and save money on health and benefit management programs. May 9-10, Atlanta - Code LINK - $100 discount.

Allure of Self-Insurance Draws Concern by Policymakers
"Federal and state officials and consumer advocates have grown worried that companies with relatively young, healthy employees may opt out of the regular health insurance market to avoid the minimum coverage standards in [the ACA], a move that could drive up costs for workers at other companies.... 'The new health care law created powerful incentives for smaller employers to self-insure,' said Deborah J. Chollet, a senior fellow at Mathematica Policy Research who has been studying the insurance industry for more than 25 years. 'This trend could destabilize small-group insurance markets and erode protections provided by the [ACA]'." (Reuters, via The New York Times; free registration required)

Health Insurers Report 2012 Earnings with Eyes on ACA in 2014
"The largest publicly traded plans say 2013 will be a year of preparation for major implementation of the [ACA].... Plans cite ACA mandates for most individuals to obtain insurance or pay tax penalties, expansion of federal assistance for purchasing health plans, and new insurance marketplaces as factors that will provide them with growth opportunities.... The growth is expected even though insurance companies, awaiting federal and state government decisions on health insurance exchange implementation, aren't sure when those marketplaces will start and exactly how they will work." (American Medical Association)

Obamacare's Health Exchanges Are Customer-Free Zones
"Last month, the CEO of the nation's largest health insurance company warned that he and his peers may balk at participating in Obamacare's insurance exchanges ... If insurers don't participate in the law's exchanges, then consumers who had hoped to secure affordable coverage through the new marketplaces will instead find few choices and high prices. Taxpayers could be hit hard, too, as higher premiums in the exchanges will require more public spending on subsidies." (Forbes)

States' Choices Set Up National Health Experiment
"A recent AP poll found that Americans prefer to have states run the new markets by 63 percent to 32 percent. Among conservatives the margin was nearly 4-1 in favor of state control... Administration officials are keeping mum about what the new federal exchange will look like, except that it will open on time and people in all 50 states will have the coverage they're entitled to by law." (Fox News)

How H&R Block Plans to Capitalize on Obamacare
"The vast majority of its consumers receive a refund; all told, their 26.5 million customers received $50 billion in refunds in 2012. The [ACA] could change that: It charges a tax penalty to Americans who do not carry health insurance coverage.... Now, during this tax season, H&R Block is rolling out a Health Care Review product, a no-charge assessment of the subsidies and penalties they will likely face in 2014." (The Washington Post; free registration required)

State by State Enrollment in the Pre-Existing Condition Insurance Plan
"The PCIP program began accepting applications for enrollment July, 2010 (July 1, 2010 for the federal program, dates for state programs varied). [This] interactive table ... details the date when each state began providing benefits to people accepted into the program and the number of people enrolled in the program by each state as of [December] 31, 2012." (Healthcare.gov)

Uninsured New Yorkers After Full Implementation of the ACA: Source of Health Insurance Coverage by Individual Characteristics and Sub-State Geographic Area
"The tables presented here provide sub-state analyses, focusing on those without insurance coverage of any kind prior to reform. [They] show the share of uninsured expected to gain coverage under the ACA, and include the distribution of characteristics for those anticipated to gain insurance of each type whenever sample sizes allow." (Urban Institute)

Geography to Play Larger Role in Cost of Health Insurance Under Federal Health Care Overhaul
"[The ACA leaves] geography as one of the few ways insurers can adjust premiums.... The federal government has proposed that a state should not create more than seven geographic rating areas to prevent insurers from charging excessively high premiums in certain areas. To accommodate California's size and diversity, the state's health exchange is proceeding with 19 regions with the understanding that its plan eventually will receive federal approval." (Associated Press, via KGO-TV)

Retail Health Clinics Continue to Grow in Popularity
"According to a recent study ... 27 percent of adults surveyed indicated that they had used a retail or workplace health clinic in the past two years. In contrast, only 7 percent of adults indicated use of a retail or workplace clinic in 2007.... Forty percent of younger adults (25-29) had used retail clinics, as opposed to 15 percent of older adults (65 and older).... [Another study] found that retail clinic use for those with acute conditions increased tenfold from 2007 to 2009 [and] found living close to a retail clinic to be one of the strongest predictors of use." (Robert Wood Johnson Foundation)

Federal Government To Run Insurance Marketplaces In Half The States
"The Obama administration will be running new health insurance marketplaces in half the states-- including the major population centers of Texas, Florida and Pennsylvania.... Obama administration officials have said they prefer states to run the marketplaces because they know their local communities and have longstanding relationships with key groups, such as insurers and insurance agents.... Nearly all states plan to finance their marketplaces with a tax or surcharge on premiums that insurers will pass on to policyholders." (Kaiser Health News)

Court Prohibits Promotion of Fraudulent Tool Plans
"The IRS has consistently maintained that recharacterizing a portion of an employee's wages as [a nontaxable] reimbursement for the cost of tools -- so the employee's total compensation is essentially unchanged -- fails to satisfy the business connection requirement of the accountable plan rules ... This injunction -- the first [the authors] have seen specifically addressing this topic -- further strengthens the IRS's position." [United States v. Cash Mgmt. Sys., Civil No. 2:13-cv-02001EFM-KGG (D. Kan., Jan. 13, 2013)] (Thomson Reuters / EBIA)

Court Allows ERISA Claim Against Employer for Failure to Produce Administrative Services Agreement
"[C]iting several cases, the court determined that the employer likely did not have to provide the claims manual because claims processing documents typically do not qualify as documents under which a plan is established or operated within the meaning of ERISA Section 104(b)(4). However, it determined that the employer might have to provide the administrative services agreement, in large part because it might be such a document if it granted discretionary authority for claims decisionmaking." [Grant v. Eaton Disability Long-Term Disability Plan, 2013 WL 485868 (S.D. Miss. 2013)] (Thomson Reuters / EBIA)


AHIP Supports Bipartisan Legislation to Repeal the ACA's Health Insurance Tax
"Starting next year the ACA imposes a new $100 billion tax on health insurance. The tax will start at $8 billion in 2014, increasing to $14.3 billion in 2018, and will continue to increase each year. The health insurance tax is larger than the device tax and the prescription drug tax combined.... he health insurance tax is far greater than the minimum penalty for those who choose not to buy health insurance -- further incentivizing young, healthy people to forgo purchasing insurance until they need medical care." (America's Health Insurance Plans (AHIP))


ACLJ Files Amicus Briefs in Two Appeals of HHS Contraceptive Mandate
[T]the ACLJ's briefs ... explain to the respective courts that the plaintiffs are deserving of injunctive relief and that they should be able to exercise their religious beliefs without interference from the federal government [and] that the Mandate violates the religious rights of the plaintiffs because it forces them to (1) comply with the Mandate in violation of their religious beliefs or (2) pay significant annual penalties to stay true to their religious beliefs. These are choices the federal government may not legally force anyone to make." (American Center for Law and Justice)


The Health Benefits That Cut Your Pay
"The [ACA] does require employers, beginning this year, to note on W-2's how much both the employee and the employer contributed to health care costs.... But even with greater awareness, many Americans still might not understand that the largest effect of the cost of our health care system is to reduce the amount of money they actually take home.... [A] 23-year-old employee will bear at least $1.8 million in health care costs over her lifetime. That's assuming that such costs don't grow by more than current government estimates, that she never has a working spouse, and that she and her dependents don't ever contract a serious illness." (Reuters, via The New York Times; free registration required)


Free-Market National Health Insurance
"Patients would pay 50% of every medical bill out of their own pockets, subject to a limit: 25% of family income above the poverty level. Government would pay the other half.... [T]he government today is paying for almost half the cost of private health insurance through the tax system, so this would not be a huge departure from the current way care is paid for now." (John Goodman's Health Policy Blog)


Obamacare Sticker Shock: It Gets Worse
"In Milwaukee ... older and less healthy people in the individual market will see average premium reductions of 15 percent. In Austin, premiums will be 32 percent lower for this group. The survey found that older and sicker individuals in all of these markets will see an average decrease in premium costs of just under 25 percent. Many young people have lower incomes and therefore will be eligible for subsidized insurance to help offset the sticker shock. But they will still face higher deductibles, co-payments, and insurance premiums than they would absent the law." (Galen Institute)


Reconsidering National Health Insurance
"One widely held goal [the ACA] clearly cannot achieve is to improve the global competiveness of American companies by removing, from employers, the costly burden of providing health insurance for employees.... [N]ational health insurance achieves every one of these goals, but only in a form ... incorporating ten features. 1. Universality ... 2. Comprehensiveness ... 3. Free Choice of Doctors ... 4. Large Co-payments ... 5. A Yearly Cap ... 6. A Long-term Cap ... 7. Free-Market Prices ... 8. Supplemental Health Insurance ... 9. Free-Market Entry ... 10. Transparency." (Health Affairs Blog)


Health Care Spending: a 21st Century Gold Rush
"[The ACA] has recognized that many people will need help making the right choices. So it has created an army of 'navigators' to help them.... (California alone plans to certify 21,000 of them). Their cost will be reflected in higher health insurance premiums and has sparked opposition from insurance brokers who view them as competition. That will be an expensive fight, without increasing the amount going to actual health care by a single dollar." (Physicians for a National Health Program)

Benefits in General; Executive Compensation

Ohio Board of Tax Appeals Finds Supplemental Executive Retirement Plan Excludable from Income for Local Income Taxes (PDF)
"The decision may create refund opportunities.... In the ruling, a pension was described as any plan sponsored by an employer that provides for post-retirement income that's designed to supplement their income for life. After reviewing a number of factors the BTA recognized that although SERP fell within the scope of a nonqualfied deferred compensation plan, such designation did not preclude it from also being defined as pension income which is excludable under the subject municipal law." (PricewaterhouseCoopers)

Several Ex-Partners Ask Judge to Reject Dewey's Bankruptcy Plan
"One objection ... highlighted the outsize compensation packages that Dewey's management used to poach star lawyers from other firms.... At the heart of the complaints is a 'partner contribution plan' to which nearly two-thirds of Dewey's former partners agreed. That plan requires the partners to return a portion of their pay from 2011 and 2012 to compensate creditors.... Among its problems, [some ex-partners] say, is that it benefits some of the members of Dewey's leadership at the expense of the rest of the partnership." (The New York Times; free registration required)

Corporate Stock Option Tax Deduction in the Cross-Hairs Yet Again
"Sen. Levin described the proposals as eliminating 'a loophole that allows large corporations to exploit what is in effect a federal subsidy that helps pay for the compensation awarded to their executives.' However, under his approach, companies would be able to take a deduction for stock options that may never produce compensation if the stock price declines. Some estimates predict that the provision would raise $25 billion over 10 years." (HR Policy Association)

Press Releases

2013 403(b) Survey Questionnaire
Plan Sponsor Council of America (PSCA)

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