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February 19, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

Account Managers
for The Plexus Groupe in IL

Benefit Coordinators
for The Plexus Groupe in IL

Vested Interest Relationship Manager
for PNC in KY

Employee Benefits Manager
for County of Sacramento in CA

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Webcasts and Conferences

FREE WEBINAR - Healthcare Reform—The Employer Pay or Play Rules!
Nationwide on March 27, 2013 presented by University Conference Services

2013 Chicago Mid-Sized Retirement & Healthcare Plan Management Conference
in Illinois on June 4, 2013 presented by University Conference Services

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[Guidance Overview]

Employer Obligations to Share and Report Coverage and Affordability Information Under the ACA (PDF)
"[B]eginning in 2014, a great deal of information is expected to flow among and between the various stakeholders (which include employers, employees, health issuers, Exchanges, and the IRS).... [A]ll 'providers' of 'minimum essential coverage' will be required to provide certain information to the IRS regarding the extent to which an individual enrollee was covered by minimum essential coverage during the preceding taxable year. The term 'providers' for this purpose is defined to include both issuers and employer plan sponsors. These reporting requirements will apply to minimal essential coverage provided on or after January 1, 2014, with the first returns to be filed in 2015." (American Benefits Council, Coalition to Preserve Defined Benefit Plans & ERIC)


[Advert.]

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]

Treatment of Noncitizen Employees Under the ACA's 'Play or Pay' Rules
"Although the ACA does not define the term 'employee' in the context of these play or pay rules, the employee definitions appearing elsewhere in the ACA draw no distinction between citizens and noncitizens. The IRS therefore announced, in Notice 2011-36, that it will simply apply the common-law definition of 'employee.' Accordingly, if noncitizens are considered common-law employees, they must generally be counted for purposes of the play or pay rules -- unless an exception, safe-harbor, or transition rule applies." (Spencer Fane)

Sixth Circuit Upholds Plan Amendment Retroactively Limiting Disability Benefits
"Examining the plan's amendment provision, the [court found] that the provision [was] ambiguous and open to multiple interpretations. The appeals court proposed hypothetical language that would eliminate the ambiguity [and then found that] the hypothetical language demonstrated the multiple interpretations that could be drawn from the plan's amendment provision.... [The dissent] maintained that the trustees applied the wrong plan document and should have based their decision on the plan that existed at the time Price was awarded benefits." [Price v. Board of Trustees of the Indiana Laborer's Pension Fund, No. 11-4126 (6th Cir., Feb. 15, 2013)] (Bloomberg BNA)

The Rising Cost of Teachers' Health Care
"According to Bureau of Labor Statistic (BLS) data, 97 percent of K-12 teachers nationally work full time with an average employer insurance cost of $8,559. Only 83 percent of private-sector professionals worked full time in 2012 with an average insurance cost of $6,803. Eighty-seven percent of K-12 teachers participate in health insurance plans through their employer compared with 80 percent of private-sector employees." (John C. Goodman, Greg Scandlen and Devon M. Herrick, via National Center for Policy Analysis)

Would You Like Insurance With Your Tax Refund?
"H&R Block seems to think that 2012 income is somehow going to be key to determining if someone is eligible for the [ACA] credit. While the IRS may very well look at that, ... the actual eligibility for the credit will be finally determined after-the-fact based on the individual's income for the year in which the credit is received. Therefore, while 2012 income is informative, it is far from dispositive. Furthermore, employers should be aware that these information efforts are taking place." (Benefits Bryan Cave)


[Advert.]

Driving Compliance and ROI through Wellness Programs - April 22-24, San Francisco

Sponsored by Human Resources IQPC

Focus on building, enhancing and implementing strategic wellness programs. HR, Benefits and Wellness professionals discuss how to move beyond making the business case to implement and expand your program. 1-800-822-8684 for registration - Code BLINK1 - $100 discount.


Walmart Health Screening Stations Touted as Part of 'Self-Service Revolution'
"As Americans gain coverage under the federal health law, putting increased demand on primary care doctors and spurring interest in cheaper, more convenient care, unmanned kiosks like these may be part of what their manufacturer bills as a 'self-service healthcare revolution.' From SoloHealth's stations, slated to be in 2,500 Walmarts and Sam's Clubs next month, to video consultations with doctors, to smartphone apps that track blood pressure and heart rate, consumer health technology is attracting big-name backers[.]" (Kaiser Health News)

Obamacare and Birth Control: Should Making a Profit Make a Difference?
"President Obama tried to accommodate religious-affiliated universities, charities and hospitals by placing a firewall between the nonprofits' health care plans and contraception policies administered and paid for by insurers. He has not made a similar offer to for-profit operations.... [Domino's Pizza founder Thomas Monaghan] has a foot in each camp, offering a direct line to the plaintiffs' line of thinking -- why, they ask, is one objector's claims to religious freedom more valid than another's?" (Washington Times)

Kaiser Permanente Seen as Model for Health Care Overhaul
"California officials also have cited the Kaiser model as they move to carry out the federal health care overhaul here. The Legislature recently selected Kaiser as a model for other insurers to follow when they offer products through the state's health exchange." (Miami Herald)

Big Tobacco and Anti-Cancer Activists Agree: ACA Provision Goes Too Far
"Big tobacco companies and anti-cancer activists are standing in opposition to a part of the [ACA] that allows insurance companies to charge smokers 50 percent more than patients who do not use tobacco. Cigarette makers ... say the policy amounts to discrimination against smokers. The American Cancer Society, meanwhile, worries that the high surcharges could make health insurance unaffordable to cigarette smokers, who are disproportionately low income.... One analysis ... estimated that the tobacco surcharge could cause a low-income individual's annual premiums to jump from $708 to $3,308." (The Washington Post; free registration required)

Maryland Bill Encourages Healthiness, at a Cost
"A group of Maryland lawmakers want state employees to be healthier. That's why they have introduced a bill to give state workers incentives to take actions like exercise more, eat healthier and get regular health assessments. While the long-term goal would be to save the state money in health care payments, analysts say the House legislation would require big up-front costs and wouldn't guarantee savings." (The Examiner)

Not-Quite-Universal Coverage
"[T]he mandate is turning out to be little more than a suggestion. Some 24 million people are expected to be exempt in 2016, according to the [CBO]. Another 6 million not lucky enough to qualify for exemptions will likely go without coverage -- and pay an estimated $45 billion in fines for doing so. With the feds now acknowledging that nearly 10 percent of Americans will remain uninsured even after they're required to buy insurance, it's clear that the individual mandate will fail to deliver the universal coverage its backers promised." (Orange County Register)

States Worry About Rate Shock During Shift to New Health Law
"Administration officials have consistently downplayed the specter of rate increases and other disruptions as millions of Americans move into overhauled insurance markets in 2014.... Exactly how high the premiums may go won't be known until later this year. But already, officials in states that support the law have sounded warnings that some people -- mostly those who are young and do not receive coverage through their work -- may see considerably higher prices than expected." (Los Angeles Times)

[Opinion]

Health Care Law Has Another Hole
"[If] an employee cannot afford a family plan now, the [ACA] probably will do little to help that individual. The only consolation -- and it is very small considering how the Obama administration promoted this law -- is that the employee would not be subject to the punitive tax for not having healthcare." (GreenvilleOnline.com)

[Opinion]

The Coming Failure of 'Accountable Care'
"The ACO concept is based on assumptions about personal and economic behavior -- by doctors, patients and others -- that aren't realistic. Health-care providers are spending hundreds of millions of dollars to build the technology and infrastructure necessary to establish ACOs. But the country isn't likely to get the improvements in cost, quality and access that it so desperately needs." (The Wall Street Journal)

[Opinion]

Cost of Health Insurance Provides Healthy Dose of Sticker Shock
"Providing decent medical coverage for [the author's] family of four -- including both what's deducted from [his] paycheck and the larger amount chipped in by The News -- costs more than the sticker price for a brand-new Ford Mustang. Per year. Holy cow. No wonder the experts are so freaked out about health care costs. The rest of us should start freaking out, too, before these costs bankrupt the country." (New York Daily News)

[Opinion]

Should Employees Get Insurance Discounts for Completing Wellness Programs?
"More employers are ... offering discounts [on health insurance premiums] to those who achieve health goals or successfully complete company wellness programs. That has some advocates concerned. They say if premiums go down for some they will go up for others, and the last thing a wellness program should do is make health care more expensive for the people who need it most. Proponents say insurance discounts can be good motivational tools when combined with other things. They also say they're fair, noting that people with zero lifestyle-related health risks spend a lot less on medical care on average than those with many risks." (The Wall Street Journal)

[Opinion]

It's Official: The Feds Will Run Most Obamacare Exchanges
"In the health policy world, there are essentially two schools of thought on this. The first is that states opting out of the exchanges is horrible for the Obama administration. All along, [HHS] has urged states to move forward on their own. Now, HHS has the massive task of setting up 26 separate state exchanges.... But there's also an optimist's take, one that suggests that federal oversight of most [ACA] marketplaces will ultimately strengthen the health overhaul." (The Washington Post; free registration required)

[Opinion]

Deloitte Health Care Reform Memo for February 18, 2013
"[T]he health care industry is woefully behind in embracing IT to improve the customer experience. There are two reasons: 1. We think we're different. We think our 'customers' are patients or members inept or incapable of making decisions about their medications, treatments or health risk without our help.... 2. We think the value proposition of IT applied in health care is limited. Complaints from physicians about meaningful use are palpable." (Deloitte Center for Health Solutions)

[Opinion]

Competition Works -- At Least for Prescription Drugs
"Of the $137 billion drop in the Medicare baseline, $104 billion -- or 75 percent -- was due to the drop in expected Medicare drug benefit spending. This is truly remarkable because CBO had already lowered the drug benefit baseline several times in the preceding years. With this latest revision, CBO's part D projections bear almost no resemblance to what was expected to occur when the law was enacted in 2003 ... And this is occurring in a program run entirely through private insurance plans competing with each other for enrollment among Medicare beneficiaries[.]" (John Goodman's Health Policy Blog)

Benefits in General; Executive Compensation

Supreme Court Cases on Same-Gender Marriage Likely to Affect Benefit Plans
"For private employers, the most significant impact may be on employee benefits governed by [ERISA]. Because of DOMA, the terms 'spouse' and "marriage" in employee benefit plans currently apply only to opposite-sex couples, and employers are not required by law to extend benefits to same-gender couples that are otherwise available to opposite sex couples (though many do so voluntarily). If this portion of DOMA were invalidated by the Supreme Court, the ERISA references to 'spouse' and 'marriage' would likely apply to same-gender marriages recognized by the states in which they are performed." (Faegre Baker Daniels)

Press Releases

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