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February 22, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

Relationship Manager
for T. Rowe Price in MD

401(k) Plan Administrator
for CecilCo in TX

Compliance Manager
for Retirement Alliance, Inc. in NH

Senior Actuarial Consultant
for USI Consulting Group in CT

Transition Manager - Client Integration
for Transamerica in NY

Senior Defined Benefit Data Analyst
for Diversified / Transamerica Retirement Solutions in MA

Development Analyst
for Diversified / Transamerica Retirement Solutions in MA

Investment Consultant
for Alerus Investment Advisors (Alerus Financial, N.A.) in MN

Affinity Retirement Administrator
for RCM&D in DC, MD, VA

Retirement and Institutional Services Transition Manager
for Wilmington Trust in AZ

Retirement Plan Advisor
for retirement advisory services corp in PA

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Webcasts and Conferences

ECFC 32nd Annual Conference
in District of Columbia on March 6, 2013 presented by Employers Council on Flexible Compensation (ECFC)

401(k) Advisor Symposium – Costa Mesa, CA
in California on March 12, 2013 presented by 401(k) Rekon

ABC of the Carolinas - Get Connected & Get Ahead!
in North Carolina on March 19, 2013 presented by ASPPA Benefits Council (ABC) of Carolinas

View All Webcasts and Conferences


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[Guidance Overview]

HHS Overview: Final Regs for Health Insurance Market Reforms (Guaranteed Availability; Fair Premiums; Single Risk Pool; Guaranteed Renewability; Catastrophic Plans)
"Today, as many as 129 million -- or 1 in 2-non-elderly Americans -- have some type of pre-existing health condition, ranging from life-threatening illnesses like cancer to chronic conditions like diabetes, asthma, or heart disease. In most states, these consumers can be denied individual health insurance coverage, charged significantly higher rates, or have benefits for medical conditions excluded by insurance companies. In addition, individuals and small employers often find that they have few protections against premiums increases. To address these problems starting in 2014, CMS [has] issued a final rule that contains: Guaranteed Availability of Coverage; Fair Health Insurance Premiums; Single Risk Pool; Guaranteed Renewability of Coverage; Catastrophic Plans; [and] Updating Rate Review[.]" (Department of Health and Human Services)


[Advert.]

A pivotal year - Prepping for ACA's full implementation & more

Sponsored by Health & Benefits Leadership Conference

Benefits-related decisions you make in the coming months will determine your organization's overall success -- or failure in 2013. Gain forward-thinking business strategies & success stories needed to help you make the right moves. April 22-24 Benefitsconf.com


[Official Guidance]

Text of HHS Final Regs: Health Insurance Market Rules; Rate Review (PDF)
"This final rule implements provisions related to fair health insurance premiums, guaranteed availability, guaranteed renewability, single risk pools, and catastrophic plans, consistent with [the ACA]. The final rule clarifies the approach used to enforce the applicable requirements of the [ACA] with respect to health insurance issuers and group health plans that are non-federal governmental plans. This final rule also amends the standards for health insurance issuers and states regarding reporting, utilization, and collection of data under the federal rate review program, and revises the timeline for states to propose state-specific thresholds for review and approval by [CMS]." (U.S. Department of Health and Human Services)

[Official Guidance]

Minimum Value Calculator
This Excel spreadsheet has been published by HHS. "The Minimum Value Calculator (MV Calculator) is designed to give an estimate of network liability for a given plan design. This build of the MV Calculator uses data from a large national commercial database to build continuance tables for Employer-Sponsored Health Plans.... The MV Calculator allows users to specify several plan design features. Please note that any data entered into greyed out boxes will not be counted towards the final calculation." (Department of Health and Human Services)

[Official Guidance]

HHS Explains Minimum Value Calculator Methodology (PDF)
"This document is accompanying the Minimum Value Calculator, which is being released in conjunction with the final rule for determining minimum value [MV] ... [An] employer-sponsored plan provides MV if this percentage is no less than 60 percent. The MV Calculator is now available for informal external testing. HHS invites testers to send any technical issues or operational concerns to minimumvalue@cms.hhs.gov as soon as possible. If necessary, HHS will release a revised version of the MV Calculator." (Department of Health and Human Services)

[Guidance Overview]

Essential Health Benefit Rule Clarifies Employer Plan Duties
"Health reform's final essential health benefits rule makes it clear that self-insured and large group health plans do not need to comply with limits on growth in employee cost-sharing, offer all 10 categories of essential health benefits, or meet actuarial minimums like small-group and individual policies. However, the regime explained in the rule is still important self-insured and large group plans because they are still subject to many of their requirements; they may want to voluntarily apply elements to their own plans even though they're not required, and some EHB rules may bear on other reform mandates." (Thompson SmartHR Manager)


[Advert.]

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

Sponsored by World Congress

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.


[Guidance Overview]

DOL Issues Final Rule Implementing Amendments to FMLA
"The final rule also affirmed the physical impossibility rule which permits an employer to count the entire period an employee is forced to be absent as FMLA leave when it is physically impossible for the employee to start or end work in the middle of a shift. The final rule clarified, however, that the physical impossibility provision may only be applied in the most limited circumstances and that the employer must restore the employee to the same or equivalent position as soon as possible." (Vorys, Sater, Seymour and Pease LLP)

[Guidance Overview]

DOL Issues New FMLA Regs
"Important changes ... include revisions to the FMLA poster employers must display in the workplace, clarification about how employers must track intermittent leave, expanded military family leave provisions that implement changes made in the National Defense Authorization Act for Fiscal Year 2010, and special rules for airline flight crews. The new regulations also explicitly refer to the Genetic Information Non-Discrimination Act (GINA), and make clear employers' FMLA recordkeeping must comply with GINA's confidentiality requirements." (Faegre Baker Daniels LLP)

[Guidance Overview]

ACA FAQs Address HRAs, Hospital Indemnity Plans and PCORI Fees (PDF)
"Because retiree-only HRAs are not subject to the ACA's prohibition on annual or lifetime dollar limits on EHBs, stand-alone retiree HRAs remain a permissible option for pre-and post-65 retirees. Although it appears that retirees will be able to use HRA funds to purchase coverage through an Exchange, it is not clear whether retirees enrolled in an HRA would be eligible to receive subsidized Exchange coverage. Additional guidance on these issues is needed." (Buck Consultants)

[Guidance Overview]

DOL Issues New Guidance on Coverage of Preventive Services Under ACA
"The guidance clarifies a number of issues related to [these] services and discusses what types of services within these categories must be covered without cost-sharing. For example, the FAQs explain that if a plan does not offer any in-network providers of these specific services, it cannot impose cost-sharing when they are provided by an out-of-network provider. Additionally, the guidance states that plans need to provide aspirin and other over-the-counter medications without cost-sharing only if they are prescribed by a health care provider." (Littler Mendelson LLC)

Big Health Insurance Rate Hikes Are Plummeting
"Researchers combed through data available from the 15 states that publicly post all requests for rate increases in the individual market. They found that, in 2009, 74 percent of all requests came in above 10 percent. By 2012, that number had fallen to 35 percent. Preliminary data for 2013, which only cover a handful of states, shows 14 percent of rate increases asking for a double-digit bump.... Does Obamacare get credit? The administration thinks so[.]" (The Washington Post; free registration required)

State Health Insurance Exchange Legislation: A Progress Report
"The [ACA] has just passed a new milestone: All states have committed to what kind of health insurance marketplace, also referred to as an 'exchange,' will be running in their states starting in January 2014.... [An] interactive state map provides a picture as of February 2013 of what type of marketplace consumers can expect to be running in their states when open enrollment begins in October. It also shows how states are shaping their marketplaces." (The Commonwealth Fund)

Why Your Boss Is Dumping Your Wife
"By denying coverage to spouses, employers not only save the annual premiums, but also the new fees that went into effect as part of the [ACA].... While surcharges for spousal coverage are more common, last year, 6% of large employers excluded spouses, up from 5% in 2010, as did 4% of huge companies with at least 20,000 employees, twice as many as in 2010[.]" (MarketWatch.com)

Employer-Sponsored Health Insurance in Flux
"To what extent employer-sponsored insurance will change over the next few years under the ACA is an open question. In early February, the Congressional Budget Office (CBO) estimated a growth in employer-coverage from 154 million people covered in 2013 to 164 million in 2020. At the same time, the CBO predicts, a confluence of market trends and compliance scenarios could see thousands of employers shedding or forgoing worker coverage." (Healthcare Payer News)

Payroll Taxes Would Fund Colorado Universal Health Care Proposal
"Sen. Irene Aguilar, D-Denver, plans to introduce a bill ... seeking universal health care in Colorado. Under her plan, employers would pay a 6 percent payroll tax for each worker while employees would pay a 3 percent share. Self-employed people and investors would pay a 9 percent tax on income and capital gains. In exchange for those costs, all Coloradans who have lived in the state for at least one year by the beginning of 2016 would become part of a statewide health care 'co-op' and would get 'platinum-level' health plans, the most generous package of essential benefits under the Affordable Care Act." (Health Policy Solutions)

An Interview with Marilyn Tavenner, Obama's Pick to Head Medicare
"In her first interview since her renomination, Tavenner ... spoke about the work she's done over the past year, whether health care costs are actually slowing and what it means for [Florida Governor] Rick Scott to sign onto the Medicaid expansion." (The Washington Post; free registration required)

ROI of Wellness: How Good Is the Data?
"[W]hy is the ROI of wellness still controversial and why are many employers still hesitating to invest? ... 20 studies in [a report by 2010 report by a team of Harvard University health economists] varied widely in methods and rigor, and none met all the criteria for a gold-standard randomized controlled trial that would definitively answer the key question of whether the lower health care costs for employees exposed to a wellness program were caused by the program." (Society for Human Resource Management)

How Have CBO's Projections of Spending for Medicare and Medicaid Changed Since the August 2012 Baseline?
"In its most recent baseline projections, CBO reduced its estimates of spending for the Medicare and Medicaid programs compared with its estimates in the August 2012 baseline. For the 2013-2022 period, projected spending for those programs is now $382 billion (or 3-1/2 percent) below the agency's estimates in August 2012. CBO makes revisions to its baseline to reflect three kinds of developments -- enacted legislation, updates to its economic forecast, and other, technical changes. In the case of Medicare and Medicaid, the downward adjustments since August reflect mostly technical changes -- totaling $373 billion; legislative and economic changes accounted for just $9 billion." (Congressional Budget Office)

Health Reform Law's Effect on Premiums
"'These new, 3-to-1 rating bands -- as these ratios are called -- will shift costs from older people to younger people, most experts agree. America's Health Insurance Plans, a trade group representing insurers, did a hypothetical illustration showing how this will affect a 24-year-old and a 60-year-old with the same individual policy in the same area: starting on Jan. 1, the 24-year-old will pay 50% more for coverage than he or she would have in 2013, and the 60-year-old will pay 10% less.'" (America's Health Insurance Plans)

[Opinion]

Health Care Law Forces Universal Orlando to Cut Part-Time Health Insurance
"Universal Orlando, home to The Wizarding World of Harry Potter, will stop providing health insurance for part-time employees starting December 31, 2013.... The reason: Universal currently offers part-time workers a limited insurance ['mini-med'] plan that has low premiums but also caps the payout of benefits.... Five hundred workers will be affected. Remember that whole 'If you like your plan, you can keep it' business? Tell it to the theme park workers who have the mini-med plan." (U.S. Chamber of Commerce)

Benefits in General; Executive Compensation

Proxy Season Brings Third Wave of 'Gotcha' Shareholder Litigation
"This new wave, which has not crested yet, consists of a return to derivative shareholder suits but no longer concerning say-on-pay votes. Instead, these lawsuits are focused on 'gotcha' allegations that companies issued stock options or restricted stock units to executives in amounts that exceed the limits of those companies' stock plans. These lawsuits are easily preventable with careful planning by Compensation Committees and their in-house and outside counsel to ensure that all stock grants and executive compensation proposals are in compliance with the company's stock plan." (Pillsbury Winthrop Shaw Pittman LLP)

Citigroup Shelving Executive Profit-Sharing Plan
"Citigroup Inc. is shelving an unusual executive profit-sharing plan that raised hackles with investors ... The decision to allow the plan to expire next year comes after ... the New York company's chairman met with numerous Citigroup shareholders in a bid to avoid a repeat of an embarrassing defeat last spring in the shareholder-advisory vote [say on pay]. Citigroup was alone among major lenders in having its plan rejected by shareholders." (FoxBusiness.com)

Many Executives Re-Examine Their Retirement Intentions
"Some executives dreaming of their golden years are unsure when those years will actually start. Nearly four in 10 (38 percent) chief financial officers (CFOs) interviewed for a Robert Half Management Resources survey said they are more uncertain about when they're going to retire than they were five years ago. Another 13 percent stated their expected retirement plans have changed compared to five years ago." (Robert Half Management Resources)

'Slayer Statute' Options for Plan Administrators
"One of the sadder tasks encountered by a plan administrator is sorting out who is the appropriate recipient of benefits when a participant has been murdered by the intended beneficiary of such benefits.... [P]lan administrators ... dealing with ... pension, 401(k), life insurance and accidental death plans ... [have] a variety of alternatives each with varying levels of cost and risk. These alternatives, each of which is summarized in more detail ... include: (1) commencing an interpleader action, (2) securing a receipt, release, and refunding agreement, and (3) obtaining an affidavit of status (e.g., heirship)." (Benefits Bryan Cave)

CalPERS Plans 85% Rate Hike for Long-Term Care Insurance
"More than 110,000 CalPERS policyholders are receiving ... news [similar to one retiree's 85% rate hike] this week after the pension fund's board approved the changes late last year. CalPERS said the hefty rate hikes won't take effect until 2015 and are necessary to keep this $3.6 billion insurance fund intact for future claims.... CalPERS, which runs the nation's second-largest long-term-care plan, after one for federal government employees, said it would offer affected policyholders several ways to adjust their benefits to avoid these premium increases." (Los Angeles Times)

What We Mean When We Refer to Pension and Health Care Costs As 'Unsustainable,' in One Chart
"This chart is from a report on Baltimore's Ten-Year Fiscal Forecast, prepared by Public Financial Management, Inc. It was commissioned by the mayor of Baltimore. It speaks for itself." (Public Sector Inc.)

Press Releases

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