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March 27, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

Defined Benefit Compliance Analyst
for Trinity Pension Consultants, Inc. in OH

Retirement Plan Administrator
for Third Party Administrator in IL

Retirement Plan Administrator
for PlanTech, LLP in AL

Compliance Account Executive
for AAAA Benefits, Inc. in NC

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Webcasts and Conferences

Voluntary Benefits Employer Boot Camp™ - Houston TX - Complimentary!
in Texas on April 12, 2013 presented by Rhodes-Joseph & Tobiason Advisors, LLC

Consumer Reports and Castlight Present: The High Cost of Low-Quality Health Care Recorded Webinar
Nationwide on April 10, 2013 presented by Castlight Health

Affordable Care Act Webcast in Spanish
Nationwide on April 10, 2013 presented by U.S. Department of Labor, Employee Benefits Security Administration (EBSA)

2013 Western Pension & Benefits Council Spring Conference
in Arizona on May 9, 2013 presented by Western Pension & Benefits Council - Phoenix Chapter

"Form 5500 Workshop 2013: Issues and Answers" - Des Moines
in Iowa on April 24, 2013 presented by SunGard Relius

"Form 5500 Workshop 2013: Issues and Answers" - St. Louis
in Missouri on April 25, 2013 presented by SunGard Relius

"Form 5500 Workshop 2013: Issues and Answers" - Syracuse
in New York on April 25, 2013 presented by SunGard Relius

View All Webcasts and Conferences


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[Official Guidance]

CMS National Training Program Materials: 'The Health Insurance Marketplace' (PDF)
"This [set of presentation slides] will help you [1] Explain the Health Insurance Marketplace; [2] Identify who will benefit; [3] Define who is eligible; [4] Explain the enrollment process; [and] [5] Define options for those with limited income." (Centers for Medicare & Medicaid Services)


[Advert.]

ACA University: A New Virtual Learning Center for Employers

Sponsored by IFEBP (International Foundation of Employee Benefit Plans)

Navigate Affordable Care Act regulations by participating in ACA University! You'll find live webcasts, Q&A with industry experts, podcasts, recorded conference sessions and more. Join the International Foundation to participate.


[Guidance Overview]

Action Item for Covered Entities: Notice of Privacy Practices
"[H]ealth care providers must include in their [notice of privacy practices ('NPP')] a statement notifying the individual of the individual's right to restrict -- and a health care provider's affirmative obligation to agree to restrict -- disclosures of PHI to the individual's health plan where the individual has paid for the items or services out-of-pocket and in full.... [F]or those health plans that do not provide access to the NPP on the company's intranet site, either (i) the revised NPP or (ii) information regarding the material change in the policy and instructions on how to obtain a copy of the revised notice must be distributed to individuals covered by the subject plan of the NPP within 60 days of such material revision." (Vedder Price)

[Guidance Overview]

DOL, HHS and Treasury Agree: 90 Days Does Not Equal 3 Months; Health Plan Entry Dates May Need Amendment
"The Departments confirm that no de minimis exception exists that would permit employers to equate three months with 90 days....[P]lans with a 90-day waiting period in which coverage begins on the first day of the month immediately following satisfaction of the waiting period will have to be amended. Employers that continue to prefer a first day of the month start date for coverage rather than random dates throughout the month could consider implementing a 60-day waiting period." (Benefits Bryan Cave)

[Guidance Overview]

How the Employer Shared Responsibility Penalty Affects Cafeteria Plans Elections (PDF)
"The individual mandate and the availability of coverage through an Exchange both are effective as of Jan. 1, 2014. This date may raise issues for [cafeteria] plans that do not have a January 1 plan year ... An employee who is eligible to enroll in an employer's plan, but did not do so, may wish to enroll in the employer's plan in the middle of the plan year to meet the individual mandate requirements. An employee who is already covered under a fiscal year plan might wish to discontinue coverage under that plan and enroll in an Exchange plan in the middle of the plan year." (Chelko Consulting Group)

Five Critical Success Factors for Participation in Exchange Markets
"The following five tactics are recommended for organizations that plan to offer qualified health plans (QHPs) on public exchanges. [1] Strategy alignment.... [2] Having a champion.... [3] Cross-functional team engagement.... [4] Defining success.... [5] Public policy involvement." (Healthcare Town Hall)


[Advert.]

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.


Some Health Care Premium Charges May Rise When Obamacare Is Implemented
"U.S. Health and Human Services Secretary Kathleen Sebelius said, ... 'Women are going to see some lower costs, some men are going to see some higher costs. It's sort of a one to one shift ... some of the older customers may see a slight decline, and some of the younger ones are going to see a slight increase.'" (Fox News)

Health Overhaul May Raise Cost of Average Medical Claim by 32%
"Medical claims costs -- the biggest driver of health insurance premiums -- will jump an average 32% for Americans' individual policies under the [ACA], according to a [new] study ... [T]he report prepared by the Society of Actuaries concluded that the overwhelming majority [of the states] will see double-digit increases in their individual health insurance markets ... By 2017, the estimated increase would be 62% for California, about 80% for Ohio, more than 20% for Florida and 67% for Maryland." (USA TODAY)

9 in 10 Health Plans Still Tied to Fee-for-Service Model
"[K]ey scorecard findings include: Of the 11% of value-oriented payments, 43% offer providers financial incentives through potential bonuses or added payment to support higher-quality care; 57% put providers at financial risk for their performance if certain quality and costs goals are not met. 6% of payments made to specialist are value-oriented." (HealthLeaders Media)

Only 11 Percent of Health Care Provider Payments Are Value-Based
"Only 10.9 percent of payments to doctors and hospitals in the commercial sector in 2013 are linked to their performance or designed to cut waste, according to the National Scorecard on Payment Reform ... The scorecard is designed to track the nation's progress as it moves from fee-for-service payments based on volume to those oriented toward value, including bundled and global payments[.]" (Healthcare Finance News)

Beating the Health Plan Enrollment Blitz
"Overwhelmed by the volume of decisions they have to make in such a narrow window of time, employees march themselves through their benefits selections on autopilot.... If employees are too frazzled to make decisions in the time they've been given, you simply have to give them more time.... In fact, prepare yourself for extending the benefits discussion throughout the entire year. Doing so gives employees the time and space they need to properly consider all their available benefits options." (The Institute for HealthCare Consumerism)

Health Coverage by Race and Ethnicity: The Potential Impact of the ACA (PDF)
"While the majority of people of color have a full-time worker in the family, they are more likely to be in low-income, low-wage jobs that provide limited access to employer-sponsored insurance. Moreover, even when offered coverage by an employer, they are likely to have difficulty affording it given their low incomes. Similarly, coverage on the individual market is often unaffordable.... The ACA coverage expansions have the potential to significantly increase coverage for people of color and reduce disparities in coverage." (Kaiser Family Foundation)

Program Provides a Bridge to Health -- And Away from ER Overuse
"Nationally, between 13.7 percent and 27.1 percent of all emergency department visits are non-urgent, according to a 2010 Health Affairs study, leading to about $4.4 billion in health care costs.... Before enrolling in the program, participants were averaging seven ER visits a year, costing an average of $14,004 per person. At the end of the first year, participants averaged three visits a year, costing an average of $2,760 per person. This amounted to $404,784 in savings for the Pardee Hospital ER that year." (Kaiser Health News)

21 Graphs That Show America's Health Care Prices Are Ludicrous
"Every year, the International Federation of Health Plans ... releases survey data showing the prices that insurers are actually paying for different drugs, devices, and medical services in different countries. And every year, the data is shocking. The IFHP just released the data for 2012. And yes, once again, the numbers are shocking." (The Washington Post)

The Fiduciary Status of Independent Review Organizations under the ACA
"The [ACA] added a 3rd level of review to the appeals process for adverse benefit determinations. The newly named 'Independent Review Organizations' (IROs) now have final decision making authority in the ultimate step of the appeals procedure. Issue: Since IROs exercise discretionary authority as they interpret the terms of a health plan, how is their fiduciary status defined?" (Pilot Employee Benefits)

The Multi-State Plan Program under the ACA
"To boost competition in new insurance exchanges, the federal government will select and oversee at least two nationwide plans.... A core issue is whether the Multi-State Plan Program will genuinely increase competition among health plans. In addition, tensions over the Multi-State Plan Program have also arisen in several areas between the federal government and states and their respective regulatory roles" (Health Affairs)

How Immigration Reform Influences Health Care Reform
"Some experts believe both scenarios would create an interim period in which even wider gaps developed between the haves and have-nots of health care. If health reform works as intended, there will not only be a boost in the number of new people covered but a steady improvement in their health. Meanwhile, undocumented immigrants sit on the sidelines for, give or take, at least a decade." (Voice of Orange County)

A Study of the Availability of Consumer Prices from U.S. Hospitals for a Common Surgical Procedure
"[The authors] found it difficult to obtain price information for [total hip arthroplasty (THA)] and observed wide variation in the prices that were quoted. Many health care providers cannot provide reasonable price estimates. Patients seeking elective THA may find considerable price savings through comparison shopping." (JAMA Internal Medicine)

Health Care Reform is Prompting Changes in Employee Benefits
"Among their top concerns, brokers expect the number of employee benefits offered (80%) and benefit communications (78%) to be highly impacted, while employers note benefits service and support (56%), as well as number of benefits offered (55%) as their top concerns. Seventy-two percent of brokers say that 'expertise and thought leadership on health care reform' from insurers is either critical or very helpful." (Prudential)

Will the Exchanges Be Ready in Six Months? Most Health Industry Execs Don't Think So
"The vast majority of those who attended [a recent summit of executives from hospitals, clearing houses, state health insurance exchanges, and health plans] are worried ... because the information they are getting from the health insurance exchanges in order to do their share of the work is poor, to very poor.... Almost all of those surveyed are concerned that the exchanges have not involved them as users in gaining input from the industry -- traditionally a very bad sign in system development." (Health Care Policy and Marketplace Review)

[Opinion]

Observations on the Third Anniversary of the Affordable Care Act
"Though the Great Recession may have contributed to the trend of slower health care cost growth, it is only part of the explanation because the trend began before the recession took hold, and has continued thus far into the recovery.... Early responses to the ACA may have already contributed to the decline in per enrollee spending since 2010." (The White House Council of Economic Advisers)

[Opinion]

ACA Brings Unintended Happy Consequences for Staffing Companies
"[I]n regulations issued last year the IRS left an opening for employers of 'variable-hour' labor such as temp agencies. If it's not clear upon hiring that an employee will consistently work more than 30 hours weekly, companies get up to 12 months to determine whether she is full time and qualifies for health benefits -- even if she does end up working full time. Few temps last 12 months." (John Goodman's Health Policy Blog)

[Opinion]

Report Card on Obamacare: What's Left to Do?
"Over the next 10 years health reform will impose upon us about $1 trillion in new taxes and it will take another $716 billion out of Medicare, imperiling access to care for the elderly and the disabled ... It will impose a mandate to buy health insurance on most people and fine us if we don't comply. It will compel all but the smallest employers to provide insurance to their employees and fine them if they don't.... The federal government will regulate the kind of insurance we must have, tell us where we must get it and regulate how much we pay for it as well. Many will ask, 'what are we getting in return for all this?' I would like to turn that question around. After doing all these things, 'What problems will be left unsolved?' (John Goodman's Health Policy Blog)

[Opinion]

The $4,450 Urgent Care Visit: Assessing Systemic Waste in Health Care
"[One study] estimated annual excess cost from systemic waste at $765 billion -- including $210 billion in unnecessary services, $130 billion in inefficiently delivered services, $190 billion in excess administration costs, $105 billion in excessively high prices, $55 billion on missed opportunities for disease prevention, and $75 billion in fraud.... [T]his problem, by comparison to other obstacles that face the US healthcare system, seems to be somewhat easier to remedy. One way to do so is through transparency[.]" (Center for Health Media & Policy at Hunter College)

Benefits in General; Executive Compensation

Attorney Q&A on Executive Compensation Proxy Disclosure Litigation
"companies should consider taking a few proactive steps before filing their proxy statements. First, the company's legal, human resources, compensation and shareholder relations professionals should understand exactly what compensation disclosures the plaintiffs' strike suit lawyers are targeting. The plaintiffs' lawyers have filed at least 22 lawsuits with very similar allegations. The lawsuits have generally targeted two areas of executive compensation disclosure." (Michael S. Melbinger via Practical Law Company)

If You Think the IRS Won't Punish a 409A Foot Fault, Think Again
"What is alarming ... is that the IRS chose to enforce the penalty tax of 409A under the facts of this case in the first place.... Unfortunately, the case before the court was not whether the IRS had shown an ounce of common sense in the Sutardja matter, but only whether a stock option could be subject to 409A as deferred compensation when granted with an exercise price below the company's then-market value." (Winston & Strawn LLP)

Nice Work If You Can Get It, and You Can Get It (Easily) If You Try: Actuaries in China
"In the U.S., the actuarial profession is consistently voted one of the top three careers for stability, compensation and prospects. In China, actuaries are not 'white collar' workers, they're 'gold collar' workers. And with Asia's fast-growing middle class demanding a growing range of insurance products, prospects for qualified actuaries in the region are incredibly bright." (Classified Post)

[Opinion]

Text of Letter to EBSA on Retention of Historical Summary Plan Descriptions (PDF)
"The [Pension Rights] Center believes that the SPD collection is still of great value for pension plan participants and beneficiaries and, for that reason EBSA should continue to maintain as much of the collection as possible. However because it appears EBSA is proceeding with its plan to dispose of the [existing SPD collection, which covers plan years from 1975 through 1997], we also ask that EBSA ... [issue] guidance clarifying the remedies available when plans fail to retain plan documents as required [by ERISA]." (Pension Rights Center)

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