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March 29, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

ERISA/LTD Attorney
for Law Offices of Eric A.Shore in NJ, PA

401(k) Assistant Administrator
for Third Party Administrator in CA

Employee Benefits Financial Client Manager
for Willis North America in KS

Associate Vice President, Retirement Plan Consulting
for United Retirement Plan Consultants in AK

Consulting Support Specialist
for Northwestern Benefit Corporation of Georgia in GA

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Webcasts and Conferences

10th Annual World Health Care Congress Live Webcast
Nationwide on April 8, 2013 presented by World Congress

Innovations in Workplace and Community Wellness: Advancing Private-Public Partnerships
in District of Columbia on April 3, 2013 presented by U.S. Chamber of Commerce

"401(k) Plan Workshop 2013: Tax Reform and the 401(k) Plan" - Des Moines
in Iowa on April 25, 2013 presented by SunGard Relius

"401(k) Plan Workshop 2013: Tax Reform and the 401(k) Plan" - St. Louis
in Missouri on April 26, 2013 presented by SunGard Relius

"401(k) Plan Workshop 2013: Tax Reform and the 401(k) Plan" - Syracuse
in New York on April 26, 2013 presented by SunGard Relius

View All Webcasts and Conferences

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[Official Guidance]

HHS Finalizes Rule Guaranteeing 100 Percent Funding for New Medicaid Beneficiaries
"Health and Human Services (HHS) Secretary Kathleen Sebelius today announced a final rule with a request for comments that provides, effective January 1, 2014, the federal government will pay 100 percent of the cost of certain newly eligible adult Medicaid beneficiaries. These payments will be in effect through 2016, phasing down to a permanent 90 percent matching rate by 2020. The Affordable Care Act authorizes states to expand Medicaid to adult Americans under age 65 with income of up to 133 percent of the federal poverty level (approximately $15,000 for a single adult in 2012) and provides unprecedented federal funding for these states." (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)


Celebrate National Employee Benefits Day on April 2, 2013

Sponsored by IFEBP (International Foundation of Employee Benefit Plans)

Employee Benefits Day recognizes benefits professionals for their dedication to providing quality benefits and the important role they play in their colleagues' well-being. In conjunction with the day, the highly anticipated ACA University will debut!

[Official Guidance]

Text of Final Medicaid Regs, Including Request for Comments, on Increased Federal Medical Assistance Percentage Changes under the ACA (PDF)
"This final rule implements the provisions of the [ACA] relating to the availability of increased Federal Medical Assistance Percentage (FMAP) rates for certain adult populations under states' Medicaid programs. This final rule implements and interprets the increased FMAP rates that will be applicable beginning January 1, 2014 and sets forth conditions for states to claim these increased FMAP rates.... While we believe that this additional detail will assist states in implementing the threshold methodology, we recognize the complexity surrounding these issues. We are seeking additional comment on these provisions so that we can determine whether additional clarification would assist states to implement these aspects of the threshold methodology more effectively." (Centers for Medicare & Medicaid Services)

[Guidance Overview]

Proposed 90-Day Waiting Period Under ACA
"Under the proposed regulations: Eligibility conditions that are based solely on the lapse of a time period are permissible for no more than 90 days. Other eligibility conditions (i.e., those that are not based solely on the lapse of a time period) are generally permissible unless the condition is designed to avoid compliance with the 90-day waiting period limitation. A requirement that an employee have a specified number of hours of service per period (e.g., 30 hours per week or 250 hours per quarter) is a plan eligibility condition." (Mintz Levin)

[Guidance Overview]

Health Care Reform Roundup
"A slew of recent guidance from regulators about the Affordable Care Act (ACA) gives employers clarity about several provisions taking effect in 2014, and provides information -- at least directionally -- about some of the changes in store for the health insurance landscape. Links to recent guidance of interest to employers are included [in this article]." (PricewaterhouseCoopers)

[Guidance Overview]

Final HIPAA/HITECH Regulations: Impact on Group Health Plan Sponsors
"Although the new risk assessment standard for breach notifications is not effective until September 23, 2013, you should use caution in making any determination that no notice is required under the existing risk of harm standard. In this interim period, it may be prudent for you to also analyze whether notification would be triggered under the new rules and, if so, follow the new rules." (McKenna Long & Aldridge LLP)

[Guidance Overview]

The Hole in the Play-or-Pay Regulations
"[An issue exists for an employee] hired two weeks into the [standard measurement period (SMP)] [when] a 12-month [initial measurement period] is used ... As the rules require, [the employee's] stability period following the IMP ends on December 31, 2014. However, at that point, he has not been employed for an entire SMP. As a result, come January 1, 2015, he is in a proverbial 'no man's land'[.]" (Benefits Bryan Cave)

Unfit for Work: the Startling Rise of Disability in America
"In the past three decades, the number of Americans who are on disability has skyrocketed. The rise has come even as medical advances have allowed many more people to remain on the job, and new laws have banned workplace discrimination against the disabled. Every month, 14 million people now get a disability check from the government.... In Hale County, Alabama, 1 in 4 working-age adults is on disability.... The health problems where there is most latitude for judgment -- back pain, mental illness -- are among the fastest growing causes of disability." ('This American Life' program on National Public Radio)

Deal Reached to Require Paid Sick Leave for Employees in New York City
"The legislation would eventually force companies with at least 15 employees to give full-time workers five compensated days off a year when they are ill, a requirement that advocates said would allow much of the city's labor force to stay home from work without fear of losing a day's wage -- or worse, a job. The advocates said the legislation would provide paid sick leave for one million New Yorkers who do not currently have such benefits.... New York City's mandate would not take effect until spring 2014, and for the first 18 months, it would apply only to businesses with 20 or more employees[.]" (The New York Times)

AMA Pushes for Better Insurance Exchange Networks
"Final regulations specified that qualified health plans must offer adequate networks of physicians and other health care professionals, including mental health and substance abuse professionals, to ensure that consumers will be able to access all needed health care services without unreasonable delays. But in the AMA's view, these standards are too vague, making it difficult to gauge whether the qualified plans are meeting them.... Without adequate networks, consumers might not seek out preventive services or might avoid obtaining needed medical care[.]" (American Medical News)

California Health Premiums for Individual Buyers Will Rise
"Middle-class Californians counting on the federal health care overhaul to lower their insurance premiums are in for a double-digit shock next year, a new state study shows.... Millions of low-income Californians will see their costs plummet while costs rise for households where incomes exceed about $46,000 for an individual or $94,000 for a family of four, the study concluded." (InsuranceNewsNet.com)

Obamacare Expected to Make Health Care Cheaper -- Just Not Right Away
"Henry Aaron, a health-care expert at the Brookings Institution ... says it is obvious that health-care spending by government and insurance companies will rise initially ... For one thing, as more people get coverage, more claims will need to be paid out. Moreover, health-care costs continue to rise, even if the pace of spending has slowed. And Obamacare forces many people to get more complete -- and therefore more expensive -- coverage than they get now. Over time, Aaron says, medical care should get cheaper." (Bloomberg BusinessWeek)

California Individual Health Insurance Premiums to Rise on Average by 14 Percent
"Californians who buy individual health plans will see their premiums increase an average of 14 percent next year under the [ACA], but payments will largely depend on income, age and where they live, according to a new report ... The report commissioned by Covered California found the increase is largely due to an influx of people who previously could not afford health insurance or were denied coverage because of pre-existing conditions." (San Francisco Chronicle)

Obamacare Is No Stumbling Block for Taxpayers This Year
"Eligibility for the new health insurance subsidies will be based on income and family size. Information from 2012 tax returns, the one people are filing this year, should be automatically pulled up on a computer screen when people apply for the subsidies this fall.... What will actually determine whether someone gets a subsidy and how big that subsidy will be isn't what they report on their tax forms this year at all, but how much they estimate they will make in 2014." (Kaiser Health News)

Five Common Gaps for Exchange Readiness
"This post describes five organizational gaps commonly standing between a [Qualified Health Plan] issuer and exchange readiness. [1] Licensure and accreditation.... [2] Marketing and distribution.... [3] Systems and reporting.... [4] Network and medical management.... [5] Operational execution." (Healthcare Town Hall)

Ancillary Employee Benefits Becoming More Important
"As more health care exchanges go online due to health care reform, fewer businesses will be burdened with a full health care plan, says a new study ... [A]ncillary employee benefits, including voluntary ones, will be a greater differentiator in 2013 than ever before. Findings indicate vast differences in ancillary benefits offered by employer size, region and industry, highlighting the importance of using local benchmarking data in benefits planning." (PLANSPONSOR.com)

The Truth Behind the CVS Wellness Program
"Despite the fact that this wellness initiative is clearly optional for employees, unfortunately the media has focused on headlines like, 'CVS CareMark demands workers disclose weight, health info!' from the LA Times, a statement which is simply untrue. In fact, there are several aspects of the CVS wellness program that are not addressed properly in the media; the issues of (1) privacy, (2) penalty cost and (3) why employers are adopting these types of wellness plans." (William Gallagher Associates)

'Appropriate Care Clause' Imposes Duty on Claimant to Seek and Accept Medical Care/Treatment Aimed at Returning Claimant to Work
"What happens when the claimant refuses to seek and accept medical care that might enable the claimant to return to work? Does the claimant have a duty to seek out and accept medical care aimed at returning to work? YES. But there are nuances.... [C]are is 'appropriate for the condition causing the disability' where, to the extent medically and otherwise reasonable, it seeks to ameliorate the condition preventing the insured from returning to his or her prior occupation." [Metropolitan Life Insurance Company Life v. Cotter, No. SJC-11135 (Mass. Mar. 15, 2013)] (Lane Powell PC)

Medicare Dashboard Advances ACA Goals for Chronic Conditions
"A new Medicare Chronic Conditions Dashboard ... furthers the [ACA]'s goals for health promotion and the prevention and management of multiple chronic conditions. The dashboard offers researchers, physicians, public health professionals, and policymakers an easy-to-use tool to get current data on where multiple chronic conditions occur, which services they require, and how much Medicare spends helping beneficiaries with multiple chronic conditions." (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)

Financial Burden of Medical Spending by State and the Implications of the 2014 Medicaid Expansions (PDF)
"Results show significant differences across states in the financial burden of medical spending. The Mountain and East South Central states have populations with the greatest burden levels, while the Middle Atlantic states have the lowest. There is also significant variation across states in burden levels for low-income Americans -- much more so than for their higher-income counterparts." (Urban Institute)

Timeline Shows Upcoming Developments in Exchanges
"[This CCIIO timeline can be used] to help track what's ready, what's lagging, what's going through dry runs before being opened to consumers in your state." (Association of Health Care Journalists)

The Big Gamble in Health Care: Would Competition Outdo Government in Controlling Costs?
"[T]he debate over injecting more market competition into health care raises issues that deserve more than a knee-jerk response. A first step may be to disentangle two questions that are generally intertwined in debates over 'competition' in health care. [1] Which approach is better at containing costs and serving patients -- traditional government programs or the private insurance market? ... [2] Would patients help hold the line on costs if they had more skin in the game?" (The Huffington Post)


What NPR's 'This American Life' Program Missed on Disability Insurance
"Disability really does need to be thought about in the context of economic opportunities. If you have a bad back, and the only jobs available are manual labor, that's a real limitation. You're unable to work. So it very much matters that we're in a deep recession, and a lot of the opportunities people faced are limited. You can't remove the economic context from the disability conversation." (The Washington Post)

Five Ways to Reform Social Security Disability Insurance
"Put a mandate on it.... Higher taxes for employers who produce disabled workers.... Try a few approaches, expand what works.... Ease the phase-out.... Longer waiting period." (The Washington Post)


U.S. Health Care Prices Are the Elephant in the Living Room
"[I]t is higher health spending coupled with lower -- not higher -- use of health services that adds up to much higher prices in the United States than in any other member nation of the Organization for Economic Cooperation and Development. Aside from a few high-tech services, Americans actually use less health care and rely on fewer real health-care resources than do residents of other industrialized countries." (Uwe E. Reinhardt in The New York Times)


For the Health Care Law, a 30.1% Bump in the Road
"One figure in a new report neatly summarizes the potential pitfalls for Obamacare: 30.1%. That's how much premiums could rise next year, on average, for the roughly 1.3 million moderate- and upper-income Californians who buy individual health insurance policies.... [W]hile it's headline-grabbing, the 30.1% average increase is just part of the story -- the ugliest part. The bigger picture is that the law is spreading the cost of medical care more broadly, barring insurers from denying coverage to those with preexisting conditions or from extracting exorbitant premiums from older and riskier customers." (Los Angeles Times)


Stay Healthy -- or Else!
"[W]ellness programs that tie financial incentives to not only participation, but to proof that employees are meeting their health-related goals is a growing trend. In fact, a survey just out by consulting firm Aon Hewitt found that 83% of firms offer some kind of incentive to encourage participation in their wellness programs. But the CVS program seems to take things a step further by punishing employees who don't participate with a financial penalty." (WebMD)


Financing Medicare and Medicaid: Testimony Before the House Subcommittee on Health Committee on Energy and Commerce
"Continuing to slow health cost growth is essential; but Medicare and Medicaid are not in crisis. Recent per beneficiary cost growth has slowed so significantly that CBO has dramatically reduced its spending projections for the coming decade. In Medicare, refinement of existing payment mechanisms alongside payment reform can produce additional savings. But as the elderly population doubles over the coming decades, a balanced deficit-reduction package must include new revenues. The alternative, changing entitlement structures ..., would undermine essential protections and shift or even increase health care costs." (Urban Institute)

Benefits in General; Executive Compensation

Supreme Court Review of the Defense of Marriage Act: Implications for Employers (PDF)
"[If] Section 3 of DOMA is ruled unconstitutional, employers will likely need to ... move to a regime for benefit administration that provides equal ERISA plan benefits and rights to employees with same-gender spouses -- at least with respect to those employees that live in states that allow for or recognize same-gender marriage.... If the Supreme Court determines it does not have jurisdiction to decide the case, plan sponsors and service providers could face interesting issues given that the First and Second Circuits have ruled that Section 3 of DOMA is unconstitutional[.]" (Crowell & Moring LLP via American Benefits Council)

Same-Gender Marriage Cases in the Supreme Court: Are Your Benefit Plans Prepared?
"[This advisory summarizes] the cases and the issues that sponsors of employee benefit plans should be considering now in preparation for the [Supreme Court] decision. If the Court determines that ... Proposition 8 (Prop 8) and Section 3 of the Defense of Marriage Act (DOMA), are constitutional, very little would change for employee benefit plans. However, if the Court affirms either case, employers will need to be prepared because a ruling striking down DOMA could require plans to promptly cover same-gender spouses." (Davis Wright Tremaine LLP)

Appeals Court Denies IRS Request for Stay in Return Preparer Regulation Case
"The IRS lost another round in its court battle to regulate tax return preparers when the U.S. Court of Appeals for the District of Columbia Circuit denied its motion to stay an injunction halting its return preparer regulation program, pending appeal of a lower court's decision ... In denying the IRS's motion, the court said the IRS had 'not satisfied the stringent requirements for a stay pending appeal.'" (Journal of Accountancy)

Requiring Choices by Employees: Employer Health and Retirement Plans Converging
"Driven by rising costs and the Affordable Care Act, employee health programs are beginning to look like employee retirement plans. Using 401(k)s and other tools, administrators of those plans have spent decades trying to influence employees to save more money and make better retirement investment decisions. Employers increasingly are approaching their health plans in similar ways, according to a recent survey. The result is a convergence that finds both types of plans trying to use incentives to change employee behavior even as they offload more key decisions and financial responsibility onto employees." (U.S.News and World Report)

Recruitment and Retention of Older Workers: Considerations for Employers
"This brief presents the motivational factors that drove companies to focus on older workers, the cultural contexts of businesses that have undertaken these practices, and the range of recruitment and retention practices and initiatives they used. Researchers offer suggestions to employers on the relevance of the findings to their own workplace practices, initiatives, and cultures." (National Center on Workforce Development/Adult)

Recruitment and Retention of Older Workers: Application to People with Disabilities
"This brief identifies strategies that can benefit both older workers and workers with disabilities. It describes each strategy that companies discussed in relation to older workers and makes a case for its effectiveness in employing workers with disabilities, offering action steps employers can take. The brief ends with recommendations for the disability community to better support businesses to employ people with disabilities. Including these practices in business operations will position employers to become more reflective of their diverse communities and the customers they strive to serve." (National Center on Workforce Development/Adult)

Press Releases

Wilton Re & Farmington Capital Join New L&H Insurance Startup Community
New England Life & Health Insurance Startup Community

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