EmployeeBenefitsJobs.com logo BenefitsLink.com logo

BenefitsLink Health & Welfare Plans Newsletter

April 3, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
         Past Issues  |  Search

Employee Benefits Jobs

Assistant Vice President, Pension
for Associated Third Party Administrators in CA

Post Your Job on employeebenefitsjobs.com

View All Jobs

RSS feed for jobs RSS Feed: All Jobs


Webcasts and Conferences

Protecting Retirement Plan Fiduciaries from Liability Webinar
Nationwide on May 8, 2013 presented by Winston & Strawn

National Employers' Health Benefits Communication Summit
in District of Columbia on June 26, 2013 presented by National Business Group on Health

SPARK National Conference
in District of Columbia on June 16, 2013 presented by SPARK Institute

National Health Insurance Exchange Summit
in District of Columbia on May 1, 2013 presented by Health Care Conference Administrators (HCCA)

National Health Insurance Exchange Summit Archived/Live Webcast
Nationwide on May 1, 2013 presented by Health Care Conference Administrators (HCCA)

3nd Annual Advanced Forum on Managed Care Disputes & Litigation
in Pennsylvania on May 9, 2013 presented by American Conference Institute

National Advanced Compliance and Benchmarking Forum on Minimizing Legal Risks in the Design, Implementation & Administration of Employee Benefit Plans
in New York on May 30, 2013 presented by American Conference Institute

DCIO Market Share Summit
in Florida on June 25, 2013 presented by Financial Research Associates

The Affordable Care Act and Elder Care
in California on April 16, 2013 presented by Western Pension & Benefits Council - San Diego Chapter

View All Webcasts and Conferences


We also publish the BenefitsLink Retirement Plans Newsletter (free): Subscribe

 

[Official Guidance]

Text of Proposed CMS Regs on Exchange Functions: Standards for Navigators and Non-Navigator Assistance Personnel (PDF)
"The proposed regulations would create conflict-of-interest, training and certification, and meaningful access standards applicable to Navigators and non-Navigator assistance personnel in Federally-facilitated Exchanges, including State Partnership Exchanges, and to non-Navigator assistance personnel in State-based Exchanges that are funded through federal Exchange Establishment grants.... [The proposed regulations would add] to the list of entities ineligible to become Navigators, those entities with relationships to issuers of stop loss insurance, including those who are compensated directly or indirectly by issuers of stop loss insurance in connection with enrollment in Qualified Health Plans or non-Qualified Health Plans. The proposed regulations would also clarify that the same ineligibility criteria that apply to Navigators would also apply to non-Navigator assistance personnel[.]" (Centers for Medicare & Medicaid Services)


[Advert.]

IPMA-HR Regional Conference - June 9-12 - New Orleans, LA

Sponsored by IPMA-HR

The Big HR Issues Made Easy! Join us in New Orleans for the IPMA-HR Southern & Central Region Training Conference, June 9-12, 2013. Learn (many benefits topics!), Laugh (we're fun!), Location (enough said!).


[Guidance Overview]

Proposed Regs Issued on 90-Day Waiting Period Limitation for Health Benefits
"The Rules have no phase-in period after Jan. 1, 2014. If an employee is hired before Jan. 1, 2014, the days of employment in 2013 will count toward the 90-day waiting period limitation as of Jan. 1. In such cases, coverage must become effective no later than the waiting period's 91st day, even if the 91st day is Jan. 1, 2014." (McGuire Woods LLP)

[Guidance Overview]

Proposed Regs Issued on ACA 90-Day Waiting Period
"[M]ultiemployer plans present some unique questions regarding eligibility determinations. Often these collectively-bargained plans yield eligibility requirements that depend on a worker's earnings and the timing of those earnings. As a general matter, the proposed regulations accept satisfaction of these earnings-based formulas, as well as the use of hour banks, as substantive eligibility provisions that are therefore permissible under PPACA's waiting period rules." (Jenner & Block)

[Guidance Overview]

OSHA Regs Protect Whistleblowers Under the ACA (PDF)
"The ACA whistleblower procedures generally follow those issued under the Consumer Product Safety Improvement Act of 2008 (CPSIA) and its implementing regulations.... Notably, the IRS, HHS, and EBSA, at their discretion, may participate as amicus curiae in a proceeding at any time. Whether or not they participate, copies of all documents in a case must be provided to them upon request." (Buck Consultants)


[Advert.]

3rd Annual Prevention & Wellness Congress May 16-17, Santa Monica, CA

Sponsored by World Congress

Prepare to challenge the way you think about wellness and reposition your program by doing away with what you know doesn't work. Wellness 3.0 means reaching beyond the employee and impacting dependants and communities too. Promo Code BLINK3 for $300 off.


DOL Offers Tools for Health Care Reform and HIPAA Compliance
"In recent months, the DOL appears to have stepped up the incidence and complexity of compliance audits. The two checklists suggest the focus of these audits, which is particularly relevant for self-insured health plans as the plan sponsor is generally solely responsible for compliance." (Towers Watson)

ACA 'Play or Pay' Day of Reckoning Looms
"With an October open enrollment deadline, employers need to get serious about their healthcare benefit decisions. But do they have enough information to act?" (Human Resource Executive Online)

Insurers See Way to Dodge Federal Health Care Law Next Year
"Some of the nation's biggest health insurers are looking to take advantage of this delay, and Arkansas officials are encouraging companies to do this by resetting customers' renewal dates for the end of December. There's also concern that some insurers and agents could rush to sell more individual policies before year-end so they could be extended in 2014. Some policy experts are expressing concern about this practice for fear that insurers will focus on renewing younger and healthier policyholders and hold them out of the broader insurance pool next year." (Los Angeles Times)

Oregon Insurance Exchange Approves 22 Carriers to Offer Medical and Dental Plans
"Cover Oregon has approved the health insurance carriers that will participate in its online marketplace -- a key step in preparing for open enrollment in October. Cover Oregon gave approval this week to 22 carriers that plan to offer individual, small employer, and dental plans. The plans themselves have not yet been reviewed or approved, and there are still many steps the carriers must follow to make their plans available this fall, but Cover Oregon expects it will provide a robust level of coverage choices to Oregonians." (Cover Oregon)

New York City Expected to Pass Wide-Ranging Paid Sick Leave Law
"Under the proposed New York City law, as of April 1, 2014, companies with 20 or more employees would have to provide at least five paid sick days a year. The law would be extended to apply to companies with 15 or more employees as of October 1, 2015 [and] will also require companies of any size to provide five days of sick leave as of April 1, 2014, but the time off may be unpaid." (Drinker Biddle)

Wellness Programs Must Accommodate Worker Disabilities, Says Informal EEOC Letter
"'If a wellness program is voluntary and an employer requires participants to meet certain health outcomes or to engage in certain activities in order to remain in the program or to earn rewards, it must provide reasonable accommodation, absent undue hardship, to those individuals who are unable to meet the outcomes or engage in specific activities due to a disability,' EEOC wrote [in response to an employer's question.]" (Thompson SmartHR Manager)

ML Strategies Health Care Reform Update, April 2, 2013 (PDF)
Update on developments in federal and state health care reform legislation and regulations, including summaries of recent announcements and regulatory activity by HHS, CCIIO, IRS and CMS. (ML Strategies, LLC)

U.S. to Boost Rather Than Cut Payments to Health Insurers in Medicare Advantage
"The Obama administration reversed itself ..., scrapping plans to cut by 2.2 percent the rates paid to health insurers that take part in the Medicare Advantage program. The insurance industry and more than 100 members of Congress had objected to the cut in the per capita growth rate, which was proposed in February. They argued that the administration was using faulty methodology.... [CMS] announced that it was changing its method of calculating reimbursement rates. Instead of cutting payments for Medicare Advantage plans, it will increase them by 3.3 percent." (The Washington Post)

CMS Softens Medicare Advantage Funding Changes
"Medicare Advantage customers may not see the drastic benefit cuts or premium hikes next year that insurers have been warning about after all. Health insurers had predicted big, painful changes for many of their Medicare Advantage customers after the federal government said in February that the amount it pays per person for the popular coverage could fall more than 2 percent in 2014. [CMS] then changed course on Monday and said it now expects that the cost per person to climb more than 3 percent." (Associated Press via Yahoo News)

How Insurers Flipped a Medicare Pay Cut Into a Pay Raise
"Monday afternoon was a really great time to be a health insurance [company]. Right before 4 p.m., the industry's stocks all skyrocketed upward.... They did so with good reason: the Obama administration reversed a proposed 2.3 percent pay cut for private Medicare plans, replacing it with a 3.3 percent raise. For health plans, this was a huge victory. As Citi analyst Carl McDonald put it in a Tuesday note to investors, this was 'Armageddon averted'." (The Washington Post)

Health Entitlement Spending: A Story in Six Charts
"The recent slowdown in health spending growth may strengthen the impulse on some fronts to delay action, but long-term projections leave little doubt that federal health spending will continue to be a major contributor to our fiscal woes. This chart story pulls together essential facts on how much the federal government is spending on mandatory health care programs, how that spending affects the budget, and the hard spending and revenue trade-offs necessary to improve our fiscal outlook." (National Institute for Health Care Management)

Hidden Limitations of Health Savings Accounts Include Dependent Coverage
"[E]ven though the [ACA] allows parents to keep their adult children on their policies until they reach age 26, they can't use funds from their HSA to pay for the child's care after age 24. That's because 'dependent' is defined differently for HSA purposes than it is under the ACA provisions that extend dependent coverage to adult children." (National Public Radio)

Six Months Before Open Enrollment, Consumers Don't Understand Obamacare Plans
"When asked how the new [ACA] health plans will differ from one another, nearly nine out of ten people surveyed ... responded 'I don't know.' This lack of consumer awareness about one of the most basic aspects of the [ACA] is a striking demonstration of the education challenge ahead as consumers face new health plan choices starting on October 1, 2013. The survey results suggest that the Act's pending impact to the health insurance market is still a mystery to the average American." (HealthPocket)

Health Care Sponsor Challenged on Church Plan Status
"The lawsuit, filed in the U.S. District Court for the Eastern District of Pennsylvania ... alleges Catholic Health East (CHE) violates numerous provisions of [ERISA] -- including underfunding the CHE Plans by over $438 million -- while erroneously claiming that the defined benefit plans are exempt from ERISA's protections because they are 'church plans'." (PLANSPONSOR.com)

Death Rates Rise At Geographically Isolated Hospitals
"For 15 years, Congress has bestowed special privileges to some small remote hospitals, usually in rural areas, to help them stay afloat. Medicare pays them more than it pays most hospitals and exempts them from financial pressure to operate efficiently and requirements to reveal how their patients fare. Nearly one in four hospitals qualifies for the program. Despite these benefits, there's new evidence that the quality of many of these hospitals may be deteriorating." (Kaiser Health News)

National Business Group on Health Newsletter, April 2013
Articles include: [1] Employer Investments in Improving Health; [2] Employers Blast Fees From New Health Law; [3] Reshaping Health Care: Best Performers Leading the Way; [4] Employee Health-plan Options Shrinking to One with a High Deductible; and [5] Are CDHP Enrollees the Ultimate Health Care Consumers? (National Business Group on Health)

[Opinion]

April Fool's: CMS Raises Medicare Advantage Rates for 2014
"[T]he cuts [that had been predicted by CMS in February] were unlikely to happen because the [Medicare Advantage ('MA')] program continues to grow in popularity among seniors. Since the advent of the [ACA] in 2010, average MA plan premiums have decreased by 10 percent and enrollment has increased by 25 percent. Overall, about 27 percent of Medicare beneficiaries are enrolled in an MA plan." (HealthLeaders InterStudy)

[Opinion]

Obamacare Causes Doctor to Retire
"[T]he country can't afford to lose good doctors like Curry, but having fewer doctors is one of many side effects of Obamacare. While a physician shortage was predicted before Obamacare, too, the law just makes things worse. The American Association of Medical Colleges estimates the U.S. faces a shortage of 91,500 physicians by 2020." (The Heritage Foundation)

[Opinion]

Anthem Blue Cross Imposes Another Unreasonable Rate Hike, This Time On 7,000 Small Businesses in California
"Consumer Watchdog's actuary, AIS Risk Consultants, found: Anthem's core medical loss trend of 10.9% (Anthem's projection of the increased cost of medical care) is about 50% higher than is reasonable; Anthem's underwriting profit factor of 6.6% before taxes results in a 25% return on equity and is unreasonable; In seven of the last eight years, Anthem had a return on net worth of more than 20% and $2.1 billion in income from its California health insurance business over those years; and Anthem's surplus has doubled since 2005 to over $1.3 billion in 2012 in addition to paying shareholder dividends of almost $900 million in the past five years alone." (Consumer Watchdog)

Benefits in General; Executive Compensation

[Guidance Overview]

Proposed IRS Regs Address Deduction Limit on Compensation Paid by Health Insurance Providers
"Issues addressed by the regulations include: [1] Application of the term 'covered health insurance provider'; [2] Attribution of deferred deduction remuneration and other types of compensation to an employer's taxable year; [3] Treatment of grandfathered amounts." (Practical Law Company)

[Guidance Overview]

IRS Issues Proposed Regulations Under Code Section 162(m)(6), Applicable to Covered Health Insurance Providers
"The Proposed Regulations go on for over 100 pages. However, among the more critical (and complicated) provisions ... are those providing extensive rules for the attribution of deferred compensation, non-qualified plan benefit accruals, equity-based compensation, and even severance pay.... [U]nlike the other provisions of Code Section 162(m), the determination of whether the $500,000 deduction cap applies ... is made in the year in which the individual performed the services, not in the year the amounts are actually paid." (Winston & Strawn LLP)

[Guidance Overview]

Summary of IRS Proposed Regs on $500,000 Deduction Limit (PDF)
"The proposed regulations confirm ... that the deduction limit only applies to deferred compensation attributable to services performed in taxable years beginning in 2010, 2011 and 2012 if (1) the employer was a [Covered Health Insurance Provider ('CHIP')] in the year the services were performed to which the deferred compensation is related, and (2) the employer is a CHIP in the year the compensation is otherwise deductible. However, the regulations reject the clarification requested ... that the deduction limit not apply to the 2010-2012 period if the provider is not a CHIP in 2013 regardless of whether it becomes a CHIP in a subsequent year." (American Benefits Council)

Better Benefits Communication Pays Off
"Three out of five employees who would strongly recommend their company said that benefits were an important reason why they remained there.... [But] a separate survey [found that] employees also don't give their companies very high marks for the effectiveness of their benefits communication. Only 60 percent said it's fairly or very effective, and 9 percent say it's not at all effective." (Society for Human Resource Management)

Verizon Retirees Win 2013 Executive Compensation Change
"Retirees of Verizon Communications Inc. have launched their 15th annual proxy campaign to call upon major shareholders at one of America's largest publicly traded companies to vote for retiree resolutions that limit 'excessive Executive Golden Parachutes' ... As its proxy statement discloses, Verizon agreed to substantially reduce the payouts of performance-based stock that its senior executives can earn for below-average stock returns. After the retirees filed their proposal, the company's board of directors approved a reduction in the amount of the Performance Stock Unit payout so that it became more closely aligned with the retirees' proposal." (MarketWatch.com)

How to Support a Deduction for Reasonable Compensation
"A ruling by the U.S. Tax Court on March 25, 2013, provides a helpful analysis of 10 factors considered by the Court in deciding that amounts deducted as compensation paid to a sole shareholder-employee, his officer-wife, employee-brother and employee-daughter were not reasonable." [(K & K Veterinary Supply, Inc. v. Commissioner, T.C. Memo 2013-84 (U.S. Tax Court Mar. 25, 2013)] (Benefits Bryan Cave)

March Madness: What Do Early Proxy Season Results Suggest?
"[D]espite strong 2012 shareholder returns, companies made increases in target direct compensation commensurate with last year's (mid-single digits). And they've taken a hard line on bonuses, with actual bonus levels significantly lower than in 2011, including a significant number of below-target payouts. In terms of say-on-pay results, and acknowledging just how early we are in the cycle, 2013 is looking much like 2012: a handful of failures, but shareholder approval levels generally 90% or above." (Towers Watson)

Press Releases

BenefitsLink.com, Inc.
1298 Minnesota Avenue, Suite H
Winter Park, Florida 32789
Phone (407) 644-4146
Fax (407) 644-2151

Lois Baker, J.D., President
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager

Copyright © 2013 BenefitsLink.com, Inc. but feel free to forward this newsletter if done without modification in any way.

All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of that content. You may not alter or remove any trademark, copyright or other notice from copies of the content.

Links to Web sites other than those owned by BenefitsLink.com, Inc. are offered as a service to readers. The editorial staff of BenefitsLink.com, Inc. was not involved in their production and is not responsible for their content.

Useful links: