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April 9, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

Defined Benefit / Pension Administrator
for T.J. Pensions, Inc. in NY

Reviewing Actuary
for Kravitz, Inc. in ANY STATE, CA

Institutional Services Support Associate
for Reliance Trust Company in GA

401k Daily Valuation Administrator
for Certified Benefits Corp in FL

Product Manager: Non-Qualified Programs
for Reliance Trust Company in GA

Director, Sales - Mid-West Territory
for New York Life Retirement Plan Services in ANY STATE

Account Manager
for Northwestern Benefit Corporation of Georgia in GA

Manager, Sales
for National Automobile Dealers Association in DC, MD, VA

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Webcasts and Conferences

Participant Behavior in Qualified Retirement Plans and What it Means to Maximize It
in California on April 18, 2013 presented by Western Pension & Benefits Council - Orange County Chapter

Health Insurance Marketplace Stakeholder Engagement Open Door Forum State-by-state Conference Calls
Nationwide on April 29, 2013 presented by Centers for Medicare & Medicaid Services (CMS)

Travel the Affordable Care Act Continuum: Past, Present and Future Employer Impact Seminar Series - Multiple Locations
Nationwide on April 16, 2013 presented by ADP

Free Webinar: Follow the H.R. Leader
Nationwide on April 16, 2013 presented by Davidson Marketing Group -- FutureOffice Network

Retirement Plan Innovation and Trends Seminar
in Massachusetts on April 26, 2013 presented by New England Employee Benefits Council

"Form 5500 Workshop 2013: Issues and Answers" - Chicago
in Illinois on May 9, 2013 presented by SunGard Relius

"Form 5500 Workshop 2013: Issues and Answers" - Cleveland
in Ohio on May 9, 2013 presented by SunGard Relius

View All Webcasts and Conferences

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[Guidance Overview]

Health Care Reform Update: SHOP Amendments and Whistleblower Rules (PDF)
"The government received significant feedback indicating that employers should have the option to choose a single [Qualified Health Plan] to offer employees. In 2015, employers using a federally facilitated Exchange will have two options within the SHOP. The first option allows employers to select a single QHP. The second option allows employers to choose the metal tier and allow employees to select any QHP in that tier." (McGraw Wentworth)


DATAIR! More Choices – Better Guidance – Less Cost

Sponsored by DATAIR Employee Benefit Systems, Inc.

FSA, DCAP, Full-Flex, HRA, HSA, 132(f)
Documents, SPDs, Amendments, Administrative Forms
(888) 328-2474   Sales@DATAIR.com   www.DATAIR.com

[Guidance Overview]

Guidance Issued on Waiting Periods and Certificates of Creditable Coverage (PDF)
"[E]ven though a plan's substantive eligibility requirement may be permitted under the waiting period rules, an employer could still be subject to a shared responsibility penalty if it results in a full-time employee being denied coverage beyond the first three calendar months of employment.... Because of the shared responsibility penalty implications, it may be advisable to limit cumulative hours-of-service requirements to employees who are expected to work fewer than 30 hours per week." (Buck Consultants)

[Guidance Overview]

IRS Proposes Regs on Compensation Deduction Limitation for Health Insurance Providers (PDF)
"The requirement to allocate deferred deduction remuneration backwards to prior years based on the amount of the ultimate deduction will be difficult for many entities to administer. Having to reallocate the deduction for the vesting period on a daily pro rata basis would not seem to result in a significant movement of deduction dollars from one year to another and adds significant complexity to the rules." (PricewaterhouseCoopers)

[Guidance Overview]

Key Points in Recent ACA Guidance for 2014
"[D]uring just the first three months of [2013], significant ACA guidance has included the following: [1] Final regulations concerning 'essential health benefits,' including key clarifications as to which health plans must comply with the ACA's limits on deductibles and out-of-pocket expenses; [2] Proposed regulations concerning the ACA's 90-day limit on eligibility waiting periods; and [3] Yet another round of [FAQs], this time addressing both the deductible and out-of-pocket limits and a number of technical questions concerning the ACA's preventive care rules." (SpencerFane)

[Guidance Overview]

Proposed IRS Regulations Address Community Health Needs Assessments
"The nonprofit hospital community likely will be pleased with the regulations because they allow hospitals some discretion in determining how best to satisfy the CHNA requirements and emphasize transparency rather than prescriptive rules. The most anticipated and likely most welcome news offered by the regulations is that an organization will not automatically jeopardize its exemption or risk the exempt status of any bonds used to finance its hospitals because of minor compliance issues." (Drinker Biddle)


3rd Annual Advanced Forum on Managed Care Disputes & Litigation - May 8-10, 2013, Philadelphia

Sponsored by ACI (American Conference Institute)

Third annual forum features trial attorneys and in-house counsel who have been active in some of the year's biggest cases. No other forum provides the opportunity to share defense strategies and tactics to enhance your litigation toolkit. Discount Code BEN200.

[Guidance Overview]

Clock Ticking Loudly on Mandatory Health Care Coverage in 2014
"By the time the 2014 enrollment season gets underway, employers are supposed to have already communicated clearly what their employees' health insurance options will be, and what these options might cost. They are nowhere close to being able to do this. And the required date set in Washington for this crucial communication has been deferred from an earlier March 31 deadline to an unknown date." (U.S.News and World Report)

[Guidance Overview]

Proposed HHS Regulations Address Navigators under Health Insurance Exchanges
"Under health care reform, navigators cannot be health insurers or receive consideration, directly or indirectly, from a health insurer in connection with enrollment of qualified individuals in [Qualified Health Plans]. Prior regulations implementing this requirement provide that a navigator also cannot be either: A subsidiary of a health insurer. An association that includes members of (or lobbies on behalf of) the insurance industry. The proposed regulations clarify that a navigator cannot: [1] Be a stop loss insurer or its subsidiary. [2] Receive consideration, directly or indirectly, from a stop loss insurer in connection with enrollment of individuals in a QHP or non-QHP." (Practical Law Company)

Tax Considerations for the Pending DOMA Decision: Should Health Plan Sponsors Take Action by April 15?
"If the U.S. Supreme Court holds that section 3 of DOMA is unconstitutional, it would appear that same-gender spouses would be eligible for certain tax-free employer-paid health benefits and, as a result, employers may be entitled to a refund of their share of any FICA taxes paid and employees may be entitled to a refund of their share of both FICA taxes and income taxes.... As April 15, 2013 is the deadline for filing a protective refund claim for 2009 calendar year taxpayers, employers may want to consider filing protective FICA tax-refund claims for all open payroll tax periods to cover the FICA taxes paid on this imputed income." (Morgan Lewis)

On a Rocky Road: Current Health Status of Adult 40+ Population and Associated Health Care Costs (PDF)
"More than a quarter (27.1%) of adults aged 50-64 are sedentary ... 27.8% of U.S. adults 18 years and older -- 66 million people -- are obese ... 9.5% of U.S. adults have diabetes ... 30.8% of U.S. adults have high blood pressure[.]" (MetLife)

After Expanding Coverage, Massachusetts Focuses on Taming Health Costs
"Seven years after its groundbreaking health reforms, which became the model for the [ACA], Massachusetts boasts an uninsured rate of less than 2 percent, compared to a national average of 16 percent. But the cost of health care in the state, the highest in the country before the reform law was passed, remains so." (Kaiser Health News)

Less Than 20% of Health Plans Will Retain 'Grandfathered' Status in 2013
"58% of employers that offered health care coverage in 2012 had at least one plan that was 'grandfathered' (or exempt from specific compliance requirements such as free preventative care). An examination of 2013 plans reveals that, on average, less than 20% of plans are grandfathered.... Nearly one-in-five plans still have a $0 deductible, and 55 percent of plans charge $20 or less for a primary care physician visit co-pay." (HighRoads)

HHS Secretary Didn't Expect Persistent Obamacare Opposition
"'The politics has been relentless and that continues,' [Kathleen] Sebelius said. 'There was some hope that once the Supreme Court ruled in July and then once an election occurred there would be a sense that, "This is the law of the land, let's get on board, let's make this work." And yet we will find ourselves having state by state political battles.'" (Reuters via Yahoo News)

Deloitte Health Care Reform Memo, April 8, 2013
"The U.S. biopharmaceutical industry is at a tipping point: increased consumerism, increased scrutiny of business relationships and conflicts with investigators, increased rigor in scientific efficacy and effectiveness (including comparative effectiveness research), increased regulation, increased margin pressure, increased costs of development, and increased competition from non-regulated products and marketing channels that require new thinking and bold transformation." (Deloitte)

Canceling Health Benefits: The Issue of Vesting
"While ERISA might generally give a plan sponsor the right to act, if you are considering eliminating health insurance coverage for employees because of PPACA, a good place to start is to see if your health plan has a provision giving you the ability to amend or terminate coverage at any time. Having a provision like this goes a long way to defeating any argument that the benefits have 'vested'." (Fox Rothschild LLP)

Europe's Strong Primary Care Systems Are Linked to Better Population Health But Also to Higher Health Spending
"Strong primary care in Europe has had a positive impact on population health, socioeconomic inequalities in health, and avoidable hospitalizations. However, health care spending is higher in countries with relatively stronger primary care provisions[.]" (The Commonwealth Fund)

States Lag on Tracking Potential Obamacare Loophole
"[A]dvocates of the law worry that more small firms with young, healthy employees will self-insure next year, exploiting what some see as an ACA loophole and leaving small-group insurance pools with sicker members and higher costs.... If self-insurance takes off among small companies, the information gap could make states slow to react to keep their small-group markets viable." (Kaiser Health News)

Navigating the Leave-Management Maze
"When an employee requires a period of leave because of a medical issue or disability, the situation is not always straightforward, and the best way to manage it is not always clear. Adding to the confusion is that employers face an ever-changing alphabet soup of federal and state laws and regulations, starting with the Family and Medical Leave Act (FMLA)." (Society for Human Resource Management)

Health Insurance Exchanges Coming, But Not As Envisioned
"The new Small Business Health Option Program [SHOP] exchanges ... are hoping to draw in firms by offering greater health plan choices for employers and their workers, and the so-called employee choice model was seen as a major incentive for businesses to seek coverage on the SHOP exchanges. But more than half the country won't have that option right away. The Obama administration said states running their own exchanges in 2014 can still offer employee choice though, and at least a few states aggressively implementing Obamacare ... say they're moving ahead with those plans right away ..., though they acknowledge it won't be easy to pull off." (Politico)

Congressman Questions 'Inflated' Salaries for Obamacare Insurance Navigators
"Rep. Kenny Marchant (R-Texas) says the new ObamaCare insurance brokers known as 'navigators' are likely to cost more than they're worth because of 'inflated' salaries.... The Federal Register document says assistance workers will be paid $20 per hour, project leaders will be paid $29 per hour and executives will make about $48 per hour. 'These seem to be inflated hourly wages compared to corresponding positions in the private sector,' he said." (The Hill)

Why Do Employers Need Help Managing FMLA Leaves? (PDF)
"Although highly valued by employees, the FMLA has its challenges for employers.... An integrated absence management program can help alleviate the risk and burden of the FMLA, while managing state and company leaves of absences too. The result: increased productivity and an improved bottom line." (Guardian Life)

Analysis of Data from 11 Countries Finds That 'Satisfaction' with Health System Performance Means Many Things
"Of any country, the U.K. had the greatest percentage of respondents who said that only minor changes to the health care system were needed (61.3%). The U.S., meanwhile, had the highest percentage of respondents who believed that their health system was in need of complete rebuilding (25.4%). Compared with the other 10 countries, the U.S. had the highest percentage of respondents who reported being very confident they would receive effective treatment (34.7%) and also the highest percentage saying they were not at all confident they would (9.2%)." (The Commonwealth Fund)

Value-Based Cost Sharing in the United States and Elsewhere Can Increase Patients' Use of High-Value Goods and Services
"[R]esearchers found that although many OECD countries are using value-based approaches to steer patients toward more efficient and less costly care, use of such strategies is limited by a lack of information about the value of many health care interventions. The high cost of comparative effectiveness studies may deter countries from more broadly pursuing value-based policies." (The Commonwealth Fund)

Health Care Cost Containment Strategies Used in Four Other High-Income Countries Hold Lessons for the United States
"Similar to Canada, France, Germany and England, the U.S. is moving toward policies aimed at promoting value and economic efficiency in health care without restricting coverage. But given the unlikelihood that the U.S. health care system will also adopt the volume and price controls used in these countries, this study concludes 'it is likely that the large gap in health care spending between the four countries in our study and the United States will remain.'" (The Commonwealth Fund)


'Bitter Pill' Analysis Missed the Target on Solutions to the U.S. Medical Crisis
"[H]ospital competition is not the answer to getting lower prices and never has been.... [C]oordination of services among hospitals within a region is a far more cost-effective way to minimize duplicative purchases of expensive technology. Furthermore, group purchases of supplies, pharmaceuticals and capital equipment by large hospital systems has been shown to drive down vendor prices by up to 20 percent versus pricing given to small independent hospitals." (Physicians for a National Health Program)

Benefits in General; Executive Compensation

[Guidance Overview]

New York State Agencies Again Revise Proposed Regs Limiting Use of State Funds for Administrative Expenses and Executive Comp by Service Providers
"Although the regulations are scheduled to go into effect on July 1, limits on administrative expenses and executive compensation are not effective until the 'first day of each provider's respective reporting period'.... The definition of 'executive compensation' has been broadened to include distributions to shareholders or partners when such distributions represent compensatory or guaranteed payments.... The definition of 'administrative expenses' and 'program services expenses' now exclude 'that portion of the salaries and benefits of staff performing policy development or research,' which will result in expenses qualifying as such to not count toward a covered provider's maximum allowable expenditures on administrative expenses." (Proskauer Rose LLP)

Another Important Company Victory in the Proxy Injunction Lawsuit Wars
"[W]hile U.S. public companies filing proxies seeking shareholder approval on their say-on-pay and equity plan approval votes are not out of the woods and need to be ever vigilant in making sure that their proxies are accurate and satisfy the applicable legal requirements, the decisions in the proxy injunction cases are decidedly breaking in their favor, which is in the interest not only of companies but of investors who do not need more inconsequential compensation disclosure minutiae or to have their investments taxed by annual legal fees settlements." [Paul Noble vs. AAR Corp., No. 12 C 7973 (N.D. Ill. Apr. 3, 2013)] (The Conference Board)

Press Releases

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