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[Official Guidance]
CMS Announces Upcoming Termination of Several ERRP Processes
"In preparation for the January 1, 2014 program sunset date, CMS is planning for the phase-down of the ERRP Secure Website so that it eventually can be taken offline and archived. The termination dates included in the notice will allow for a phase-down of ERRP operational processes related to the ERRP Secure Website."
(Centers for Medicare & Medicaid Services)
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The Elephant in the Living Room: Health Plan Nondiscrimination Rules Under the ACA
"Prior to health care reform, the law prohibited only self-funded health plans from discriminating in favor of highly compensated employees with regard to health insurance benefits. Employers were able to provide executive medical plans, class-based benefits, and overall better benefits packages to executives. But health care reform changes that, applying nondiscrimination to all group health plans. This may not seem that significant, but in reality, it changes the entire health insurance landscape."
(Employee Benefit News)
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Most Employers Plan to Wait and See If Private Exchanges Prove Viable
"[T]he majority of employers (82%) remain uncertain about health care exchanges and plan to wait at least 1-3 years before potentially joining one.... 98% of employers expect an increase in their costs as a result of ACA.... Even with the expected impact of health care reform, most surveyed employers are not ready to change their health plans to defined contribution arrangements or private exchanges."
(Chelko Consulting Group)
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States Seek Licensing on Health Reform Outreach
"[A Georgia] bill would require those who want to serve as navigators or provide advice about enrolling in the health insurance exchanges to be licensed and to have 'not less than 35 hours of instruction in health benefit insurance,' in how the exchanges work and knowledge of Georgia Medicaid and PeachCare. They would also have to pass an exam and take continuing education."
(InsuranceNewsNet.com)
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[Advert.]
BenefitsLink would like your help
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Ahead of Reform, Medical Care Slowdown Hits Companies
"As the clock ticks down to the start of a U.S. healthcare overhaul, companies from device makers to hospital chains have been surprised to see Americans make even fewer trips to the doctor's office.... Part of the reason is that employers are shifting more of the insurance benefits they offer to so-called high-deductible plans, requiring employees to pay more for their medical care upfront, to buffer new costs they face under 'Obamacare'."
(Reuters)
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Cost of Retiree Healthcare Benefits for States and Municipalities: The Next Shoe to Drop?
"Kentucky is ... opting to issue bonds in order to cover its annual costs for 'other post-employment benefits' (OPEB), which includes benefits like health care and life insurance for retired workers. In fiscal 2012, the state's five main retirement health insurance plans combined for a total unfunded liability of more than $6 billion, while the state's OPEB cost that year was nearly $850 million ... The tactic of borrowing money to pay for those costs has not won the state favor with ratings analysts."
(Governing)
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Does Experience Rating Reduce Disability Inflow?
"To identify the causal effect of experience rating, [the authors] exploit a pension reform [in Finland] that extended the coverage of the experience-rated premiums. The results show that a new disability benefit claim can cause substantial cost to the former employer through an increased premium. Nonetheless, [they] find no evidence of the significant effects of experience rating on the disability inflow."
(Tomi Kyyra and Juha Tuomala, via SSRN)
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Third Circuit Rejects Call to Change $3,000 COBRA Notice Penalty
"In rejecting a qualified beneficiary's attempt to increase a nearly $3,000 COBRA notice penalty, the [court] noted that the employer/plan administrator's efforts to remedy the violation did not warrant any higher award.... But in affirming the lower court decision, the appeals court also rejected the employer/plan administrator's contention that because it had extended active coverage due to an administrative error, no COBRA qualifying event occurred at all." [Fama v. Design Assistance Corp., 2013 WL 1443463 (3rd Cir. 2013)
(Thompson SmartHR Manager)
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Five Insurers to Share Blue Shield's CalPERS Contract
"CalPERS, the third largest healthcare buyer in the nation and Blue Shield's largest customer, spends about $7 billion each year for its 1.3 million members, including 400,000 public workers and their families with coverage through Blue Shield of California's HMO plans since 2003. But the CalPERS board of directors chose four new HMO plans -- Anthem Blue Cross, UnitedHealth, Sharp Health Plan and Health Net -- to receive five-year contracts alongside Blue Shield."
(FierceHealthPayer)
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Penalty for Late COBRA Notice Upheld on Appeal
"This case should remind employers of the importance of proper COBRA administration -- although the penalty amount was relatively low, the cost of litigation likely was not." [Fama v. Design Assistance Corp., 2013 WL 1443463 (3d Cir. 2013)]
(Thomson Reuters / EBIA)
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Court Limits Liability of Delivery Service That Mishandled Documents Containing PHI
"[C]overed entities (and business associates) can face liability when PHI is entrusted to any third party, regardless of whether the third party is a HIPAA business associate, and the compliance costs of responding to impermissible disclosures (including breach notification) can be significant. Even when business associate contracts are not legally required, covered entities and business associates should consider how they can protect themselves in case a third party loses or mishandles PHI." [North Cypress Med. Ctr. Oper. Co. v. FedEx Corp., 892 F. Supp. 2d 861 (S.D. Tex. 2012)]
(Thomson Reuters / EBIA)
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Valuing Good Health in Vermont: The Costs and Benefits of Earned Health Care Time (PDF)
"Annually, Vermont employers are expected to expend about $21 million in providing new earned health care time for employees. This cost of the law for employers -- which accrues due to lost productivity and increased wages, including benefits and administrative expenses -- is equivalent in size to a $0.19 per hour increase in wages for employees receiving new leave, or about $6.53 per week for covered workers[.]"
(Institute for Women's Policy Research)
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Tracking Costs of Obama's Health Law in Budget Isn't Easy
"You'd think there'd be a chapter in the new 2014 budget that lays it all out. Wrong. Well, maybe a table? Wrong again. A box? Nope. It turns out that the costs of the Affordable Care Act ... are sprinkled here and there through hundreds of pages of budget books.... So how much will the new coverage cost the government? Hard to tell."
(Associated Press via The Washington Post)
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House Committee Approves Comp-Time Bill After Rejecting Paid Leave and Other Amendments
"Responding to criticisms of the bill by Committee Democrats, Chairman John Kline (R-MN) emphasized that the bill 'includes numerous employee protections to ensure the voluntary use of comp time.' Arguing against the bill, Ranking Democrat George Miller (D-CA) asserted: 'Effectively, this bill asks workers to work extra hours and give their employers an interest-free loan[.]'"
(HR Policy Association)
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Proposed Legislation Would Extend ACA Employer Penalty to Part-Time Employees
"[T]he Part-Time Worker Bill of Rights (H.R. 675)... would amend the [ACA] to ... prorate the $2,000 employer penalty for not offering health insurance to part-time employees by the number of hours, less than 30, they work. Similar bills for large employers have also been recently introduced in Connecticut and California."
(HR Policy Association)
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The Cost of Extended Dependent Coverage
"[E]mployers are not allowed to directly charge higher premiums for the cost of this 'adult-dependent' coverage.... [A] single large employer ... found that nearly 700 adult children enrolled in the employer plan in 2011 as a result of the adult dependent mandate -- and this group used about $2 million in health care services in 2011 (about 0.2 percent of the over $1 billion in total spending on health care services by that employer that year)."
(Nevin Adams via EBRI)
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[Opinion]
Achieving Obamacare Goals Without Obamacare
"Do you know how many forests have been felled to produce enough paper for all of the articles and books that have been written about these 10 problems? Yet what I've just described is an entrepreneurial solution to all of them -- without any pilot program, without any demonstration project, without any ACO and without spending any taxpayer money.... Notice that all of this is happening outside the third-party payer system. In fact, that is why it is happening."
(John Goodman's Health Policy Blog)
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[Opinion]
We Still Have a Healthcare Spending Problem
"The idea that we have licked the problem of health-care cost increases is no more probable today than it was in the past. Our nation has made no fundamental change in how health care is paid for or delivered."
(Drew Altman and Larry Levitt in the Washington Post)
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[Opinion]
Coverage Continues Even When Premiums Are Late
"'ACA allows insurance plans offered through the exchanges to delay paying the claims of consumers who have failed to pay their premiums for two months and to deny all claims for beneficiaries who have not paid for three months.' ... If every vender in the world (from gas stations to taxicab drivers) can verify a credit card in a matter of seconds, why can't doctors verify whether an insurance card is valid?"
(John Goodman's Health Policy Blog)
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[Opinion]
How to Deliver Patient-Centered Care: Learn from Service Industries
"[P]atients are a diverse group with diverse needs.... [L]essons from [the] hospitality industry hold promise in helping physicians understand patient preferences and deliver tailored care.... Additionally, consumer-marketing tools, such as customer segmentation, can help providers deliver tailored care."
(Harvard Business Review)
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Benefits in General; Executive Compensation
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[Guidance Overview]
IRS Regs Address ACA $500,000 Deduction Limit for Health Insurance Companies; Who's Next?
"[T]hese new compensation deduction limits on health insurers are much broader than the longstanding $1 million deduction limit that applies to the 'Top 5' employees of public companies.... In the current economic and political environment, Congress may well consider similar proposals that would apply to a much broader group of companies (e.g., all public companies) as potential revenue raisers in future budget and tax reform legislation."
(Groom Law Group)
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IRS Decides to Shut Down Completely on Furlough Dates
"Acting IRS Commissioner Steve Miller announced that the IRS will close 'all public-facing operations,' including toll-free operations and Taxpayer Assistance Centers, on May 24, June 14, July 5, July 22, and August 30, with another two days of closings possible in August or September, in response to the budget cuts from sequestration."
(Journal of Accountancy)
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Press Releases
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