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

Account Management Positions, Retirement Plans
for Cammack LaRhette Consulting in NY

Sr. Employee Benefits Trust Officer
for Industry Leader in Retirement Plan Services in PA

Client Success Specialist
for The Online 401(k) in CA

Manager of Retirement Services
for McCamish Systems an Infosys Company in GA

Benefit Consultant
for TPA in Champaign, Illinois in IL

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Webcasts and Conferences

Voluntary Fiduciary Correction Program Workshop
June 12, 2013
(U.S. Department of Labor, Employee Benefits Security Administration (EBSA)) in CA

"Form 5500 Workshop 2013: Issues and Answers" - Cincinnati
May 29, 2013
(SunGard Relius) in OH

"401(k) Plan Workshop 2013: Tax Reform and the 401(k) Plan" - Cincinnati
May 30, 2013
(SunGard Relius) in OH

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[Official Guidance]

Text of CMS Q&As Related to Health Insurance Market Reforms
Eight questions and answered, grouped under 4 topics: [1] Withdrawal of Non-Grandfathered Business; [2] Maintenance of Alternative Mechanisms; [3] Geographic Rating Areas; Definition of Association Coverage; and [4] Premium Adjustment When Coverage Becomes Secondary to Medicare. (Centers for Medicare & Medicaid Services)


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[Guidance Overview]

Updated Summary of Benefits and Coverage Released by DOL
"The new FAQs discuss and provide an updated Summary of Benefits and Coverage (SBC) template to be used by group health plans and insurers to describe the coverage in effect for plan and policy years beginning on and after January 1, 2014. The new SBC template ... now includes statements describing whether the plan or policy (i) provides 'minimum essential coverage' and (ii) meets the 'minimum value' standard." (Bass, Berry & Sims)

[Guidance Overview]

CMS Proposed Rule Would Establish Powerful New Measures for Uncovering and Combating Medicare Fraud
"In addition to reducing high-risk enrollments, these changes greatly enhance incentives to whistleblowers and could sharply increase the number of tips that CMS receives regarding potential fraud. Taken together, these changes could significantly boost CMS's ability to detect and recover fraudulent payments." (Vorys, Sater, Seymour and Pease LLP)

[Guidance Overview]

Temporary Exemption from Certain ACA Provisions Granted to Insured Expatriate Plans (PDF)
"Many expatriate plan sponsors have already complied with some of the market reform measures such as extending coverage to children up to age 26 and removing lifetime dollar limits. Because the exemption is temporary, it is unlikely that they will reverse those decisions." (Buck Consultants)

[Guidance Overview]

Summary of IRS and Treasury Public Hearing on Shared Responsibility for Employers Regarding Health Coverage
"[O]ver twenty stakeholders presented comments ... [S]ome stakeholder groups, in particular those who represented less formal employment sectors, charged that the rules as proposed provide employers with too much latitude for circumventing penalties, which could countervail the ACA's core tenet: to expand access to affordable health care coverage.... [C]omments revealed the extensive disagreement over the role wellness programs serve in benefit packages and in driving health care costs down." (HighRoads)

Disappointment and Vexation: Stakeholders Share Concerns on Employer Mandate Regs
"'Disappointing.' 'Vexing.' 'Astounding.' 'Could be catastrophic.' These are some of the phrases used by attendees at a recent IRS hearing to describe their concerns with aspects of the proposed employer mandate regulations under the [ACA].... Employer representatives expressed concerns about the costs and impacts on employers (large and small), while employee advocates want the final version of the regulations to provide more protection for employees' health insurance benefits." (Wolters Kluwer Law & Business)

Why Aren't Employers Choosing Your Hospital?
"Benefits managers of huge corporations are taking their hospital business elsewhere as they arm themselves with knowledge and exert their purchasing power. They are realizing they can tweak benefits packages and inform employees of individual hospital performance with a revolutionary energy." (Hospital Impact)

Prefunding California State Retiree Health Care: Is This the Year?
"'The state's retiree health care premium costs have increased by more than 60 percent in the last five years and will almost double over 10 years,' the governor's 12-point proposal said in October 2011. 'This approach has to change.' ... The state owes $64 billion over the next 30 years for retiree health care promised current state workers[.]" (CalPensions)

Oregon's Dilemma: How To Measure Health
"[T]he Obama Administration gave Oregon almost $2 billion to come up with its own system to coordinate care better. The idea is to get doctors, nurses, hospitals and other caregivers to work together -- and get paid well -- to keep people healthy and to get rid of wasteful, unnecessary care. But which metrics should Oregon and the federal government look at to decide if the experiment succeeds?" (Kaiser Health News)

Debate Over Part-Time ACA Exemption Intensifies
"Sen. Susan Collins (R-ME) has introduced a bill to 'allow employees to work up to 39 hours per week without triggering penalties on the businesses that hire them' ... [T]he Forty Hours Is Full Time Act of 2013, (S. 701), follows the introduction of the Part-Time Worker Bill of Rights (H.R. 675) ... and bills in state legislatures that would amend the ACA to penalize employers who fail to provide health insurance to part-time employees, regardless of the number of hours worked." (HR Policy Association)

If This Was a Pill, You'd Do Anything to Get It
Very extensive analysis of the effects of chronic care on the healthcare system, and efforts to improve outcomes while containing costs. "With chronic illnesses like diabetes and heart disease you don't get better, or at least not quickly. They don't require cures so much as management.... This ... is the core truth, and core problem, of today's medical system: Its successes have changed the problems, but the health-care system hasn't kept up." (The Washington Post)

$1.3M Settlement in COBRA Class Action Now Final
"On April 23, a federal district court in Alabama gave final approval to a settlement agreement under which an employer and plan administrator will pay $1.3 million to a group of former employees who alleged they never received COBRA election or premium subsidy information after their involuntary termination of employment.... In agreeing to settle, the employer and plan administrator admitted no wrongdoing. However, they are paying a hefty price as a result of the legal challenge -- a $1.3 million settlement, out of which $350,000 is to be distributed to an estimated 248 class members, and $950,000 will go to pay for administrative costs and legal fees." (Thompson SmartHR Manager)

Updated Treasury Priority Guidance Plan Includes Guidance for Cafeteria Plans, Health Plans and Fringe Benefits
"This year's Priority Guidance Plan includes new items (e.g., regulations on medical and dental expenses), as well as items that have appeared in prior years (e.g., final cafeteria plan regulations)." (Thomson Reuters / EBIA)

Eleventh Circuit Holds HIPAA Preempts Florida Law Requiring Disclosure of Decedents' Medical Records
"[H]ealth plans and plan sponsors frequently face questions of when PHI may be shared with a living individual's personal representative (defined differently than for deceased individuals), relative, friend, or designee.... [T]his case also reminds us that even if a state law seems aimed at helping consumers in some respect (here, surviving family members), it still may run afoul of HIPAA." [OPIS Mgmt. Resources LLC v. Secretary, Fla. Agency for Health Care Admin., 2013 WL 1405035 (11th Cir. 2013) ] (Thomson Reuters / EBIA)

Court Allows Employer's Claim Against Broker for Failure to Explain Coordination of Stop-Loss Policy and Self-Insured Health Plan Document
"The compelling facts of this case drive home the importance of aligning stop-loss coverage with a self-insured health plan's terms. Ironically, the case involves exactly the type of unpredictable but catastrophic claims risk (premature twins) that stop-loss insurance is intended to alleviate. This employer was new to self-insurance and relied on others for plan design and stop-loss procurement. But there is no substitute for reading and understanding the plan and policy terms -- or engaging experienced legal counsel to do so." [Express Oil Change, LLC v. ANB Ins. Serv., Inc., 2013 WL 1245748 (N.D. Ala. 2013)] (Thomson Reuters / EBIA)

Will Obamacare End Bankruptcies Brought on by Medical Expenses? Probably Not.
"[T]here's space for better education about how much health insurance will cover, and what consumers might be expected to pay. Some employers, for example, will provide cost calculators where enrollees can input some data on what type of health-care spending they expect and get a sense of which plan might provide the best deal. That can move consumers away from just comparing premiums, and towards thinking about all the other costs they could incur from various co-payments and cost-sharing." (The Washington Post)


Employer-Sponsored Health Insurance: Is a Subsidy Necessary Post-Reform?
"[A] comprehensive consideration of the major provisions of the [ACA] suggests that there may be an opportunity to significantly alter or remove the current employer-sponsored insurance tax subsidy without sacrificing its most important beneficial effects. Contrary to popular perceptions, the ESI subsidy benefits employees, not employers.... [I]t makes sense to consider the possibility that more targeted alternatives may prove to be more efficient in doing so than the current exemption." (Georgetown Public Policy Review)


Malpractice Law Is Bad for Your Health
"For half of the estimated $300 billion our nation spends on the medical malpractice system, we could afford to pay $200,000 for every death that occurs due to an adverse event and an average of $20,000 for every injury (with the actual amounts varying based on the severity of the injury).... These reforms could save billions of dollars in defensive medicine costs as well as court costs." (John Goodman's Health Policy Blog)


Nebraska State Employee Wellness Program Motto: 'First, Do Harm'
"If Nebraska's public relations blitz about the success of its wellness program is to be believed, state employees have sixty times the cancer incidence of former residents of Love Canal. The only other interpretation is that, in the name of wellness, state employees were subject to the most overdiagnosis and overtreatment ever documented -- at taxpayer expense, no less." (TDWI Blog)


ACA's Negative Impact on Employment
"Private employers have already begun to reduce their employees' hours to qualify them for the exchange plans, and now ... state governments are considering the same approach.... [E]mployees in this sector that was to be left intact [by the ACA] -- those with employer-sponsored plans -- are not only experiencing changes in their health insurance coverage, they are also experiencing a major loss of income[.]" (Physicians for a National Health Program)


Caution: Wellness Programs May Be Hazardous to Your Health
"[W]orkplace medicalization saves no money -- indeed, it probably increases direct costs with these extra doctor visits -- but all this medicalization at least should make a company's workforce healthier. Except when it doesn't -- and harms employees instead, which happens altogether too often." (The Health Care Blog)

Benefits in General; Executive Compensation

Roundtable Discussion: The Evolving Governance Model for the Say-on-Pay Era
"As public companies prepare to hold their annual meetings and shareholders weigh in on how executives are compensated, the governance of compensation programs looms large. Five Towers Watson executive compensation experts talk about the issues being discussed in boardrooms and compensation committee meetings as companies prepare for the proxy season." (Towers Watson)

Press Releases

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