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April 30, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

Senior Actuarial Analyst
for Verisight, Inc. in IL

Pension Analyst
for Hooker & Holcombe, Inc. in CT

Plan Investment and Advisory Specialist
for Christian Retirement Ministries in CO

Sr. Compliance Administrator
for VALIC in TX

Director, Operational Risk Management
for Prudential in CT

Retirement Specialist
for Nationwide Insurance in OR, WA

Retirement and Group Benefits Compliance Process & Procedure Specialist
for National Rural Electric Cooperative Association in VA

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[Official Guidance]

Text of DOL, IRS and HHS 'FAQs XV' on Various ACA Implementation Issues
Set of three questions and answers on the following topics: [1] Annual Limit Waiver Expiration Date based on a Change to a Plan or Policy Year, [2] Provider Non-Discrimination, and [3] Coverage for Individuals Participating in Approved Clinical Trials. (U.S. Departments of Labor, Treasury, and Health and Human Services)


Health Care Reform – A One-Hour E-Learning Course

Sponsored by IFEBP (International Foundation of Employee Benefit Plans)

Need a quick tutorial on health care reform? This e-learning course from the International Foundation covers the latest regulations and compliance deadlines, all in an interactive, online format available 24/7. Enroll now for instant course access!

[Official Guidance]

CMS Simplifies, Significantly Shortens Application for Health Insurance
"The application for individuals without health insurance has been reduced from twenty-one to three pages, and the application for families is reduce by two-thirds. The consumer friendly forms are much shorter than industry standards for health insurance applications today. In addition, for the first time consumers will be able to fill out one simple application and see their entire range of health insurance options, including plans in the Health Insurance Marketplace, Medicaid, the Children's Health Insurance Program (CHIP) and tax credits that will help pay for premiums. The applications ... can be submitted starting on October 1[.]" (Centers for Medicare & Medicaid Services)

[Guidance Overview]

Changing a Plan Year Won't Work to Extend the Plan's Eligibility for Application of Previously Granted Waiver of Rule Prohibiting Annual or Lifetime Caps
"[With respect to a previously granted waiver of the ACA's rule eliminating annual or lifetime income caps for certain non-grandfathered plans that applied for same, the federal agencies stated, in the recently issued "FAQ XV," that] changes in plan or policy years made after the waiver is obtained and while a waiver remains in effect do not change the termination date of an otherwise applicable waiver. Rather, Annual Limit Rule waivers are granted based on the date of the plan or policy year in effect when the initial application was submitted regardless of whether the plan or issuer later amends its plan or policy year." (Solutions Law Press)

[Guidance Overview]

DOL, Other Agencies Issue Part XV of ACA Frequently Asked Questions
"Unfortunately, the guidance states that the Agencies will not be issuing any guidance with respect to the [provider nondiscrimination rule or the clinical trial requirement], as the Agencies view these two provisions as self-effectuating. While the statutory language may be self-effectuating, the application of that language to group health plans certainly is not. Plan sponsors will have a difficult time applying these requirements beginning in 2014." (Kilpatrick Townsend)

Trucker Huss Benefits Report, April 2013 (PDF)
Articles include: [1] The Ninth Circuit's Decision in Bilyeu Poses Stricter Requirements for Recovering Plan Overpayments, [2] HHS Finalizes Transitional Reinsurance Fee Regulation, and [3] Health Care Reform and the Health Insurance Market: Guaranteeing Better Access. (Trucker Huss)

California Moves to Protect Smokers from Higher Obamacare Insurance Costs
"The federal health law allows states to charge smokers up to 50 percent more for a health plan -- but legislation is moving forward in the California legislature that will make sure that doesn't happen.... If state opted for the maximum surcharge, health insurance would become unaffordable for those with the lowest incomes, according to Rick Curtis, president of the Institute for Health Policy Solutions in Washington D.C. And, he points out, that is the group that's most likely to smoke[.]" (Kaiser Health News)

For Some People Covered Through Work, an Exchange Might Be a Good Option for the Family
"I'd like to know if the health-reform law is doing anything for the kids of families -- like mine -- that earn less than 200 percent of the federal poverty level.... I want to know if we can participate in the October open enrollment period for plans on the health insurance exchanges." (Kaiser Health News)

Employers See Self-Insurance As Hedge Against ACA Health Costs
"Employers view [self-insurance] as a way to further control what they see as cost hikes prompted by health system reform.... 82% said they heard more interest during the last 12 months in employers self-funding their group health insurance plans. That includes 32% who said interest has increased 'significantly.' As a result, 69% said they expected their business in administering self-funded plans to grow." (American Medical News)

Health Care's 'Dirty Little Secret': No One May Be Coordinating Care
"Coordinated care is touted as the key to better and more cost-effective care, and is being encouraged with financial rewards and penalties under the 2010 federal health care overhaul, as well as by private insurers. But experts say ... communication failures ... remain disturbingly common." (Kaiser Health News)

ML Strategies Health Care Reform Update, April 29, 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)

California Health Plans Release Affordable Care Act 101 Guide (PDF)
"[The ACA's] restructuring of the state's individual insurance market will result in more comprehensive benefits, expanded coverage and subsidies for many individuals to purchase insurance. While many individuals will pay less for coverage, some will see premiums rise. Many Californians are unaware of what the ACA will mean for them, and the guide [issued by CAHP] can serve as a basic roadmap for the upcoming changes." (California Association of Health Plans)

Deloitte Health Care Reform Memo, April 29, 2013
"The drug manufacturing industry -- both large and small molecule -- is at a tipping point. Its adaptation to the forces of change is complicated perhaps more than other U.S. health sectors by virtue of its global scope." (Deloitte)

HHS Awards $28 Million Contract for Health Marketplace Call Center
"The call center will be responsible for all inquiries related to the insurance marketplaces in at least 34 states that will be run wholly or partly by the federal government. Sixteen states are setting up their own online insurance marketplaces.... [T]he company will also field inquiries about Medicare, Medicare Advantage and 'other relevant programs,' the award announcement stated." (Kaiser Health News)

Text of Massachusetts Attorney General Report: Examination of Health Care Cost Trends and Cost Drivers (PDF)
"[Findings include:] [1] Purchasers have increasingly moved to tiered and limited network products. [2] Purchasers have increasingly moved to PPO products, including self-insured PPO products, and away from fully-insured HMO products. [3] Purchasers have increasingly moved to high-deductible products (in general, defined in this Report as products with an annual individual deductible of $1,000 or more). [4] Purchaser enrollment trends have significant implications for health plans designing products and for providers managing risk contracts." (Department of Revenue, Commonwealth of Massachusetts)

Benefits That Drive Employees: Global Car Policies
"Company car benefits represent a key component of the compensation package that employers offer in recruiting and retaining the best talent -- especially at the executive and management levels and for sales professionals... Policies and practices can vary significantly by country, so it is important for multinational employers to have a solid understanding of these differences to ensure that their car benefits are competitive in each market in which they operate." (Mercer)

Bending the Curve of Health Care Cost Growth: Person-Centered Health Care Reform
"While some of these proposals are specific to particular programs and regulations, they are all grounded in our core goal of supporting quality care resulting in lower cost. This means a clear path for moving away from [fee-for-service] payments and benefits and open-ended subsidies for insurance plan choices toward a direct focus on supporting better care and lower costs at the person level." (Brookings)

The Million-Dollar Workplace Wellness Heart Attack Screen
"Three years after wellness was hailed as perhaps the only truly bipartisan component of the [ACA], both lay and trade commentators have begun observing that the assumptions behind it were incorrect while downsides were overlooked.... One reason for the absence of savings is that the biometric screenings themselves on which wellness economics are based cost far more money than they can conceivably save, due to both the likelihood of overdiagnosis and the marginal benefit of taking frequent measurements in generally healthy adults." (Health Affairs)

42 Percent of Americans Unsure If Obamacare Is Still Law
"Fewer than six in 10 Americans know that the Obamacare law is still on the books. Seven percent think the Supreme Court struck it down; 12 percent say Congress repealed Obamacare.... The challenge that the Obama administration faces is more complex than just increasing awareness and improving public awareness. It has a lot to do with improving knowledge at the exact right time -- not when benefits are way out in the distance, but also not when the public has passed them by." (The Washington Post)

Affordable Excellence: The Singapore Health Care System
"Singapore ranks sixth in the world in healthcare outcomes, yet spends proportionally less on healthcare than any other high-income country. This [free downloadable e-book sets] out a comprehensive system-level description of healthcare in Singapore, with a view to understanding what can be learned from its unique system design and development path." (Brookings)


Medicare Releases a 1,424-Page Rule That's Actually Really Interesting!
"It's one of the first things you'll learn as a health policy wonk in Washington: Medicare releases its most important, most crucial regulations around 5 p.m. on Friday, dashing happy hour hopes across the city. Last Friday was no exception. Medicare released a 1,424-page rule that tells Medicare hospitals what they will get paid in 2014. The table of contents alone stretches on for 37 pages. Still, if you want to understand how the country's largest health insurance plan wants to change how it pays for health care, this is the exact place to look." (The Washington Post)


The ACA Tsunami Is Coming: Are You Prepared?
"There is general agreement that insuring the uninsured is a noble cause -- the question is can we afford to do it the way 'Obamacare' and its one-size-fits-all construct has been designed and at the pace it is being dictated? And the bigger question for brokers and advisers all over this country is how can you help your clients mitigate the financial impact and in so doing, bolster your value proposition?" (Employee Benefit Adviser)


Text of ERIC Comments to IRS on ACA Shared Responsibility Requirements: Special Rules Are Needed for Service Contract Employees (PDF)
"Employers should not be put in the unfair and untenable position of paying 'twice' for health care coverage for their service employees: once pursuant to the fringe benefit payment provisions of the [McNamara-O'Hara Service Contract Act of 1965 (SCA), which applies to every contract entered into by the United States or the District of Columbia, the principal purpose of which is to furnish services in the United States through the use of service employees], and once by virtue of the significant additional penalty potentially triggered by full-time service employees who have received the SCA-mandate fringe benefit payment in cash and have chosen not to be covered by the employer's plan." (The ERISA Industry Committee)


California State Senator Says Employer Health Programs Can Backfire on Employees
"A premium cost penalty based on certain health achievements will backfire if it results in employees being priced out of the market and dropping coverage. For national health reform to be effective, those with more challenging health problems should not risk losing their health coverage because of higher costs. This is exactly the type of employee we want to assure has access to prevention and wellness treatment before a health risk becomes a full blown disease or illness." (San Jose Mercury News)

Benefits in General; Executive Compensation

[Official Guidance]

Text of IRS Notice 2013-30: Filing and Payment Extension for Those Affected by the Boston Marathon Explosions (PDF)
"The [IRS] is granting an extension of time to file 2012 tax returns and pay any tax due on those returns until July 15, 2013, to those affected by the Boston Marathon explosions.... This relief applies to all individuals who live in Suffolk County, Massachusetts, including the city of Boston, victims of the explosions, their families, first responders, others impacted by the tragedy who live outside of Suffolk County, and taxpayers whose tax return preparers were adversely affected." (Internal Revenue Service)

BLS Employment Cost Index, March 2013
"Benefit costs decelerated to 0.1 percent in March 2013, down from 0.6 percent in December 2012.... Benefit costs increased 1.9 percent for the 12-month period ending March 2013, down from the March 2012 increase of 2.7 percent. BLS has discovered an error in the benefits data for March 2013 primarily affecting private industry benefits data for sales and office occupations.... Other benefit and compensation data may also be affected by this error." (U.S. Bureau of Labor Statistics)

Providing Same-Gender Domestic Partner Benefits Is Violation of Texas Constitution, Says Texas Attorney General
"The Texas Constitution bars local governments -- including the City of Austin, Travis County and area school districts -- from offering domestic partner benefits to employees in same-gender relationships, according to a legal opinion ... by Attorney General Greg Abbott. Domestic partnerships, as recognized by Austin and the other governments, are close enough to the definition of marriage to violate a constitutional amendment banning same-gender unions that 76 percent of Texas voters approved in 2005, the opinion stated." (The Austin American-Statesman)

Employers Should Review How Plan Documents Define 'Spouse' in Light of Recent Benefits Litigation
"[P]roviding a clear definition of spouse can help to minimize the risk of competing claims for death benefits under the employer's retirement plans brought by a deceased employee's same-gender spouse and the blood relatives who otherwise may be entitled to death benefits under the plan's default beneficiary rules." (McDermott Will & Emery)

Looking Closely at Operational Competence: ERISA Litigation Moves Away from Doctrine and Towards a Careful Review of Plan Performance (PDF)
"Over the years ... [ERISA's] tightly limited scope of remedies has been giving way, reducing the protection from liability that this aspect of ERISA litigation had subtly and quietly granted to plan sponsors, administrators, and fiduciaries. This quiet shift ... has picked up steam over the past year in particular, raising the stakes for plans both in terms of the need to perform at a high level in administration and operation, and in the potential liability outcomes from litigation.... [T]he transition means that the factual elements of plan management and performance are now moving towards the forefront in disputes over benefit plans[.]" (Journal of Pension Benefits, via Boston ERISA Law Blog)

Must Financial Institutions Choose Between Pay for Performance and Avoiding Compensation Plan Designs that May Incentive Risk Taking?
"[I]n 2010, the Fed embarked on a project known as the Horizontal Review of Practices at Large Banking Organizations (the 'Horizontal Review') under which it thoroughly reviewed the incentive compensation practices at 25 large, complex banking organizations ... Because the Horizontal Review process took place behind closed doors between the Fed and each institution, what the rest of corporate America (and investors and their advisors) did not necessarily see was that the Fed was strongly urging financial institutions to make their compensation programs less likely to create risk . . . by making the performance targets easier for officers and employees to achieve!" (Winston & Strawn LLP)

Disclosure of CEO-to-Worker Pay Ratios Stalls
"Almost three years after Congress ordered public companies to reveal actual CEO-to-worker pay ratios under the Dodd-Frank law, the numbers remain unknown.... [M]andatory disclosure of the ratios remained bottled up at the [SEC], which hasn't yet drawn up the rules to implement it." (Treasury & Risk)

Press Releases

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