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May 2, 2013          Get Retirement News  |  Advertise  |  Unsubscribe
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Employee Benefits Jobs

Senior Actuarial Analyst
for Transamerica Retirement Solutions in MA

Consultant, Retirement Plans
for Cammack LaRhette Consulting in NY

Retirement Services Client Relationship Consultant
for Gallagher Retirement Services in TX

Retirement Plan Services Manager
for se2 in KS

Sales Support Specialist
for Intac Actuarial Services in NJ

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Webcasts and Conferences

26th Annual Administrators' Symposium: The Gateway to Opportunity
July 31, 2013
(Employers Council on Flexible Compensation (ECFC)) in MO

Overview of Types of Plans
May 13, 2013
(McKay Hochman Co., Inc.) WEBCAST

Ethics Case Studies One
May 14, 2013
(McKay Hochman Co., Inc.) WEBCAST

Qualified Plan Essentials Plus Series
May 13, 2013
(McKay Hochman Co., Inc.) WEBCAST

Dr. Dee Edington - Creating a Sustainable Wellness Culture . . . In Light of Health Care Reform
May 16, 2013
(No. Calif. Chapter of Certified Employee Benefits Specialists (ISCEBS)) in CA

Voluntary Fiduciary Correction Program And Abandoned Plan Workshop
June 24, 2013
(U.S. Department of Labor, Employee Benefits Security Administration (EBSA)) in KY

Legal Series: Say on Pay and Executive Compensation Litigation Webcast
May 9, 2013
(Knowledge Group) WEBCAST

Hungry, Hungry HIPAA! Webcast
May 3, 2013
(Littler Mendelson) WEBCAST

View All Webcasts and Conferences

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[Official Guidance]

Text of Rev. Proc. 2013-25: 2014 Inflation-Adjusted Amounts for Health Savings Accounts (HSAs) (PDF)
"For calendar year 2014, the annual limitation on deductions under [Section 223] for an individual with self-only coverage under a high deductible health plan is $3,300.... [T]he annual limitation ... for an individual with family coverage under a high deductible health plan is $6,550.... For calendar year 2014, a 'high deductible health plan' is ... a health plan with an annual deductible that is not less than $1,250 for self-only coverage or $2,500 for family coverage, and the annual out-of-pocket expenses (deductibles, co-payments, and other amounts, but not premiums) do not exceed $6,350 for self-only coverage or $12,700 for family coverage." (Internal Revenue Service)

[Guidance Overview]

CMS Issues Guidance on Role of Agents and Brokers in Health Exchanges
"Agents and brokers will be able to assist consumers either through an insurer-based pathway, in which the agent or broker uses an insurer's website to assist consumers, or directly through the exchange website.... Web brokers are potentially problematic because they resemble and may be seen as a substitute for the exchange website itself. ... Unlike traditional brokers and agents, web brokers must display all QHPs, regardless of appointment or compensation arrangements. If a consumer wishes to enroll in a plan for which the web broker does not have an appointment, the web broker must direct the consumer to the exchange website for enrollment." (Timothy Jost in Health Affairs)

[Guidance Overview]

DOL Issues New Guidance on Certain Aspects of ACA Implementation But Declines to Address 'Self-Implementing' Provisions
"[T]he FAQs explain that section 2706(a) [which states that 'group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider's license or certification under applicable state law'] is a self-implementing provision, and that the federal agencies charged with enforcing ACA will not be issuing regulations on this section prior to its effective date. Similarly, the requirement imposed on non-grandfathered group health plans and issuers offering group or individual coverage regarding participation in approved clinical trials is deemed to be self-implementing. This provision becomes effective for the 2014 plan year, and the federal agencies do not intend to issue regulations prior to its effective date." (Littler Mendelson LLC)

[Guidance Overview]

A Restraining Order on Stand-alone Health Reimbursement Accounts
"An HRA that does not require enrollment in a qualified medical plan is considered 'stand-alone.' Stand-alone HRAs are impermissible because, by their very nature, they do not meet the ACA requirement to provide coverage for essential benefits. There are exceptions to the rule. Retiree-only HRAs are permissible. There is also some confusion about HRAs that look like flexible spending accounts because they limit rollover amounts or the employer contribution to the account is small." (HighRoads)

IRS Treatment of Wellness Programs Deals Employers a Setback in Health Care Rules
"Employer-sponsored healthcare plans cannot include most 'wellness programs' as part of minimum coverage requirements ... Businesses and non-profits had hoped to include wellness programs as part of the affordable and bare-bone coverage they must provide workers. Now employers may need to spend more for workers' health coverage[.]" (Reuters)

Fewer Carriers Than Expected Apply for Illinois Health Marketplace; Raises National Concerns
"Only six insurance carriers have told the state of Illinois they want to sell a combined 165 health policies on the state's online insurance marketplace under the nation's new health care law ... The Illinois numbers are an early indicator that insurance companies are backing away from full participation in the online marketplaces[.]" (The Washington Post)

State-By-State: A Progress Report on Medicaid Expansion
"As of May 1, 16 states plus the District of Columbia have approved the expansion or are headed in that direction, 27 have rejected it or about to and seven states could still go either way.... With uncertainty about those plans and legislative battles still unfolding in a number of states, it's not yet known how many states will expand their Medicaid programs come Jan. 1, when the [ACA] is set to take effect. [A chart provides] up-to-date look at where each state and the District of Columbia stand at the moment." (Kaiser Health News)

Republicans Propose Medicaid Caps
"Under the plan ... the federal government's share of each state's Medicaid payments would be determined by the type of patients who use Medicaid. Separate funding pools would be created for the four populations Medicaid serves: elderly beneficiaries, disabled people, children and adults. The proposal would cap per-person spending within each category." (The Hill)

Health Plans Try New Approaches to End-of-Life Care
"Although research shows that patients benefit from palliative care earlier in the course of serious illness, it is not always accessible to them.... Some of California's health plans, however, are developing palliative care benefits for earlier access to services. This landscape report describes the findings of research on payers working to increase access to care. Among the initiatives: Enhanced case management.... Liberalized hospice benefit.... Home-based palliative care." (California HealthCare Foundation)

End-of-Life Care in California: You Don't Always Get What You Want
"This report documents research on end-of-life care for Medicare beneficiaries, and analyses it in light of what is known about Californian's preferences for care as they approach death. The research found sharp variation that cannot be explained by differences among patients in age, sex, or race. In general, the overall intensity of the care rose; dying patients in the hospital had many more physician visits on average, and they spent more days in an intensive care unit (ICU)." (California HealthCare Foundation)

Oregon Study: Medicaid Had 'No Significant Effect' On Health Outcomes vs. Being Uninsured
"The result calls into question the $450 billion a year we spend on Medicaid, and the fact that Obamacare throws 11 million more Americans into this broken program." (Avik Roy, in Forbes)

How Medicaid Affects Adult Health
"Enrollment in Medicaid helps lower-income Americans overcome depression, get proper treatment for diabetes, and avoid catastrophic medical bills, but does not appear to reduce the prevalence of diabetes, high blood pressure and high cholesterol ... [Researchers] found about a 30 percent decline in the rate of depression among people on Medicaid; an increase in people being diagnosed with, and treated for, diabetes; and increases in doctor visits, use of preventative care, and prescription drugs. They also found that Medicaid reduced, by about 80 percent, the chance of a person having catastrophic out-of-pocket medical expenses, defined as spending 30 percent of one's annual income on health care." (MITnews)

Medicaid Reduces Financial Hardship, Doesn't Quickly Improve Physical Health
"The new data could come to bear in states' decisions on whether to expand Medicaid to cover millions of low-income Americans in 2014, as the Affordable Care Act allows. Many states with large uninsured populations, most notably Florida and Ohio, have yet to decide whether to move forward." (The Washington Post)

Health Care Use Rises With Expanded Medicaid
"[The Oregon Health Study] found that those who gained Medicaid coverage spent more on health care, making more visits to doctors and trips to the hospital. But the study suggests that Medicaid coverage did not make those adults much healthier, at least within the two-year time frame of the research, judging by their blood pressure, blood sugar and other measures.... Health economists anticipate that new enrollees to the Medicaid program will swell the country's health spending costs by hundreds of billions of dollars over time." (The New York Times)

Emergency Department Cost of Care May Be Greatly Underreported
"A widely accepted federal report which represents emergency department care costs as only 2% of the nation's total healthcare bill is seriously flawed ... The true cost is in the range of 6.2% to 10% ... [The] analysis suggests that patients who are admitted require ED services that cost between 26% and 48% more than patients who are treated in the ED and released." (HealthLeaders Media)

Will Individuals Pay or Play? The Impact of Healthcare Reform on Employees
"For many individuals, the decision may come down to the cost of the tax vs. the cost of insurance on an annual basis, at least initially.... Employers should bear in mind the impact on employees and their families when exploring benefit strategies. However, many employers also have a golden opportunity to communicate to employees how PPACA will impact them individually, and the role the employer's group health plan (or lack thereof) will factor in to employee's individual decisions." (Healthcare Reform Digest)

Congressional Representatives and Staffers to Meet Obamacare
"[M]embers of Congress and their staffers are faced with the reality of losing FEHBP coverage.... Currently, the federal government covers about 70 percent of health care premium costs for lawmakers and their aides. It is unclear what percent, if any, the government will cover when the legislative branch moves to the exchange market. OPM also will have to determine what will come of health benefits for retirees, which are also currently run through FEHBP." (Government Executive)

Obamacare Could Cover More People At Less Cost
"Obamacare aims to shift how doctors and hospitals are paid -- they'll be rewarded for taking care of the whole patient, not just for every test or visit. But this is an idea that some practices have already embraced, with success. Two practices in Virginia and California have been working like this for years, and have seen their overall costs decline and patient health improve." (National Public Radio)

Text of GAO Report on Activities, Staffing and Funding for the CMS Center for Strategic Planning (PDF)
"CSP assists individual offices and centers in developing strategic plans for their units, leads the agency's senior-level strategic planning meetings, and is helping to develop a centralized approach to monitor the implementation of CMS's agency-wide strategic plan. As of January 2013, CSP had 11 staff and it had $1.9 million in funds obligated for fiscal year 2012. Staff size and funding for CSP's most recent fiscal year represent a decrease compared to prior years, in part because CSP's activities have been narrowed in scope since the office was established in 2010[.]" (U.S. Government Accountability Office)

Seven Choices Medicare Advantage Plans Will Need To Make In Order To Survive
"In the short term, MA plans will need to take action in order to survive the initial impact, such as optimizing 2014 plan benefits, reprioritizing star focus areas, and even exiting selected geographies. In the long term, however, more will be needed as Medicare becomes increasingly consumer-centric. In this market, MA plans must develop a fundamentally different business model that allows them to preserve margins in a future environment of rate parity with Medicare [fee-for-service] costs while still offering equal or better aggregate benefits." (Timothy Jost in Health Affairs)

Ohio Governor Signs Rules for Health Navigators
"Consumer advocates have criticized the measure, saying it limits the number of navigators available to help people by tying the certification process to those funded by the health law. Ohio navigator applicants will share about $2.2 million in federal funds." (InsuranceNewsNet.com)

CMS Issues Final Consumer Applications for Health Care Coverage Under ACA
"The online version of the application will be a 'dynamic experience' that shortens the application process based on responses, and it will minimize the administrative burden on states, individuals, and health plans, CMS said. The paper application was simplified and tailored to meet personal situations based on feedback from consumer groups, it said." (Bloomberg BNA)


Shocker: Oregon Health Study Shows No Significant Health Impacts from Joining Medicaid
"Either people with insurance are doing an okay job of getting treatment for all the major chronic diseases -- which is startling, because as you may recall one of the main reasons that we needed Obamacare was all the poor uninsured people who can't control their blood pressure or diabetes. Or that the treatment Medicaid patients get for their chronic diseases doesn't do them much good." (The Daily Beast)


Twelve Reasons Why States Should Not Expand Medicaid
"[1] Medicaid harms the poor.... [2] Medicaid spending will explode.... [3] Medicaid's access problems will get worse as more doctors drop out.... [4] States will be exposed to higher Medicaid costs when Washington recalculates its matching payments.... [5] Medicaid expansion will worsen the cycle of dependence and harm the economy.... [6] Claims about job creation are exaggerated.... [7] Medicaid crowds out private coverage.... [8] Medicaid raises premiums for those with private insurance.... [9] Medicaid's undercompensated care is a bigger problem than providing uncompensated care for the uninsured.... [10] Expanding Medicaid will expose states to increased risks of fraud and waste.... [11] By rejecting the Medicaid expansion, states encourage others to do the same, fueling the spending cycle.... [12] States should demand more control and flexibility to expand coverage their own way." (Galen Institute)


Everything You Need to Know About the Groundbreaking Oregon Health Study
"The Oregon Medicaid experiment is a unicorn. A beautiful, rare unicorn.... It's the first randomized-controlled trial testing any kind of health insurance against being uninsured -- period.... The problem with the Oregon study ... is we don't really know what we're learning. It's not clear, for instance, if the results are applicable to all health insurance, to all Medicaid insurance, or just to Oregon's Medicaid program." (The Washington Post)


Oregon Study Throws a Stop Sign in Front of Obamacare's Medicaid Expansion
"The Oregon Health Insurance Experiment ... may be the most important study ever conducted on health insurance. Oregon officials randomly assigned thousands of low-income Medicaid applicants -- basically, the most vulnerable portion of the group that would receive coverage under ObamaCare's Medicaid expansion -- either to receive Medicaid coverage, or nothing.... Consistent with lackluster results from the first year, the OHIE's second-year results found no evidence that Medicaid improves the physical health of enrollees." (Cato Institute)


'Health Court' Proposal Gains Key Support
"Momentum for the creation of specialized health courts continues to build, as the nation faces rising health care costs without addressing the avoidable waste caused by unreliable medical justice, which fuels billions of dollars in unnecessary 'defensive medicine' annually." (Common Good)


Text of Comments to OSHA About Interim Final Rule on ACA Procedures for Handling Retaliation Complaints (PDF)
"[The Chamber urges] the Administration to remain mindful of the damage that this [interim final rule ('IFR')] will inflict by giving disgruntled employees and job-applicants -- particularly the many millions who will receive federal subsidies -- an open-ended opportunity to pursue frivolous claims. To mitigate this, we recommend more precise definitions and more equitable treatment for employers or respondents. The Chamber also has significant regulatory procedure concerns with the IFR. OSHA has issued this IFR as an interpretive rule and in so doing has avoided any of the requirements of the Administrative Procedure Act. OSHA has failed to provide the economic analyses required ... Finally, the Agency also claims that because this is an IFR, no proposal has been issued thereby allowing the Agency to avoid any the requirements of the Regulatory Flexibility Act." (U.S. Chamber of Commerce)

Benefits in General; Executive Compensation

[Official Guidance]

Information for IRS Approved Continuing Education Providers (PDF)
Talking points for conference call on April 23 and 24, 2013; topics include: [1] Advertising Voluntary CE; What programs qualify for ERPAs vs. EAs; [2] Program content reviews to be conducted on a random selection of the approved provider population; [3] Record Retention Requirements; [4] Collecting and Reporting CE to IRS; [5] Hot Topics, including ACA programs. (Internal Revenue Service)

Franczek Radelet Monthly Benefits Update, April 2013
Articles include: [1] Health Care Reform Guidance on Required Future Modifications to SBC, for Employers Contributing to Multiemployer Welfare Plans and for Individuals Seeking Health Insurance Premium Tax Credit; [2] United States Supreme Court Decision: US Airways Inc. v. McCutchen; [3] Obama Administration Revenue Proposals Affecting Retirement Savings; [4] PBGC Proposed Rule on Reportable Events. (Franczek Radelet P.C.)

Shareholders Ratify Executive Compensation at 91% Clip
"Shareholders have voted on average 91% to ratify executive compensation in non-binding say-pay-pay voting at U.S. companies so far this proxy season, up from 89% in all of 2012 ... Six companies had a majority of shareholder votes rejecting their executive compensation program[.]" (Pensions & Investments)

Press Releases

Cedar Brook Financial Partners Welcomes Jo Ross
Cedar Brook Financial Partners

Happy Older Americans Month!
Pension Rights Center

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