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May 14, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Technical Research Consultant
for Transamerica Retirement Solutions Corporation in NY

401(k) Administrator
for The Guardian Life Insurance Company of America in MA

DC Plan Administrator
for MPH Pension Consultants, LLC in TX

ERISA QRP Specialist
for Ascensus in MN

Executive Assistant
for Benefit Equity Inc in CA

Retirement Plan Document Specialist
for Pension Consulting Firm in MA, NH

Client Service Manager - Retirement Plan Services
for John Hancock Financial Services in MA

Non-Qualified Benefits Coordinator
for JPMorgan in KS

Retirement Plan Service Specialist
for Growing Firm in CO

Retirement Plan Service Specialist - Part-time
for Growing Firm in CO

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Webcasts and Conferences

Running an Effective Board
July 2, 2013
(National Center for Employee Ownership) WEBCAST

Communicating Valuation: Tools, Tips and Examples
July 9, 2013
(National Center for Employee Ownership) WEBCAST

Employee Communication and Education:
June 26, 2013
(National Center for Employee Ownership) WEBCAST

2nd Annual Retirement & Benefits Compliance Customer Conference
August 4, 2013
(Wolters Kluwer Law & Business) in IL

Issues, Concerns and Solutions in Auditing 403(b) Plans
May 23, 2013
(Western Pension & Benefits Council - Orange County Chapter) in CA

View All Webcasts and Conferences


[Official Guidance]

Text of CMS FAQs on Essential Community Providers (PDF)
Set of 12 Q&As. Excerpt: "Q1. What should providers that serve predominantly low -- income, medically underserved individuals be aware of as issuers build their qualified health plan (QHP) networks? ... Q4. Will issuers be able to write in [Essential Community Providers (ECPs)] that are not on the list? ... Q5. Is an issuer seeking QHP certification required to do business with my organization? ... Q6. How does CMS determine what are considered 'available' ECPs?" (Centers for Medicare & Medicaid Services)


Form 5500 Webinar with Expert Janice Wegesin

Sponsored by ftwilliam.com

On 5/30, learn about the Form 5500 updates to 2012 forms and EFAST2 processing as well as how to respond to governmental correspondence regarding such filings. Filing options for one-participant plans and Form 8955-SSA will also be addressed.

[Guidance Overview]

DOL Issues Model Notices on Employer Health Insurance Options
"[A]t least some of the required information and most of the optional information can only be determined by an employer if it has already determined what the status of its plan will be under the employer shared responsibility rules and how it will comply or not comply with the shared responsibility rules for its different categories of employees." (Pillsbury Winthrop Shaw Pittman LLP)

[Guidance Overview]

More Guidance on 'Minimum Value'
"[I]t appears employers could still offer a basic plan that provides minimum essential coverage but not minimum value, as long as employees may choose to decline that plan. So, for instance, an employer could offer a preventive services-only plan (which would comply with the requirement to cover first-dollar preventive care at 100%), and the employer would never be subject to the larger penalty under the employer mandate ($2,000 multiplied by all full-time employees). While the employer may still be subject to the smaller penalty ($3,000 multiplied by only those full-time employees who receive a tax credit) because they have not offered a plan that provides Minimum Value, presumably this penalty would be significantly less than the alternative." (Seyfarth Shaw LLP)

[Guidance Overview]

Guidance Issued on Required Notice to Employees of Available Coverage on Health Insurance Exchanges (PDF)
"Employers should be embarking on their own communications efforts around the Marketplace to help manage employee concerns and minimize the need for responding to individual questions. This is also a way to underscore the value of employer-provided coverage.... Employers may want to supplement the notice with some of their own information and terminology." (PricewaterhouseCoopers)

[Guidance Overview]

Implementing Health Reform: Medicaid DSH Payments, Utah Exchanges and More
"The [CMS] FAQ, moreover, allows Utah to operate a SHOP navigator program in which navigators can only conduct consumer outreach and education activities and not assist with enrollment or perform other required navigator functions. CMS will operate the navigator program in the individual market, where navigators will be able to fulfill all required functions ... [I]t is disconcerting that CMS has folded on this issue in Utah." (Timothy Jost in Health Affairs)


Employer healthcare at the crossroads -- where are your benefits headed?

Sponsored by University Conference Services

50+ workshops led by benefits experts prepare you for the challenges of complying with ACA, containing costs, understanding exchanges and more. Exclusively for employers. Earn 16 HRCI recertification credits. 99% of past attendees recommend this program!

Court Cites Governmental Plan Exemption Under ERISA in Dismissing Retirees' Claims
"The retirees initially worked for NOPSI, a privately-held company that ran the New Orleans transit system until the early 1980s, when the system transitioned into a publicly held system owned by RTA and operated by TMSEL.... RTA and TMSEL moved to dismiss the retirees' ERISA claims, arguing that the plan in question qualified as a 'governmental plan' and was therefore exempt from ERISA's statutory framework. According to RTA and TMSEL, the status of a governmental plan is determined 'at the time the suit is filed,' rather than at the plan's establishment.... [After determining] RTA's status as a political subdivision and TMSEL's status as an agency or instrumentality of a political subdivision, the court concluded that ERISA's exception for governmental plans applied." (Bloomberg BNA)

US Airways v. McCutchen Health Plan Reimbursement Case: When Silence Is Not Golden
"[T]he Court noted that if the plan sponsor ... had wished to depart from application of equitable doctrines, it was free to draft its plan to say so. In other words, if a plan sponsor does have an intent inconsistent with certain commonplace equitable doctrines, it can avoid application of those doctrines by expressly drafting around the issue in the plan itself." (Jones Day)

Invasion of the Health Insurance Brokers
"Largely dealt out of benefit distribution by Obamacare, intermediaries are looking to work directly with your employees.... In addition to insurance carriers and brokers, the commercial players looking to pick up business directly from workers will include worksite marketers, benefit consultants, retirement-plan representatives and payroll-services providers[.]" (CFO.com)

Streamlined Exchange Applications Released by HHS; Employers Will Need to Complete Employer Coverage Tool
"Employers with employees who may seek enrollment in the public Health Insurance Marketplace should become familiar with the content of the applications and with the information they will need to provide as part of the Employer Coverage Tool. The application process will be an important step in the initial determination of an applicant's eligibility for federal premium tax credits and an employer's potential liability for penalties under the play-or-pay mandate." (Towers Watson)

Obamacare Application Form Isn't So Simple
"The much-derided 21-page application was for families. It is now down to 11 pages ... Eight pages in the longer application called for filling in information for four additional family members. The new form cuts these pages but says that if you have children, 'make a copy of Step 2: Person 2 (pages 4 and 5) and complete.' The work required of the applicant remains the same." (John Goodman's Health Policy Blog)

State Health Insurance Exchange Navigators Prepare to Help Applicants
"When enrollment in the health care law's new insurance exchanges opens in October, the prospects for success will turn on a crucial element: people who actually understand health insurance coverage and can explain it in plain language to consumers.... [T]he states and [HHS] will oversee the training of what's expected to be thousands of paid health insurance experts who will be available to guide Americans through the enrollment process." (Roll Call)

Oregon's Upstart Health CO-OPs to Challenge Mainstream Insurers
"In October, [two startup health insurers offering a consumer-run experience] will go head-to-head with about a dozen established insurers to appeal to small businesses as well as more than 200,000 expected to buy their own insurance next year.... Only one state received federal funding for two co-ops: Oregon. Now the upstarts will have to sink or swim in an insurance market already ranked among the most competitive in the country." (The Oregonian)

EEOC Settles First GINA Lawsuit
"Fabricut, Inc.... will pay $50,000 and furnish other relief to settle the suit.... The EEOC claimed that after the woman was offered a position, Fabricut sent her to a contract medical facility to complete a post-offer medical examination and drug test. When she appeared for the medical examination, she was required to complete a questionnaire that asked her to disclose the existence of various conditions in her family medical history, such as heart disease, hypertension, cancer, tuberculosis, diabetes, arthritis and 'mental disorders.'" (Thompson Hine)

Hospitals, Testing Companies Face Questions About Value of Community Screenings
"Hospitals hoping to attract patients and build their brands are teaming up with medical-screening companies to promote tests aimed at consumers worried about potentially deadly heart disease or strokes. What their promotions don't say is that an influential government panel recommends against using many of the tests on people without symptoms or risk factors. The panel says such screenings find too few problems to outweigh their drawbacks ... Other medical experts warn that the tests could needlessly raise health-care spending." (Kaiser Health News)

Colorado Law Allows Employees to Take Leave to Care for Civil Union and Domestic Partners
"The [law] will take effect on August 7, 2013. However, if a referendum petition is filed against it, the [law] would not become effective unless approved by the electorate in the November 2014 general election.... An employer may require the employee requesting leave to confirm the relationship by providing reasonable documentation or a written statement of family relationship in accordance with the FMLA." (Jackson Lewis LLP)

Rock, Paper, Scissors: Life Insurance Beneficiary Designation Beats Will
"The U.S. District Court in Minnesota, in Hall v. Metropolitan Life Insurance Company ... declined to give any effect to the fill in the blank form Will completed at the direction of Dennis Hall (the Decedent) by the Decedent's daughter that attempted to dispose of the proceeds of the group term life insurance policy provided through the Decedent's employment." (Bryan Cave LLP)

Text of CCIIO Letter to Essential Community Providers (PDF)
"At this time, health insurance issuers that wish to establish QHPs may be approaching you with offers to join their provider networks. Whether or not you are currently engaged with private insurers, I encourage you to thoughtfully consider these overtures. Many of the patients whom you serve will be eligible to purchase health insurance from these QHPs." (Centers for Medicare & Medicaid Services)

Short-Term Strategies for Healthcare Savings
"Offer and promote a section 125 plan... Implement dependent verification ... Increase health insurance deductibles and co-pays... Offer benefit waivers... Whatever changes a government chooses to make to its benefits plan, employee communications need to be clear and specific so workers will understand what is on the horizon." (Colonial Life, in Government Finance Review)

Some Nevadans May See Higher Premiums Under Obamacare
"The benchmark doesn't mean every Nevadan must buy point-of-service coverage through Health Plan of Nevada, but it does mean every insurance carrier's individual plan must meet those coverage levels. So, whether they need it or not, Nevadans buying individual policies will be covered for maternity care, mental health services, infertility treatments, home health, bariatric surgery, chiropractic care and hearing aids." (Las Vegas Review-Journal)

Enroll America Will Not Be Enrolling
"Enroll America has not filed to serve as navigators and has no intention of doing so. So there you have it. The group that is supposed to be leading the charge to serve those who need it most won't be serving them much at all." (InsureBlog)

Patient Is Out of Network, Out of Luck
"[Castleman's Disease sufferer Jalal] Afshar's fight with Kaiser highlights the growing tension in healthcare over how to eliminate wasteful spending without compromising the care of the sickest, most expensive patients. Under pressure to curb ballooning medical costs and hold down premiums in advance of a massive expansion of health coverage, insurers are increasingly forming smaller networks of physicians and hospitals. But some experts worry these cost-control measures could go too far." (Los Angeles Times)

Half of U.S. Small Businesses Think Health Law Bad for Them
"Forty-eight percent of U.S. small-business owners say the 2010 Affordable Care Act (ACA) is going to be bad for their business, compared with 9% who say it is going to be good, and 39% who expect no impact.... Similarly, 52% of owners say the ACA is going to reduce the quality of healthcare they and their employees receive." (Gallup)

Private Insurers' Medicare Advantage Plans Cost Medicare an Extra $34.1 Billion in 2012
"[T]he private insurance companies that participate in Medicare under the Medicare Advantage program and its predecessors have cost the publicly funded program for the elderly and disabled an extra $282.6 billion since 1985, most of it over the past eight years. In 2012 alone, private insurers were overpaid $34.1 billion." (Physicians for a National Health Program)


Deloitte Health Care Reform Memo, May 13, 2013
"There's widespread consensus across the health system that leveraging information technologies to better coordinate care and reduce error is both necessary and appropriate.... Non-adopter physicians should not be allowed to participate with hospitals, health plans and employers in risk sharing arrangements like ACOs, bundled payments, and other models that require optimal clinical coordination. It's potentially harmful to patients, and certainly suboptimal for the group of committed physicians and their business partners." (Deloitte)


Why Medicare Won't Cover You Overseas
"While allowing seniors to receive Medicare coverage abroad is not a cure-all to this fiscal crisis, the potential savings could be significant. Health care costs for a procedure overseas can be less than half of the cost of the exact same procedure performed in the United States, saving both Medicare and the retiree money." (U.S.News and World Report)

Benefits in General; Executive Compensation

Sutardja Decision Shows Employers How to Preserve Stock Option Flexibility In a 409A World
"What's surprising isn't so much the court's decision, but that the IRS chose this particular fact pattern to assess Code Section 409A penalties.... [I]n order to grant options that provide this type of flexibility, employers need to follow detailed stock option grant requirements under the Code Section 409A regulations. This lesson may be harsh for the executive in Sutardja considering that most of those requirements hadn't been written yet, but it gives the rest of us a chance to learn from those mistakes." (Porter Wright Morris & Arthur LLP)

Press Releases

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