EmployeeBenefitsJobs.com logo BenefitsLink.com logo

BenefitsLink Health & Welfare Plans Newsletter

May 21, 2013          Get Retirement News  |  Advertise
         Past Issues  |  Search

Employee Benefits Jobs

Senior Health Benefits Analyst
for The Segal Company in CA

Senior Sales/Relationship Management Consultant
for United Retirement Plan Consultants in OR

Retirement Plan Administrator
for Fred S. Shapiro & Associates, Inc. in MD

Retirement Specialist
for Nationwide Insurance in KY

Communications Manager 2
for Wells Fargo in MN

Sr. Health Plan Analyst
for Unite Here Health in IL

Retirement Plan Administrator
for TPA Firm in NH

Pension Project Coordinator
for CUNA Mutual Group in WI

Post Your Job on EmployeeBenefitsJobs.com

View All Jobs

RSS feed for jobs RSS Feed: All Jobs

Webcasts and Conferences

Form 5500: Lessons Learned, New Issues and Best Practices for the 2012 Filing Season (NY CLE Program)
June 20, 2013 in NY
(WEB (Worldwide Employee Benefits Network ), New York Chapter)

Health Insurance Marketplace 101 Webinar
June 6, 2013 WEBCAST
(Centers for Medicare & Medicaid Services (CMS))

Health Insurance Marketplace 101 Webinar
June 12, 2013 WEBCAST
(Centers for Medicare & Medicaid Services (CMS))

Health Insurance Marketplace 101 Webinar
June 19, 2013 WEBCAST
(Centers for Medicare & Medicaid Services (CMS))

Health Insurance Marketplace 101 Webinar
June 20, 2013 WEBCAST
(Centers for Medicare & Medicaid Services (CMS))

Retirement Plan Compliance Assistance Seminar for Small Business
June 6, 2013 in KY
(U.S. Department of Labor, Employee Benefits Security Administration (EBSA))

2013 ERISA Update Seminar
November 20, 2013 in HI
(TRI Pension Services)

Affordable Care Act Compliance: Most Commonly Asked Questions Webinar
June 6, 2013 WEBCAST
(Tango Health)

View All Webcasts and Conferences


[Guidance Overview]

New York City Council Passes Paid Sick Leave Bill (PDF)
"An employer will not have to provide additional [paid time off (PTO)] if it already provides an amount of paid vacation, paid personal days, paid days of rest, or PTO sufficient to satisfy the new mandate and allows the leave to be used for the same purposes and under the same conditions as required by the Act. Similarly, an employer required to provide unpaid sick time will not have to provide additional unpaid sick time if it already provides a sufficient number of unpaid or paid PTO, vacation, or personal days to satisfy the Act's requirements, regardless of whether the employee chooses to use the days as sick time." (Buck Consultants)


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!

[Guidance Overview]

Employers are Required to Notify Employees of Private Healthcare Exchanges
"With some very limited exceptions, all employers (including those who have less than 50 full-time/full-time equivalent employees) are required to provide this Notice, meaning that many employers that are not subject to the 'pay-to play' provisions of Healthcare Reform are required to provide this Notice." (Buchanan Ingersoll & Rooney PC)

[Guidance Overview]

What's New with the Affordable Care Act?
Compact but useful descriptions of recent regulatory developments. Article titles: [1] Recap of the play-or-pay rules, [2] Minimum Value standards, [3] Impact of Account-Based Plans on Minimum Value and Affordability, and [4] Limitations on mandatory coverage. (Nixon Peabody LLP)

[Guidance Overview]

Out-of-Pocket But Not Out-of-Mind
"[F]or the 2014 plan year only, if a non-grandfathered health plan uses different service providers to administer different health benefits, the Departments will consider the limitation on out-of-pocket maximums satisfied, if the out-of-pocket maximum of each health benefit that is separately administered individually complies with the limitation on out-of-pocket maximums." (Miller Johnson)

[Guidance Overview]

Now is the Time to Prepare for Health Plan Pay-or-Play Rules in 2014
"Determining whether your [company] is subject to penalties, when your [company] has incurred a penalty, and the amount of the penalty is a multi-step process.... Although some changes to the rules can be expected, the time is now to work out a strategy for avoiding or minimizing the penalties." [Article includes a flow chart outlining the process.] (Vorys, Sater, Seymour and Pease LLP)

Comp Time Bill Passes U.S. House, Heads for Senate
"Under the proposed legislation, employers must give employees 30 days' notice before ending a compensatory time program, and employees, at any time, may request in writing to be paid for any accrued, but unused, compensatory time. Such payments must be made within 30 days of receiving a request." (Jackson Lewis LLP)

Is a Private Exchange Right for Your Organization?
[T]the number of employers considering offering a private exchange for active and/or retired employees has tripled in the past year to 56%." [An infographic provides three considerations for employers in making this decision.] (Mercer)

High Net Worth Investors Refocus on Growth but Overlook Family, Health and Retirement Risks
"[F]amily health has emerged as the new risk to family wealth. Long-term care and out-of-pocket healthcare costs, combined with financial support for extended family, are weighing heavily on families, particularly women and younger generations, yet are risks to wealth that are not well reflected in financial planning." (Merrill Lynch)

Role of Health Reform 'Navigators' Under Fire
"Critics see the navigators as potential competitors to insurance brokers, and say that they are effectively federal government employees who should be subject to rigorous screening." (The Wall Street Journal)

Phyllis Borzi: Clarity of ACA Guidance Limited by the Statute Itself
"Phyllis Borzi, assistant secretary for employee benefits security, acknowledged that those in the audience -- mostly multi-plan trustees -- are struggling with how to implement the ACA and although the DOL is working with them 'these are very, very difficult issues because the statute is so unforgiving in a number of areas.' Borzi ... said that many times people come into the department's offices to talk about the law and want to put aside the statute during the conversation. 'We can't do that,' Borzi said. 'It's only when the statute gives us some wiggle room and often it does not.'" (Employee Benefit News)

Overruns Forcing Lower Payments to Some Providers Under Pre-Existing Condition Insurance Plan
"In most cases, payments to health care providers will be capped at Medicare rates, which are substantially less than the commercial insurance rates they have been receiving. The new policy generally prohibits doctors and hospitals from increasing charges to consumers to make up the difference." (The New York Times; subscription may be required)

Florida Medical Record Disclosure Law Preempted by HIPAA
"This case ... suggests that the question of whether HIPAA or state law is stricter may not always be binary or straightforward, and that in some cases state law will be seen as framing or contextualizing HIPAA and in other cases will be seen as less protective. Thus, while the HIPAA preemption principle is well-settled, the application of that principle still presents some uncertainty, especially given the varied nature of state law." [Opis Management Resources LLC et al. v. Secretary, Florida Agency for Healthcare Administration, Case No. 12-12593 (11th Cir. 2013)] (McDermott Will & Emery)

A Checkup for Your EAP and Health and Wellness Programs
"Absent an industry standard for measuring and reporting utilization, employers are left to question what these rates mean, as well as how effective the program and services truly are. The simple use of a program does not equate to achieving outcomes that are relevant to your workplace." (Healthcare Reform Magazine)

ML Strategies Health Care Reform Update, May 20, 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)

Some Individual Policies Offer Way to Shrink Deductibles, But Is It Legal?
"Supporters say these programs reward good health by helping customers reduce their costs. But consumer advocates say the programs may discriminate against sick people and run afoul of the Affordable Care Act." (Kaiser Health News)

A Failure to Communicate: How Cultural Incompetence Leaves Many Wellness Programs Incomplete
"Without improving cultural competency, the inability of minority wellness program participants to effectively communicate with healthcare providers and vendors is likely to worsen.... Poorer health outcomes may result when sociocultural differences between employees and providers, like language are not reconciled in the clinical encounter. This can lead to: [1] Increased likelihood of mistakes in collecting medical histories, [2] Decreased use of preventative services, [3] Increased use of diagnostic testing, and [4] Increased risk of drug complications affecting work or home life." (Healthcare Reform Magazine)

Surviving a 'Reformed' Open Enrollment
"Open-enrollment season may still be months away for many organizations, but experts are urging employers to prepare now to successfully guide employees into a new era of healthcare-reform-mandated options -- and with it, potentially overwhelming amounts of information and misinformation -- to begin Jan. 1." (Human Resource Executive Online)

Is the Future of American Health Care in Oregon?
"[Oregon Gov. John] Kitzhaber said. 'What we're doing is instead of putting our budget into the ER and paying for congestive heart failure after congestive heart failure, we're putting it into care coordination and community health workers. We're investing in health. It's just a paradigm shift.' ... This is a potentially transformational notion, based on a belief that the health-care system doesn't decide or drive health, even that individuals don't particularly drive their own health." (The Washington Post)

Deloitte Health Care Reform Memo, May 20, 2013
"According to the National Conference of State Legislators, in the average state, health care is 28-35 percent of the budget.... Governors across the country are asking good questions. They ask about the ACA ... They ask about Medicaid: ... They ask about state employee health plans ... They ask about the private sector ... They wonder about the health care workforce and jobs in their state ... And they ask about public awareness." (Deloitte)

Fifth Circuit Holds that Health Plan Can Obtain Reimbursement from Special Needs Trust
"[U]nder the terms of the settlement agreement, which Mr. Griffin signed, some of the settlement proceeds were segregated for attorneys' fees and other expenses, and the remaining sum was used by the Third Party's insurance company to purchase an annuity contract, pursuant to which monthly payments would be paid into a statutory special needs trust for Mr. Griffin's benefit over a 20-year period ... The [Fifth Circuit] pointed out that in order to assent to the disposition of the funds as outlined in the settlement agreement, Mr. Griffin must have had at least constructive possession and control of the funds." (Haynes and Boone, LLP)

Living in America Takes Toll on Immigrants' Health
"A growing body of mortality research on immigrants has shown that the longer they live in this country, the worse their rates of heart disease, high blood pressure and diabetes.... Why does life in the United States -- despite its sophisticated health care system and high per capita wages -- lead to worse health? New research is showing that the immigrant advantage wears off with the adoption of American behaviors -- smoking, drinking, high-calorie diets and sedentary lifestyles." (The New York Times; subscription may be required)

Majority of Employers Plan to Offer Healthcare Coverage After 2014
"More than two-thirds of employers (69%) say they will continue to provide healthcare coverage when health insurance exchanges begin operation in 2014. That's up from 46% in 2012 ... Meanwhile, only 2% of employers are considering terminating their healthcare coverage as a result of the healthcare reform law[.]" (HealthLeaders Media)

How Will the 'Unbanked' Buy Insurance on the Exchanges?
"One in five households in the United States, or about 51 million adults, [has] only a tenuous relationship with a traditional bank ... The new federal health law which requires most Americans to carry health insurance starting in January presents a particular problem for those households, since most health plans accept a credit card for the first month's premium payment and then require customers to pay monthly with a check or an electronic funds transfer from a checking account." (Kaiser Health News)


Fears of Widespread 'Rate Shock' Unfounded
"Yes, a relatively small number of people with coverage in the existing individual insurance market can expect premium increases in 2014, particularly if they are young and healthy, are not eligible for new federal subsidies or expanded Medicaid coverage, and have a relatively skimpy plan today. But others will pay less, and still others will be able to get better benefits for about the same premiums." (Center on Budget and Policy Priorities)


The Market for Medical Care Should Work Like Cosmetic Surgery
"When patients pay their own medical bills, they become prudent consumers. Thus, the real (inflation-adjusted) price of cosmetic surgery fell over the past two decades -- despite a huge increase in demand and considerable innovation. Since 1992: The price of medical care has increased an average of 118 percent. The price of physician services rose by 92 percent. All goods, as measured by the inflation rate, increased by 64 percent. Cosmetic surgery prices only rose only about 30 percent." (National Center for Policy Analysis)


Obamacare Could Result in Reduced Employee Health Benefits
"[E]mployers and employee-benefits consultants have found, and federal regulators now confirm, that the law actually requires most employers to offer no more than very flimsy coverage. Many employers are now exploring the option of offering limited-benefit health plans that cover preventive services and maybe '$100 a day for a hospital visit' but 'wouldn't cover surgery, X-rays or prenatal care.' Indeed, the law could push many employers to reduce the amount of coverage workers receive on the job.... The Law of Unintended Consequences strikes again." (Cato Institute)


Health Insurance Exchanges -- The Top Ten Terribles (PDF)
"Higher Premiums ... Limited Choice of Providers ... Privacy Intrusions ... No private insurance ... IRS Enforcement ... Conscientious Objections Dismissed ... Federal Application ... Limited Choice of Coverage ... State Control Board ... Employer Penalties [and] Medicaid for Employees." (Citizens' Council for Health Freedom)

Benefits in General; Executive Compensation

[Official Guidance]

Text of Revised SEC Compliance and Disclosure Interpretations: Regulation S-K
Q&As include: "Is restricted stock that has been granted subject to forfeiture pursuant to an equity compensation plan reportable in the Item 201(d) Equity Compensation Plan Information table? ... Should shares that may be issued under performance share awards if specified targets are met and shares that are credited as phantom shares under a deferred compensation plan be reported in column (a) of the Equity Compensation Plan Information table as securities to be issued upon exercise of outstanding options, warrants and rights?" (Securities and Exchange Commission)

[Guidance Overview]

SEC Staff Updates Interpretive Guidance On Executive and Director Compensation Disclosure Rules (PDF)
"The staff of the [SEC] periodically updates its interpretive guidance on executive and director compensation proxy disclosure rules through the release of Compliance & Disclosure Interpretations (CDIs). The CDIs are drafted in question and answer format for issues of general applicability, and also in the form of interpretive responses regarding particular situations. The most recent guidance was released on May 17, 2013. The interpretative guidance is briefly summarized [in the linked article]." (Frederic W. Cook & Co., Inc.)

PCAOB Re-Proposes New Auditing Standard Affecting Executive Compensation and Risk Assessments
"[The] re-proposed amendments [by the Public Company Accounting Oversight Board], like the proposed amendments, would require the auditor to perform procedures that include, but are not limited to: [1] Reading the employment and compensation contracts between the company and its executive officers; [2] Reading proxy statements and other relevant company filings with the SEC and other regulatory agencies that relate to the company's financial relationships and transactions with its executive officers, and [3] Consider inquiring of the chair of the compensation committee, or the compensation committee's equivalent, and any compensation consultants engaged by either the compensation committee or the company regarding the structuring of the company's compensation for executive officers." (Winston & Strawn LLP)

Press Releases

BenefitsLink.com, Inc.
1298 Minnesota Avenue, Suite H
Winter Park, Florida 32789
Phone (407) 644-4146
Fax (407) 644-2151

Lois Baker, J.D., President
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager

Copyright © 2013 BenefitsLink.com, Inc. but feel free to forward this newsletter if done without modification in any way.

All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of that content. You may not alter or remove any trademark, copyright or other notice from copies of the content.

Links to Web sites other than those owned by BenefitsLink.com, Inc. are offered as a service to readers. The editorial staff of BenefitsLink.com, Inc. was not involved in their production and is not responsible for their content.

Useful links: