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May 24, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Legal Counsel - ERISA - Title I
for T. Rowe Price in MD

Retirement Education Specialist
for The Newport Group in NC

Qualified Retirement Plan Administrator
for PACE TPA in CA

Investment Consultant
for Pension Consultants, Inc. in MO

Lead Marketing Development Writer
for GuideStone Financial Resources in TX

Payroll Data Conversion Specialist - Retirement Plan Services
for John Hancock Financial Services in MA

Relationship Manager
for Prudential in IA

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Webcasts and Conferences

Health Insurance Marketplace 101 Webinar
July 18, 2013 WEBCAST
(Centers for Medicare & Medicaid Services (CMS))

Health Insurance Marketplace 101 Webinar
July 24, 2013 WEBCAST
(Centers for Medicare & Medicaid Services (CMS))

Health Insurance Marketplace 101 Webinar
July 31, 2013 WEBCAST
(Centers for Medicare & Medicaid Services (CMS))

Understanding the Health Insurance Marketplace Webinar
July 25, 2013 WEBCAST
(Centers for Medicare & Medicaid Services (CMS))

Health Benefits Laws Compliance Assistance Seminar
June 12, 2013 in VT
(U.S. Department of Labor, Employee Benefits Security Administration (EBSA))

Worker Wellness Programs: Do They Work?
May 31, 2013 in DC
(Alliance for Health Reform)

View All Webcasts and Conferences


[Guidance Overview]

IRS Issues Guidance on How Wellness Incentives Affect Affordability and Minimum Value (PDF)
"A group health plan that covers all the EHB included in the MV calculator generally will satisfy the MV requirement easily. However, if a plan does not cover one or more of these EHB (e.g., hospitalization, prescription drugs, outpatient services), it may not satisfy MV. (Buck Consultants)


Controlling Health Care Costs With Self-Funded Plans – May 31, 2013

Sponsored by Lorman and BenefitsLink

This live audio conference examines the factors that may motivate employers to self-insure and the way incentives to self-insure might change after PPACA becomes effective. Registration discount for BenefitsLink readers.

[Guidance Overview]

FAQs Provide Details on SBCs for 2014 (PDF)
"The government previously indicated that it would change the 2014 SBC to eliminate annual maximums on essential health benefits. However, it did not change the template. The FAQs indicate that the SBC should keep the question 'Is there an overall annual limit on what the plan pays.' The SBC answer column should say 'no.' For the second year of applicability, plans may, at their discretion, remove the row with the question regarding annual dollar maximums." (McGraw Wentworth)

Still a Mystery: Whether Insurance Premiums Will Rise When ACA Kicks In
"Whether health insurance rates under the [ACA] will rise or fall is still a big unknown, as a recent congressional report made clear.... [O]ne company estimated that the combination of the individual mandate and subsidies would drive down premiums by $2,840 per year for a 60-year-old man, contributing to a 23 percent annual reduction. This estimate, however, is contingent on younger, healthier residents purchasing insurance and sharing in the risks and burdens of paying for care. The other company worked with a different scenario, estimating instead that the overall cost of premiums would rise by 6 percent for a 60-year-old man." (NJ Spotlight)

California Obamacare Premiums: No 'Rate Shock' Here
"Health insurers will charge 25-year-olds between $142 and $190 per month for a bare-bones health plan in Los Angeles. A 40-year-old in San Francisco who wants a top-of-the-line plan would receive a bill between $451 and $525. Downgrade to a less robust option, and premiums fall as low as $221." (Sarah Kliff in The Washington Post)

California Health Insurance Rates Unveiled
"California received better-than-expected insurance rates for a new state-run marketplace, but many consumers still won't be spared from sharply higher premiums.... Consumers shopping in the exchange will have three to six health insurance plans to choose from in each of the state's 19 regions. In the south Los Angeles County region, for instance, rates for a 40-year-old purchasing a Silver plan ranged from $242 a month through Health Net Inc. to $325 a month through Kaiser Permanente. Overall, Los Angeles County had the lowest premiums statewide for the Silver plans." (Los Angeles Times)

California Exchange Premiums Closely Watched by Industry, Nation
"About 5.3 million people will be eligible for coverage through Covered California -- more than 13% of the state. Not only will more of the state's population get coverage through the exchange, but the public competition in Covered California may influence coverage and premiums in group markets as well." (Kitsap Sun)

Supplemental Life Benefits, Paid for by Employee, Governed by ERISA
"[W]hat happens when the plan offers employees the choice to purchase supplemental life insurance? If the employee pays the entire premium for the supplemental benefit, is that benefit still governed by ERISA? ... [This] case outlines the tests to determine when ERISA should govern supplemental life insurance benefits." [Cox v Reliance Standard Life Insurance Co., 2013 WL 2156546 (E.D. Cal. May 17, 2013)] (Lane Powell PC)

56 Percent Want to Go Back to Pre-Obamacare System
"[W]hile 26 percent of voters say their health care situation will be better under the new law, twice as many -- 53 percent -- say it will be worse. Another 13 percent say it won't make a difference.... [A] 56-percent majority wants to go back to the health care system that was in place in 2009. Some 34 percent would stick with the new law." (Fox News)

Stop-loss Restrictions Advance in Several States
"Fast-moving events have advanced state-level proposals aimed at regulating stop-loss, which would make it more expensive for small employers to self-insure health benefits, and put power over self-funding in the hands of state insurance commissioners." [Article includes summaries of developments in Utah, California, Colorado, Idaho, Rhode Island, and North Carolina.] (Thompson SmartHR Manager)

Employers, Exchanges Are Your Competition
"In a talk intended to educate an employer audience about public health insurance exchanges, employee benefits attorney Jeffrey Endick pointed to pros and cons in the [ACA] that established the entities.... His overarching messages to the audience were to think of exchanges as an 'alternative to the employer-based system,' remember the 'enormous complexity' of the exchanges and think about the extreme amount of money that is and will continue to 'flood' into the exchanges." (Employee Benefit News)

Contraception Coverage and the Liberty University Case
"Since the individual mandate claim that had been the centerpiece of the original case has now been settled by the Supreme Court ... the case on remand was supposed to focus on the constitutionality of the employer mandate.... Most of the argument was consumed with jurisdictional issues, which are complex, and with whether the court could properly consider a new challenge Liberty is now mounting against regulations implementing a different statutory provision, the preventive services mandate." (Timothy Jost in Health Affairs)

Hello, Out There! Is Anybody Listening? Exchanges Will Launch Soon
"Rhode Island being the smallest state, you might think word would travel faster there. But according to a recent survey commissioned by the Rhode Island Health Benefits Exchange, four out of five state residents have never heard of the exchange. So much for brand awareness." (HealthLeaders InterStudy)

Two Tips to Manage Health Plan Data Overload
"Quarterly reports are virtually useless for giving you any insight about your group. The reason is that very little changes from one three-month period to the next, and what does change is more often a natural fluctuation or a fluke.... press the plan administrator for reports that list your group's costs by clinical condition. Even if the report gives the clinical conditions only for your top two or three major diagnostic categories, this will give you a great deal more insight." (Employee Benefit News)

Enrollment Assistance Under Health Reform Has Roots in Other Successful Programs
"The exchange model included navigators because similar 'helper' programs have worked well to connect people with the programs and services for which they're eligible ... For example, the federally funded and administered State Health Insurance Assistance Program offers one-on-one guidance to Medicare beneficiaries in every state. And similar assister programs have played a significant role in increasing enrollment in Medicaid and CHIP across the country[.]" (Center on Budget and Policy Priorities)


Coming Soon to the United States: A Two-Tiered, Canadian-Style Health Care System
"The evolution toward a two-tiered system was already under way before Barack Obama became president. But ironically, the [ACA] is accelerating the pace of change.... [W]e are about to see a huge increase in the demand for care and a major decrease in the supply. In any other market, that would cause prices to soar. But government plans to control costs (even more so than in the past) by vigorously suppressing provider fees and the private insurers are likely to resist fee increases as well. That means we are going to have a rationing problem." (John Goodman in Forbes)


New Insurance Rates in California Bring Good News for Obamacare
"The California exchange will have 13 insurance options, and the heavy competition appears to be driving down prices.... California is a particularly important test for Obamacare. It's not just the largest state in the nation. It's also one of the states most committed to implementing Obamacare effectively" (Ezra Klein and Evan Soltas in The Washington Post)


The Oregon Experiment Revisited
"The far more interesting lesson from Oregon is that we should not oversell the value of health insurance to improving people's health. While health insurance improves access to healthcare services (modestly), its impact on health is surprisingly and disappointingly small." (The Health Care Blog)

Benefits in General; Executive Compensation

Musing About the Impact on ERISA Plans Depending on the Supreme Court's Rulings on the Issue of [Same-Gender] Marriage
"Assuming the Court does not find all state laws prohibiting [same-gender] marriage unconstitutional, we would be left with the current patchwork of state laws that either permit or prohibit [same-gender] marriage and civil unions. Merely removing Section 3 of DOMA would most likely not herald in a new era of simplicity. What happens if the married [same-gender] couple from New York moves to a state that does not recognize [same-gender] marriage, like Texas?" (Baker Botts LLP)

Senate Finance Committee Staff Report: Tax Reform Options for Economic Security -- Health, Retirement, Life Insurance, Fringe Benefits and Executive Compensation (PDF)
"Following are several potential goals that could serve as guidelines for the [Senate Finance Committee] when reviewing the tax rules that affect the economic security of Americans: [1] Minimize the disruption to business practices and employee expectations inherent in any fundamental tax reform; [2] Simplify the taxation of retirement savings and health insurance; [3] Increase the number of people with enough resources for an adequate standard of living in retirement, and expand access to health insurance; [4] Maximize the bang-for-the-buck of any tax incentives that are retained or reformed; [6] Develop neutral rules regarding compensation and fringe benefits to ensure that business needs and not tax planning drive compensation decisions, while minimizing compliance costs[.]" (Senate Finance Committee Staff)

Your Corporate Structure and Ownership Status Matter
"[W]hen considering your benefit offerings, what plans to provide and how to administer them, make sure your benefit professionals know as much about the ownership structure and corporate form of the company that can be provided. Don't hide the existence of a control group. Make sure everyone know how the company operates, and all other entities that might be considered as related to that company and make sure to ask if the structure has an impact on your benefit plan design." (Fox Rothschild LLP)

Cypen & Cypen Newsletter for May 23, 2013
Article titles include: National League of Cities Says Public Pension Plans Are Not in a Current Crisis; 2013 Trends in State and Local Government Workforce; DB Plans Starting To Allow Lump Sum Distributions; You Work, You Retire and Then You Die; and Couples Retiring in 2013 Will Need $220,000 To Pay Medical Expenses Throughout Retirement. (Cypen & Cypen)

Mere Negligence May Be All That's Required for Clawbacks
"'What the SEC wants to do is push the envelope of Section 304 further, and the next horizon appears to be negligence-based cases without regard to fraud,' says [attorney Junaid] Zubairi ... 'As the SEC staff has made clear in litigation filings, during the investigative phases of these matters there are ongoing discussions about whether mere negligence is enough to trigger a clawback, and the staff is taking the position that it is.'" (CFO.com)

A Preliminary Review of 2013 Directors' Pay
"The median value of total direct compensation for directors increased 4% from the previous year. The mix of pay remained the same, however, with pay typically delivered 45% in cash and 55% in equity. The median cash compensation grew by 3% while the median level of equity compensation increased by 4% over 2012 levels." (Towers Watson)

Press Releases

IHC FORUM East Sets Record Number of Attendees, Sponsors
The Institute for HealthCare Consumerism

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