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May 29, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Senior Counsel, Health & Welfare Benefits
for Aon Hewitt in IL

Pension Administrator
for Compensation Benefit Planning, Inc. in MO

Retirement Plan Administrator
for Pension Firm in New York City in NY

Senior Technical Implementation Specialist
for Transamerica Retirement Solutions Corporation in MA

Senior Defined Benefit Calculation Analyst
for Transamerica Retirement Solutions Corporation in MA

Loan and Distribution Processor
for TPA Firm located in Hunt Valley, MD in MD

Regional Retirement Plan Wholesaler
for Nationwide Insurance in CA

Relationship Manager / Administrator
for Qualified Plans, LLC in GA

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Webcasts and Conferences

Form 8928 and Excise Tax Compliance: Avoiding Penalties Under HCR, COBRA, and Other Rules
May 23, 2013 WEBCAST
(Thomson Reuters / EBIA)

More is Not Always Better: Encouraging Appropriate Use of Health Care Webinar
June 4, 2013 WEBCAST

HRAs, FSAs, and MERPs post ACA: Just What’s an Employer to do?
June 12, 2013 WEBCAST
(Employers Council on Flexible Compensation (ECFC))

Health Care Reform for Employers: Now What?
July 25, 2013 in WA
(Lorman Education Services)

Health Care Reform for Employers: Now What?
July 25, 2013 in LA
(Lorman Education Services)

View All Webcasts and Conferences


[Official Guidance]

Text of Final Regs on Incentives for Nondiscriminatory Wellness Programs in Group Health Plans
"[T]hese final regulations increase the maximum permissible reward under a health-contingent wellness program offered in connection with a group health plan (and any related health insurance coverage) from 20 percent to 30 percent of the cost of coverage. The final regulations further increase the maximum permissible reward to 50 percent for wellness programs designed to prevent or reduce tobacco use. These regulations also include other clarifications regarding the reasonable design of health-contingent wellness programs and the reasonable alternatives they must offer in order to avoid prohibited discrimination." (U.S. Department of Labor; U.S. Department of the Treasury; U.S. Department of Health and Human Services)


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[Guidance Overview]

Nondiscrimination Rules for Health Plans Looming
"[T]he biggest difference between these PPACA nondiscrimination rules and the nondiscrimination rules for other types of benefits lies in the penalty calculation. In short, the penalties for noncompliance under the PPACA are calculated based on the number of people who are discriminated against. For example, a business with 100 employees that offers a discriminatory fully insured health plan for 10 highly compensated employees would pay a penalty based on the 90 employees who are facing discrimination." (Society for Human Resource Management)

[Guidance Overview]

Employers Must Provide Notice of Exchange to Employees by October 1
"Because the notice must provide information about the specific exchange available to employees based on the state in which they reside, the challenge for some employers will be to customize the notice forms for each of the states where they have employees (although it will be helpful that the same notice can be used for each state that will be relying on the federal exchange instead of creating its own)." (Holland & Hart)

Workplace Wellness Programs Study: RAND Corporation Research Report Prepared for DOL and HHS (PDF)
165 pages. Excerpt: "[E]mployers overwhelmingly expressed confidence that workplace wellness programs reduce medical cost, absenteeism, and health-related productivity losses. But ... only about half stated that they have evaluated program impacts formally and only 2 percent reported actual savings estimates.... [S]tatistical analyses suggest that participation in a wellness program over five years is associated with a trend toward lower health care costs and decreasing health care use. We estimate the average annual difference to be $157, but the change is not statistically significant.... Well-executed programs appear to improve employee health meaningfully, whereas significant reductions in health care cost may take time to materialize.... Although participation incentives appear to be effective, intended and unintended effects of incentives for health-related standards need to be studied further." (RAND Corporation)

The Play or Pay Tax: Employer Shared Responsibility Payments for Health Coverage
"[E]ven for applicable large employers, if the only employees not covered either: 1) don't buy their own health insurance (for instance, because they're covered through a spouse); or 2) buy their health insurance through an exchange but have enough income to be ineligible for the premium assistance tax credit or other subsidies, then the [employer shared responsibility tax] will not apply. On the other hand, it's important to note that it only takes one employee not offered coverage who enrolls for his/her own health insurance with premium assistance to trigger the tax." (Nerd's Eye View)


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Expected U.S. Supreme Court Decision on DOMA May Impact Status of Children of Same-Gender Spouses for Employee Benefits Purposes
"[B]ecause a child of a [same-gender] spouse is already considered to be an employee's stepchild for federal income tax purposes if the couple resides in a state that recognizes the employee as the stepparent, the employee can avoid having imputed income for federal tax purposes on the value of employer-sponsored health coverage provided to the child. If DOMA is struck down (and depending on the impact of the decision on state mini-DOMA laws), additional children of [same-gender] spouses may attain similar favorable tax status. This status may even extend to situations where a couple resides in a state that does not recognize the child as a stepchild or permit [same-gender] marriage depending on the specific definition of 'child' in the benefit plan." (Proskauer's ERISA Practice Center Blog)

ML Strategies Health Care Reform Update, May 28, 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)

Fewer Employers Planning to Continue to Offer Pharmacy Benefits to Medicare-eligible Participants (PDF)
"Currently, 48 percent of respondents offer prescription drug plans to Medicare-eligible participants. Of these respondents, only 55 percent intend to continue this benefit, down from 75 percent in the previous survey.... Nearly all (99 percent) respondents provide active employees with prescription drug coverage, an increase from 96 percent in 2011.... 61 percent of employers now use [pharmacy benefit managers (PBMs)] compared to 57 percent in 2011 and 47 percent in 2009. The majority (68 percent) cite 'pricing competitiveness' as an extremely important PBM service." (Buck Consultants)

Minnesota Ranked Best State for Seniors
"Minnesota won the top spot on the list of healthiest states for seniors to live, followed by Vermont, New Hampshire, Massachusetts and Iowa. Bringing up the rear, Mississippi was found to be the unhealthiest state for older adults, with Oklahoma, Louisiana, West Virginia and Arkansas following, in that order. The report is meant to become a benchmark against which to evaluate future efforts to improve the health of the nation's fastest growing demographic group -- adults 65 and older." (Kaiser Health News)

Hospitals Thinking Beyond 30-Day Readmissions
"When asked why their efforts to prevent 30-day readmissions focus only on patients with heart failure, pneumonia, or heart attack, many hospital leaders shrug: because those readmissions are the only ones for which hospitals suffer a stiff reimbursement penalty. While many hospitals intend to target all-cause readmissions eventually, for now, it represents a steep front-end expense their budgets are not yet ready to absorb in a fee-for-service world, especially for readmissions that are not yet at risk for penalties." (HealthLeaders Media)

Obama to Hit the Campaign Trail for Health Law
"When Obama delivered the commencement address at Morehouse College this month, his advice to the graduates -- along with working hard and helping others -- was to sign up for health insurance this fall.... 'It is an on-the-ground effort,' [says David Simas, deputy senior adviser to the president].... 'But [it's] all leading to the same thing, which is that man or woman sitting in their living room online, comparing different prices for different products and deciding what works best for them.'" (Kaiser Health News)

A Second Chance at Insuring the Masses
"Years ago, Peter V. Lee presided over a failed effort to help California small businesses buy health insurance by pooling their purchasing power. Now he is getting another shot at expanding health-care access as executive director of Covered California, the largest state exchange spawned by the 2010 federal health-care law.... The state-run program is so big that the federal government would have a hard time stepping in if it falters at the outset, which could hurt the timely roll out of the law, exchange consultants said." (The Wall Street Journal; subscription may be required)

Medicare Spending Variations Mostly Due to Health Differences
"The idea that uneven Medicare health care spending around the country is due to wasteful practices and overtreatment -- a concept that influenced the federal health law -- takes another hit in a [new] study ... The paper concludes that health differences around the country explain between 75 percent and 85 percent of the cost variations. 'People really are sicker in some parts of the country,' said Dr. Patrick Romano, one of the authors." (Kaiser Health News)

Good News on Innovation and Health Care
"After implementing policies to incentivize better care coordination after a hospital discharge, the 30-day, all-cause readmission rate is estimated to have dropped during 2012 to a low of 18 percent in October, after averaging 19 percent for the previous five years. This downward trend translates to about 70,000 fewer admissions in 2012. Insurance companies are also now required to publicly justify their actions if they want to raise rates by 10% or more. Since the passage of the [ACA], the proportion of requests for double-digit rate increases fell from 75 percent in 2010 to 14 percent so far in 2013." (HHS Secretary Kathleen Sebelius)

Top 10 Causes of Disability Leave
"While you might not be able to have much influence over maternity or pregnancy complications, you can certainly help prevent some of the issues on these lists, which can lead to insurance savings.... Here are three steps you can take to spark injury and illness prevention among employees: 1. Promote physical well-being.... 2. Reduce stress.... 3. Improve safety." (HR Benefits Alert)

Obamacare Has Cost the IRS $881 Million Since 2010
"Among other areas, the IRS devoted: $2.1 million and 13 full-time employees to implement the tax increases on drug manufacturers and health insurers, $12 million and 150 full-time employees to 'customer service support,' $405.2 million and 700 full-time employees to creating the infrastructure to support the exchanges and the individual mandate tax, and $20.8 million and 161 full-time employees to 'promot[e] compliance with other new provisions.'" (The Heritage Foundation)

Illustrating Potential Efficiency Gains from Using Cost-Effectiveness Evidence to Reallocate Medicare Expenses
"Based on a review of published studies, [researchers] determined the cost-effectiveness of 36 treatments considered by CMS from 1999 through 2007. The analysis found that: Increasing investment in cost-saving and health-increasing interventions resulted in 270,000 additional quality-adjusted life years (QALYs) and savings of $12.9 billion. Reallocating expenditures to include a broader set of interventions yielded an additional 1.8 million QALYs. After reallocation, a greater proportion of resources went to oncology, diagnostic imaging/tests, and the most prevalent diseases. Fewer resources went to cardiology, to drugs or surgeries (as opposed to preventive services), and to treatments for the least prevalent diseases." (The Commonwealth Fund)

Planning for Health Care Reform: How Income Impacts Employee Health Benefits Participation
"[E]mployees earning $22,340 or more per annum (200% of the [Federal Poverty Level ('FPL')] for a single wage earner in 2012) would likely obtain better coverage at lower cost through their employer's group health plan.... Affordability of coverage will likely remain an issue for employees with incomes in the 200-400% FPL range, regardless of source of coverage." (ADP Research Institute; free registration required to download full report)


Obamacare's Original Sin
"Over time, the portions of Obamacare that encourage employer provision of health care are likely to be vulnerable. Employers hate the mandate, and argue (correctly) that it discourages job creation. Republicans want to repeal it. And Democrats may not remain totally averse to weakening it, since doing so would move more Americans into portable, government-subsidized coverage -- that is, one step closer to the liberal single-payer vision." (Bloomberg)


Mandatory Purchase of Health Insurance in 2014: An Episode of Mad Men
"Put yourself in the shoes of a healthy, young American without employer-sponsored health care. What message would convince you to buy something expensive from the federal government that you can't see and might not ever use? Even Donald Draper couldn't write an ad for this." (HighRoads)


End Drug Company Price Setting
"If Congress wants to contain long-term Medicare spending and keep health care affordable in America, lawmakers should start with the low-hanging fruit: the excessive prices Medicare and our citizens pay for drugs. Medicare easily pays between 150 and 300 percent of the average cost of prescription drugs in the other wealthy nations." (Diane Archer in Health Affairs)


The New Health Insurance Exchange Plans -- Comparing Apples to Oranges to Grapefruit
"Are people going to get more coverage for their money? Yes. Do they want more coverage if the premium costs for those plans is a lot higher? Likely yes if taxpayers are paying for most of it. If not, clearly they didn't want to pay for it before. Come January, lots of California consumers in the small group and individual market are going to get a letter from their existing insurer telling them their current plan is no longer available and the cost of the new required plans will be a lot more. Simply, the new law is taking plan design choices away instead of letting the consumer decide what is good for them." (Health Care Policy and Marketplace Review)


The IRS Has an Unwelcome Role in Obamacare: A Regulatory Power Grab
"[T]he statute makes no mention of the IRS providing credits and subsidies through federal exchanges. Without subsidies, employers and some individuals in those states would be exempt from mandates. Obamacare would be unworkable in over half the country.... So: The IRS seized the authority to spend about $800 billion over 10 years on benefits that were not authorized by Congress." (Michael Gerson in The Washington Post)

Benefits in General; Executive Compensation

IRS Makes Employee Classification More Confusing
"If you're still unclear on a worker's designation after a thorough analysis of all of his or her jobs, one question may help shed some light on the subject: Could the circumstances of the individual's work lend itself to an employee-employer relationship at all? Basically, this question forces you to look at whether any single aspect of the person's work arrangement could disqualify him or her as an [Independent Contractor]." (HR Benefits Alert)

2013 Proxy Vote Outcomes, Year to Date (PDF)
"Thus far, of the 806 Russell 3000 companies that have reported vote results on [management Say on Pay ('MSOP')] proposals, only 17 companies have failed to receive majority support.... Of the Russell 3000 companies that have reported vote results on their MSOP proposals, nearly 80% of these companies have received at least 90% shareholder support, while approximately 4.6 % of these companies received shareholder support ranging from 50% to 70%[.]" (Meridian Compensation Partners, LLC)

Press Releases

CalPERS Considers Fund Lineup Changes to Supplemental Income Plans
CalPERS (California Public Employees' Retirement System)

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