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June 4, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Pension Administrator
for AFC Pensions, Inc. in MA

Plan Design Specialist
for American National Insurance Company in TX

Retirement Plan Project Manager
for Defined Benefit Plan Team Leader in DC

Conversions Consultant
for JPMorgan in KS

ERISA Paralegal
for Kaufman and Canoles, P.C. in VA

Relationship Manager
for Verisight, Inc. in CA

Director of Exchange Partnerships
for Prudential in NJ

Director of Group Benefit Strategic Partnerships & Voluntary Initiatives
for Prudential in NJ

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Webcasts and Conferences

Northeast Area Benefits Conference - Boston
July 8, 2013 in MA
(American Society of Pension Professionals & Actuaries (ASPPA))

Northeast Area Benefits Conference - New York City
July 9, 2013 in NY
(American Society of Pension Professionals & Actuaries (ASPPA))

ERIC FocusOn Conference Call on the Impact of the DOMA Decision on Benefit Plans
June 28, 2013 WEBCAST
(ERIC (ERISA Industry Committee))

ERIC FocusOn Call: the ACA Challenges of Collectively Bargained Plans
June 18, 2013 WEBCAST
(ERIC (ERISA Industry Committee))

What's the News in the 2013 Social Security Trustees Report? Archived Webcast
June 18, 2013 WEBCAST
(National Academy of Social Insurance)

Defending and Managing Employment Discrimination
July 31, 2013 in NY
(American Conference Institute)

2013 National Conference
September 9, 2013 in AZ
(Plan Sponsor Council of America (PSCA))

View All Webcasts and Conferences


[Guidance Overview]

OSHA to Police Whistleblower Claims under the Affordable Care Act
"Employers with an employee population that might be eligible for tax credits or subsidies on the Exchange, and who are planning to not offer affordable health insurance of a minimum value next year, should ensure that employees who get such tax credits face no retaliation. Employers who are considering providing a small financial incentive to such employees to not apply for assistance on the Exchange should re-think such plans, as doing so may be considered retaliation under the terms of OSHA's interim final rule[.]" (Epstein Becker Green)


Self-Auditing Your Employee Benefits - June 12, 2013

Sponsored by Lorman and BenefitsLink

This live audio conference gives you a legal and a practical perspective for each type of benefit plan. Helps you identify and prioritize so you can focus your time and resources on the important areas. Registration discount for BenefitsLink readers.

[Guidance Overview]

The Final (and Not Interim Final) Regulations on Wellness Programs
"Although the evidence on the effectiveness of wellness programs was, in some previous studies, found to be promising, it was not conclusive and may not be supported by the RAND survey.... Nonetheless, employers generally seemed satisfied with their wellness programs, even those who did not know their programs' return in investment.... [T]he remaining question is whether the new 30% total cost threshold under the recently issued final regulations (or even the 20% threshold under the prior 2006 regulations) will pass muster with the EEOC." (Benefits Bryan Cave)

[Guidance Overview]

Finally, Final Wellness Regulations
"The new rules subdivide health-contingent wellness plans into 'activity-only' and 'outcome-based' wellness programs and explain how the five requirements apply to each type.... [S]ample language [for the required notice to employees] is provided, which differs from the proposed rules in that it indicates that the plan will work with the individual's doctor ... Health-contingent wellness programs are not considered to be uniformly available to all similarly situated individuals unless reasonable alternative standards are made available as described in the following chart." (Seyfarth Shaw LLP)

[Guidance Overview]

Managing the ACA Onslaught: Top 10 Employer Tasks for 2013
14 pages. Excerpt: "[1] Decide whether to 'play' ... or 'pay' employer shared-responsibility penalties. [2] If playing, analyze the affordability and minimum value of coverage and determine whether, when, and how to start counting hours. If paying, establish how full-time employees will be identified for shared-responsibility reporting and penalty assessment. [3] Understand the public exchanges -- how they will affect the employer's particular workforce and plan design and how to best interact with the exchanges. [4] Review plan terms for 2014 compliance (considering 2014 mandates and current plans that may no longer be permitted), and implement required plan design changes." (Mercer Select)

District of Columbia Council to Consider Moving All Insurance for Individuals, Small Businesses to Exchange
"The bill being considered Tuesday would require that all health insurance for individuals and small businesses be purchased through the exchange by 2015, essentially closing the city's insurance market." (The Washington Post)


Executive Forum on Employee Health & Wellness Clinics -July 24-26, Chicago, IL

Sponsored by World Congress

Join the industry experts and thought leaders for the leading event strictly dedicated to improving the health, productivity, and engagement of employees through the on-site health and wellness clinic! Save $300 with promo code BLINK3.

Evidence Shows Provider Consolidation Leads to Higher Health Costs for Consumers and Employers
"As health care costs continue to rise, there is a substantial body of evidence demonstrating that provider consolidation gives hospitals greater negotiating strength and limits competition, resulting in higher prices for services, higher costs for patients, and no improvement in the quality of care delivered.... Experience in the marketplace demonstrates that consolidation among providers is not necessary to reform the payment and delivery system to better reward value, quality, and health outcomes." (America's Health Insurance Plans)

Workplace Wellness Programs Study: Case Studies Summary Report (PDF)
"This report describes findings from four case studies of existing workplace wellness programs in a diverse set of employers. The authors describe characteristics of wellness programs, use of financial incentive and engagement strategies, facilitators and challenges to success, and impact of programs. Case studies were based on data collected through semi-structured interviews with organizational leaders, focus groups with employees, review of program materials, and direct observation." (RAND Corporation, for the Employee Benefits Security Administration and the Department of Health and Human Services)

Five Myths About Group Voluntary Products
"[W]hile more and more brokers have come to know voluntary benefits, group products tend to get the lion's share of attention. That's because group products are easy to understand, easy to implement and more familiar to brokers. But that doesn't mean they're always the best option." (Colonial Life, in Health Insurance Underwriter)

Newsletter from National Business Group on Health, June 2013
Articles include: [1] Final Wellness Program Rules; [2] Health Care's Service Fanatics; [3] AAFP, Others Urge Hospitals to Stop Early Elective Deliveries; [4] Employees Opening Health Savings Accounts in Record Numbers; [5] Wal-Mart's Super Counterintuitive Health Care Plan; and [6] Designing Benefits That Fit the Need. (National Business Group on Health)

Our Continuing Healthcare Crisis: The Obamacare Scorecard
"As major provisions in the [ACA] are rolled out, we'll need a way to track its effectiveness -- a scorecard for 'Obamacare' ... What's the best way to do that? The U.S. lags behind the rest of the developed world by virtually any reasonable measure, including rates of illness, mortality, life expectancy, overall cost, access to care, overall economic impact, and the household cost of care. Here are some initial forecasts, using reports and statistical databases from the Organization for Economic Co-Operation and Development as a baseline[.]" (Campaign for America's Future)

Getting Paid by Your Employer to Be Healthy Works -- Except When It Doesn't
"In one study, ... General Electric [developed] financial incentives to get employees to quit smoking. The smokers in the incentive group were three times more likely to join a smoking-cessation program, and three times more likely to quit smoking than those who were not offered financial rewards. But when GE rolled these financial incentives to quit smoking to the rest of their workforce, employees complained about rewarding smokers to do something they should be doing anyway. From their perspective, GE turned the program into a penalty rather than reward program." (Quartz)

Private Online Health Insurance Exchange Data Falls Short Against Government Finders
"For Medicare Advantage, private exchanges displayed an average of 35% (31 out of 88) of the available carriers on the CMS site. The percentage of MA plans shown to the consumer by the private exchanges averaged 41% (92.5 out of 228). For Medicare PDP, private exchange carriers presented 43% (47 out of 110) of the Medicare Plan D plans on the CMS site. The percentage of CMS plans shown to the consumer by the private exchanges averaged 49% (105.5 out of 215) for the Medicare Plan D plans." (HealthPocket)

Insurers Can Offer One Choice of SHOP Coverage in 2015
"Delaying that requirement until 2015 would provide stability to the small-group insurance market as insurers gain their footing in SHOP marketplace, HHS said in the rule. Employers with plan years starting before Jan. 1, 2015 may have just one choice of coverage (per insurer), but starting Jan. 1, 2015, insurers will have to start offering all four coverage options on the SHOP." (Thompson SmartHR Manager)

U.S. Supreme Court Decision: Virginia State Law Cannot Override Federal Employee's Life Insurance Beneficiary Designation (PDF)
"Excerpt: "The Federal Employees' Group Life Insurance Act of 1954 (FEGLIA) establishes an insurance program for federal employees. FEGLIA permits an employee to name a beneficiary of life insurance proceeds, and specifies an 'order of precedence' providing that an employee's death benefits accrue first to that beneficiary ahead of other potential recipients.... A Virginia statute ['Section A'] revokes a beneficiary designation in any contract that provides a death benefit to a former spouse where there has been a change in the decedent's marital status.... In the event that this provision is pre-empted by federal law, a separate provision of Virginia law, Section D, provides a cause of action rendering the former spouse liable for the principal amount of the proceeds to the party who would have received them were Section A not pre-empted.... Held: Section D of the Virginia statute is pre-empted by FEGLIA." [Hillman v. Maretta, No 11-1221 (U.S. June 3, 2013)] (Supreme Court of the United States)

Supreme Court Says States Can't Override Federal Employees' Life Insurance Designations
"The decision does not break new ground. The Court applied settled rules of statutory construction and conflict preemption to hold that when state laws conflict with Congress's purposes and objectives, the Supremacy Clause does not permit those laws to stand. The ideological diversity of seven Justices joining the main opinion, and the speed with which the Court delivered the result, further signals that the case was a relatively easy one. Nevertheless, three Justices took the opportunity to express disagreement with the Court's approach." [Hillman v. Maretta, No 11-1221 (U.S. June 3, 2013)] (SCOTUSblog)

Money Damages Not Permitted Under ERISA Section 502(a)(3)
"The [District Court of South Dakota's] ruling seems to underscore that future district court decisions considering money damages under section 502(a)(3) will be fact-oriented, and as the facts become more egregious, the possibility of money damage awards will likely improve." (Epstein Becker Green)

Consumer-Directed Health Plans Reduce the Long-Term Use of Outpatient Physician Visits and Prescription Drugs
"After four years under the CDHP, there were 0.26 fewer physician office visits per enrollee per year and 0.85 fewer prescriptions filled, but there were 0.018 more emergency department visits. Also, the likelihood of receiving recommended cancer screenings was lower under the CDHP after one year and, even after recovering somewhat, still lower than baseline at the study ' s conclusion. If CDHPs succeed in getting people to make more cost-sensitive decisions, plan sponsors will have to design plans to incentivize primary care and prevention and educate members about what the plan cover" (Health Affairs)

Colonoscopies Explain Why U.S. Leads the World in Health Expenditures
"Americans pay more for almost every interaction with the medical system. They are typically prescribed more expensive procedures and tests than people in other countries, no matter if those nations operate a private or national health system. A list of drug, scan and procedure prices compiled by the International Federation of Health Plans, a global network of health insurers, found that the United States came out the most costly in all 21 categories -- and often by a huge margin." (The New York Times; subscription may be required)

Judge Ends 33-Year Injunction That Shielded Medicare Data on Doctors
"The injunction had been in place since 1979, when a federal court in Florida sided with the American Medical Association's contention that doctors' right to privacy trumped the public's interest in knowing how tax dollars were spent. In a ruling issued Friday, U.S. District Judge Marcia Morales Howard said this was no longer the case, citing case law that had narrowed the scope of the Privacy Act over the ensuing three decades and no longer supported such a broad injunction." (The Wall Street Journal; subscription may be required)

Ten Insurers File for New Florida Health Exchange
"Ten Florida health insurers have filed documents indicating they want to compete for shoppers on the [ACA] marketplace when it opens Oct. 1, state records indicate. However, it is not clear whether all of them will follow through or receive federal approval. The list has not been released by the Florida Office of Insurance Regulation (OIR) nor the U.S. Department of Health and Human Services." (Health News Florida)

Medical Debt: A Curable Affliction Health Reform Won't Fix
"Why are so many middle-class, privately insured Americans swamped by medical costs? The reason is that private coverage has holes -- unaffordable deductibles and copayments, as well as brief or nonexistent coverage of medical services like physical therapy. Moreover, since illness often reduces work-related income, families may experience a double whammy, as medical bills arrive just when the paychecks stop." (Physicians for a National Health Program)

Eight Questions Employers Must Help Employees Answer in Health Exchange Applications
"The 12-page edition of the Application for Health Coverage & Help Paying Costs requires employers to provide information to employees for the section marked 'Employer Coverage Tool'.... There are eight main questions you'll want to prepare to help employees answer ... Only states that opted to have the federal government run their exchanges are currently required to use these forms. The other states may choose whether or not to adopt them." (HR Benefits Alert)


Obamacare Is Raising Insurance Costs
"Although the premiums [in California and Oregon] are lower than some anticipated, this has been achieved by designing the plans around much more limited provider networks and including greater cost-sharing than the typical commercial health-insurance plan. The premiums for the policies that will be offered on the states' exchanges are much higher than analogous plans being sold today." (Daniel Kessler in The Wall Street Journal; subscription may be required)


Deloitte Health Care Reform Memo, June 3, 2013
"[The Patient-Centered Outcomes Research Institute (PCORI)] 21-member board began work in September 2010 and has, for the most part, stayed below the radar while pursuing its enormous responsibility. A central focus of PCORI is evidence-based medicine (EBM): 'the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.' In essence, EBM uses a set of analytic tools to assess the strength of the evidence of risks and benefits of treatments (including lack of treatment) and diagnostic tests so clinicians and patients can predict whether a treatment will do more good than harm." (Deloitte)


Why Do U.S. Colonoscopies Cost So Much?
"So why are colonoscopy charges ten times higher than they were ten years ago? And why are my own costs for going through the process also about ten times higher (considering the number of hours of lost time in the office, travel, hotel, etc.)? It's not because of anything physicians have done. It's because of regulatory changes that prevent small practices from practicing and that reward the higher overhead facilities (medical centers) for, frankly, having higher costs." (John Goodman's Health Policy Blog)


The Six Ways Obamacare Changes Insurance Premiums
"A trillion dollars is a lot of money. Those subsidies are the gamechanger in this market. Absent them -- and arguably absent the individual mandate -- these rules would simply shift costs around. They would help older and sicker applicants at the expense of younger and healthier ones, and if they drove younger and healthier folks out of the insurance market, they'd hurt everybody. But a trillion dollars in subsidies helps a lot of people buy insurance. And most of those people are, surprisingly, young and healthy." (The Washington Post)


Brilliant Mistakes: What Really Has an Effect on Employee Health?
"[If] HR executives invested more time in the classic principles of good HR leadership, companies could potentially have a greater impact on employee health and productivity than they could implementing any wellness program." (Human Resource Executive Online)

Benefits in General; Executive Compensation

The Future of Domestic Partner Health Benefits
"[If] DOMA is repealed, ... [same-gender] couples will have the opportunity to avoid federal taxation of their benefits by marrying. That could lead employers to conclude that the special category of domestic partner coverage is no longer needed. On the other hand, employers also need to consider the impact of state law. If the Supreme Court strikes DOMA, that does not mean that state laws necessarily would change (it will depend on the rationale of the Court's decision). So if a state law prohibiting [same-gender] marriage stands, an employer that otherwise provided domestic partner coverage may keep that category of coverage in place in order to handle the case of employees living in states where only opposite-sex marriage is legal." (Proskauer's ERISA Practice Center Blog)

Round Two of Shareholder Say-on-Pay Litigation
"Unlike the first round of say-on-pay lawsuits, which were based on negative advisory votes that had already occurred, this second wave of shareholder litigation, which began in 2012, seeks to enjoin advisory votes on executive compensation based on allegedly deficient proxy disclosures. Some cases seek also to enjoin binding shareholder votes on proposals to issue additional shares of stock for equity incentive plans. Because these lawyer-driven suits do not allege an actual violation of a disclosure statute or rule, every public company with a shareholder vote scheduled for the second half of 2013 is a potential target." (Pepper Hamilton LLP)

Executive Compensation Litigation: Nightmare or Nuisance
"[I]s it the latest fad in an ongoing series of quick-hit, nuisance-level efforts by plaintiffs' lawyers to replace the income they have lost in the recent decline of more traditional securities class action litigation? Broadly speaking, it seems reasonable to predict that consistently more robust and thorough corporate processes and proxy statement disclosures relating to executive compensation will lead to a decline in cases that don't present what courts are likely to interpret as some supposedly aggravating factor." (William Gallagher Associates)

Smaller Companies Seeing More Say-on-Pay Failures
"[A]verage shareholder support at the first 1,351 Russell 3000 companies reporting their voting results in 2013 is up to 90% from 89% overall in 2012, while the say-on-pay failure rate edged down from 3% to 2%. Meanwhile, the percentage of Russell 3000 companies receiving negative Institutional Shareholder Services (ISS) voting recommendations dipped to 11% from 13% last year." (Towers Watson)

2013 Say on Pay Voting Results as of June 3, 2013
"2,034 companies have held Say on Pay votes in 2013; 37 companies have failed with an average 59% 'Against' vote ... 72% of companies have received a greater than 90% 'For' vote." (Steven Hall & Partners)

Press Releases

Robert E. Rice Named as Chief Counsel to SEC Chair
Securities and Exchange Commission

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