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June 5, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Defined Contribution Plan Administrator
for Pension Consulting Firm in CA

Manager - Underwriting & Funding Implementation
for Mullin TBG - A Prudential Company in CA

Senior Director - Client Relationship Manager
for Mullin TBG - A Prudential Company in CA

Retirement - Executive Assistant
for Mullin TBG - A Prudential Company in FL

Data Conversion Specialist
for Transamerica Retirement Solutions in NY

Trading & Corrections Associate
for Aspire Financial Services in CO

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Webcasts and Conferences


 

[Guidance Overview]

Agencies Issue Final HIPAA Wellness Program Rules under ACA
"[This 9-page memorandum] sets out a step-by-step approach for group health plans to evaluate their wellness programs under the new final HIPAA wellness regulations." (Groom Law Group)


[Advert.]

ECFC Offers Essentials on Thriving in a Post-ACA Environment

Sponsored by ECFC (Employer's Council on Flexible Compensation)

Innovative compliance leaders and benefits attorneys lead this 3-day program focused on the needs of professionals in the flexible compensation industry. Learn more at www.ecfc.org/conferences, register by June 19, to receive early bird rate. July 31-August 2, St. Louis.


[Guidance Overview]

New Wellness Regs May Cause Headaches (PDF)
"[O]utcome-based programs must allow individuals to follow the recommendations of a personal physician as a second reasonable alternative standard, even if the individual has no medical reason for not being able to comply with the program's standard.... This deference to an individual's personal physician's recommendation, with no ability on the part of the plan or policy, or its own medical professionals, to determine whether the recommendation is reasonable or not, could present challenges in operation." (PricewaterhouseCoopers)

Advocacy Group Says ACA Requires Federally-Funded Employers to Provide Pregnancy Coverage for Dependents
"The complaints appear to be among the first instances in which a group is using specific provisions of the federal health-care law to challenge the design of an insurance policy. The complaints are rooted in a health-law provision requiring employers to allow workers to keep dependents up to 26 years old on their coverage plans.... [T]he National Women's Law Center contends that excluding maternity coverage for employees' daughters violates a provision of the law barring sex discrimination in health-care programs that receive federal funds." (The Wall Street Journal; subscription may be required)

Blue Shield, Anthem Owe Small Employers in California Millions of Dollars in Rebates
"Blue Shield of California owes $24.5 million in [Medical Loss Ratio] rebates to thousands of small-business customers, and rival Anthem Blue Cross will return $12 million to small firms under requirements of the federal healthcare law. The annual rebates were disclosed in reports to state regulators, and the final tally from some companies may change before they are paid out by Aug. 1." (Los Angeles Times)

ML Strategies Health Care Reform Update, June 3, 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)

The Effect of Imposing a Cap on Tax Exclusion of Employer-Sponsored Health Insurance Premiums
"As lawmakers attempt to balance the budget, some have begun to consider the idea of lifting or modifying the exclusion of employer-sponsored health insurance premiums and medical benefits from taxable income, while others remain adamantly opposed. The Urban Institute, with funding from the Robert Wood Johnson Foundation, has analyzed the imposition of a cap at the 75th percentile and determined that it would increase revenue, while leaving the vast majority of current tax subsidies in place and having a limited impact on those at lower-income levels. The cap would build on the modest limitation already put in place by the ACA." (Wolters Kluwer Law & Business)

Maryland Attorney General Tells Maryland Insurance Regulators: 'Freeze the Rates'
"With evidence indicating that President Obama's healthcare reform is beginning to bend the healthcare cost curve in favor of consumers, it would be irresponsible to grant massive rate hikes to CareFirst or any other healthcare insurance provider based on current information.... Major insurance companies, including CareFirst, are filing massive rate hike requests to enrich their coffers before the full impact of the [ACA] is fully known." (Attorney General of Maryland)

Achieving the Potential of Health Care Performance Measures
"This report provides an overview of performance measurement in U.S. health care, and includes policy recommendations aimed at improving the performance measurement enterprise. Specifically, they recommend how to develop better measures; when and how to use measures; and how to ensure the validity and comparability of publicly-reported performance measure data." (Urban Institute via Robert Wood Johnson Foundation)

When It's Too Late to Get FMLA: Court Draws the Line
"[I]magine you have an employee who's been taking intermittent FMLA leave in relation to a chronic medical condition. She's finally released by her doctor to come back to work with no restrictions. And on her first day back, she leaves early with no notice. Then, she submits a written resignation the next day. Do you have to at least assume the employee is entitled to additional FMLA leave before accepting her resignation? Absolutely not, according to a recent ruling by the Sixth Circuit Court of Appeals." (HR Benefits Alert)

Americans Having Less Trouble Paying Medical Bills
"[T]here were 57.8 million Americans who had trouble paying their health care bills in the first six months of 2011. That number fell by 3.6 million, hitting 54.2 million in the same span of 2012.... [F]amilies with children under 17 saw a statistically significant change in their ability to pay medical bills that did not occur among families with members between 18 and 64." (Sarah Kliff in The Washington Post)

Sebelius Says She Talked to Health Firms on Obamacare Outreach
"Sebelius vigorously defended her efforts to rally private support for a summer outreach campaign to persuade uninsured Americans to sign up for subsidized health coverage through new online state insurance marketplaces.... 'It was always recognized from the day the president signed the bill that there would never be enough government funding and that there would not be enough opportunity if this is only a government-run program,' Sebelius said[.]" (Reuters)

OIG Issues Updated Bulletin on Exclusions from Federal Health Care Programs
"[P]erhaps the most valuable piece is the straightforward instruction to providers on how they may utilize OIG's List of Excluded Individuals and Entities (LEIE) to screen not only employees, but contractors, subcontractors, volunteers and other personnel as well, who may provide services or items payable by a Federal health care program. Although using the LEIE is not required by law, LEIE is the most reliable tool available to providers to conduct effective screening." (Drinker Biddle)

Five Ways to Improve the Success of Your Voluntary Benefits Plan
"Employees who graded their company's communication tactics with an 'A' or 'B' ... consider the following methods most helpful: post-enrollment confirmation of benefits elections (58%); personalized messages and materials reflecting individual needs and/or life stages (53%); employer benefits website (53%); one-on-one meetings (49%); and online decision-support tools, such as calculators, FAQS, etc. (48%)." (HR Benefits Alert)

Interest in Private Health Exchanges Keeps Growing
"Nearly 30 percent of employers are facilitating access to an exchange-based solution for their retirees this year, with another 36 percent planning to do so over the next three years ... Yet, when it comes to active employees, most of the NBGH's 364 member companies -- 66 of them members of the Fortune 100 -- are taking a 'wait-and-see' approach to private exchanges for now[.]" (Human Resource Executive Online)

FMLA Absences Continue to Rise
"From 2008 to 2012 ... Average length of continuous leave for health care employees jumped 27 percent to 28 days. Total FMLA time off for manufacturing companies increased by 62 percent to 26.9 days. Total FMLA time off for call center companies increased by 30 percent to 27.2 days.... Hospitality providers had the most overall FMLA absences, with 49 percent of employees with an open FMLA leave at any given time." (ComPsych)

[Opinion]

Comments by U.S. Chamber of Commerce on Proposed Rules for Health Insurance Providers Fee (PDF)
"We urge the Treasury and the IRS to follow long-standing tax policy principles to mitigate the unnecessary excess costs that improper tax treatment of the [Health Insurance Providers Fee] would impose on businesses and workers in the form of higher premiums. We also request specific clarification in the final rule that stop loss coverage is not a covered entity and therefore not subject to the fee." (U.S. Chamber of Commerce)

Benefits in General; Executive Compensation

[Official Guidance]

Text of OPM Proposed Regs on Phased Retirement for Federal Employees
"The purpose of phased retirement is to allow the Federal Government to continue to benefit from the services of experienced employees who might otherwise choose to retire. These proposed regulations inform agencies and employees about who may elect phased retirement, what benefits are provided in phased retirement, how an annuity is computed during and after phased retirement, and how employees fully retire from phased retirement." (Office of Personnel Management)

OPM Issues Guidance on How Federal Employees May Partially Retire
"All retirement-eligible employees working full time in federal service for the previous three years are eligible for phased retirement, OPM said, though the agency must consent to the arrangement. An employee 'does not have an entitlement' to partially retire.... These employees will receive half of the normal pay of the position, as well as half their normal retirement annuity.... Most other benefits -- such as health benefits, the Federal Employee Group Life Insurance benefit, survivor benefits and annuity garnishment protection -- are calculated as if the partial retiree were still a full-time employee." (Government Executive)

Assessing the Reasonableness of Physician Executive Compensation
"With reimbursement levels (and, thus, the bottom line) increasingly contingent on clinical performance, many acute care providers are beginning to employ physicians in executive positions. In many cases, these 'physician executives' choose to maintain a clinical practice -- and, at some organizations, are required by the organization to continue to practice medicine on a part-time basis. While these physician executives serve a crucial role in influencing physician behavior, they present specific challenges for tax-exempt organizations when evaluating the reasonableness of their pay." (Towers Watson)

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David Rhett Baker, J.D., Editor and Publisher
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