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June 18, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Benefits Compliance Manager
for Employee Benefits Professional Services Firm in GA

Client Relationship Consultant
for Gallagher Retirement Services in NJ

Client Service Representative
for Benetrends, Inc. in PA

Associate Pension Administrator
for Alliance Pension Consultants, LLC in IL

Pension Administrator
for Alliance Pension Consultants, LLC in IL

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Webcasts and Conferences


[Guidance Overview]

Employers Must Issue Employee Notices of Health Care Exchanges by October 1, 2013 (PDF)
"The DOL has provided model language for two situations; employers with no health plan and employers with a plan. The first case will be quite simple using the DOL model language.... The second case of an employer with a health plan requires information about who is covered, dependent coverage, wellness provisions (with the premium rate impact of tobacco use), and premium rates for the 2014 year. The employer is also required to state whether or not the lowest cost health plan offered meets the 'minimum value standard'. This could be a very involved determination." (Dean Actuaries, LLC)


Achieve a New Level of Professional Growth With CEBS!

Sponsored by IFEBP (International Foundation of Employee Benefit Plans)

As the most respected designation in the industry, Certified Employee Benefit Specialist (CEBS) courses give you the knowledge and confidence to succeed in today's business environment. Learn More!

[Guidance Overview]

90-Day Waiting Period and the Measuring Period Safe Harbor for New Hires (PDF)
"IRS Notice 2011-26 proposed the method for ascertaining the status of ongoing employees.... IRS Notice 2012-17 proposed the method for ascertaining the status of new employees.... IRS Notice 2012-17 states that ... if a new employee was reasonably expected to be employed an average of 30 hours of service per week on an annual basis and was employed full- time during the first three months of employment, the employer's group health plan would be required to offer the employee coverage as of the end of that period ... IRS Notice 2012-58 states that, for new employees who are reasonably expected to be full-time employees, an employer that maintains a group health plan that meets certain requirements will not be subject to an assessable payment under section 4980H for failing to offer coverage to the employee for the initial three months of employment." (Chao & Company, Ltd.)

[Guidance Overview]

HIPAA Final Omnibus Rule Contains New Requirements for Business Associate Agreements
"The Final Rule slightly modified some of the requirements surrounding BAAs, added some new required statements regarding delegated duties and removed some requirements relating to notifications to HHS in certain circumstances. While these modifications, additions and subtractions may not result in substantial modifications, they will likely require some changes to existing BAAs. In addition, the HHS Office for Civil Rights has issued a new sample BAA, which may serve as the new standard in the industry." (Leonard Street and Deinard)

[Guidance Overview]

Proposed Regulations Explain Federal Monitoring of Exchanges
"The proposed rules determine how federal government agencies will oversee the integrity of state, federal and mixed health insurance exchanges, premium stabilization programs under health reform. The rules include (1) oversight and financial integrity standards; (2) proposals on insurer participation in individual exchanges and small business health option programs; (3) new standards on guaranteed availability and renewability, among other things[.]" (Thompson SmartHR Manager)

Will Small Employers Self-Insure After Jan. 1, 2014?
"Recent RAND work provides estimates of the proportion of small firms that will self-insure after implementation of the ACA. These simulations suggest that a critical factor affecting self-insurance decisions will be the pricing and availability of stop-loss coverage, a type of reinsurance for self-insured firms. One common type of stop-loss policy reimburses the self-insured firm if an enrollee's health care claims exceed a specific dollar value, called the attachment point. An attachment point of $10,000 per enrollee is considered generous." (RAND Corporation)


Defined Contribution Healthcare & Private Exchanges Summit

Sponsored by Healthcare Education Associates

Join us for this exceptional opportunity to share ideas and network with leaders from 4 and 5-star plans, quality consultants and healthcare executives – July 29-30 in Westlake Village, CA. Mention HMP164 for 10% discount.

2014 Health Care and Medical Cost Trends
"[M]edical inflation in 2014 will dip even lower than in 2013.... Care continues to move outside costly settings such as hospitals to more affordable retail clinics and mobile health.... Major employers such as Walmart, Boeing, and Lowe's now contract directly with big-name health systems for costly, complicated procedures ... Seventeen percent of employers ... offer a high deductible health plan as the only option for employees.... [T]he rise of expensive complex biologics will nudge spending trends upward.... [H]ospital mergers can lead to price increases of up to 20.3%." (PricewaterhouseCoopers)

2013 National Health Insurer Report Card (PDF)
"The American Medical Association's (AMA) National Health Insurer Report Card (NHIRC) provides physicians and the general public a reliable and defensible source of critical metrics concerning the timeliness, transparency and accuracy of claims processing by health insurance companies." [Charts include: Payment Timeliness, Cash Flow, Accuracy, Claim Edit Sources and Frequency, Denials, and Improvement of Claims Cycle Workflow.] (American Medical Association)

ACA Bringing Opportunities for Tax and Accounting Firms
"Without question, tax professionals and tax form preparers are among the most important cogs in the Obamacare machine. That is because the IRS, rocked by political scandals in recent months, is central to implementing the health care reform system." (Kaiser Health News)

Wide Variation in ACA's Consumer Assistance Programs
"Depending on where people live and the type of coverage they have, the assistance that's available and where to find it may vary considerably. Health policy experts and consumer advocates 'are concerned about consumers falling through the cracks and not having clear information about where to go for what' ... It wasn't supposed to be this way." (The Washington Post)

Feds Want Broad Payment Options for Obamacare Customers
"The government's decision to mandate a menu of payment options including cashier's checks, money orders and re-loadable pre-paid debit cards comes amid increasing pressure from consumer advocates and business groups that are concerned low-income working families would be required to purchase health coverage under the Affordable Care Act but would have no way to pay their monthly bill." (Kaiser Health News)

ML Strategies Health Care Reform Update, June 17, 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)

Large Employers Add CDHPs at Record Pace in 2012 (PDF)
"Among large employers -- those with 500 or more employees -- offerings of [consumer-directed health plans (CDHPs)] rose from 32 percent in 2011 to 36 percent in 2012. Small employers (those with 10-499 employees) are somewhat less likely to offer a CDHP (22 percent), but they are also more likely to offer a CDHP as the only medical plan option. CDHPs are offered by 59 percent of the nation's largest employers -- those with 20,000 or more employees. CDHPs are most popular in the Midwest, where they enrolled 19 percent of all covered employees. While CDHP enrollment is lowest in the West, it rose from 10 percent in 2011 to 12 percent in 2012." (American Association of Preferred Provider Organizations)

Los Angeles Leads Nation in Medicare Spending on End-Of-Life Care: $112,000
"Spending in the last two years of life was about $112,000 per patient in Los Angeles as of 2010, about 60% higher than the national average ... From 2007 to 2010, Medicare spending on end-of-life care rose 15% nationwide." (Los Angeles Times)

Consumers in State Insurance Exchanges Will See Increased Competition Among Health Plans
"Across the 10 states, the number of carriers offering nongroup insurance plans will increase substantially, from 52 to 70 plans -- an increase of 35 percent. Six of the 10 states will see more insurers operating on the nongroup exchange compared to the number of significant competitors pre-reform. Four states expect no change." (Robert Wood Johnson Foundation)

Impact of National Health Reform and State-Based Exchanges on the Level of Competition in the Nongroup Market
"The report compares the number of insurers offering plans prior to national health reform with insurers applying to operate in state exchanges, and finds that the number of carriers offering non-group insurance plans will increase substantially, from 52 to 70 -- an increase of 35 percent. Six of the 10 states will see more insurers operating on the non-group exchange compared to the number of significant competitors pre-reform. Four states expect no change." (Robert Wood Johnson Foundation)

Expert Points to Impending ACA Changes That Employers Should Consider
"Thirty-three percent of [employers responding to a survey] do not think that the [ACA] will increase health care costs at all ... The survey also found that: 29 percent expected the ACA to increase health care costs only by 1 percent to 2 percent; 16 percent expected it to increase costs by 3 percent to 4 percent; ... [and just] 7 percent expected an increase of more than 10 percent.... Respondents' apparent failure to predict possible cost increases should not be entirely surprising, in light of ... 2013 survey results revealing that a full 64 percent of respondents had not completed a formal analysis of the cost impact of the ACA." (Wolters Kluwer Law & Business)

Obamacare Will Share Personal Health Info with Federal, State Agencies
"Personal health information, or PHI, is highly protected under federal law, but the latest ruling from the Department of Health and Human Services allows agencies to trade the information to verify that Obamacare applicants are getting the minimum amount of health insurance coverage they need from the health 'exchanges.' The ruling, explained on pages 72-73 of the book-thick guidance, does not mention any requirement that applicants first OK the release of their PHI." (Committee on Ways and Means, U.S. House of Representatives)


Deloitte Health Care Reform Memo, June 17, 2013
"The fervor about risk sharing and accountable care is not new: we've been there before.... But in wave two, 'accountable care' will be different for four reasons: Economic realities ... The regulatory framework ... Big data about quality and costs ... Transparency:" (Deloitte)


What Obama's Campaign Group Won't Tell You About Obamacare
"Obamacare forces insurers to cover preventive services without a co-payment, but just because some services now don't have a co-payment doesn't mean they're 'free.' Mandates like the one surrounding preventive care are raising health insurance premiums.... While candidate Obama promised that premiums would go down by $2,500 by the end of his first term, the average employer premium has actually gone up by $3,065 -- from $12,680 in 2008 to $15,745 in 2012[.]" (The Heritage Foundation)

Benefits in General; Executive Compensation

Reinhart Employee Benefits Update, June 2013 (PDF)
Articles include: [DOL] Issues Advance Notice of Proposed Rulemaking on Illustration of Lifetime Benefits; DOL Issues Proposed Amendment to Prohibited Transaction Class Exemption (PTE) 80-2; Seventh Circuit Reaffirms Position in "Stock Drop" Laws; and DOL Issues Model Exchange Notices. (Reinhart Boerner Van Deuren s.c.)

Supreme Court Denies Certiorari in Appeal of Disallowed Insurance Deductions
"The U.S. Supreme Court denied certiorari June 17 to two automobile dealership owners who sought review of a Court of Appeals decision disallowing business expense deductions for contributions to a 'Benistar 419 Plan' that the two men used to acquire life insurance policies on each other so that if one died, the other could buy out the deceased partner's share in the business[.]" [Curcio v. Commissioner, No. 12-1085 (U.S., cert. denied June 17, 2013)] (Bloomberg BNA)

Restricted Stock: Maximizing the Value and Asking the Right Questions
"Most executives do not have a choice in the type of restricted stock they receive. In the more likely scenario where a choice or blend of restricted stock and stock options may be offered, there are three issues to consider: [1] When do you need the money? ... [2] How volatile is the company's stock price? ... [3] How optimistic are you about your company?" (SFG Wealth Planning Services, Inc.)

Press Releases

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