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

PT Benefit Enroller Specialist - English and/or Bilingual
for Total Benefit Concepts in ANY STATE

Installation Coordinator
for Ascensus in MN, PA

401K Client Service Representative
for Ascensus in PA

Senior Consultant, Retirement Programs
for Sutter Health in CA

Manager Claims & Customer Service (Benefits TPA)
for Zenith American Solutions in NV

Manager, Complaint Resolution
for Prudential in ME, NJ

Senior Benefits Analyst
for County of San Diego in CA

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Webcasts and Conferences

Health Benefits Laws Compliance Assistance Seminar
July 23, 2013 in FL
(Employee Benefits Security Administration (EBSA), U.S. Department of Labor)

Health Benefits Laws Compliance Assistance Seminar
August 6, 2013 in AZ
(Employee Benefits Security Administration (EBSA), U.S. Department of Labor)

A Busy 2013 for Executive Compensation eLunch
June 27, 2013 WEBCAST
(Winston & Strawn)

Tax Planning for Retirement Asset Withdrawals -- Webcast
August 1, 2013 WEBCAST
(American Society of Pension Professionals & Actuaries (ASPPA))

Advanced Issues with Participant Loans, Hardship Withdrawals, & QDROs -- Webcast
August 7, 2013 WEBCAST
(American Society of Pension Professionals & Actuaries (ASPPA))

EPCRS and Plan Corrections
August 29, 2013 in PA
(ASPPA Benefits Council of Western PA)

View All Webcasts and Conferences


[Official Guidance]

The Health Plan Administrator's Guide to the Health Coverage Tax Credit (PDF)
"This Guide is designed as a comprehensive reference tool to help Health Plan Administrators (HPAs) understand the IRS Health Coverage Tax Credit (HCTC) Program, including the enrollment process and HPA responsibilities while enrolled. The Guide also contains a glossary of terms, copies of forms, and HCTC contact information." (Internal Revenue Service)


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.

[Guidance Overview]

EBSA Makes Available Model Notices of Coverage Options in Spanish
"[The ACA] requires employers to provide employees with a notice of their health insurance coverage options available through the future health insurance exchanges by October 1, 2013. Last month, the EBSA issued guidance on this obligation and model notices in English. The new notices posted on the EBSA's website include a model notice for employers who offer a health plan to some or all employees in Spanish and a model notice for employers who do not offer a health plan in Spanish." (Littler)

[Guidance Overview]

HHS Launches Health Insurance Marketplace Educational Tools
"The Obama administration ... kicked off the Health Insurance Marketplace education effort with a new, consumer-focused HealthCare.gov website and the 24-hours-a-day consumer call center to help Americans prepare for open enrollment and ultimately sign up for private health insurance. The new tools will help Americans understand their choices and select the coverage that best suits their needs when open enrollment in the new Health Insurance Marketplace begins October 1.... 'The re-launched Healthcare.gov and new call center will help consumers prepare for the new coverage opportunities coming later this year,' said [CMS] Administrator Marilyn Tavenner. 'In October, HealthCare.gov will be the online destination for consumers to compare and enroll in affordable, qualified health plans.'" (U.S. Department of Health and Human Services)

[Guidance Overview]

New CMS Publications & Articles for Businesses and Individuals about Health Insurance and the Marketplaces
New publications include: [1] Fact sheets: Key Dates for the Health Insurance Marketplace; Things to Think About When Choosing a Plan; Things to Think About When Choosing a Plan for Your Business; Get Ready to Enroll in the Marketplace; Marketplace Application Checklist; Getting Help in a Language Other Than English; and Helping Consumers Apply & Enroll Through the Marketplace; [2] Drop In Articles: Are You Ready? The Health Insurance Marketplace is Coming (4 versions), and Now is the Time to Get Ready for the New Health Insurance Marketplace (2 versions); [3] Early Awareness and Open Enrollment (short multi-purpose messages); [4] Better Options, Better Health (radio Public Service Announcement); and [5] Other resources: Better Options. Better Health. (resources card), and Need affordable health insurance? Get answers! (customizable flyer, poster and 5x7 card). (Centers for Medicare & Medicaid Services)

[Guidance Overview]

The SHOP Marketplace: New Health Insurance Options for Small Businesses (PDF)
14 presentation slides with speaker notes. Topics include: [1] What is the SHOP Marketplace? [2] The Situation for Small Employers Today; [3] Removing the Obstacles: Insurance Reforms, Tax Credits and Choice and Transparency; [4] Enrolling in SHOP: Who, When & How? [5] How SHOP Works: Different Plan Options for Different Budgets, Moving Toward Employee Choice, and Employer Control and Simplicity; [6] SHOP: Basic Guarantees; [7] SHOP: a Market-based Approach; and [8] The Bottom Line. (Centers for Medicare & Medicaid Services)


Innovative Drivers of Value-Based Purchasing of Healthcase Benefits

Sponsored by World Congress

A meeting that gets rid of the fluff and elevates and directs the conversation to non-traditional and innovative areas of value-based purchasing, so you can master modern day benefit design. July 25-26, Chicago.

Promise of Price Cut on Hospital Bills Is in Limbo
"A provision in President Barack Obama's healthcare overhaul says most hospitals must charge uninsured patients no more than what people with health insurance are billed.... Critics say the law has several problems: It applies only to nonprofit institutions, which means about 40 percent of all community hospitals are exempted.... It lacks a clear formula for hospitals to determine which uninsured patients qualify for financial aid, and how deep a discount is reasonable.... More than three years after Obama signed his law, the Internal Revenue Service has not issued final rules explaining how hospitals should comply[.]" (Modern Healthcare Online; free registration required)

Obamacare Starts in 100 Days
"There are, arguably, two big things that need to happen between now and October. The first is technical: The federal government needs to finish building the infrastructure that allows multiple government agencies to transmit information, determining whether an individual should qualify for tax subsidies.... There's one other task on the Obama administration's plate just as big as technological work, and that's outreach. Even if the technological launch goes off without a hitch, that won't be much good if no shoppers show up to the marketplace." (The Washington Post)

Caps on Costs for Certain Surgeries Save CalPERS $5.5 million
"The nation's largest pension fund and health insurer WellPoint Inc. (WLP) cut medical costs 19 percent by capping the price of some surgeries, in the latest sign payers are taking a tougher line against rising hospital claims.... Cost capping, which steers consumers away from high-priced providers that don't produce better outcomes, is gaining currency among employers grappling with the wide variation in hospital expenses[.]" (Bloomberg)

Another Settlement Marks Continued Increase in HIPAA Enforcement
"'When senior level executives intentionally and repeatedly violate HIPAA by disclosing identifiable patient information, OCR will respond quickly and decisively to stop such behavior,' said OCR Director Leon Rodriguez. In addition to the settlement amount, the CAP requires [Shasta Regional Medical Center of Redding, California,] to revise and distribute its policies and procedures on safeguarding PHI, obtain compliance certifications from its workforce, conduct PHI-related training for employees, and report any violations of these policies to HHS." (Sidley Austin LLP)

Medicare Part D Benefit and RDS Values for 2014
"Because program costs have been declining, copayments and deductibles will be lower in 2014 than they were in 2013, according to CMS. The Part D standard benefit deductible will be $310 (down from $325 in 2013). The initial coverage limit will be $2,850 (down from $2,970 in 2013), and the out-of-pocket threshold will be $4,550 (down from $4,750 in 2013)." (Towers Watson)

Shortage of Doctors Looms in Rural California
"California is projected to face a shortage of as many as 17,000 doctors within two years, a problem that is especially acute in rural areas and minority communities. One Democratic lawmaker has proposed a package of bills intended to fill that provider gap by expanding the health services that can be provided by nurse practitioners, optometrists and pharmacists." (AppealDemocrat.com)

The Cost of Dying: A Shift Away from Expensive Interventions
"The experience of death is changing in America, gradually shifting from costly, high-tech battles against death in hospitals into hospices that gently accept the inevitable end.... 25 percent of Medicare patients died in a hospital in 2010, down from 28 percent in 2007. More than 47 percent died in hospice environments, often at home, up from 42 percent." (San Jose Mercury News)

Senate Hearing Highlights Connection Between Lack of Health Care Transparency, Higher Health Care Costs
"Describing the continuing mystery around prices for services and how they are set, the witnesses recommended a number of steps to increase transparency including: [1] Building on efforts by Medicare to release data on inpatient procedures; [2] Allowing more access to Medicare's databases; and [3] Requiring health plans participating in the health care marketplaces under the health care reform law to be more transparent." (HR Policy Association)

Blue Cross and Blue Shield Member Companies Bet Big on Obamacare Exchanges
"David Windley, who follows the industry for Jefferies & Co., [said] "[UnitedHealth Group, Aetna, and most other non-Blue insurers] are evaluating markets state by state and in some cases region by region within the state to assess the viability of all the different pieces.' Not the Blues. They're expected to offer health-exchange plans nearly everywhere, ensuring at least a minimum choice for individuals seeking subsidized coverage when the marketplaces open Oct. 1. It also makes them an undeclared Obama ally in implementing the health law." (Kaiser Health News)

Is There a Doctor in the House -- or Office? Health Care Provider Strategies for Employers (PDF)
"Have frank discussions with your health plan partners and consultants, and ask about their approach to the changing patient base to help you better understand access issues for your population. There may be significant opportunities to improve the overall cost of health benefits and the type and quality of treatment decisions your employees and their providers make. Focusing on this aspect of your health care strategy will be critical in the future." (Fidelity)

'Blue Map' Online Tool Designed for North Carolina Residents for Navigation of Health Care Changes
"The insurer said about 1.2 million residents could benefit from the tool as the October open-enrollment period for insurance plans nears. Among the regulatory issues described on the website are new health plans featuring essential benefits, eligibility to keep current plans, premium tax credits and cost-sharing reductions. The map is aimed at people who may be purchasing health insurance for the first time." (Winston-Salem Journal)

More Dental, Vision Insurance Choices for Federal Employees
"The Office of Personnel Management ... announced that it will add four carriers in 2014 to its current dental and vision portfolio, for a total of 14 insurance contracts. The agency will award 10 contracts for dental plans and four vision contracts. This is the first time since 2006 that OPM has solicited new contracts." (Government Executive)

No Obamacare Exchange in 36 Mississippi Counties?
"Insurance Commissioner Mike Chaney says two insurers have announced offerings so far, planning to serve 46 counties. Unless more companies sign up or the existing companies expand their plans, consumers in the remaining counties won't be able to buy health insurance through the online exchange.... Mississippi employers cannot be penalized for failure to provide 'affordable' health insurance to residents of those 36 counties because without any exchange at all, those residents will not be able to receive the tax credits. But employers could be penalized for failing to provide those residents 'minimum value' coverage -- if a firm employs even a single person in one of the other 46 counties that do receive such a tax credit." (Cato Institute)

Adverse Selection and an Individual Mandate: Determining the Optimal Penalty Amount
"The authors] compare health insurance coverage, premiums, and insurer average health claim expenditures between Massachusetts and other states in the periods before and after the passage of Massachusetts health reform. In the individual market for health insurance, ... premiums and average costs decreased significantly in response to the individual mandate ... Combining demand and cost estimates ... an annual welfare gain of $335 dollars per person or $71 million annually in Massachusetts [results from] the reduction in adverse selection.... [This] model and empirical estimates suggest an optimal mandate penalty of $2,190. A penalty of this magnitude would increase health insurance to near universal levels." (National Bureau of Economic Research)


Improving the Rhetoric of Health Care Rationing: Part 1
"Despite public distaste for rationing, the term remains remarkably resilient.... Yet what exactly is rationing, and should 'rationing,' properly defined, be the focus of any current health policy discussion?" (Health Affairs)


What If the Exchanges Aren't Ready on Time?
"There are five reasons why the supply side of the market may not be ready when the buyers are ready to buy.... [1] Cost ... too little money was budgeted for creating the exchanges.... [2] Complexity ... a computer system that connects HHS, the [IRS], the [SSA], Homeland Security and perhaps other departments. This is a herculean task with unclear benefits.... [3] Incompetency ... the federal government is probably the worst entity possible to design an exchange.... [4] Re-inventing the Wheel ... completely ignoring private exchanges that are up and running.... [5] Anti-Private Sector Bias ... so far no state exchange has allowed a private company to serve as an entry point for anyone who is entitled to a subsidy." (John Goodman's Health Policy Blog)


Canadians Pay Taxes for Universal Health Care, and Now They're Richer Than Us
"If everybody was in the same health care system in the U.S., as is the norm in most wealthy nations, we would be having a much different and more civil conversation than what we are now witnessing ... No other wealthy country relies on the exorbitantly expensive and divisive practice of insurance underwriting to finance their health care system. They finance their publicly administered systems through broad-based taxes or a simplified system of tax-like, highly regulated premiums. Participation is mandatory and universal." (Physicians for a National Health Program)


How Misplaced Reimbursement Incentives Drive Up Healthcare Costs
"A federal advisory panel just said that Congress should move immediately to cut payments to hospitals for many services that can be provided at much lower cost in doctors' offices. So after taking measures to increase the cost of care and testing, it has finally dawned on them that they have incentivized the wrong entity. Unfortunately the Genie has left the bottle, and it is unlikely that the steady tide of cardiology groups selling their practices to hospitals will be stemmed." (The Health Care Blog)

Benefits in General; Executive Compensation

If the Supreme Court Rules Against DOMA: Ten Questions Employers Will Ask
"If the Court strikes down part of DOMA, it is likely to leave two significant questions for employee benefit plans unanswered: Is the change retroactive? And how will plans define 'spouse' in light of a patchwork of [same-gender] marriage laws across the country? These questions, and other employee benefit issues, are discussed [in this article]." (Ivins, Phillips & Barker)

The ISS: What a Compensation Committee Needs to Know (PDF)
"[C]ompanies should consider several actions to help ensure successful vote results at its shareholders meeting: [1] Request a draft copy of ISS's Proxy Report, which will be available 24-48 hours before ISS issues its final report, and prepare to comment on any factual inaccuracies or harsh but irrelevant rhetoric in the report ... [2] Know the proxy voting policies of the company's institutional base and other major shareholders; [3] Communicate with top institutional investors through direct shareholder engagement; and [4] Consider filing supplemental materials to communicate with shareholders." (Meridian Compensation Partners, LLC)

Press Releases

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