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BenefitsLink Health & Welfare Plans Newsletter

June 26, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Executive Assistant
for Mullin TBG - A Prudential Company in FL

Administrative Assistant III
for Verisight, Inc. in MN

Conversion Consultant
for ASPire Financial Services LLC in FL

Sales Representative
for Retirement Security - Advisory Council, LLC in AZ

Enrolled Actuary Consultant
for The Pension Studio, LLC in ANY STATE

Benefits Account Manager
for Gallagher Benefit Services, Inc. in TX

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Webcasts and Conferences

Prohibited Transactions
September 19, 2013 in PA
(ASPPA Benefits Council of Greater Philadelphia)

IRS Tax Forum
August 13, 2013 in LA
(Internal Revenue Service (IRS))

IRS Tax Forum
August 20, 2013 in GA
(Internal Revenue Service (IRS))

Unraveling the Windsor Knot: How the Supreme Courtís Opinion on DOMA Will Affect Employers and Employee Benefits -- Webinar
June 28, 2013 WEBCAST
(Bloomberg BNA)

Ascensus Fall Forum - Boston 2013
September 23, 2013 in MA

Ascensus IRA Supertrain - Boston 2013
August 19, 2013 in MA

View All Webcasts and Conferences


[Official Guidance]

Text of IRS Notice 2013-42: Transition Relief for Employees and Related Individuals Eligible to Enroll in Eligible Employer-Sponsored Health Plans for Non-Calendar Plan Years that Begin in 2013 and End in 2014 (PDF)
"In general, if an applicable large employer offers to an employee coverage that is affordable and provides minimum value for the first non-calendar year plan year beginning in 2014 ('2014-2015 plan year'), the employer will not be liable for a Section 4980H assessable payment with respect to that employee for the period prior to the first day of the 2014-2015 plan year if the employee was eligible to participate in the plan as of December 27, 2012. Similar relief may also be available for certain employers with respect to employees not eligible to participate in the plan as of December 27, 2012." (Internal Revenue Service)


New In the Foundation Bookstore: Healthcare Reform Facts

Sponsored by IFEBP (International Foundation of Employee Benefit Plans)

Find answers to more than 300 frequently asked questions concerning the Patient Protection and Affordable Care Act (PPACA). Organized in a Q&A format, this reference book addresses implementation, compliance and tax implications for employers. Order now!

[Official Guidance]

Text of IRS Notice 2013-41: Eligibility for Minimum Essential Coverage for Purposes of the Premium Tax Credit (PDF)
"This notice provides rules for determining whether or when certain individuals are eligible for minimum essential coverage under the Medicaid, Medicare, CHIP, or TRICARE programs for purposes of the premium tax credit. For convenience, this notice also provides rules for eligibility for minimum essential coverage through self-funded student health plans and state high risk pools." (Internal Revenue Service)

PCORI Fees: What They Are, How to Count Them and Who Pays
"If you sponsor a self-funded HRA and an insured health plan, the HRA is subject to a fee as well as the insured plan. Basically this means the fee is paid twice. But, if both the HRA and the health plan are self-funded, then the plans are treated as one plan and there is only one PCORI fee due." (Fox Rothschild LLP)

January 2013 AHIP Census Shows 15.5 Million People Covered by HSA/HDHPs
"The number of people with [Health Savings Account/High-Deductible Health Plans (HSA/HDHP)] coverage rose to nearly 15.5 million in January 2013, up from 13.5 million in January 2012 and 11.4 million in January 2011; an annual growth rate of approximately 15 percent over the last several years. Most enrollment gains in the HSA/HDHP market in 2013 were in the large group market. The share of HSA/HDHP covered lives enrolled in large group plans jumped from 59 percent in January 2012 to 68 percent in January 2013." (America's Health Insurance Plans)

Reform Puts a Squeeze on Hospitals' Revenue Cycle
"The [ACA] is designed, in part, to provide more patients with health insurance through expanded Medicaid eligibility and the introduction of government-run health insurance exchanges that will allow low-income individuals to purchase medical coverage at a subsidized rate. The goals include improving access to care for this segment of the population and reducing the amount of uncompensated care provided by the nation's hospitals. While this sounds good on paper, many hospital finance administrators are not convinced that the [ACA] will benefit providers and are instead bracing to take a hit to the revenue cycle." (HealthLeaders Media)


Defined Contribution Health Plan Update

Sponsored by Lorman and BenefitsLink

Learn how to identify keys to a proper defined contribution plan with individual policies, and explain challenges to implementation. >Registration discount for BenefitsLink readers.

ADP Annual Health Benefits Report, 2013
"This research includes analyses of health care premiums, eligibility and participation by various demographic categories -- including age, gender, marital status, income, number of dependents, state and industry.... Key findings include: Eligibility and Participation Remain Relatively Steady... Overall Premium Costs Continue to Rise but Are Moderating... Employees with Higher Incomes Covered more Dependents... Lower Wage Employees Pay Larger Percentage of Income... Fewer Young Employees Opt to Purchase Coverage." (ADP Research Institute; free registration required to download full report)

Young Americans May Dodge Health Law
"[In] 2014 ... the cheapest option for 20-somethings will be to pay the penalty for not buying health insurance, rather than paying for any health insurance at all -- that is, provided they don't get sick. And as more young people do the math, more seem to be deciding the Affordable Care Act isn't such a good deal for them: Support for a national health-care plan dropped nearly 11% among American college freshmen between 2008 to 2012, with under 63% in favor of it today, down from 70%[.]" (MarketWatch.com)

MLR Rebates Round 2: Employers Prepare for Rebate Distribution
"Employer policy holders have 90 days to distribute the rebates to participants. After 90 days, the employer must establish a trust to hold the rebate funds as they are considered ERISA plan assets.... If participants paid premiums pre-tax through a Section 125 cafeteria plan, MLR rebate amounts are considered taxable wages." (Hill, Chesson & Woody)

Caps on Payments for Specific Healthcare Procedures Help Employers Cut Costs
"As companies seek ways to curb health-care spending, insurer WellPoint Inc. is rolling out a program that lets employers pay only a set amount for a medical service, asking workers who select costlier care to pay the difference.... [B]roader availability of the per-procedure pricing setups, if they work smoothly, may spark more widespread adoption by employers. A survey of large and midsize employers ... found that 8% were using the approach. However, nearly two-thirds were considering the model for the future." (The Wall Street Journal; subscription may be required)

Five Health Planning Essentials for Self-Funding Under Obamacare
"On the surface, this newly centralized control of health care makes the concept of self-funding very attractive. Self-funding provides employers the ability to develop a systemic process to managing health risks and the opportunity to control costs surrounding their members.... Employers who master these areas increase their chances of lowering costs for high-quality health care, while positioning their plan members to lead healthier and more productive lives. [1] Use healthcare data.... [2] Pay for performance.... [3] Comparison shop.... [4] Educate consumers.... [5] Understand health risks." (Employee Benefit News)

Attorneys for Both Plaintiffs, Employers Offer Views on Leave Under the ADA, FMLA
"[E]mployees typically think about medical leave in terms of the FMLA or the employer's disability leave policy, but rarely see the ADA as a tool for getting additional leave. In most cases ... the human resources office has informed the employee about leave under FMLA and the employer's short-term disability policy, but not about leave under the ADA." (Bloomberg BNA)

Losing Weight Doesn't Reduce Heart Attack Deaths
"Weight loss is recommended for overweight or obese patients with type 2 diabetes on the basis of short-term studies, but long-term effects on cardiovascular disease remain unknown. [This study] examined whether an intensive lifestyle intervention for weight loss would decrease cardiovascular morbidity and mortality among such patients.... The trial was stopped early on the basis of a futility analysis when the median follow-up was 9.6 years.... An intensive lifestyle intervention focusing on weight loss did not reduce the rate of cardiovascular events in overweight or obese adults with type 2 diabetes." (New England Journal of Medicine)

Latino Enrollment Key to Success of Health Insurance Marketplaces
"Just as Latinos were crucial to President Barack Obama's re-election success in 2012, they are now key to the success of his health law. And the administration is doing everything it can to make sure that Latinos ... enroll.... Latinos make up 17 percent of the total U.S. population, but 32 percent of the nation's uninsured." (Kaiser Health News)

Use of Health Care Services and Access Issues, Grouped by Type of Health Plan
"Individuals in households with less than $50,000 in annual income were more likely than those in households with $50,000 or more in annual income to report access issues. Very few differences in access issues were found by whether employers contributed to the account, but access issues were found by the level of contribution." (EBRI)


Think NSA Spying Is Bad? Here Comes the Obamacare Database Hub
"HHS said the ObamaCare data hub will 'interact' with seven other federal agencies: Social Security Administration, the IRS, the Department of Homeland Security, the Veterans Administration, Office of Personnel Management, the Department of Defense and -- believe it or not -- the Peace Corps. Plus the Hub will plug into state Medicaid databases. And what sort of data will be 'routed through' the Hub? Social Security numbers, income, family size, citizenship and immigration status, incarceration status, and enrollment status in other health plans, according to the HHS." (Investor's Business Daily)


What Is the Best Role for Government in Health Care?
"We frequently hear that health care is special.... But that specialness does not prima facie warrant regulation. To the contrary, because of the specialness of health care it is extra important that politicians and special interests not be allowed to muck things up. As it turns out, almost all the special regulation in health care has left us worse off than if it had never been legislated in the first place." (John Goodman's Health Policy Blog)

Benefits in General; Executive Compensation

[Official Guidance]

Text of Supreme Court Opinion Ruling DOMA Is Unconstitutional on Equal Protection Grounds (PDF)
5-4 decision; opinion written by Justice Kennedy; dissenting are Justices Roberts, Scalia, Alito, and Thomas. Excerpt from the syllabus: "DOMA is unconstitutional as a deprivation of the equal liberty of persons that is protected by the Fifth Amendment.... By history and tradition the definition and regulation of marriage has been treated as being with in the authority and realm of the separate States.... DOMA rejects this long-established precept. The State's decision to give this class of persons the right to marry conferred upon them a dignity and status of immense import. But the Federal Government uses the state-defined class for the opposite purpose -- to impose restrictions and disabilities." [U.S. v. Windsor, No. 12-307 (U.S. June 26, 2013)] (Supreme Court of the United States)

[Official Guidance]

Text of Supreme Court Opinion Finding Ninth Circuit Had No Jurisdiction to Hear Appeal from District Court's Decision That California Prop. 8 Is Unconstitutional (PDF)
5-4 decision; opinion written by Justice Roberts; dissenting are Justices Alito, Kennedy, Sotomayor and Thomas. Excerpt: "We have never before upheld the standing of a private party to defend the constitutionality of a state statute when state officials have chosen not to. We decline to do so for the first time here. Because petitioners have not satisfied their burden to demonstrate standing to appeal the judgment of the District Court, the Ninth Circuit was without jurisdiction to consider the appeal. The judgment of the Ninth Circuit is vacated, and the case is remanded with instructions to dismiss the appeal for lack of jurisdiction. " [Hollingsworth v. Perry, No. 12-144 (U.S. June 26, 2013)] (Supreme Court of the United States)

[Guidance Overview]

Effect on Benefits Plans of the Supreme Court Decision on DOMA
"[E]mployers with pension and 401(k) plans will be required to recognize [same-gender] spouses for purposes of determining surviving spouse annuities or death benefits. The [same-gender] spouse of an employee will also be able to elect spousal rollovers to his or her own [IRA] upon the employee's death, enabling the surviving spouse to receive payments over his or her lifetime.... [An] employee with a [same-gender] spouse will have to obtain spousal consent to change the beneficiary of his or her retirement benefit ... If a [same-gender] couple divorces, benefits in qualified retirement plans may be split pursuant to a [QDRO].... [T]he decision will simplify life for employers who currently provide welfare benefits to [same-gender] couples by eliminating the current situation in which employers provide tax-free benefits to opposite-sex partners, but must tax benefits to [same-gender] partners. In addition, an employee with a [same-gender] spouse will now be able to contribute to health savings and flexible spending accounts at the same levels as an employee with an opposite-sex spouse. COBRA will apply to [same-gender] spouses." (Thompson Hine)

Links to DOMA and Prop 8 Articles by Leading Law Firms and Others
A list of our collected links about DOMA or Proposition 8 will appear if you click on the title, above. On the resulting web page, click on the title of any link and your web browser will take you to the author's web site for the full text of that item. This list is updated daily. (BenefitsLink.com)

Cancelling a SERP and the Limits of Preemption
"The [Sixth Circuit] found that the dispute over the SERPs concerned a decision to cancel them so as to smooth the sailing for a particular corporate acquisition ... [U]nder those circumstances, the executives who were participants in the SERPs could prosecute a state law claim in state court, on the thesis that it does not affect the terms of the SERPs or the duties imposed by it. The Court found that the state law claims did not require interpreting the SERPs or applying duties owed under them, but only required reference to the SERPs for the specific purpose of determining the damages due the executives if the SERPs were, as alleged, canceled in violation of state law." [Gardner v. Heartland, No. 11-2327 (6th Cir. May 10, 2013)] (Stephen Rosenberg of The McCormack Firm, LLC)


ERIC Comments on Supreme Court's DOMA Decisions
"ERIC is concerned about the ability of companies that operate nationwide to administer their plans in a uniform manner. [ERISA] was structured to allow employers of all sizes to maintain and offer health and retirement benefits under a single set of rules regardless of where they do business or how many states their employees and retirees reside in. Some possible uncertainties left by the Court's decisions could adversely impact the administration of employer-sponsored benefit plans if it results in having to comply with overlapping and inconsistent state laws." (The ERISA Industry Committee)

Press Releases

Texas Muni CIO to Retire
Texas Municipal Retirement System (TMRS)

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