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June 28, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

401k Administrator
for Hunter Benefits Consulting Group, Inc. in CO, IL, WA

Manager SBSS
for Ascensus in IN

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Webcasts and Conferences

"Impact of Same Gender Marriage Rulings on Retirement Plans" Web Seminar
July 18, 2013 WEBCAST
(SunGard Relius)

Washington Update
November 13, 2013 in PA
(ASPPA Benefits Council of Greater Philadelphia)

"Impact of Same Gender Marriage Rulings on Retirement Plans" Web Seminar
July 23, 2013 WEBCAST
(SunGard Relius)

2013 Executive Compensation and Benefit Year End To Do List
November 21, 2013 WEBCAST
(Winston & Strawn)

View All Webcasts and Conferences


[Official Guidance]

Text of Final Regs on Coverage of Certain Preventive Services Under the Affordable Care Act (PDF)
110 pages. Excerpt: "The Departments received over 400,000 comments (many of them standardized form letters) in response to the proposed regulations.... Based on their review of these comments, the Departments are finalizing without change the definition of religious employer in the proposed regulations. As indicated in the preamble to the proposed regulations (78 FR 8461), the simplified and clarified definition of religious employer does not expand the universe of religious employers that qualify for the exemption beyond that which was intended in the 2012 final regulations, but only eliminates any perceived potential disincentive for religious employers to provide educational, charitable, and social services to their communities." (Internal Revenue Service, Employee Benefits Security Administration, and U.S. Department of Health and Human Services)

[Official Guidance]

HHS Issues Final Rules on Contraception Coverage and Religious Organizations
"Today, the Obama administration issued final rules that balance the goal of providing women with coverage for recommended preventive care -- including contraceptive services prescribed by a health care provider -- with no cost-sharing, with the goal of respecting the concerns of non-profit religious organizations that object to contraceptive coverage. The final rules reflect public feedback received in response to the Notice of Proposed Rulemaking issued in February 2013.... The final rules also lay out the accommodation for other non-profit religious organizations -- such as non-profit religious hospitals and institutions of higher education -- that object to contraceptive coverage." (U.S. Department of Health and Human Services)

[Official Guidance]

HHS Fact Sheet: Women's Preventive Services Coverage and Non-Profit Religious Organizations
"[T]he final rules eliminate the requirements that a religious employer: have the inculcation of religious values as its purpose; primarily employ persons who share its religious tenets; and primarily serve persons who share its religious tenets. The simplified definition of 'religious employer' for purposes of the exemption is based solely on Section 6033(a)(3)(A)(i) or (iii) of the Internal Revenue Code, which primarily concerns churches and other houses of worship." (Center for Consumer Information & Insurance Oversight, Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)

[Official Guidance]

HHS Fact Sheet: ACA Rules on Expanding Access to Preventive Services for Women
"Health insurance companies or third party administrators -- rather than objecting non-profit religious organizations -- will pay for contraceptive services used by women who otherwise receive health coverage under health plans offered by these organizations. In short, these final rules provide accommodations under which women in health plans offered by eligible non-profit religious organizations that object to contraceptive coverage on religious grounds have access to free contraceptive coverage, but such organizations do not have to contract, arrange, pay or refer such coverage." (U.S. Department of Health and Human Services)

[Official Guidance]

Women's Preventive Services Guidelines: ACA Expands Prevention Coverage for Women's Health and Well-Being
"The HRSA-supported health plan coverage guidelines, developed by the Institute of Medicine (IOM), will help ensure that women receive a comprehensive set of preventive services without having to pay a co-payment, co-insurance or a deductible. HHS commissioned an IOM study to review what preventive services are necessary for women's health and well-being and therefore should be considered in the development of comprehensive guidelines for preventive services for women. HRSA is supporting the IOM's recommendations on preventive services that address health needs specific to women and fill gaps in existing guidelines." (Health Resources and Services Administration, U.S. Department of Health and Human Services)


A Practical Approach to Developing a Wellness Program

Sponsored by Lorman and BenefitsLink

Learn to use a six step model process for designing your program, look at a practical example of a program, find out how to locate resources for your program, and how to keep it fresh and effective. Registration discount for BenefitsLink readers.

[Official Guidance]

Text of CMS Guidance on the Temporary Enforcement Safe Harbor for Certain Employers, Group Health Plans and Group Health Insurance Issuers with Respect to the Requirement to Cover Contraceptive Services (PDF)
"On February 10, 2012, CMS established a temporary enforcement safe harbor with respect to non-grandfathered health plans established or maintained or arranged by certain nonprofit organizations with religious objections to contraceptive coverage (and any health insurance coverage offered in connection with such plans). This bulletin modifies the applicable time period of the previous version of this bulletin.... In reissuing this bulletin, CMS is not changing the substance of the temporary enforcement safe harbor policy; it is only extending the safe harbor to encompass plan years beginning on or after August 1, 2013, and before January 1, 2014. This transitional enforcement safe harbor is intended to maintain the status quo with respect to organizations that qualify for the safe harbor during the period that exists between the prior expiration date of the safe harbor and the applicability date of the final regulations.... [O]rganizations that qualify under the safe harbor are not required to execute another self-certification, but are required to provide another notice to plan enrollees in connection with any new plan year." (Center for Consumer Information & Insurance Oversight, Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)

[Official Guidance]

EBSA Form 700: Certification for Safe Harbor Exemption from Contraceptive Coverage Mandate
[Microsoft Word document.] "This form is to be used to certify that the health coverage established or maintained or arranged by the organization listed below qualifies for an accommodation with respect to the federal requirement to cover certain contraceptive services without cost sharing[.]" (Employee Benefits Security Administration, U.S. Department of Labor)

[Guidance Overview]

What Employers Participating in Multiemployer Health Plans Need to Know about the ACA Model Employer Notice
"The obligation to provide the Notice is legally that of the employer, not the plan, but [employers] will need the assistance of multiemployer plans to complete the information on the form. Employers concerned about not being subjected to the employer shared responsibility penalty are also likely to seek assurance from trustees that the multiemployer plan to which they contribute meets the coverage standards for the transition rule, including 60 percent actuarial value." (Segal)

[Guidance Overview]

HHS Final Rule Addresses Exemptions from the Individual Mandate
"The final rule [issued by HHS on June 26] makes an exceptional number of modifications to the proposed rule. While few of these changes are radical, they do demonstrate a serious attempt by HHS to take into account the myriad circumstances in which individuals should not be penalized for not purchasing health insurance, as presented by the 220 comments they received on the proposed rule." (Timothy Jost in Health Affairs)

[Guidance Overview]

A Limited Future for HRAs after 2014?
"One often-overlooked option for employers who wish to continue to offer stand-alone HRAs is to reimburse only excepted benefits under HIPAA, which are also excepted from the annual dollar limit prohibition. Excepted benefits include: [1] limited scope dental and vision benefits (however, since pediatric dental and vision benefits are EHBs that are expressly subject to the annual limit prohibition, it is unclear how this exclusion would actually work -- hopefully future guidance will help clarify this issue); and [2] health flexible spending accounts limited to $500 in reimbursable funds." (McKenna Long & Aldridge LLP)

Tenth Circuit Court of Appeals: For-Profit Corporations Have Religious Rights
"The U.S. Court of Appeals for the 10th Circuit ruled ... that Hobby Lobby and Mardel could likely make their case but stopped short of blocking the contraceptive mandate. The court instead sent the case back to a federal district judge for further consideration. But five of the eight judges made a strong statement about corporate personhood -- the idea that companies share some legal rights and protections with in-the-flesh people." (The Wall Street Journal; subscription may be required)

Text of Tenth Circuit Decision in Hobby Lobby Contraceptive Mandate Case (PDF)
165 pages. Excerpt: "The district court ruled that the corporations failed the likelihood-of-success element because even closely held family businesses like Hobby Lobby and Mardel are not protected by [the Religious Freedom Restoration Act (RFRA)]. We disagree with this conclusion and determine that the contraceptive-coverage requirement substantially burdens Hobby Lobby and Mardel's rights under RFRA. And at this stage, the government has not shown a narrowly tailored compelling interest to justify this burden.... [We] hold as a matter of statutory interpretation that Congress did not exclude for-profit corporations from RFRA's protections. Such corporations can be 'persons' exercising religion for purposes of the statute. Second, as a matter of constitutional law, Free Exercise rights may extend to some for-profit organizations." [Hobby Lobby v. Sebelius et al, No. 12-6294 (10th Cir. June 27, 2013)] (U.S. Court of Appeals for the Tenth Circuit)

43% of U.S. Uninsured Unaware They Must Get Health Care Coverage
"The vast majority of Americans, 81%, say they are aware of the 2010 Affordable Care Act's (ACA's) requirement that most Americans must carry health insurance or pay a fine. Americans who are currently uninsured -- those most directly affected by this requirement -- are much less likely to be aware of the provision, with 56% saying they know about it and 43% saying they are unaware.... The subgroups that are less likely to be aware of the health insurance requirement are also the subgroups that are least likely to be insured, including Hispanics, blacks, young adults, and those in lower-income households." (Gallup)

California's Health Insurance Exchange at Forefront
"Obamacare supporters know the health law needs enough healthy young people to sign up for insurance to balance out the influx of sick patients expected to seek coverage in 2014, when insurers can no longer turn them away. The White House figures that one out of three young people is in California, Texas or Florida. There's not a whole lot of Obamacare love in Texas and Florida, putting even more pressure on California to get it right." (Politico)

Structuring a Settlement to Fund a Special Needs Trust May Not Work to Block ERISA Plan's Recovery
"[The participant] entered into a settlement with a third party for $294,440, but did not reimburse the ERISA group health plan for the $50,076 in medical expenses it paid.... [T]he settlement required the defendant to purchase an annuity from an unrelated insurer.... [The participant's] attorney indicated that the settlement was specifically structured to avoid any equitable lien claimed by the ERISA group health plan.... [T]he plan sued the trustee of the plan participant's special needs trust.... [T]he Fifth Circuit concluded that it was appropriate equitable relief under ERISA to impose a constructive trust on ... the proceeds from the annuity as they are paid into the special needs trust." [ACS Recovery Services, Inc. v. Griffin, No. 11-40446 (5th Cir. May 7, 2013)] (Benefits Bryan Cave)

Big Improvements in Benefits Ahead for Those Who Buy Their Own Insurance
"Most of the debate about how the health law will change the individual market has centered on whether consumers will experience 'rate shock' from higher premiums when key changes go into effect next year. But there's a flip side: new rules that broaden benefits, prohibit discrimination against those with health issues and cap consumers' out-of-pocket costs, which can cut far deeper than premiums." (Kaiser Health News)

Congress Contemplating ACA Modifications to Help Small Businesses Weather Health Care Reform
"An effort to repeal a tax on insurance companies in the new healthcare reform law is gaining momentum in Congress, fueled by concerns that the fee would hit small businesses particularly hard. The legislation would eliminate a fee ... commonly referred to as the health insurance tax (HIT tax), [which] will be calculated based on the plans insurers sell directly to individuals and companies ... and excludes ... the self-insured market. Most large companies self-insure their employees; consequently, experts warn that insurance firms will pass the added costs of collecting the fee to small businesses, which tend to purchase coverage in the fully insured market." (The Washington Post)

An Overview of the Implementation of Small Business Exchanges in Six States
"This paper provides an overview of SHOP exchange development in six states. The six state based exchanges studied are all intending to offer employee choice in 2014 and report an encouraging amount of carrier interest. Specific policy decisions in design tend to reflect prior state differences in small group markets. State contacts note that employer education is one of the major challenges they face, and outreach efforts to small businesses are just beginning." (Urban Institute)

Bending the Health Care Cost Curve by Using Reference Pricing
"[H]ealth insurers are increasingly turning to the ideas that drove [premium support] -- choice, competition, and the power of a (carefully regulated) market -- to address high costs on the procedural level. Call it the micro-voucherization of health insurance. This is known by wonks as reference pricing, and its recent results in California are promising: the costs of hip and knee replacements fell by 19%, with no attendant decrease in quality." (The Health Care Blog)

Health Plans Risk Losing Employer-Sponsored Group Business Unless Satisfaction Improves
"Among fully insured employers, satisfaction averages 709 (on a 1,000-point scale); among self-funded employers, satisfaction averages 696. Satisfaction across all factors among employers that do not intend to offer coverage five years from now is at least 76 points lower than employers who intend to offer coverage... In both the fully insured and self-funded segments, employer satisfaction with program offerings, such as preventive health programs, disease management or wellness initiatives, is a key area of differentiation between employers that intend to offer coverage in the future and those that intend to drop coverage." (J.D. Power and Associates)

Test Driving the Obamacare Software
"Health-act proponents liken the signup software to Expedia or Travelocity, where travelers can book flights and hotels. It may be more like TurboTax, escorting you through requirements and choices much more complex than whether you want a flight in the afternoon or the morning." (MedPage Today)

Employers' Use of Health Insurance Exchanges: Lessons from Massachusetts (PDF)
"[The Massachusetts health insurance exchange], called the Health Connector, has had notable success in expanding coverage for individuals, but so far it has not made major in-roads into the employer-based insurance market.... Of 40,000 people who purchase private insurance through the Connector, only about ten percent do so as part of employer coverage, and almost all of these employers are 'micro-sized' (five or fewer), with an average of only about 1.5 employees per group policy. This employee enrollment constitutes less than one percent of small-group employee coverage statewide." (Saint Louis University School of Law)

Financial Reporting by Health Insurers: Implications Under the ACA (PDF)
25 pages. Excerpt: "Much of this uncertainty [created by the ACA for health insurance issuers] surrounds the risk that customer behavior in the reformed market may deviate from the projections made by each issuer in its pricing and strategic decisions. Another element has received comparatively less attention -- the extent that an issuer's future financial statements may be subject to additional volatility due to the ACA because of an increased need for actuarial estimates in financial reporting. The purpose of this white paper is to address that topic, as well as new ways in which the ACA may affect financial statement comparability both among issuers and over time." (Health Practice Financial Reporting Committee, American Academy of Actuaries)


Health Care Solutions from America's Business Community: The Path Forward for U.S. Health Reform (PDF)
67 pages. Excerpt: "[The Chamber] will advocate the proposals and principles ... to advance: [1] meaningful transparency of health care quality and cost information; [2] greater value in the health care system; [3] effective employer-sponsored and private health care coverage; and [4] Medicare and Medicaid reforms to support greater value.... [L]everaging the private sector initiatives currently underway and modifying the PPACA to mitigate the disruption to the private insurance markets, and employer coverage in particular, will help avoid instability and achieve greater value in health care during this implementation phase and as the nation tackles future health reform challenges." (U.S. Chamber of Commerce's Health Care Solutions Council)


Unpacking the Meaning of Health Care 'Rationing': A Response to Dowd and Allison
"[A]ccording to Dowd and Allison, rationing occurs only when limits are placed upon choices that some potential buyer of a good or service would otherwise be willing and able to make, and I emphasize here the words 'and able.' ... Dowd and Allison certainly are free to posit this as their definition of rationing. They should not assume, however, that their definition is universally shared, even among economists, nor should they assume that in the debate on health policy the more expansive definition of rationing, including price-rationing, is abusive." (Uwe Reinhardt in Health Affairs)

Benefits in General; Executive Compensation

[Official Guidance]

Text of FASB Proposed Accounting Standards Update for Insurance Contracts
"The guidance in this proposed Update would require an entity to measure its insurance contracts under one of two measurement models, referred to as the building block approach (for most life, annuity, and long-term health contracts) and the premium allocation approach (for most property, liability, and short-term health contracts). Under the guidance in this proposed Update, contracts accounted for using the building block approach generally would be measured in a way that portrays a current assessment of the insurance contract." (Financial Accounting Standards Board (FASB))

[Guidance Overview]

An In-Depth Look at the Final New York Regulations Limiting Executive Compensation Paid by State-Funded Service-Providers
"If a provider chooses to pay an executive more than $199,000 (i.e., using other funds), the provider must ensure that several conditions are met: [1] The executive's compensation can be no greater than the 75th percentile of compensation provided to comparable executives in comparable organizations. [2] The compensation must have been approved by the organization's governing body, which must include at least two independent directors. [3] These decisions are substantiated with contemporaneous documentation." (Towers Watson)

Supreme Court Strikes Down DOMA: What This Means in the Workplace (PDF)
"This briefing explains what employers in same-sex marriage states (like Massachusetts) should consider doing in the very near future, and touches cursorily on the dilemma employers face in non-recognizing jurisdictions. Federal guidance w ill provide modest lead time, but individual claims of earlier (even retroactive) rights are conceivable[.]" (Davis, Malm & D'Agostine P.C.)

Top Ten Considerations for Employee Benefit Plans After the Windsor Decision (PDF)
"Generally, spousal provisions in an employer's employee benefit plans ... should apply to same-sex spouses in the same manner as they are applied to opposite-sex spouses.... [In] the case of welfare plans and fringe benefits that define covered 'spouses' by reference to the law of a state that does not recognize same-sex spouses or such plans that do not clearly define the term 'spouse' ... plan administrators may still have the authority to interpret the term 'spouse' to exclude same-sex spouses. However, it is unclear whether such interpretation would enjoy Firestone deference, or might now be considered 'arbitrary and capricious' if challenged in litigation following the Windsor decision." (Sutherland)

What Does the DOMA Ruling Mean for Benefit Plans?
"In those states that do not recognize same-sex marriages, additional guidance on how federal law will coordinate with state marriage laws is needed.... The litigation risk, however, is greater if the employer uses the state of domicile rule and the state of marriage rule is ultimately determined to control. For example, same-sex spouses could claim they were improperly denied rights to medical coverage or survivor benefits in retirement plans. The risk in following the state of marriage rule, if the state of domicile rule is ultimately determined to control, is only that the employer would have reported income incorrectly on W-2s for health coverage or participants would have been wrongly required to get spousal consent to retirement distributions." (Warner Norcross & Judd LLP)

The Impact on ERISA Benefit Plans of the Supreme Court's DOMA Decision (PDF)
"What action should employers take now? [1] Review ERISA plan provisions to determine if updates are required.... [2] Coordinate implementation with ERISA plan service providers.... [3] Update payroll systems and plan administration processes and procedures.... [4] Continue to monitor legal developments[.]" (Wilkins Finston Law Group)

Trends and Developments in Executive Compensation, 2013 (PDF)
31 pages. Excerpt: "Three-quarters of responding companies performed a pay-for-performance analysis in the past year. Most companies looked at pay and performance over a 3-year period and used the grant-date value of [long-term incentives] in their definition of compensation.... No significant changes in year-over-year merit increases; the majority of companies increased budgets between 3.0% and 3.5%. 2013 annual incentive payouts (for 2012 performance) were slightly lower than 2012 payouts, although 61% reported payouts were at or above target." (Meridian Compensation Partners, LLC)

Press Releases

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