EmployeeBenefitsJobs.com logo BenefitsLink.com logo

BenefitsLink Health & Welfare Plans Newsletter

July 11, 2013          Get Retirement News  |  Advertise
         Past Issues  |  Search

Employee Benefits Jobs

U.S. Health and Welfare Benefits Specialist
for Fluor Corporation in TX

Pension Administrator
for Retirement Strategies, Inc in GA

Plan Document Specialist
for Kravitz, Inc. in CA

Post Your Job on EmployeeBenefitsJobs.com

View All Jobs

RSS feed for jobs RSS Feed: All Jobs

Webcasts and Conferences

11th Annual Value Based Care Congress
August 5, 2013 in MA
(World Congress)

32nd Annual ISCEBS Employee Benefits Symposium
September 22, 2013 in MA
(International Society of Certified Employee Benefit Specialists (ISCEBS))

ERPA-SEE Summer 2013 Exam Registration Deadline Extended to July 18
July 10, 2013 WEBCAST
(American Institute of Retirement Education, LLC (AIRE, LLC))

Free Immigration Webinar for Employers
July 16, 2013 WEBCAST
(Davidson Marketing Group -- FutureOffice Network)

View All Webcasts and Conferences

Join the discussion LinkedIn   Follow us Twitter   Like us Facebook
[Official Guidance]

Text of CCIIO Question and Answer Regarding Assessment Fees (PDF)
This non-numbered publication is dated July 10, 2013. Excerpt: "Can States collect assessment fees in their first year of Exchange operations for use in the second year of operations? A1: Each State-based Marketplace is expected to be self-sustaining in 2015 and assessment fees, or user fees, are one way that states can meet the sustainability requirements of the [ACA]. States may decide to collect assessment fees in year one for operations in year two, however, in doing so, states must develop and maintain appropriate internal processes and controls, such as generally accepted accounting procedures, to distinguish and appropriately utilize section 1311 grant funds from other operational funds." (Center for Consumer Information & Insurance Oversight, Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)


11th Annual Value Based Care Congress - August 5-6 - Boston, MA

Sponsored by World Congress

Top visionaries and thought leaders discuss incentives, pay-for-performance, bundled payments, global reimbursement strategies, physician/hospital alignment, accountable care organizations, and measurement to improve the delivery of care.

[Guidance Overview]

Transition Relief on Various Information Reporting and Employer Shared Responsibility Provisions
"The transition rules in the proposed pay-or-play regulations have not been extended for 2015. Therefore, absent subsequent guidance from the IRS, employers should be prepared to comply with the proposed regulations as they apply for 2015. For example, under the proposed regulations, employers wishing to adopt a 12-month measurement period, generally, were permitted to adopt a shorter measurement period (not less than six months) for 2014 coverage purposes only. This was an acknowledgment of the difficulties employers may have given the late publication date of the proposed pay-or-play rules. Employers should ensure that appropriate hours tracking systems are in place in 2013 and 2014 so that employers can identify full-time employees eligible for coverage in 2015." (McDermott Will & Emery)

Congressional Representatives Spar Over Significance of Delay in Employer Mandate
"In a session that at times was testy, the witnesses and the committee members spent more than two hours debating the value of the employer mandate, focusing on the familiar themes that clearly resonated with many of the committee members: harm to low income workers, the negative effect on job growth, and the definition of affordability." (HealthLeaders Media)

Testimony of Witnesses at July 10 House Hearing on Delay of Employer Mandate
Includes links to testimony submitted for July 10 hearing on the Administration's decision to delay the ACA employer mandate and employer information reporting requirements. Witnesses included Avik Roy, Senior Fellow, Manhattan Institute; James Capretta, Fellow, Ethics and Public Policy Center; William Dennis Jr., Senior Research Fellow, National Federation of Independent Business; Sean Falk on behalf of the International Franchise Association; and Timothy Jost, Robert L. Willett Family Professor of Law, Washington and Lee University School of Law. (Subcommittee on Health, Committee on Ways and Means, U.S. House of Representatives)

Tax Break Can Help in Advance with Health Insurance Premiums -- But There's a Catch
"Instead of waiting until tax time to claim the credit for the premiums on their return, people can apply to get it in advance, based on their estimated income for 2014. In that case, the state health exchange, or marketplace, will estimate the tax credit and send it directly to the insurer. But there's a catch. When April 15 rolls around, the Internal Revenue Service will reconcile the amount of the advance payments sent to the insurer with the taxpayer's actual income. If a person's income is higher than the estimate, the taxpayer will have to repay the difference. But there's some good news, too. If a person's income is lower than estimated, the taxpayer will get a credit." (Kaiser Health News)

Healthcare Spending Growth Projected to Slow in 2014
"PwC's Health Research Institute projects that 2014 medical cost trend will be 6.5% -- a full percentage point lower than our estimate of 7.5% for 2013. This projection is based on analysis of medical costs in the large employer market, which covers about 150 million Americans. The net growth rate, after accounting for benefit design changes such as higher deductibles, will be about 4.5%." (PricewaterhouseCoopers)


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.

UnitedHealth Sees Accountable-Care Work Doubling by 2017
"UnitedHealth, the biggest U.S. insurer, said it expects to spend about $50 billion under accountable-care contracts by 2017, compared with $20 billion now. The programs already have slowed the increase in medical costs and reduced emergency-room visits by 17 percent ... The insurer said it shaved as much as 4.5 percentage points off the rise in medical costs under accountable-care programs." (Bloomberg)

The Critical Link Between Market Reforms and the Individual Mandate
"In the 1990s, eight states tried implementing insurance market reforms without covering everyone and it failed. Premiums increased dramatically, consumers and employers had fewer coverage choices, and the number of uninsured increased. Policymakers in these states, including Kentucky and Washington, amended or repealed these laws because of the significant negative impact on consumers. There is broad agreement that requiring health plans to cover everyone, including those with pre-existing conditions, cannot work without an individual mandate." (America's Health Insurance Plans)

Health Care Law Opponents Dominate Advertising Wars to Date
"Opponents of the 2010 health care law have out-spent supporters by nearly 5-1 on the airwaves ... Critics of the Affordable Care Act spent at least $385 million from March 2010, when Congress enacted the sweeping health care measure, through the end of [June] ... 'There's been no other law we can think of that has been the focus of this much ad spending' immediately following its passage, said Elizabeth Wilner, vice president of the Campaign Media Analysis Group. 'The gap between enactment and implementation has created an opening for this to continue to be a point of attack for its critics.'" (USA TODAY)

What Do Porta-Potties, Coffee Cups and Airplanes Have in Common? The Answer: Obamacare
"The advertisements, developed with political consultants and communications firms, illustrate the ability of the health-care law's supporters to pinpoint the precise group they want to sign up for Obamacare -- young and healthy Americans who won't weigh down the system with high medical bills. However sophisticated, the outreach also underscores how states have become willing to try almost anything to make their pitch in the face of a poorly informed and politically divided public. With 82 days left until the insurance marketplaces open for business, public awareness remains low. Most polling data suggest that few Americans are aware of how the [ACA] works -- or that it even exists." (Sarah Kliff, in The Washington Post)

Some States Are Pushing 'Employee Choice' for Small Business Insurance
"In the 17 states doing their own marketplaces, 15 intend to offer the choice model, as will the District of Columbia ... Idaho is not including an employee-choice program because it is using the federal marketplaces' information technology platform, which will not include it. New Mexico is still considering its options." (Kaiser Health News)

Educating Florida About Health Care Reform Starts With Conversation
"Enroll America, a Washington, D.C.-based nonprofit whose mission is to educate Americans about their health care options under the [ACA], kicked off its Florida campaign Wednesday in Miami with a training session for more than 25 newly hired organizers who will be reaching out to residents statewide.... Florida Organizing Director Ray Paultre, who helped kick off the training session, said he expects educating people on healthcare reform will take six or seven conversations per person to reach each 'target' in his organization's database, which includes hundreds of thousands across the state." (Kaiser Health News)

E-Prescribing Adoption and Use Increased Substantially Following Start of a Federal Incentive Program
"The data also suggest that among providers who were already e-prescribing, the federal incentive program was associated with a 9-11 percent increase in the use of e-prescribing -- equivalent to an additional 6.8-8.2 e-prescriptions per provider per month.... [F]inancial incentives can drive providers' adoption and use of health information technology such as e-prescribing, and ... health information networks can be a powerful tool in tracking incentives' progress." (Health Affairs)

House Subcommittee on Health to Hold Second Hearing on Administration Decision to Delay Employer Mandate and Reporting Requirements
"[The] House Ways and Means Health Subcommittee ... will hold a hearing on the Obama Administration's recent decision to delay the information reporting requirements and penalties associated with the employer mandate in the [ACA] until 2015. This hearing will allow the Subcommittee to hear directly from the U.S. Department of the Treasury about its decision to not enforce statutory provisions in law. The Subcommittee will hear testimony from J. Mark Iwry, Senior Advisor to the Secretary and Deputy Assistant Secretary for Retirement and Health Policy. The hearing will take place on Wednesday, July 17, 2013[.]" (Subcommittee on Health, Committee on Ways and Means, U.S. House of Representatives)


Did Employers Just Become Aggressive Obamacare Implementers?
"'The Obama administration has just put dropping health coverage on sale for employers,' [American Action Forum president Douglas] Holtz-Eakin said. 'There is an unambiguous incentive now for employers to stop providing health insurance, prepare to pay the penalty, and send their employees to the exchanges instead, where they can get much more heavily subsidized coverage,' Holtz-Eakin said. 'They now have a year to make the transition.'" (Galen Institute)


'The Potential for Massively Expensive Fraud, or Even Massively Expensive Confusion, Is Just Enormous'
"That's from Yuval Levin ... on why the numbers are likely to be wrong when people self-report their income to the health insurance exchanges in order to get subsidies. What happens when the subsidies are later discovered to have been too large?" (John Goodman's Health Policy Blog)


Even People Who Haven't Filed a Tax Return Will Get Insurance Subsidies with No Verification Required
"So, if your submitted information matches the information on record, or you have a plausible explanation for why it doesn't, the government is happy but if your income representations don't match anything they have on record or you 'cannot provide an acceptable explanation' -- including those who don't have a tax return on file -- they are only going to check that small statistically valid sample? What am I missing here?" (Health Care Policy and Marketplace Review)


How Companies Can Resuscitate Their Health Plans
"In theory, companies across the U.S. have spent the last several years implementing initiatives to make their health benefit plans more efficient, to maintain the option of offering every full-time employee 'affordable' coverage ... [T]he bad news, all these efforts have been for naught. The good news is you've been given an extension....First, even if you do keep your wellness program, stop poking your employees with needles.... Second, fire your health care consultants.... Third, conduct an old-fashioned claims and eligibility audit ... Fourth, do you know how much money your prescriptions benefits manager makes off each prescription?... Fifth, a small percentage of your employees generate a large percentage of claims due to ongoing health needs[.]" (Tom Emerick and Al Lewis via CNN Money)


Getting Obamacare's Messaging Right
"At the heart of most public health communication plans are three main functions: create a message, deliver the message and get people to act on the message ... The HHS/NFL combo would likely have failed the test: What exactly does someone who catches a football for a living say that would make the uninsured purchase insurance on an exchange? While it's easy to single out HHS and the administration, the opposition party also thinks messaging alone will solve all of its ills but that is far from correct assumption in our view." (The Health Care Blog)

Benefits in General; Executive Compensation

[Guidance Overview]

Supreme Court Rules Part of DOMA Unconstitutional; Action Steps for Employers
"[T]here are at least five steps that any affected employer should now be considering: [1] Stop imputing income for federal income and FICA tax purposes on health plan coverage provided for a same-sex spouse, but continue imputing income for state income tax purposes if the employee resides in a non-recognizing state; [2] Communicate the Supreme Court's decision to employees, and request that any employees in same-sex marriages that may not be known to the employer identify themselves; [3] Offer a mid-2013 enrollment right under welfare plans for same-sex spouses not previously eligible; [4] Identify all employee plan provisions that may be affected by a changed definition of the term 'spouse'; [and] [5] Identify all past and present employees who are in a same-sex marriage." (The Wagner Law Group)

Use of Flexible Benefits Increases, Improving Employee Engagement
"The use of flex plans is becoming ever more widespread, with 70% of organizations surveyed offering them -- up from 62% in 2012.... [Other] key findings ... include: [1] Over half of respondents spend more than 15% of payroll on benefits and more than a third spend more than 20% of payroll on benefits.... [2] 45% of respondents cite attracting and retaining talent as the most popular reason for offering benefits. [3] More than half of respondents evaluate their benefits strategy. The evaluation measures they use are partly aligned with the reasons they give for offering benefits." (Aon Hewitt)

DOMA is (Almost) Dead -- Now What?
27 presentation slides. Titles include: Review of the Supreme Court's Decision; Health and Welfare Plans; Retirement Plans; Other Plans; Retroactivity and Other Sticky Issues; Expected Future Guidance. (Morgan Lewis)

CBO Cost Estimate for H.R. 1135, 'Burdensome Data Collection Relief Act'
"Under current law, issuers must disclose the relationship between executive compensation paid and the financial performance of the issuer as well as a comparison of the median total compensation of the issuer's employees, exclusive of the chief executive officer's (CEO) compensation, with the total annual compensation of that CEO. Under [H.R. 1135] that information would no longer be reported to the SEC. Based on information from the SEC, CBO expects that incorporating the provisions of H.R. 1135 at this point in the regulatory process would not require a significant change in the workload of any agency. Hence, CBO estimates that any change in discretionary spending by the SEC to implement the legislation would not be significant." (Congressional Budget Office)

Press Releases

NCPA Offers Members Turnkey Resource to Keep Prescription Drug Benefits Local
National Community Pharmacists Association (NCPA)

Join the discussion LinkedIn   Follow us Twitter   Like us Facebook
BenefitsLink.com, Inc.
1298 Minnesota Avenue, Suite H
Winter Park, Florida 32789
Phone (407) 644-4146
Fax (407) 644-2151

Lois Baker, J.D., President
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager

Copyright © 2013 BenefitsLink.com, Inc. but feel free to forward this newsletter if done without modification in any way.

All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of that content. You may not alter or remove any trademark, copyright or other notice from copies of the content.

Links to Web sites other than those owned by BenefitsLink.com, Inc. are offered as a service to readers. The editorial staff of BenefitsLink.com, Inc. was not involved in their production and is not responsible for their content.

Useful links: