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July 19, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Benefits Director (Personnel Director)
for Municipality of Anchorage in AK

Retirement Services Consultant
for CUNA Mutual Group in WI

Sr. 401K/DC Plan Administration Specialist
for CUNA Mutual Group in WI

Director, Account Management - Large Market
for Lincoln Financial Group in IL, IN

Pension Actuarial Analyst
for Cammack LaRhette Consulting, Inc. in NY

Communications Specialist for Defined Contribution/401(k) Plans
for Hays Companies in MN

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Webcasts and Conferences

Health Care Reform for Employers: Now What? - Washington, DC
September 27, 2013 in DC
(Lorman Education Services)

Health Care Reform for Employers: Now What? - Eugene, OR
September 25, 2013 in OR
(Lorman Education Services)

The Importance of Good Internal Controls Phone Forum
August 8, 2013 WEBCAST
(Internal Revenue Service (IRS))

Retirement Due Diligence Conference is coming to Chicago on Wednesday, August 14th.
August 14, 2013 in IL
(401(k) Rekon)

View All Webcasts and Conferences


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[Guidance Overview]

Applying the Play or Pay Requirement: How to Handle Contingent Workers Hired Through a Staffing Agency
"Although the government has delayed the effective date for the new employer penalty, if a company uses a staffing agency, leasing company, professional employer organization (PEO), or other third party to secure workers, these concerns may result in questions for the company as early as this fall when workers begin exploring coverage through the new state insurance marketplaces. These concerns apply to all 'contingent workers,' including temporary workers, long-term regular workers, and rehired retirees.... It is entirely possible, and in fact likely in some circumstances, that a company that uses a third party for some of its staffing needs is actually the common law employer of these workers, even though the third party handles payroll and benefits, and may have initially hired the worker." (Jones Day)

[Guidance Overview]

Stop-Loss Insurers Maneuvered Out of Navigator Role
"HHS said in order to provide information to consumers, Navigators must be 'fair and impartial.' However, in the agency's view, stop-loss insurers cannot meet this standard because they have a financial incentive both to encourage small employers to self-fund, and to not explain coverage options that may include insured products. The rules become effective on Aug. 12, 2013." (Thompson SmartHR Manager)

[Guidance Overview]

Massachusetts Fair Share Law and HIRD Form Requirements Repealed
"While this is welcome news for employers doing business in Massachusetts, there remains cause for vigilance: The Department of Unemployment Assistance intends to continue its enforcement efforts of Fair Share filing periods ending on or before June 30, 2013.... The budget creates a new Employer Medical Assistance Contribution, which requires each employer with more than 5 employees to contribute an amount equal to wages times .36 of 1%.... Governor Patrick has said that, if businesses start dropping coverage between now and the advent of the [ACA] mandate, he is 'confident that the Legislature would act to re-implement the state [fair share] program.'" (Mintz Levin)

New York Health Exchange Rates: Comparing Apples to Donuts
"[O]ver the next few weeks, many more states will release their exchange rates and much will be made about whether there will be great savings or too high or good or bad in comparison to other things. In reality, for employers, they are sort of just noise. Plans sponsors have to look at their costs and evaluate three things: (1) whether to offer coverage, (2) what level to offer and (3) what contributions to require. Comparing the exchange rates to group premiums for employer-sponsored coverage is not a fair comparison." (Fox Rothschild LLP)

U.S. Sees Lower-Than-Expected Obamacare Insurance Costs
"[HHS] said data from 10 states and the District of Columbia shows preliminary 2014 premiums on the lowest-cost mid-range silver plans in those marketplaces to be 18 percent lower on average than earlier administration and congressional estimates. Rates for businesses with fewer than 50 employees that purchase small-group coverage through exchanges could also be 18 percent lower than what the same plans would cost without the healthcare reform law, based on data from six states, HHS said." (Reuters)


[Advert.]

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.



Health Exchange Rates Surprisingly Low
"Blue Shield of California says it expects rates for its policyholders to increase 13% on average in 2014, an increase executives say will be 'legitimately below what people expected them to be.'" (HealthLeaders Media)

A Refund from Your Health Insurance Company? Thank the ACA
"President Obama explained that 'last year, millions of Americans opened letters from their insurance companies -- but instead of the usual dread that comes from getting a bill they were pleasantly surprised with a check. In 2012, 13 million rebates went out, in all 50 states.' Another 8.5 million rebates are being sent out this summer, averaging around $100 each, he said." (The White House Blog)

Does Temporary Employment Count Toward FMLA Eligibility?
"No wiggle room here, as far as the DOL is concerned. As to FMLA eligibility, a temp employee apparently is no different than a regular employee on day one. No 326-point joint employer test required. No nothin'. It's just a done deal." (FMLA Insights)

The Math Behind the Government's Subsidy of Employer Health Care Costs in 2014
"If the workforce demographics are right, the employer's workforce will be eligible for premium tax credits and be in a better position than they were if the employer had not terminated their health plan -- a win-win situation for an employer and their employees. This publication explains the math behind the strategy to give readers a better idea of how valuable the strategy could be if the workforce demographics are right." (Moulder Law)

Obamacare Penalties Spawn 'Skinny' Health Plans
"Employers heaved a sigh of relief when the Obama administration announced it would not enforce Obamacare's mandate that large companies provide insurance to their workers next year. But some companies plan to offer 'skinny plans' designed to duck the biggest penalties anyway ... And the Obama administration has extended its blessing to this limited coverage, even though it would not protect individuals from medical bills that could cause financial ruin in the case of severe injury or illness." (Politico)

Insurance Exchanges Foster Competition, Consumers Stand to Benefit
"These developments sound like the dreams of health reformers that fueled passage of the [ACA]. But they're proving to be reality now in many states -- particularly in the 17 jurisdictions (including the District of Columbia) that are creating state-based health insurance exchanges ... [1] Health insurance for many individuals that is cheaper and better than what's available now. [2] More competition among health insurers than ever before. [3] Partnerships between health plans and providers to deliver care at affordable cost." (Robert Wood Johnson Foundation)

House Bill Would Repeal Medicare SGR Formula, Grant Annual Pay Raises for 5 Years
"House lawmakers late Thursday released the final draft of a bill that repeals Medicare's sustainable growth rate (SGR) payment formula and replaces it with a system that incentivizes quality and efficiency starting in 2019. The bipartisan measure provides 5 years of stable Medicare payments starting next year, with reimbursements growing 0.5% for each year between then and 2018, according to the 70-page, yet-to-be-named bill. After those 5 years, physicians would be subject to having reimbursements based on performance on quality measures, or may opt out of that requirement if they practice in certain alternative payment models." (MedPage Today)

Sixth Circuit Finds Self-Dealing by Blue Cross When 'Other-than-Group' Fee Used to Pay Medigap Obligation (PDF)
"[Blue Cross] unilaterally determined whether to collect the ['other-than-group' (OTG)] fee and determined the rate at which it would collect the fee from [the self-funded plan] despite the fact that the [administrative services contract] did not authorize the exercise of such discretion. [Blue Cross] then used the discretionarily collected OTG fees 'for [its] own account' -- specifically, to satisfy its independent Medigap obligation to the State of Michigan.... Though ERISA's duties of loyalty and care are undeniably broader than the prohibition against self-dealing, acting with the 'care, skill, prudence, and diligence' 'with an eye single to the interests of the participants and beneficiaries,' ... necessarily requires that an ERISA fiduciary not use plan assets for its own purposes." [Pipefitters Local 636 Insurance Fund v. Blue Cross and Blue Shield of Michigan, No. 12-2265 (6th Cir. July 18, 2013)] (U.S. Court of Appeals for the Sixth Circuit)

Medicaid Demonstration Waivers: Approval Process Raises Cost Concerns and Lacks Transparency
"The [HHS] budget neutrality policy and process did not provide assurances that all recently approved demonstrations will be budget neutral. For 4 of 10 demonstrations GAO reviewed, HHS approved spending limits that were based on assumptions of cost growth that were higher than its benchmark rates, and that, in some cases, included costs states never incurred in their base year spending. HHS's benchmark growth rates are the lower of the state's recent growth rates or projections for Medicaid program growth nationwide.... For 6 other demonstrations, the approved spending limits reflected the states' actual historical costs or criteria that were specified in law, which HHS followed." (U.S. Government Accountability Office)

Developments of Interest to Sponsors of Multiemployer Health Plans, Third Quarter 2013 (PDF)
Covered topics include the rate of increase in health plan costs trends for 2013, Treasury's decision to delay the employer shared responsibility requirements until 2015, opportunities being explored by plan sponsors that focus on improved patient outcomes and cost efficacy, and the continued entrance into the health care market of alternative medical delivery and reimbursement systems such as accountable care organizations. (Segal)

Health Status of Exchange Enrollees: Putting Rate Shock in Perspective
"If the populations are comparable, unsubsidized premiums in the reformed nongroup market should be set at reasonable levels once reform is fully phased-in. While individuals with higher-than-average health care needs may be somewhat more likely to enroll in the nongroup market in the first year, once past the transition period, the health characteristics of nongroup enrollees can be expected to be quite similar to those with employer-based insurance." (Urban Institute)

[Opinion]

Obama Spins Health Insurance Rebates
"In his speech defending his health care law Thursday, Obama said rebates averaging $100 are coming from insurance companies to 8.5 million Americans. In fact, most of the money is going straight to employers who provide health insurance, not to their workers, who benefit indirectly. Obama danced around that reality in remarks that also blamed problems in establishing affordable insurance markets on political opponents, glossing over complex obstacles also faced in states that support the law." (Ricardo Alonso-Zaldivar via U.S. House Committee on Ways and Means)

[Opinion]

A Really Helpful Chart on Premiums Under Obamacare
"[This chart] shows what insurance plans will charge for coverage that will cover 70 percent of a typical subscriber's health-care costs.... What's striking ... is that premiums look relatively similar despite wildly different rhetoric across the country. California and Ohio might be the best examples of this. When California announced its rates, the Democrat-led state celebrated how affordable prices came in. When Ohio released data, it derided how expensive health insurance would be under the federal reforms." (Sarah Kliff in The Washington Post)

[Opinion]

Obamacare: Simplified
"[A chart shows] how the Treasury's inspector general for tax administration explained the Obamacare enrollment process ... The process for determining subsidy eligibility could require 21 different steps, involving at least five separate entities -- the Social Security Administration, the Department of Homeland Security, the Department of Health and Human Services, the Internal Revenue Service, and state exchanges[.]" (The Heritage Foundation)

[Opinion]

Fact-Checking Obama's Healthcare Speech
"New York's premiums will remain among the costliest in the nation after Obamacare becomes fully operational. Legislation passed over the last two decades has driven health insurance premiums in the state to among the highest in the country. Premiums have nowhere to go but down, and the primary driver of the lower premiums is the widely-despised individual mandate which will force healthier, reluctant buyers into the exchanges." (Galen Institute)

[Opinion]

Rebutting President Obama on Obamacare and Premiums
"[1] The President claimed that Obamacare was serving as a 'check on rising costs.' But what he didn't say is that Obamacare is actually reducing costs -- because it's not. The non-partisan Medicare actuary concluded that Obamacare would raise national health spending by hundreds of billions of dollars. [2] The President claimed that the 85 percent of individuals with employer-provided health insurance are seeing 'better benefits.' But there's a catch ... Obamacare's 'free' preventive benefits in most cases will actually raise costs and premiums.... [3] The President claimed that those buying health insurance in the individual market would see more choice lower premiums due to Obamacare. But that's not what the Congressional Budget Office said[.]" (The Heritage Foundation)

Benefits in General; Executive Compensation

[Guidance Overview]

Transcript and Video of IRS Phone Forum: 'When is a Government Entity and Their Employees Excluded from Participating in Social Security: FICA Replacement Plans'
"[In this recording of the phone forum, we] discuss those other circumstances Government Employers and Employees don't participate in Social Security; namely FICA replacement plans. We will discuss Revenue Procedure 91-40 that sets forth rules relating to the minimum retirement benefit requirement prescribed under Employment Tax Regulations.... Let's take a look at our decision tree or flow chart for Social Security and Medicare Coverage of State and Local Government Employees. This can also be found in IRS Publication 963 'Federal-State Reference Guide'[.]" (Internal Revenue Service)

SEC Said Near Proposal on Disclosure of CEO-to-Worker Pay
"Public companies would be required to disclose how much more their chief executives are paid than rank-and-file workers under a rule to be proposed next month by U.S. securities regulators, according to two people familiar with the matter.... The SEC could vote to introduce the regulation as soon as Aug. 21[.]" (Bloomberg)

2013 Director Compensation Study Summary
"Total compensation paid to non-employee directors rose +4.5% over 2011 levels, to a median of $261,333.... Pay mix for non-employee directors has remained relatively unchanged since 2007. Directors continue to receive just over half of their total compensation in the form of equity (55% in 2012), in accordance with governance best practices.... Annual Cash Board Retainer increased $5,000 in 2012 to a median of $85,000 and the median Annual Equity Board Retainer increased $10,000 to $140,000 ... Equity compensation is delivered predominantly in full value shares while the prevalence of options continues to sink, reaching the lowest level observed over the last five years." (Steven Hall & Partners)

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