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August 12, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Senior Analyst - Health Benefits
for Unite Here Health in IL

for Sullivan, Ward, Asher & Patton, P.C. in MI

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Webcasts and Conferences

Technology for the Retirement Plan Professional -- Webcast
September 18, 2013 WEBCAST
(American Society of Pension Professionals & Actuaries (ASPPA))

Defined Benefit Plan Half Day Workshop
August 27, 2013 in OH
(ASPPA Benefits Council of Cleveland)

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  LinkedIn   Twitter   Facebook Hand-picked links to the web's best news articles,
official guidance, jobs, webcasts and more.
[Official Guidance]

Online Training for Federally-Facilitated ACA Exchanges Now Open
Online training is open for agents and brokers who wish to operate within the federally facilitated health insurance marketplaces (exchanges). Agents and brokers who wish to participate in the exchange also must undergo an exchange training course, and agree to comply with federal and state exchange laws. Agents are able to select training in the Individual Market, the Small Business Health Options Program (SHOP), or a combination Individual Market/SHOP course. Although the online training is open, a high volume of users to the training curriculum may delay your access to this training. (U.S. Department for Health and Human Services)  


DATAIR! 5500 Filing for Welfare, Flex & Pension Plans

Sponsored by DATAIR Employee Benefit Systems, Inc.

EFAST2 5500 filing with all schedules and SAR. Instant validation.
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(888) 328-2474   Sales@DATAIR.com   www.DATAIR.com

[Official Guidance]

CMS Submits Process for Obtaining Exemptions from Individual Shared Responsibility Payments for OMB approval
The description of CMS' expectations about the exemption application process begins at page 7 of the Supporting Statement included in the agency's Paperwork Reduction Act filing with OMB ("Information Collection Request"). Excerpt: "To develop the notice [of exemption], Exchange staff would need to learn exemption eligibility rules related to exemptions and draft notice text for various decision points, follow up, referrals, and appeals procedures. A health policy analyst, senior manager, and an attorney would review the notice. The Exchange would then engage in review and editing to incorporate changes from the consultation and user testing including review to ensure compliance with plain writing, language access, and readability standards. Finally, a computer programmer would program the template notice into the eligibility system so that the notice may be populated and generated in the correct format. HHS is currently developing model notices, which will decrease the burden on Exchanges associated with providing such notices." (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

[Official Guidance]

CMS Submits Proposed Form for Use in Obtaining Minimum Essential Coverage Certification for OMB Approval
Excerpt from the Supporting Statement: "CMS will need the information to determine whether the plan sponsored by the requesting sponsor may be recognized as minimum essential coverage. CMS will maintain a public list of the types of coverage that have submitted this information and have been determined by the Secretary to meet the eligibility requirements to be recognized as minimum essential coverage. Consumers will also need to know that the types of coverage they are enrolled in are recognized as minimum essential coverage." (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

[Official Guidance]

Guidance on State Alternative Applications for Health Coverage Through the Small Business Health Options Program (SHOP) (PDF)
"There are a number of ways that a state may adapt the model applications without need for formal approval from CMS as an alternative application.... Formal approval from CMS is not required for these changes if they do not add burden on the consumer.... If your state's application differs from the model application in ways other than those ... which do not require CMS approval, CMS will review these changes to ensure that the state's application is consistent with the applicable statute and regulations, and maintains the principle of minimizing burden on the consumer.... States proposing to use an alternative application should also provide an analysis document that identifies and describes key differences between the model application and the state's alternative application, in terms of the modifications that require CMS approval[.]" (Center for Consumer Information & Insurance Oversight, Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

Oregon to Take Two to Four Weeks for Debugging of Exchange Website
"Oregon's health-insurance exchange -- the marketplace created by federal law to let consumers shop online for coverage -- will open for business on Oct. 1, but with a glitch: Consumers won't be able to access it online. Officials at Cover Oregon ... said people will be able to use the new website at home by the end of October. They decided to limit access for two to four weeks while they debug the site, fixing flaws before opening it up to the general public." (The Wall Street Journal; subscription may be required)  


National Business Coalition on Health Annual Conference

Sponsored by National Business Coalition on Health

Register now for the National Business Coalition on Health's (NBCH) 17th Annual Conference, November 18-20, 2013 in Scottsdale, AZ to gain insight and learn best practices for improving health and transforming health care.

Retroactive Withdrawal of COBRA Offer Can Be Breach of Fiduciary Duty
"Withdrawing an offer of COBRA is risky -- withdrawing an offer retroactively even more so. While the court refused to impose notice penalties (presumably because a timely election notice had been provided), the employer must still stand trial to determine if it breached its fiduciary duties by withdrawing the COBRA offer after it learned of the employees' relationship. The DOL's conclusion that the employees were not terminated for gross misconduct is interesting, and we wonder if it was influenced by the fact that the evidence of the misconduct was not uncovered until after the employees' termination." [Danois v. i3 Archive Inc., 2013 WL 3556083 (E.D. Pa. 2013)] (Thomson Reuters / EBIA)  

Court Overturns Benefit Denial Due to Plan's Improper Application of Experimental Exclusion
"An accumulation of procedural irregularities contributed to this result. Notably, proper delegation of discretionary authority would have increased the likelihood of deferential, rather than de novo, review. But the real problem lies in the plan's failure to adequately support its rationale for applying the experimental exclusion. Claim denials are more likely to be upheld when the administrative record shows that the decision resulted from meaningful consideration and was supported by the evidence and adequately communicated to the participant." [Dubaich v. Connecticut General Life Ins. Co., 2013 WL 3946108 (C.D. Cal. 2013)] (Thomson Reuters / EBIA)  

The Slowing of Health Care Spending: Have We Turned a Corner?
"It is likely that important structural changes are occurring in health care and that these changes are a major contributor to bending the spending curve and to permanently removing costs from the delivery system. Although the proof for this point of view is not yet definitive, the depth and breadth of change suggest that significant transformation in the nation's delivery system is under way." (Kenneth Kaufman and Mark Grube in Health Affairs)  


When a Co-Pay Gets in the Way of Health
"In health care, a doctor or patient might order an extra test casually, just because it's free. This is inefficiency at its worst: from money spent on costly procedures to tests and medicines that provide little medical benefit, some actions are undertaken only because someone else picks up the check. To discourage this waste, insurance plans charge co-payments. The logic is simple: if patients face costs, they will think more carefully about the benefits. But people don't always follow a cost-benefit logic." (The New York Times; subscription may be required)  


Beyond the ACA: A Framework for Getting Health Care Reform Right
"[W]e've gotten very far away from thinking about overarching principles that we think should guide the design of a health system, and what that implies for what it would look like.... First, economic efficiency is a goal.... The second goal is that no American is exposed to excessive risk to their health or finances due to medical expenses. Last, the overarching design principle is to create basic ground rules for the system and then let the system run, avoiding heavy handed regulation or micro management. The key objective of these ground rules is to give participants the right incentives insofar as possible, while achieving insurance objectives." (The Health Care Blog)  

Benefits in General; Executive Compensation

Department of the Treasury 2013-2014 Priority Guidance Plan, August 9, 2013 (PDF)
"The 2013-2014 Priority Guidance Plan contains 324 projects that are priorities for allocation of the resources of our offices during the twelve-month period from July 2013 through June 2014 (the plan year). The plan represents projects we intend to work on actively during the plan year and does not place any deadline on completion of projects.... Some projects that were on the 2012-2013 Priority Guidance Plan have not been included on the 2013-2014 plan because they are no longer considered priorities for purposes of allocating resources during the 2013-2014 plan year." [Employee Benefits projects start at page 5; they include 40 Retirement Plan projects, and 26 involving Executive Compensation, Health Care and Other Benefits.] (U.S. Department of the Treasury)  

College and University Benefits Study: 2012 Results and Strategies for 2013
"[P]ublic institutions are more likely than private institutions to offer retiree health benefits to new hires (87 percent vs. 66 percent), and private institutions are more likely than public institutions to offer an account-based defined contribution (DC) retiree health plan to new hires (29 percent vs. 7 percent).... All private institutions offered DC retirement-income plans and only 5 percent offered defined benefit (DB) pension plans. In contrast, 79 percent of public institutions offered both DB and DC plans." (Sibson Consulting)  

District Court Case Shows Difficulty of Administering Windsor Decision
"[If] Illinois does not recognize same-sex marriages, how could the court come to a conclusion that there was no doubt that the women were married under Illinois law? The court addressed this issue in a footnote by noting that, while Illinois does not issue marriage licenses to same-sex couples, Illinois can recognize same-sex marriages solemnized in other jurisdictions, such as Canada, by virtue of its civil union statute. Seemingly, because Illinois' civil union statute provides individuals with the obligations, responsibilities, protections and benefits afforded or recognized by the law of Illinois to spouses, the issue is really one of semantics[.]" [Cozen O'Connor v. Tobits, No. 2:11-cv-00045-CDJ (E.D. Pa. July 29, 2013)] (Bloomberg BNA)  

Federal Life Insurance Rules Preempt State Law
"The Supreme Court recently decided ... that the federal laws governing a life insurance program for federal employees preempt a state equitable remedy. The decision suggests that a state law ownership claim, whether based on domestic relations law (other than one complying with plan terms), contract law, property disposition on death law, a court order, or other equitable principles, is preempted if it attempts to limit the ability of a participant in a plan governed by [ERISA] to choose beneficiaries, or the right of a beneficiary chosen by the participant under the plan terms to receive and keep those designated benefits.... These ERISA and FERS conclusions are supported by the ringing endorsement of [this case] and its reasoning in the Court's majority opinion of United States v. Windsor." (Albert Feuer in Bloomberg BNA Tax Management Weekly Report, via SSRN)  

Is Your Compensation Arrangement Subject to These 409A Rules? [Video]
"The 409A rules do not provide a clear roadmap to determine what compensation arrangements are subject to their regime of requirements and restrictions. [This video] provides a description of the approach you should take to evaluate whether your compensation arrangement should be structured to comply with the 409A rules regarding deferral elections, timing of payments and other requirements." (Benefits Bryan Cave)  

California Superior Court Dismisses Say on Pay Case
"The court found: None of the compensation-related information was rendered materially misleading by omission of information about the financial performance of Symantec or the other companies in the peer group. It was not substantially likely that disclosure of the comparative TSR information would have significantly altered the total mix of information available to the Symantec shareholders. The proxy adequately disclosed what the pay targets were based on, as well as the fact that compensation may be above the positioning benchmark based on consideration of factors other than performance." [Gordon v. Symantec, No. 1-12-CV-231541 (Cal. Super. Ct. for Santa Clara Cty. Aug. 2, 2013)] (Dodd-Frank.com, a blog by Leonard, Street and Deinard)  

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