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August 13, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

DC Plan Administrator
for The Retirement Plan Company, LLC in ANY STATE, OH, SC, TN

Senior Benefits Consultant/Team Leader
for Hub International Midwest Limited in IL

Account Coordinator
for The Plexus Groupe LLC in IL, TX

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Webcasts and Conferences

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

18th Annual Conference
November 18, 2013 in AZ
(National Business Coalition on Health)

"Focused Topics for the Experienced Practitioner" - New Web Seminar Series, 12 Segments, September - December
September 3, 2013 WEBCAST
(SunGard Relius)

HIPAA Business Associate Contracts: Sample Language and Compliance Steps for Covered Entities and Business Associates
September 12, 2013 WEBCAST
(Thomson Reuters / EBIA)

Helping Small Business Owners Save for Retirement -- Webcast Archive
August 27, 2013 WEBCAST
(Employee Benefits Security Administration (EBSA), U.S. Department of Labor)

Helping Small Business Owners With New Retirement Plan Fee Disclosures -- Webcast Archive
August 28, 2013 WEBCAST
(Employee Benefits Security Administration (EBSA), U.S. Department of Labor)

Voluntary Fiduciary Correction Program Webinar
August 29, 2013 WEBCAST
(Employee Benefits Security Administration (EBSA), U.S. Department of Labor)

View All Webcasts and Conferences


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

Text of Final IRS Regs on Disclosure of Return Information to Carry Out Eligibility Requirements for Health Insurance Affordability Programs
"This document contains final regulations relating to the disclosure of return information under section 6103(l)(21) of the Internal Revenue Code, as enacted by the [ACA]. The regulations define certain terms and prescribe certain items of return information in addition to those items prescribed by statute that will be disclosed, upon written request, under section 6103(l)(21).... After consideration of the written comments and the information provided to the IRS by HHS, the proposed regulations under section 6103(l)(21) are adopted as revised by this final regulation." (Internal Revenue Service)  


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[Guidance Overview]

Administration Delays ACA Rule That Would Have Capped Out-of-Pocket Costs for Consumers
"[T]he administration has delayed until 2015 a significant consumer protection in the law that limits how much people may have to spend on their own health care. The limit on out-of-pocket costs, including deductibles and co-payments, was not supposed to exceed $6,350 for an individual and $12,700 for a family. But under a little-noticed ruling, federal officials have granted a one-year grace period to some insurers, allowing them to set higher limits, or no limit at all on some costs, in 2014." (The New York Times; subscription may be required)  

[Guidance Overview]

Too Soon for Party Hats: Employers Face Array of 'Underground' Challenges Following the Employer Mandate Delay
"[B]eginning October 1, 2013, tens of millions of individuals -- many of them someone's employee -- will be prompted and prodded (perhaps, even shamed and scared) into seeking individual health insurance coverage for themselves and their families through one of the new Marketplaces ... Because all other stakeholders must deal directly with the ACA in 2014, no organization that depends on employees and non-employee workers to function will have the luxury of simply taking a year off and revisiting the ACA sometime next summer when it comes time to figure out what to do for 2015." (BakerHostetler)  

[Guidance Overview]

The Interaction of ERISA 510 and FLSA 18C with the ACA
"Many employers have discussed a strategy of limiting a certain segment of their workforce's hours of service to less than 30 hours per week so that segment of employees will not count for purposes of the Play or Pay Mandate. The hotly debated issue is whether this strategy violates ERISA Section 510.... Although [it] has garnered far less attention, FLSA Section 18C, which was added by the ACA, was also adopted to protect employees.... [It] prohibits an employer from discriminating against an employee with respect to his/her compensation, terms, conditions or other privileges of employment because the employee received a premium tax credit." (Moulder Law)  

[Guidance Overview]

Breach Notification Rules under HIPAA Omnibus Rule
"Health plan sponsors should make training workforce members about the breach notification rules a priority.... A breach is treated as discovered by the covered entity on the first day a breach is known, or, by exercising reasonable diligence would have been known, to the covered entity. This standard is met if even one workforce member knows of the breach or would know of it by exercising reasonable diligence, and even if the breach is not immediately reported to the privacy officer." (DrinkerBiddle)  


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23rd Annual National Health Benefits Conference & Expo

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DOL Staff Memo Extends Family Leave to Same-Sex Spouses
"The Labor Department [has affirmed] that same-sex married couples can take a leave from their jobs to care for an ill spouse, the first of several moves the agency said it would make after the Supreme Court struck down a law denying federal benefits to legally married same-sex couples.... Labor Secretary Tom Perez announced the changes in a memo to [DOL] staff on Friday [August 9.]" (The Wall Street Journal; subscription may be required)  

Sixth Circuit Finds Lifetime Vesting of Retiree Medical Benefits, But Allows 'Reasonable Changes' to Benefit Terms (PDF)
"The district court's presumption that, in the absence of extrinsic evidence to the contrary, the agreements indicated an intent to vest lifetime contribution-free benefits was in accordance with both Tackett I and the CBA language promising a 'full contribution' to qualifying employees. To the extent that vesting was presumed, it was not the district court that, sua sponte, shifted the burden of proof, but rather the language of the CBA and its linkage of health care benefits to pension benefits ... that led to the conclusion that retirees had a vested right to health care benefits and, in the absence of evidence to the contrary, a vested right to contribution-free health care benefits. Having reached the conclusion that benefits were vested, it was then reasonable for the district court to conclude that those benefits could not be bargained away without retiree permission." (U.S. Court of Appeals for the Sixth Circuit)  

Employers Reassess Retiree Health Benefits Strategy
"[M]ore than 60 percent of U.S. employers are reassessing their long-term retiree health strategies ... Of those companies that have already decided to make strategy changes to health coverage for post-65 retirees, more than 40 percent have moved forward with directing retirees to the individual market for coverage, often accompanied by a defined contribution subsidy." (Society for Human Resource Management)  

Short-Term Disability Claim Trumps FMLA Certification Request
"A recent appeals court ruling indicates that an employer may wait and see if short-term disability benefits are granted or denied to the employee on leave before it sends a request for medical certification that verifies the employee's eligibility under the [FMLA].... 'The standard for disability status under Ohio Bell's short-term disability insurance policy is similar enough to the "serious health condition" standard for FMLA leave that denial of the former at least raises a question as to the appropriateness of the latter,' the circuit court found." [Kinds v. Ohio Bell Telephone Company, No. 12-4048 (6th Cir. July 29, 2013)] (Thompson SmartHR Manager)  

No-Cost Healthcare Screenings Required by ACA
"Certain publicly and privately insured patients starting in 2014 will be able to receive approved preventive services at no additional out-of-pocket cost. Services given a grade of A (substantial net benefit) or B (moderate-to-substantial net benefit) by the U.S. Preventive Services Task Force will be covered for free for patients meeting gender, age and risk factor prerequisites. Select the [individual's gender] and age to see full list of preventive services that might apply to him or her." (amednews.com)  

Obamacare Presents Complex Choices For People With Disabilities
"The [ACA] has set new standards -- called essential health benefits -- outlining what health insurance companies must now cover. But there's a catch: Insurance firms can still pick and choose to some degree which specific therapies they'll cover within some categories of benefit. And the way insurers interpret the rules could turn out to be a big deal for people with disabilities who need ongoing therapy to improve their day-to-day lives." (Kaiser Health News)  

With 50 Days to Enrollment, a Focus on Ten States
"[Enroll America] has been using more than 100 staff and about 3,000 volunteers to go door-to-door and to stage community events this summer to inform people about the opportunities for health care coverage on the exchanges.... [T]he group [will] focus most of its effort on 10 states with the largest number of uninsured and the lowest level of state-funded outreach... In the remaining 40 states, the group's regional directors will be working without staff to support state-led and other local efforts." (The Pew Charitable Trusts)  

A One-of-a-Kind Private Exchange
"While an expanded roster of health plans that employees can choose from is generally considered a fundamental element of health-insurance exchanges ... Buck contracts with a single insurance carrier in each geographic market (there are hundreds of them in the United States) to provide a portfolio of plan designs, and each employer-customer can offer employees as many of them -- or as few -- as it likes. But if there are only one or two options, is it really an 'exchange'?" (CFO)  

ACA Exchanges May Aid Quality Reporting
"As many as nine states, with California leading the way and others like Delaware and Rhode Island following, will already have exchange plans reporting quality measures next year. The hope is to give consumers more information to help them select plans in the exchanges, much like Medicare Advantage does with its current star-ratings system." (MedPage Today)  

High-Deductible Plans Increase Bad Debt, Hospitals Say
"The rate of workers in high-deductible plans has more than doubled since 2009 to 19 percent ... The deductibles can be as high as $5,000 annually, although they're meant to be offset at least in part by a tax-free health savings account.... 'The number of accounts that we're seeing that relate to these high-deductible plans has been building, and it has been putting pressure on our bad debt levels,' [said] Daniel Cancelmi, financial chief at Tenet Healthcare [which] operates 49 hospitals and 129 outpatient centers across the country[.]" (FierceHealthPayer)  

Exposure Draft: Minimum Value and Actuarial Value Determinations Under the ACA (PDF)
"This practice note is intended to provide information to health actuaries who will be determining minimum value (MV) and actuarial value (AV) for health insurance plans, including providing an independent actuarial certification, in accordance with the [ACA] ... There is significant conceptual and mathematical overlap between the AV required for individual and small group determination of 'metal values' and the MV requirements for large-group plans, as well as large and small-group self-insured plans. There are also some important differences between the two." (2013 MV/AV Practice Note Work Group, American Academy of Actuaries)  

[Opinion]

Strong Opinions, Strongly Divided on ACA
"Given that a majority views [the] health system's performance unfavorably, why is it so divided about the ACA? The reasons are three ... [1] The public has no view of what a 'high performing health system' should be.... [2] The system is complicated -- labor intense, capital intense, highly regulated at the state and federal levels, and fragmented.... [3] The ACA's elements targeted to reducing health costs are not understood." (Paul Keckley, Deloitte Center for Health Solutions)  

Benefits in General; Executive Compensation

Who Is a Spouse? Different Federal Agencies Take Differing Approaches After Windsor
"Weeks after the Windsor decision, the few federal agencies that have issued guidance have taken wildly disparate approaches.... There is a clear need for prompt guidance, coordinated among the various agencies. Moreover, unless the guidance takes the OPM approach (treating a marriage as valid if it was recognized by the state performed, regardless of the laws of the state of residence), employers can expect to have to undertake determinations of marital status far more complex than just determining whether the employee's current state of residence permits same-sex marriage." (Calhoun Law Group)  

Press Releases

Santa Rosa, Calif., Investment Firm, Officers Ordered to Restore Nearly $602,018 to 13 Employee Benefit Plans
Employee Benefits Security Administration (EBSA), U.S. Department of Labor

Legal Services Plan Customer Service Matters
Hyatt Legal Plans, a MetLife company

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