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August 14, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Client Service Representative, Employee Benefits
for e3 Financial in CA

Defined Contribution Client Manager
for Milliman in CA

Defined Contribution Compliance Specialist
for The Guardian Life Insurance Company of America in MA

401k Administrator
for The Guardian Life Insurance Company of America in MA

Pension Administrator
for AFC Pensions, Inc. in MA

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Webcasts and Conferences

"Fundamentals of 401(k) Plans Web Series" New Format, September - October, 7 segments
September 9, 2013 WEBCAST
(SunGard Relius)

Free Work Comp Webinar: Controlling Work Comp Costs What Employers Need to Know
October 24, 2013 WEBCAST
(Davidson Marketing Group -- FutureOffice Network)

Worker Classification: What's New and What You Need to Do
September 12, 2013 WEBCAST
(ABA Joint Committee on Employee Benefits)

ERISA Basics National Institute
October 16, 2013 in IL
(ABA Joint Committee on Employee Benefits)

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]

DOL Updated Fact Sheet #28F: Qualifying Reasons for Leave under the FMLA (PDF)
"Spouse: Spouse means a husband or wife as defined or recognized under state law for purposes of marriage in the state where the employee resides, including 'common law' marriage and same-sex marriage." (Wage and Hour Division, U.S. Department of Labor)  


[Advert.]

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Sponsored by International Foundation of Employee Benefit Plans (IFEBP)

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[Guidance Overview]

DOL Says FMLA 'State of Residence' Rule Applies to Same-Sex Couples (PDF)
"Current FMLA regulations provide that status as a spouse is determined by the laws of the employee's state of residence. Fact Sheet #28F is just reiterating the provisions of the DOL FMLA regulations as they apply today to same-sex spouses. However, a recent statement made by Labor Secretary Tom Perez that the DOL will take additional steps to implement the Supreme Court's decision 'in a way that provides the maximum protection for workers and their families' opens the possibility that the DOL may ultimately revise the regulations to extend FMLA rights to all legally married same-sex spouses regardless of their state of residence." (Buck Consultants)  

[Guidance Overview]

Final Rules Issued on IRS Disclosure of Tax Return Information Under ACA
"[I]tems the IRS will disclose include adjusted gross income, any amount excluded under Sec. 911, tax-exempt interest, the fact that the taxpayer did not have a filing requirement for the year, and the fact that the taxpayer did not file a return for the year reconciling advance payments of the Sec. 36B premium tax credit with the amount of the premium tax credit available for the year ... [and] the amount of the taxpayer's Social Security benefits that are included in income under Sec. 86. This information will allow exchanges to determine a taxpayer's MAGI." (Journal of Accountancy)  

[Guidance Overview]

Clearing Up Confusion About Health Reform's Out-of-Pocket Protections
"In 2014, the maximum out-of-pocket limit will apply, as scheduled, to the individual (non-group) health insurance market.... The maximum out-of-pocket limit will also continue to generally apply to non-grandfathered plans offered by employers, including small group, large group, and self-insured plans.... An employer plan wouldn't have to add a cap to a separate benefit if the separate benefit currently lacks one. But this exception shouldn't be misunderstood as broadly waiving the important out-of-pocket protection that health reform will bring in 2014." (Center on Budget and Policy Priorities)  

[Guidance Overview]

Subcontractor Liability under the HIPAA Final Rules
"[U]nder the Final Regulations, a subcontractor that creates, receives, maintains or transmits protected health information (PHI) on a [business associate's (BA's)] behalf is a BA in its own right. A subcontractor is a person to whom a BA delegates a function, activity or service, other than in the person's capacity as a member of the BA's workforce.... For example, assume that a BA (such as a third-party administrator), hires a company to handle document and media shredding to securely dispose of paper and electronic PHI. The shredding company is directly required to comply with: The Privacy Rule ... [and] The HIPAA Security Rule[.]" (Practical Law Company)  


[Advert.]

Member Retention and Customer Service for Consumer-Based Health Plans - Sept. 19-20 - Boston

Sponsored by World Congress

Health plan executives and industry thought leaders discuss actionable strategies in the transformation to a consumer-driven and customer-focused health plan marketplace.



ACA Consumer Protections Take Effect, on Time -- Including Cap on Out of Pocket Expenses
"February guidance recognized that some employer plans use separate benefit administrators for their insurance coverage (for instance one for major medical coverage and another for drug coverage). Tech systems cannot communicate with one another yet, so the guidance allowed these existing plans to separately limit out of pocket spending on major medical expenses, and drug plans that currently have out-of-pocket limits. By 2015, Americans in these plans will have one, single maximum out-of-pocket limit of $6,350 for combined medical and drug costs, just like in the Marketplaces." (The White House Blog)  

Challenges To Premium Subsidies And Cost-Sharing Reduction Payments In States With Federal Exchanges
"The Oklahoma case was originally one of many cases brought by state attorneys general challenging the individual mandate. After the Supreme Court's decision in NFIB, however, [Oklahoma Attorney] General Pruitt amended his complaint to raise the premium tax credit issue.... [T]he Oklahoma case is likely to reach the merits of the challenge to the IRS rule. It will do so, however, before a judge that seems skeptical of the claim that the state of Oklahoma has been injured in some way by the IRS's decision to ensure that its residents receive premium tax credits." (Timothy Jost in Health Affairs)  

Quantifying Tax Credits for People Now Buying Insurance on Their Own
"Using CBO's estimate of an average premium for the second-lowest-cost silver in 2016, we estimate that the national average benchmark premium for a 40-year-old in 2014 would be $3,857 per year (or $321 per month).... We estimate that current individual market purchasers will face an average premium per family for the second-lowest-cost silver plan of $8,250 in 2014. This is an average premium across families of all sizes. Most current individual market enrollees are in families of one person (55%) or two people (29%)." (Kaiser Family Foundation)  

U.S. Schools Face Tough Decisions on Obamacare Benefits
"School boards, already struggling to manage after years of state budget cuts, are trying to get ahead of the potential costs of Obamacare for the current academic year ... The need to find creative solutions, or risk cutting back staff hours further, will increase as they finalize their budgets ... The National School Board Association said many states and school districts have at least explored reducing hours ... Most of the employees affected are substitute teachers, classroom aides, cafeteria workers, bus drivers or similar support staff, according to school officials and labor representatives. T" (Reuters)  

Moving to High Quality, Adequate Coverage: State Implementation of New Essential Health Benefits Requirement
"Technical glitches and tight deadlines posed challenges for insurers and regulators alike, but an 'all hands on deck' mentality and commitment to consumers have kept the product development and review process moving forward. Officials in all but one state reported that they have had good, if not always timely, communication with CMS regarding plan management and oversight. Insurers and regulators in most study states reported that the shift to an EHB standard would cause minimal change or disruption, but one state noted it would result in a significantly expanded set of benefits for individual policyholders. Insurers are engaging in minimal substitution of covered benefits in the first year, meaning that plans will closely resemble the benefits, limits, and exclusions prescribed in the benchmark package, with differences primarily reflected in cost-sharing and network design." (Robert Wood Johnson Foundation)  

DOL Backing Up FMLA Enforcement Promise: Employers Feel the Pinch
"Not too long ago, the DOL announced it would start ramping up FMLA enforcement, and that promise has already led to a number of costly settlements and court orders.... [President] Obama's proposed budget for 2014 called for the DOL's Wage and Hour Division to receive $243 million, an increase of about $14 million. And $3.4 million of that was specifically for increased enforcement of the FMLA. Now it looks like the agency is putting that money to use." (HR Benefits Alert)  

ML Strategies Health Care Reform Update, August 12th, 2013 (PDF)
Update on developments in federal and state health care reform legislation and regulations, including summaries of recent announcements and regulatory activity by HHS, CCIIO, IRS and CMS. (ML Strategies, LLC)  

[Opinion]

It's Not the Age Bands, It's the Medical Underwriting
"Advocates of universal coverage should think carefully about the prospects of adverse selection undermining health insurance exchanges. These dangers will be especially acute at the origin of such arrangements. Enrollment may be limited. The individual mandate will be weak and untested. Outreach to healthy consumers may be poor. Disproportionate numbers of people with preexisting conditions, participants in state high-risk pools, and others with high expected expenditures may be the first to enroll. The mere act of suggesting alternatives and modifications of the ACA in response to such challenges should not be dismissed." (The Washington Monthly)  

[Opinion]

Leviathan Eats Its Tail
"Government autocannibalism is emerging as perhaps the oddest unintended consequence of the Obama health law. As Big Government tinkers with the insurance market, Small(er) Government is being forced to cut back on the hours of its employees.... Late last year, businesses ... came under fire for accurately describing how the employer mandate would affect their hiring and employment policies.... This summer, municipal governments are realizing they face the same problem." (National Review)  

[Opinion]

America Needs Cost-Effective Universal Health Care
"When people are under-insured or have no insurance, they delay getting necessary health care and they don't fill life-saving prescriptions due to cost. That leads to poor health outcomes. When people delay too long, the outcomes are catastrophic. In Maine, someone dies every three days because of lack of health insurance (over 130 deaths per year)." (Physicians for a National Health Program)  

Benefits in General; Executive Compensation

First Circuit Decision on Pension Plan Liability for Private Equity Firm Also May Impact Executive Compensation
"[The First Circuit's recent Sun Capital] decision has tax and securities law implication in the executive compensation area ... [1] Section 409A looks to an entire controlled group for several purposes, most notably to determine when a participant has had a 'separation from service.' [2] The deduction limitations under Section 162(m)(6) apply to all members of any controlled group that includes a 'covered health insurance provider.'... [3] Current taxation of PE funds is based on fact that they are mere passive investors in their portfolio companies not a trade or business. The Sun Capital case endangers the way PE fund executives are taxed." (Winston & Strawn LLP)  

Massachusetts Nurses Petition for Limits on Hospital Profit Margins, CEO Pay
"A series of alternative proposed Initiative Petitions were filed Thursday, August 7, with the Office of the Attorney General of Massachusetts seeking primarily to establish specified limits on operating margins achieved by many Massachusetts hospitals and on the compensation of the CEOs of such hospitals. The proposed cap on operating margins is 5% in some versions and 8% in others.... The proposed cap on CEO compensation is 100 times the amount of the compensation of the lowest-paid full time employee of the hospital." (Mintz Levin)  

Pension/OPEB 2013 Assumption and Disclosure Survey (PDF)
"[For pensions:] The 2012 median discount rate decreased 75 basis points since 2011 and 225 basis points since 2007. The 2012 median expected long-term rate of return on pension plan assets decreased 25 basis points since 2011 and 55 basis points since 2007. The 2012 median salary scale assumption is unchanged since 2011 but has decreased 25 basis points since 2007. [For OPEB:] The 2012 median discount rate decreased 71 basis points since 2011 and 236 basis points since 2007.... OPEB plan funding has changed slightly with 48% of plans being funded in 2012 compared to 50% of plans being funded in 2011 and 53% being funded in 2007." (PricewaterhouseCoopers)  

[Opinion]

There's a Big Gender Gap in CEO Pay -- Bad Negotiating Isn't the Reason.
"Of the top executives at each of the companies in the S&P 500 index, only 8 percent were women, and that these women at the top ranks of Corporate America earned 18 percent less than men.... It's true that women often don't bargain hard enough for higher pay... But consider that women at the very top of the S&P 500 are probably among the best negotiators in the world, given their day jobs. And even if some of them might feel shy sometimes about asking for more money, the idea that their unwillingness to negotiate can account for an 18 percent pay gap flies in the face of study after study showing that gender inequality isn't the result of women being scared to stand up for themselves. It's subtle biases that inform how we all -- men and women -- evaluate one another." (The Washington Post; subscription may be required)  

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