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August 15, 2013          Get Retirement News  |  Advertise
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Retirement Services Manager
for District of Columbia Retirement Board in DC

Senior Operations Leader - Retirement Plan Services (1301925)
for Manulife Financial in MA

Benefit Advocate Member Services Specialist/Benefits Administrator for Client Services
for Gallagher Benefit Services in TX

Defined Contribution Pension Plan Administrator
for The Angell Pension Group, Inc. in ANY STATE

Call Center Manager
for ASPire Financial Services LLC in FL

Distribution Supervisor
for Nova 401(k) Associates in TX

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[Guidance Overview]

Minnesota Weighs in on Coverage of Same-Sex Spouses
"Effective August 1, 2013, any policy issued in Minnesota that provides dependent coverage for spouses must make that coverage available on the same terms and conditions regardless of the sex of the spouse. Any property/casualty policy that provides a rating or liability benefit because two residents in the same household are married must afford that benefit regardless of the sex of the spouses. Defining 'spouse' in a way that limits coverage to opposite-sex spouses will be considered an unfair and discriminatory practice." (Faegre Baker Daniels LLP)  


[Advert.]

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[Guidance Overview]

Employer Mandate Delay: Beware of Ignoring the ACA
"The delay affords employers an opportunity to more carefully consider and implement their ACA play-or-pay strategy ... The announcement of the employer mandate delay emphasized that other provisions of the ACA will become effective as scheduled -- and that the delay was only a delay and not a repeal of the provision.... [E]mployers likely will need to disclose imminently whether their plan meets 'minimum value' and 'affordability' standards as part of their obligation to inform employees about the new health insurance exchanges. The ACA requires employees to send a notice to current employees by October 1, 2013 advising them about the availability of coverage through a health insurance exchange." (Littler)  

Health Plan Pays $1.2M+ HIPAA Settlement For Not Protecting PHI On Copiers
"In its breach report, Affinity indicated that ... CBS had purchased a photocopier previously leased by Affinity. CBS informed Affinity that the copier that Affinity had used contained confidential medical information on the hard drive. Affinity estimated in its breach report that up to 344,579 individuals may have been affected by this breach. OCR's investigation indicated that Affinity impermissibly disclosed the protected health information of these affected individuals when it returned multiple photocopiers to leasing agents without erasing the data contained on the copier hard drives." (Solutions Law Press)  

Text of DOL Amicus Brief Opposing ERISA Preemption of Vermont Requirement for Self-Insured Plans to Provide the State with Participant Eligibility and Claims Data
"ERISA does not preempt the state-law reporting requirements at issue here.... [T]he Vermont law promotes the state's legitimate interest in gathering information on the provision of health care to its citizens and other residents. The presumption against preemption is not overcome because the Vermont law does not relate to ERISA plans in any way that dictates benefit choices or interferes with plan administration or structure. Moreover, while imposing some costs on plans, the law does not otherwise burden the uniform, multi-state administration of plans, and does not conflict with, or frustrate the purposes of, ERISA's reporting requirements." (Employee Benefits Security Administration (EBSA), U.S. Department of Labor)  

Oklahoma's Challenge to ACA Will Proceed
"While the Obama health care law treats states differently, depending on whether they establish an exchange or leave it up to the U.S., the accompanying IRS regulation eliminates that distinction. Oklahoma contends the regulation wasn't authorized by Congress. [U.S. District Judge Ronald A.] White ruled that the state, as a large employer itself, has standing to pursue two of the four IRS-related claims, and he allowed another federal constitutional claim to proceed." (Employee Benefit News)  

HRAs and Exchange Coverage: Do As We Say Not as We Do
"[T]he Office of Personnel Management issued a rule recently that will allow Congressional Representatives and Senators and their staff to receive payments from the federal government to help them defray the cost of insurance through the exchange.... This is, functionally, a premium-only health reimbursement arrangement run by the Federal government. Interestingly, if a private employer (or even another governmental employer) sought to set up such an arrangement with public exchange coverage, it would expressly be forbidden." (Benefits Bryan Cave)  

Poll Finds Federal Employees Overwhelmingly Reject Inclusion in New Health Care Program
"Federal employees do not want to be part of the new system. Instead, they prefer to keep their current health plan ... Employees who are already retired have a much stronger negative reaction to being moved to a new system. Those with more than 15 years until retirement are not as unanimous in their opposition to moving into the new health care exchanges.... The results were definitive with 92.3% of those responding to the survey preferring to continue in the current program." (FedSmith.com)  

Massachusetts Residents Paying More, Getting Less From Health Insurance
"If Massachusetts residents have the feeling they're getting less coverage from their health insurance even though it's costing more, there's now evidence that they're right.... Bay State premiums rose 9.7 percent between 2009 and 2011, while the value of that coverage shrank 5.1 percent." (Kaiser Health News)  

Moving to High Quality, Adequate Coverage: State Implementation of New Essential Health Benefits Requirements
"This paper documents challenges faced by insurance companies and state officials in the development and oversight of new plans that meet the new EHB requirements.... [M]ost people will see little change in the number of benefits covered by plans, but some will gain benefits, such as maternity care, mental health, and prescription drugs, that have often not been covered. The study also finds that insurers are taking limited advantage of their flexibility to add and subtract benefits through substitution." (Urban Institute)  

Many Health Insurers to Limit Choices of Doctors, Hospitals
"This fall, Indiana's new online health-insurance marketplace will present some tough choices for consumers ... Similar situations are likely to occur around the country, as details emerge about the coverage available through the new consumer marketplaces created by the federal health law. Many of the plans will include relatively few choices of doctors and hospitals. In some cases, plans will layer on other limits, such as requirements that patients get referrals to see specialists, or obtain insurer authorization before pricey procedures." (The Wall Street Journal; subscription may be required)  

Private Exchanges Pose Challenge to State- and Federally-Operated Models
"[E]nrollment in private [health insurance exchanges (HIX)] may exceed public by 10 million members in 2018... A recent study ... predicts that although enrollment will start slowly -- with one estimated million enrollees in 2014 -- and trail public HIX for several years, private HIX enrollment will catch up by 2017 and even exceed public HIX enrollment by 10 million members in 2018." (HealthLeaders Media)  

The Challenge of Helping the Uninsured Find Coverage
"Navigators are seen as crucial to the success of the [ACA].... But as the navigator effort gets under way across the country, it is clear that their impact will vary from state to state, with wide discrepancies in how much will be spent to hire and train navigators and how many people they will be able to reach. Many will be operating on shoestring budgets, with extremely tight time frames and hostile political climates." (The New York Times; subscription may be required)  

Businesses Claim Obamacare Has Forced Them to Cut Employee Hours
"Jason Furman, chairman of the president's Council of Economic Advisors, said, 'We are seeing no systematic evidence that the [ACA] is having an adverse impact on job growth or the number of hours employees are working.'... But the president of an influential union that supports Obamacare said the White House is wrong. 'It IS happening,' insisted Joseph Hansen, president of the United Food and Commercial Workers union, which has 1.2 million members. 'Wait a year. You'll see tremendous impact as workers have their hours reduced and their incomes reduced. The facts are already starting to show up. Their statistics, I think, are a little behind the time.'" (NBC News)  

Your Company's Obamacare Game Plan
"If you already offer health insurance, consider renewing early for 2014 ... By doing so, you may avoid premium increases caused by some of the provisions in the law.... Winter is a good time to determine whether you should shift to a largely part-time workforce to dodge the ACA all together, or at least to hold down the costs covering your employees ... By the time the flowers start blooming next year, you should have a pretty good idea about how you'd like to structure your benefits plan in 2015.... With your benefits plan firmly in place for 2015, next summer is when you need to start thinking about the best way to educate your employees about the impending changes." (Entrepreneur)  

Employers, Remember Your SBC and New Template!
"The updated templates are not required for SBCs issued for the 2014 plan year; however, if the group health plan does not use the updated templates for the upcoming open enrollment, the new guidance requires the plan or insurance company to include a disclosure with the SBC.... Plans and insurance companies should continue to answer questions on the SBC template regarding annual limits even though plans are prohibited from imposing annual limits on essential health benefits effective for plan or policy years beginning on or after January 1, 2014. The SBC should include detailed information on any limits on specific covered benefits that are not essential health benefits." (Ogletree Deakins)  

[Opinion]

The Obamacare Numbers: Difficult to Measure and Subject to Spin
"When California announced that individual premiums in its health insurance exchange could be 29% lower than expected, President Obama cheered. When Indiana announced premiums might be 72% higher than before, state officials predicted doom. So who is right? Are health insurance premiums going up or down?" (The Health Care Blog)  

[Opinion]

Two Americas: Divided Geographically by Disparities in Access to Affordable, High-Quality Health Care.
"The reasons for regional disparities in health and health care are not yet fully understood, and we must understand them before we can address them. Poor-performing regions tend to have much higher proportions of uninsured citizens. This could get somewhat better because of the [ACA] (though not if states in those areas don't take advantage of the law). Other explanations undoubtedly lie outside the realm of health care, in education, poverty levels, diet, and lifestyle." (The Commonwealth Fund)  

Benefits in General; Executive Compensation

[Official Guidance]

Defense Department to Extend Benefits to Same-Sex Spouses of Military Personnel (PDF)
"The Department will construe the words 'spouse' and 'marriage' to include same-sex spouses and marriages, and the Department will work to make the same benefits available to all military spouses ... [A]ll spousal and family benefits, including identification cards, will be made available to same-sex spouses no later than September 3, 2013." (U.S. Secretary of Defense)  

[Guidance Overview]

New York Regs Limiting the Use of State Funds for Administrative Expenses and Executive Compensation Go Into Effect
"[A] 'covered executive' includes directors, trustees, managing partners, officers and key employees, all as defined in the Form 990 instructions, whose compensation in whole or in part is an administrative expense. This limitation on compensation for 'covered executives' applies to covered executives of service providers as well as covered executives of a related organization with which a service provider contracts for administrative program services, if at least 30 percent of that executive's compensation is derived from state funding from the service provider." (Proskauer Rose LLP)  

Did The Supreme Court Flunk Constitutional Law When It Permitted Discretionary Review Of Insured ERISA Benefits Cases? (PDF)
"Beginning with Firestone Tire & Rubber Co. v. Bruch, and its affirmance in Metropolitan Life Ins. Co. v. Glenn, and most recently in Conkright v. Frommert, the Supreme Court permitted District Courts to treat insured ERISA welfare benefits cases as summary review proceedings. In each case, the court focused on trust law, but never addressed whether the regulatory scheme it set up by these cases satisfies the requirements of Article III of the Constitution. The authors argue that discretionary review, without a full trial on the merits, violates Article III." (Health and Disability & Life Insurance Law Committees, American Bar Association)  

Federal District Court in Ohio Orders Recognition of Same-Gender Marriage Legally Performed Outside Ohio (PDF)
"Throughout Ohio's history, Ohio law has been clear: a marriage solemnized outside of Ohio is valid in Ohio if it is valid where solemnized.... How then can Ohio, especially given the historical status of Ohio law, single out same sex marriages as ones it will not recognize? The short answer is that Ohio cannot ...... By treating lawful same sex marriages differently than it treats lawful opposite sex marriages (e.g. , marriages of first cousins and marriages of minors), Ohio law, as applied to these Plaintiffs, likely violates the United States Constitution[.]" (U.S. District Court, Western District of Oklahoma)  

DOMA Decision Answers One Question But Raises Many More (PDF)
"[P]lan sponsors may want to postpone actual changes to documents until the IRS and other regulatory agencies provide guidance. In addition to identifying which state's (state of celebration, residence, or work) law determines marital status, there is also the big question of the effective date of this change, as it could be retroactive to the enactment of DOMA in 1996, which preceded all of the state laws allowing or recognizing same-sex marriages. The first state to legalize same-sex marriages was Massachusetts in 2004." (Prudential)  

Text of DOL Amicus Brief to Sixth Circuit Supporting Application of Section 510 to Unsolicited Employee Inquiries
"The district court aptly recognized that section 510's application to 'any inquiry' includes both employee- and employer-initiated inquiries, but stated that employee-initiated inquiry must include a question for section 510 to apply -- so that inquiries in the form of a complaint do not trigger the statute's protections. Such hair-splitting is unsupported by the statute and does a disservice to the purposes of anti-retaliation provisions in general and section 510 in particular." (Employee Benefits Security Administration (EBSA), U.S. Department of Labor)  

Changes in Insurance Brokerage a Cautionary Tale for Mutual Fund Wholesalers
"'Creative destruction' is coming to the $2.8 trillion health care industry, changing everything from eligibility requirements to coverage options, but the changes also are fundamentally affecting a small, but power group unknown to consumers: insurance brokers. However, as this small, but lucrative profession of insurance brokers undergoes major changes, they also may indicate the future of another group of lesser-known professionals -- mutual fund wholesalers[.]" (Paladin Research & Registry)  

Employers Using Technology to Enhance Management of Employee Benefits Programs
"Fifty-three percent of those using an administrative platform say it is integrated for all employer-paid and voluntary benefits, 21% have only employer-paid benefits on the platform.... Fifty-two percent of employers have an enrollment platform and more than half (59%) are integrated for all employer-paid and voluntary products. Integration is most common among companies with more than 10,000 employees at 73%." (Prudential)  

North American Employers Not Expecting to Fully Fund Annual Bonuses in 2013
"North American employers do not expect to fully fund their annual employee bonuses this year, marking the third consecutive year and seventh time since 2005 that their bonus pools for annual incentives will be below target ... Additionally, one in four employers will pay bonuses to workers who fail to meet performance expectations, raising questions as to whether employers are receiving a good return on their investment in these plans." (Towers Watson)  

Pay-Wise, CFOs Gain a Bit on Their Bosses
"Total direct compensation for CFOs ... grew by just 1.4 percent last year, compared to 7.5 percent in 2011 and 20 percent in 2010. CEO pay, which had climbed by 3.6 percent last year, actually declined by 0.3 percent in 2012. CFOs fared all right in salary, which rose 3 percent, just a half-point less than the prior year and six times the growth CEOs saw. But the value of long-term incentives fell off a cliff for both groups. That value, which had grown about 10 percent for both roles in 2011, grew only 2 percent last year for CFOs and not at all (0 percent) for their bosses." (CFO)  

Press Releases

ACOPA Announces 2013-2014 Leadership
American College of Pension Actuaries (ACOPA)

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