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August 20, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Legal Counsel - ERISA - Title I
for T. Rowe Price in MD

Employee Benefits Associate
for Hanson Bridgett LLP in CA

Cash Balance Administration Specialist
for Cash Balance Online in CA

Benefit Administrator
for Beneco in AZ

Section Manager: Institutional Retirement Marketing
for T. Rowe Price in MD

Defined Contribution Plan Administrator
for Retirement, LLC - Series Two in OK

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Webcasts and Conferences

EPCRS Gives You Shelter/Regulatory Update
September 10, 2013 in TX
(ASPPA Benefits Council of Central Texas)

The Death of DOMA -- What You Need to Know
September 19, 2013 in NY
(WEB (Worldwide Employee Benefits Network), New York Chapter)

Managed Care Disputes and Litigation
October 22, 2013 in GA
(American Conference Institute)

401(k) Plans: Beyond the Basics 2013 - A 2-day seminar - Kansas City
September 18, 2013 in KS
(SunGard Relius)

Census Collection: Fast & Easy (really)
September 10, 2013 WEBCAST
(Actuarial Systems Corporation (ASC))

License Roulette: Donít Gamble With Your Business
September 11, 2013 WEBCAST
(Employers Council on Flexible Compensation (ECFC))

Research Results Unveiled Ė Employer Perceptions Regarding Private Exchanges and Defined Contribution -- Free Webinar
August 29, 2013 WEBCAST
(Institute for HealthCare Consumerism)

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 HHS Announcement of Requirements and Registration for 'Healthy Young America Video Contest'
"In an effort to enroll the maximum number of uninsured young Americans into individual health plans in the upcoming open enrollment period, multiple mediums and methods of reaching the uninsured population are necessary. HHS and Young Invincibles are co-sponsoring the 'Healthy Young America' Video Contest with two primary goals: First, directly reaching the uninsured population through video views and votes; and second, the production of high-quality videos that can be further promoted to the target population.... The Contest is open ... through 11:59 p.m. EDT on September 23, 2013." (U.S. Department of Health and Human Services)  


[Advert.]

23rd Annual National Health Benefits Conference & Expo

Sponsored by HBCE- Health Benefits Conference & Expo

The Biggest Challenge Remains: Addressing the Most Intractable Cost Problem Facing Employers, Employees & Governments at All Levels - January 28-29, 2014 - Clearwater Beach, FL. High quality, moderate cost - Register now for best rates!



State Insurance Commissioner's 'Non-Binding' Opinion Banning Discretionary Language in a Disability Policy Has No Effect in Court, Says Sixth Circuit
"The plan contained discretionary language, but Kentucky's Insurance Commissioner issued a non-binding opinion that 'discretionary clauses deceptively affect the risk purported to be assumed in any policy and as such, any forms containing discretionary clauses may be disapproved.' ... The court applied discretionary review, and not de novo review, because the court is '"not bound by language in a non-binding opinion" by Kentucky's [Insurance] Commissioner.'" [Frazier v. Life Insurance Company of North America, No. 12-6216 (6th Cir. August 5, 2013)] (Lane Powell PC)  

Employer-Sponsored Family Health Premiums Rise a Modest 4 Percent in 2013, Employer Survey Finds
"[K]ey findings ... include modest increases in premiums for both single coverage (5%) and family coverage (4%). Covered workers generally face similar premium contributions and cost-sharing requirements in 2013 compared to 2012. However, the percentage of covered workers enrolled in plan with a general annual deductible increased in 2013, to over three quarters of covered workers (78%). Additionally, over half (58%) of covered workers at small firms (3-199 workers) now have a deductible of a $1,000 dollars or more. The percentage of firms (57%) which offer health benefits to at least some of their employees and the percentage of workers covered at those firms (62%) are statistically unchanged from 2012." (Kaiser Family Foundation)  

First Circuit Overturns Precedent, Applies De Novo Judicial Review Despite Plan's Language
"After examining the intervening case law, the First Circuit said that it 'agree[s] with those courts holding that the "satisfactory to us" wording, without more, will ordinarily fail to meet the "requisite if minimum clarity" necessary to shift from de novo to deferential review.' The court emphasized that while 'no precise words are required,' plan administrators must still 'offer more than subtle inferences drawn from such unrevealing language' to secure the benefit of deferential judicial review. 'To conclude otherwise would negate our requirement of a clear grant of discretion,' the court explained." [(Gross v. Sun Life Assurance Co. of Canada, No. 12-1175 (1st Cir. Aug. 16, 2013)] (Bloomberg BNA)  

District Court Judge Invites the 11th Circuit Court of Appeals to Reverse Him on Benefit Claim Review
"The Honorable William Acker, sitting in the United States District Court for the Northern District of Alabama, was not shy in letting his opinion be known, when he lambasted the entire ERISA benefits review process -- from the fiduciary's administrative claims handling to the 11th Circuit's unique six-step methodology in reviewing the fiduciary's decision -- even while ruling in favor of the defendants.... Judge Acker gave Plaintiff the 'unsolicited advice' to forego an appeal, citing insurmountable odds. Nevertheless, Judge Acker made it known that, in the event Plaintiff appealed, 'his feelings would not be hurt' if he were reversed." (Womble Carlyle)  


[Advert.]

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.



Missouri Consumers in the Dark as Health Insurance Exchange Nears
"Unlike some states, which have released detailed information about the proposed premiums that insurers will charge for policies sold through the exchange, Missouri won't provide any hints. Last November, Missouri voters overwhelmingly approved a law that barred [Gov. Jay Nixon] from setting up the exchange without legislative or voter approval. As a result, the federal government will operate Missouri's exchange.... Though they don't know how much the new plans will cost, Missouri's social services agencies and community groups that work with the uninsured are gearing up to spread the word about the exchange." (Kaiser Health News)  

One in Five Health Systems to Become Payers by 2018
"Health systems are increasingly taking on new roles and becoming health insurers. Spurred by healthcare reform, the creation of health insurance exchanges, and a shift to population health, health systems are assessing the opportunities of becoming a payer against the risk of taking that step in the ever evolving healthcare industry. In a June survey of more than 100 hospitals and health system across the country, 34% responded that they already own health plans. Another 21% said they plan to launch a health insurance plan by 2018[.]" (HealthLeaders Media)  

HHS Offering Prizes For Videos Promoting Obamacare
"The digital demographic may not know co-pays from co-insurance, but creating and uploading free 'content' practically defines that generation. HHS hopes to tap that creativity and essentially get young adults to market Obamacare to themselves." (Kaiser Health News)  

ML Strategies Health Care Reform Update, August 19, 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)  

Proposed USPS Health Plan Could Improve Financial Condition
"Some elements of USPS's proposal would add uncertainties that could reduce funds available for its employees' and retirees' future health care[:] Investment of Health Plan Assets ... Transfer of Surplus Funds ... Selection of Assumptions[.]" (U.S. Government Accountability Office)  

Hospitals May Absorb Risk of Insurers' Debtor Patients
"Less than two months before health exchanges open to the public, hospitals are asking to change a part of the [ACA] that leaves them at financial risk for patients who fall behind on their insurance premiums.... The conflict arose when regulations written to implement the core parts of the [Affordable Care Act] next year created a 90-day grace period before insurers can drop patients who fall behind on premiums. Insurers balked and the Obama administration changed the rules so that the financial burden for the first 30 days fell on insurers, while hospitals would carry the default risk for care provided in the remaining 60 days." (Bloomberg)  

Obama Administration Has Missed Half of ACA's Legally Imposed Implementation Deadlines
"The [Congressional Research Service] compiled [a list of] 82 deadlines that the Affordable Care Act mandates upon the first three years of its own implementation. Remarkably, it turns out that the White House has missed half of the deadlines legally required by the ACA. And some of those deadlines remain unmet to this day." (Forbes)  

USPS Plan to Pull Out of Federal Health Benefits Program Could Cost Postal Workers
"The USPS plan to opt out of the Federal Employees Health Benefits Program would save the agency billions of dollars annually, the [GAO] found in a new report, but it would likely put postal workers at risk of paying higher premiums, incurring more out-of-pocket costs and receiving less insurance coverage for a variety of procedures." (Government Executive)  

[Opinion]

The Danger of Wellness Programs: Don't Become the Next Penn State
"Wellness is supposed to 'empower' employees but instead did just the opposite at Penn State. Ironically, the only thing that has empowered Penn State employees has been fighting back against this misdirected wellness tyranny. Instead of creating what one of Penn State's health care suppliers called a 'culture of wellness,' Penn State has created a culture of resentment. This whole slow-motion debacle would have been completely avoidable at many points in the last week or two... if only Penn State's administration had had access to a search engine and a calculator." (Harvard Business Review; free registration required)  

[Opinion]

Health Costs Are Growing Really Slowly -- But Americans Haven't Noticed
"Ask any health economist and they'll no doubt tell you that health care cost growth is slowing, growing at a low, unprecedented rate.... Ask any American about what direction health costs are moving, and you'll likely get a completely different story.... [Results from a new] Kaiser Family Foundation poll show that most Americans think that health care costs are actually growing faster than usual right now. Fewer than 10 percent say the growth is slowing down." (Sarah Kliff in The Washington Post; subscription may be required)  

[Opinion]

The 'Cadillac' Health Plan Is a Myth
"Before concluding that such luxurious plans are the sole preserve of supposedly greedy city workers, keep in mind that by the estimate of one health economist, as many as 75 percent of employer health plans could fall under the 'Cadillac' umbrella over the next decade. Reasonably good insurance -- you know, the kind that covers all of your medical needs, without making you pay an arm and leg out-of-pocket every time you need to use it -- has stealthily become the new Cadillac. However much the reputation of General Motors may have fallen in recent years, this seems like a bit of a stretch." (Salon)  

[Opinion]

Gaming Obamacare's Health Insurance Mandate for Fun and Profit
"The penalty is a 'stick' intended to force people to get coverage. But even though President Obama repeatedly claims the ObamaCare house of cards would collapse without his mandate, the legislation's drafters made it very easy to avoid the penalty. That's why Team Obama is in a projectile sweat and trying to push the young and healthy to enroll now, before they figure out how easy it will be to game the system." (Forbes)  

[Opinion]

Obama's 2009 Promise of Cheaper Healthcare Has Morphed Into 2013 Price Hikes
"Georgia insurance commissioner Ralph Hudgens said that premiums for individuals in his state's health insurance exchange could be 198 percent higher than what's available there today.... Ohio estimates premiums will shoot up an average of 41 percent. Indiana officials say theirs will climb 72 percent." (Forbes)  

[Opinion]

Seven Challenges for Continued Health Care Cost Control: Will Congress Step Up to the Plate?
"[1] Lessen Excessive Partisanship ... [2] Tell the American People the Truth ... [3] Be Honest about the Cost of Taking Care of the Poor ... [4] Enable Clinicians to Lead the Transformation ... [5] Acknowledge that Local Market Power Must be Countered ... [6] Engage Consumers and Patients ... [7] Emphasize Community Health Policy." (Altarum Institute)  

[Opinion]

Where's the Outrage Over Our Failed Health Care System?
"By requiring many Americans to buy private health insurance, the federal government is now obliged to see to it that insurance remains affordable. Whether they are actually able to do so remains to be seen. Because of that, both government and the lay media have now joined academicians in paying a lot more attention to the costs of medical care in the U.S. and how they compare to those in other countries." (Physicians for a National Health Program)  

Benefits in General; Executive Compensation

Federal Employees to Be Surveyed Again About Benefits
"In the most recent sampling, more than 90 percent of respondents said they consider important or extremely important the 401(k)-style Thrift Savings Plan, the Federal Employee Health Benefits Program, health benefits in retirement and their civil service defined benefit retirement programs. In contrast, only slightly more than half had the same view of the flexible spending account program that lets federal workers put aside pre-tax money for certain dependent care and health care expenses." (The Washington Post; subscription may be required)  

Executive Compensation: Balancing Business Needs with External Pressure (PDF)
"[T]here is no shortage of advice on how to 'fix' executive compensation.... A board's compensation committee, working closely with senior management, is in the best position ... At times, actions required may deviate from what is commonly viewed as 'best practice.' In those situations, it will be necessary to provide additional explanations in the proxy (and possibly directly to shareholders).... Some of the more common areas of potential deviation from what might be considered 'best practice' include ... Defining (and Paying) for Performance ... Using Discretion ... One-Time Awards ... Appropriate Goal Setting." (Meridian Compensation Partners, LLC)  

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