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August 27, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Member Service Manager
for DC Retirement Board in DC

Senior Health Benefits Analyst
for The Segal Company in DC

Retirement Plan Consultant
for General Pension Planning, a TWG Benefits company in OH

Retirement Plan Analyst
for Trinity Pension Group, LLC in NC

National Account Executive
for Liberty Mutual Insurance in IL

Project Coordinator
for Unite Here Health in IL

Actuarial Assistant
for Acuff & Associates, Inc. in TN

New Plan + Conversion Specialist or SUPERSTAR!
for The Online 401(k) in CA

Relationship Mgr II/III
for The Standard in TX

Account Specialist
for The Standard in CA

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Webcasts and Conferences

Next Wave of Wellness and Disease Management Strategies for Health Plans Conference
October 29, 2013 in DC
(Corporate Research Group)

4th Annual Executive Forum on Creating a Culture of Health & Wellness
October 9, 2013 in IL
(World Congress)

Affordable Care Act 101 for Small Business
September 19, 2013 WEBCAST
(U.S. Small Business Administration (SBA))

401(k) Plans: Beyond the Basics 2013 - Minneapolis
September 26, 2013 in MN
(SunGard Relius)

Advanced Cross-Tested Plans: Adding More Tools - Minneapolis
September 25, 2013 in MN
(SunGard Relius)

90 Minute Crash Course on DC Plans
September 10, 2013 WEBCAST

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 IRS Final Regs on Shared Responsibility Payment by Individuals for Not Maintaining Minimum Essential Coverage
75 pages. "This document contains final regulations on the requirement to maintain minimum essential coverage enacted by the [ACA]. These final regulations provide guidance to individual taxpayers on the liability under section 5000A of the Internal Revenue Code for the shared responsibility payment for not maintaining minimum essential coverage and largely finalize the rules in the notice of proposed rulemaking published in the Federal Register on February 1, 2013." (Internal Revenue Service)  


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[Guidance Overview]

Grandfathered Health Plans in 2014 and Beyond
"[This article presents] 14 frequently asked questions and answers about grandfathering and group health plans. [Questions include:] May plans maintain grandfathered status after 2014? ... What are the advantages of grandfathered status? ... What must a plan do to maintain grandfathered status? ... If an employer offers several plan options, can it keep grandfathered status for some plans even if it has lost it for others? ... Can an employer add tiers without losing grandfathered status? ... What happens if a plan loses grandfathered status?" (Society for Human Resource Management)  

Will Premium Subsidies Come in a Lump Sum, and What Happens When You Don't Pay Your Premium?
"If they qualify, consumers can opt to receive the tax credits in advance, and the exchange will send the money directly to the insurer every month. This subsidy will reduce how much people owe up front. Consumers can also choose to receive their credit when they file their taxes the following year.... Consumers who are receiving premium tax credits for coverage on the exchange will get a 90-day grace period to catch up on late premiums ... Other consumers not getting the subsidies may get more or less time, depending on the exchange rules or state law," (Kaiser Health News)  

Third Circuit Says Insurer Did Not Breach its Fiduciary Duties in Paying Benefits Through a Retained Asset Account
"The Third Circuit recently found that while a life insurance company acts as a fiduciary in choosing to use a retained asset account to distribute benefits, it did not breach its fiduciary duties in making that choice.... [T]he Court found that 'Lincoln was not managing or administering the plan when it invested the retained assets,' and ... determined that the retained assets were not plan assets. Once it created the retained asset accounts, Lincoln simply remained obligated to honor checks drawn on the accounts and pay interest at the stipulated rate." (Proskauer's ERISA Practice Center)  

Want to Know If Your Hospital Is a Rip Off? Move to North Carolina.
"Medicare made waves earlier this year by releasing the prices that hospitals charge for the most common procedures. North Carolina now wants to take a step further: Gov. Pat McCrory (R) signed legislation last week that will require hospitals to publish the prices that they negotiate with insurers. This data has the potential to be significantly more useful for consumers. The prices that hospitals charge are, essentially, sticker prices. Insurance plans usually negotiate a rate lower than that opening bid. The data that North Carolina will make public is the actual amount that hospitals end up charging health plans for their services. Beginning in June 2014, the state's Health and Human Services Web site will post that information." (The Washington Post; subscription may be required)  


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!

ML Strategies Health Care Reform Update, August 26, 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)  

House Committees Hold Joint Hearing on Health Care Challenges Facing Workers and Employers
Subcommittee on Health, Employment, Labor, and Pensions Chairman Phil Roe (R-TN) joined Representatives Brett Guthrie (R-KY) and Andy Barr (R-KY) to host a field hearing in Kentucky entitled, 'Health Care Challenges Facing Kentucky's Workers and Job Creators.' Page includes video of the hearing, and links to opening statements and witness testimony. (Subcommittee on Health, Employment, Labor, and Pensions, jointly with the Subcommittee on Workforce Protections, U.S. House of Representatives)  

Adverse Selection and Inertia in Health Insurance Markets: When Nudging Hurts (PDF)
"[I]nertia has a substantial impact on health plan enrollment as the choice environment evolves over time.... While reducing inertia increases welfare in the naive setting where health plan prices are held fixed, in the setting where health plan premiums adjust as enrollees switch plans reduced inertia leads to incremental adverse selection and a welfare loss.... [T]he interaction between inertia and adverse selection can be quite important, and that policies to improve consumer choices in health insurance markets should consider the potential for incremental risk-based plan selection." (Benjamin R. Handel, Dept. of Economics, University of California at Berkeley)  

Rejections Could Send Washington State Health Insurance Exchange Off the Rails
"For most of its brief existence, the Washington Health Plan Finder looked like a model state-run exchange. Nine carriers representing a good mix of commercial and Medicaid players filed to sell policies. The state moved quickly to build its exchange infrastructure and chose to operate as an active purchaser, requiring insurers to bid on exchange business. Then Washington Insurance Commissioner Mike Kreidler rejected half of the [managed care organizations] that applied to sell policies.... That places Washington on very unsteady footing." (HealthLeaders InterStudy)  

Misunderstanding of HSAs Poses Open-Enrollment Hurdle
"Confusion between an HSA and a flexible spending account (FSA) remains high. A full 73 percent of respondents said an HSA is pretty much the same thing as a health FSA or were unsure, and the 'use it or lose it' provision of FSAs was one of the most commonly misunderstood differences between the account types." (Society for Human Resource Management)  


It's Fact, Not Anecdote, That Obamacare Is Turning Us Into a Part-Time Nation
"Bureau of Labor Statistics data show that the ratio of part-time to full-time jobs has completely flipped this year from historical trends. Last year, six full-time jobs were created for every one part time job. This year, only one full-time job is being created for every four new part-time jobs. The shift to part-time has accelerated over the past several months because of the 'look back' provision in ObamaCare that sets the baseline this year for the number of full-time workers a company employs to determine their compliance with the employer pay-or-play mandate." (Galen Institute)  


Wielding the Carrot and the Stick: How to Move the U.S. Health Care System Away from Fee-for-Service Payment
"Three elements are key to successfully moving toward alternative payment approaches: [1] The carrot -- Implement policies that reward high performance and encourage changes in the organization and delivery of health care. [2] The stick -- Reduce and eventually eliminate the option of remaining in the fee-for-service payment system. [3] The muscle -- Coordinate policies across public programs and private payers so they are applied consistently and their impact is maximized." (The Commonwealth Fund)  


Deloitte Health Care Reform Memo, August 26, 2013
"The [ACA] is but one chapter in the history of the U.S. health care industry. Others will be written. And the authors will likely be those leaders who see our industry's challenges through the long-range lens of history. Like the butler's story, our journey will be difficult, but no less necessary." (Paul Keckley, Deloitte Center for Health Solutions)  


Adverse Selection at Every Turn
"The difficulty consumers face in appreciating the value of plans and the resistance they exhibit in plan switching has a risk pooling effect.... That consumers don't perfectly identify their costs under each plan and have status quo bias (inertia) undoes some of this selection. That's not to say you want to keep people in the dark just for the risk pooling effect. It's just to point out that there a selection issue that arises as people are better informed and, perhaps, more willing to switch plans on that basis." (The Incidental Economist)  


The White House Says Obamacare Begins on October 1... Not Really.
"Oct. 1 is a completely arbitrary date, one that never shows up in the text of the [ACA] and that has little bearing on the health law's success or failure.... [It has become] increasingly clear that [the state marketplaces'] big day isn't necessarily Oct. 1. Instead, it's Jan. 1, the day that the individual mandate takes effect and any plans purchased on the marketplace actually kick in. The space between October and December is viewed, by many standing up the health care law, as a soft launch: the time to make their new Web sites live, sort out the kinks and get the site in prime condition for the beginning of 2014." (Sarah Kliff in The Washington Post; subscription may be required)  

Benefits in General; Executive Compensation

The Sun Capital Case Could Have Broader Implications for Employee Benefit Plans
"[O]ne wonders whether the Sun Capital decision could ultimately have broader implications in the world of employee benefits and executive compensation, where the controlled group rules arise in many contexts. If a private equity fund and one or more of its portfolio companies can be treated as a controlled group (and, therefore, as a single employer) under the 'investment plus' standard of Sun Capital, the constituent entities could experience a number of undesirable consequences: [1] The retirement plans maintained by the controlled group members would be subject to coverage and nondiscrimination testing based on the entire combined workforce of the fund and the portfolio companies; [2] There would be joint and several liability for any defined benefit pension plan unfunded benefit obligations (not just for multiemployer plans); [3] Employees who move from one portfolio company to another may not be considered to have separated from service in a way that would trigger the right to receive benefit payments; [and] [4] The employers would have to be combined for purposes of applying the employer shared responsibility requirements of the Affordable Care Act (a/k/a the play or pay mandate)." [Sun Capital Partners III, L.P. v. New England Teamsters & Trucking Ind. Pension Fund, No. 12-2312 (1st Cir. July 24, 2013)] (Verrill Dana LLP)  

A State of the Art ERISA Benefits Decision from the First Circuit
"[T]he Court raises the bar for establishing discretionary review, and in so doing, gives a careful presentation of exactly why this is the normal and logical result of years of jurisprudence.... . In this latest decision out of the First Circuit, however, you see something very interesting: the pure application of the need for remand to the administrator, as though this is simply the basic rule in this circuit (which, in fact, is what it has become)." [Gross v. Sun Life, No. 12-1175 (1st Cir. Aug. 12, 2013)] (Stephen Rosenberg of The McCormack Firm, LLC)  

Determining the Death Beneficiary, and Beneficiary Rights, Under an ERISA Plan
"The article suggests plan policies and provisions to minimize ambiguous beneficiary designations while fulfilling the participant's intentions, such as the use of plan beneficiary designation template that clearly describes the consequences of one or more beneficiaries predeceasing the participant and limit beneficiary choices. This article also discusses how Federal common-law rather than state common-law determines how the doctrines of fraud, undue influence, substantial compliance, and the capacity to make designations apply to determining the effectiveness of beneficiary designations." (Albert Feuer via SSRN)  

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