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August 28, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

ERISA/Benefits Attorney
for New York City Law Firm in NY

Daily Trader - Temporary
for Mercer Advisors Inc. in AZ

Retirement Platform Manager
for New York Life Retirement Plan Services in MA

Manager, Health and Welfare Administration
for Buck Consultants in AZ

Defined Contribution Plan Administrator
for Interactive Retirement Systems, Ltd. in MN

Plan Compliance Consultant
for T. Rowe Price in MD

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Webcasts and Conferences

401(k) Questionnaire Final Report
September 17, 2013 WEBCAST
(McKay Hochman Co., Inc.)

2013 403(b) Update
September 19, 2013 WEBCAST
(McKay Hochman Co., Inc.)

2013 Fall Forum
October 28, 2013 in TX

Affordable Care Act 101 for Small Business
September 26, 2013 WEBCAST
(U.S. Small Business Administration (SBA))

Health Care Reform for Employers: Now What?
November 19, 2013 in CA
(Lorman Education Services)

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]

CMS Submits State Health Insurance Exchange Security Incident Report Form and Supporting Statement to OMB, Requests Expedited Approval
"As part of the privacy and security oversight of State Health Insurance Exchanges the States will be required to report security incidents include breaches of personally identifiable information (PII). This reporting will be made by completing and electronically submitting the State Health Insurance Exchange Security Incident Report (Incident Report), or providing identical information telephonically.... [CMS] is requesting that [this] information collection request ... be processed under the emergency clearance process ... Public harm is reasonably likely to occur if the normal, non-emergency clearance procedures are followed. The approval of this data collection process is essential to ensuring that Information Security (IS) incidents, which also include Personally Identifiable Information (PII) and Protected Health Information (PHI), are captured within the specified timeframe. In absence of this change, a significant number of incidents will not be detected; therefore causing harm and potential risk to the public's identity with identity fraud. Additionally ... a statutory implementation date of the [ACA], which is October 1, 2013, will be missed, if the normal clearance procedures are followed. Incidents could potentially occur on this statutory date; therefore, the reporting capability must be in place for States to inform CMS should an incident occur during this time." (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  


HIPAA Compliance Deadline Fast Approaching: September 23

Sponsored by International Foundation of Employee Benefit Plans (IFEBP)

HIPAA Privacy for Health Plans After HITECH is a comprehensive manual to help plan sponsors remain compliant. The helpful guide is updated to reflect the 2013 regulations and includes a CD with model policies, procedures, notices and more. Order Now!

[Guidance Overview]

White House Publishes Final Regulations for Obamacare's Individual Mandate
"[A] worker who gets coverage through his job will be forced, under the individual mandate, to purchase coverage on his own for his family, if his dependents don't have other sources of coverage.... Pretty much any employer-sponsored plan meets the mandate's requirements.... The mandate fine is small, and will have even less impact over time.... The IRS can't go after you if you don't pay the fine.... Many older individuals will be exempt from the mandate.... If you don't file a tax return, you're exempt.... 'Members of recognized religious sects' and American Indians are also exempt." (Avik Roy, in Forbes)  

[Guidance Overview]

IRS Issues Final Individual Mandate Regs
"The final rule clarifies that a taxpayer has [minimum essential coverage (MEC)] for any month in which the taxpayer has MEC for at least one day of the month. In most instances, if a taxpayer has coverage for one day in a month the coverage lasts for the entire month; for the few cases where this was not true, the IRS did not want to have to figure how many days of coverage were sufficient.... A taxpayer is responsible for ensuring [MEC] not only for him or herself but also for any persons who qualify as the taxpayer's dependents under the Internal Revenue Code. This applies whether or not the taxpayer actually claims the dependent for the taxable year[.]" (Health Affairs Blog)  

[Guidance Overview]

Fact Sheet: Individual Shared Responsibility for Health Insurance Coverage and Minimum Essential Coverage Final Rules
"[T]he Treasury Department and [IRS] issued final regulations on the individual shared responsibility provision that largely finalize the provisions of the proposed regulations without change. At the same time, the final regulations clarify certain rules regarding government coverage and the process that will be used for further clarifications in the future ... According to the Congressional Budget Office, less than two percent of Americans are expected to choose to go without coverage and will owe a shared responsibility payment." (U.S. Department of the Treasury)  

[Guidance Overview]

Final Regs Issued on Individual Health Care Mandate
"The final regulations were changed from the proposed rules to clarify that medical coverage offered to employees by an organization acting on an employer's behalf qualifies as an employer-sponsored plan.... And the final regulations clarify that a self-insured health plan is an eligible employer-sponsored plan, regardless of whether it could be offered in a large or small group market in a state." (Journal of Accountancy)  


ACI's 6th Annual ERISA Litigation Conference -- October 24-25 -- New York

Sponsored by ACI (American Conference Institute)

Advanced forum designed to bring together the nation's leading in-house experts and outside counsel for a two-day seminar geared towards developing winning litigation strategies and exploring new and emerging theories of liability from the plaintiffs' bar.

[Guidance Overview]

$100-A-Day Penalties: ACA Non-Compliance Can Be Expensive for Employers
"While a lot of employers are focused on the penalties associated with not offering appropriate coverage (the $2,000 penalty) or not offering affordable coverage (the $3,000 penalty), ... PPACA has a $100 a day general 'non-compliance' penalty. This general penalty requires employers to correct compliance failures within 30 days of discovery or self-report a $100 a day penalty for failing to comply on IRS Form 8928 for each day the employer failed to comply with a PPACA mandate.... The solution is to sit down with your plan and go line by line, requirement by requirement, and make sure your plan does not have any violations." (Fox Rothschild LLP)  

Administration Releases New Rules To Implement Health Law's Individual Mandate
"Tuesday's announcement from Treasury and the IRS -- along with the final individual mandate regulations that HHS issued in June -- make it clear that the administration is moving ahead with implementing the individual mandate, which has become one of the law's most politically explosive elements.... Supporters of the law and many health care economists say that the requirement that most Americans have coverage or pay a fine is critical to making the law work as intended." (Kaiser Health News)  

Wal-Mart Offers Health Benefits to U.S. Employees' Domestic Partners
"Wal-Mart Stores Inc.... will offer health insurance benefits to domestic partners of its U.S. employees starting next year ... Wal-Mart is the single biggest U.S. employer outside of the federal government. More than half of its 1.3 million U.S. employees are on its health-care plans. The company said it does not know how many workers would use the new benefits ... Sixty-two percent of the Fortune 500 already offer health benefits for domestic partners[.]" (Reuters)  

Large U.S. Employers Predict 7% Increase in Health Care Benefit Costs in 2014
"The cost of providing employee health care benefits at the nation's largest employers is projected to increase 7% in 2014 -- the third consecutive year employers have budgeted this amount, according to a new survey by the National Business Group on Health ... The survey -- one of the industry's first look at costs and plan design changes for 2014 -- also found that some employers believe health insurance exchanges could be a viable option for certain populations. Additionally, more companies plan to offer workers a consumer-directed health plan as their only health benefits option in 2014." (National Business Group on Health)  

District Court Orders Trial to Determine Whether Whirlpool CBA Vested Lifetime Health Benefits for Certain Retirees (PDF)
55 pages. Excerpt: "This class action is calibrated to determine the fate of company-paid health benefits for more than two thousand retired workers (and their spouses) who produced vacuum cleaners for Hoover, Maytag, and Whirlpool, in the Canton, Ohio, area.... Retirees and Whirlpool have filed cross-motions for summary judgment ... calling on the Court to decide, among many contentions, the question at the heart of the controversy: Did the relevant collective bargaining agreements promise Retirees lifetime, unalterable health benefits to be paid by their employer upon retirement? The Court concludes that genuine issues of material fact exist with respect to the claims of the majority of Retirees. Those claims will proceed to trial." [Zino et al. v. Whirlpool Corp. et al., No. 5:11CV01676 (N.D. Ohio, Aug. 27, 2013)] (U.S. District Court for the Northern District of Ohio, Eastern Division)  

ACOs' Coordinated Care Savings May Be Contagious
"[U]sually only a portion of patients in a health system are actually in the ACO -- the rest of the patients served by a network remain in the regular old fee-for-service system. Still, researchers at the Harvard Medical School say there appears to be a 'spillover savings' for other patients in the health system." (Kaiser Health News)  

Changes in Health Care Spending and Quality for Medicare Beneficiaries Associated With a Commercial ACO Contract
"The [Blue Cross Blue Shield (BCBS) of Massachusetts' Alternative Quality Contract] was associated with lower spending for Medicare beneficiaries but not with consistently improved quality. Savings among Medicare beneficiaries and previously demonstrated savings among BCBS enrollees varied similarly across settings, services, and time, suggesting that organizational responses were associated with broad changes in patient care." (JAMA)  

HHS Delays Deadline for Finalizing Health Plans to be Sold on Federal Exchanges
"[HHS] notified insurance companies on Tuesday that it would not sign final agreements with the plans between September 5 and 9, as originally anticipated, but would wait until mid-September instead ... Nevertheless, Joanne Peters, a spokeswoman for HHS, said the department remains 'on track to open' the marketplaces on time on October 1. The reason for the hold-up was unclear. Sources attributed it to technology problems involving the display of insurance products within the federal information technology system." (Reuters)  

DOL Negotiates Reinstatement of COBRA Coverage Terminated Because of 26-Cent Premium Shortfall
"[A recent news story] reported that a qualified beneficiary with leukemia had his coverage terminated early because his premium payment was 26 cents short.... The IRS' final COBRA regulations establish special rules for COBRA premium payments that are short by an amount that is 'not significant.' In such cases, a plan must choose between one of two options: treat the payment as satisfying the plan's payment requirement as payment in full for COBRA coverage; or notify the qualified beneficiary of the deficiency amount and grant him or her a reasonable period (as a safe harbor, 30 days is deemed reasonable) to pay the shortfall. The IRS regulations state the term 'not significant' means the shortfall is not greater than the lesser of $50, or 10 percent of the amount to be paid." (Thompson SmartHR Manager)  

Drop Spouses from Health Plan or Add a Surcharge: Is Either Move Right for Your Company?
"If your company is thinking about dropping spouses from your healthcare plan, there are a number of things that UPS did right that can serve as a guide in making such a drastic move. Here are three examples: [1] Be as honest -- and detailed -- as possible.... [2] Prepare for recurring questions ahead of time.... [3] Provide assistance for impacted employees." (HR Benefits Alert)  

As October 1 Nears, Most Employers Have Yet to Communicate Employee Benefits Changes (PDF)
"[A] large number of American workers remain unaware, confused and unprepared for looming changes to their benefits coverage.... 69 percent of workers say their employer hasn't communicated changes coming to their benefits package due to health care reform despite the October 1 deadline for employers to notify their employees of their coverage options.... [S]ome employers (41 percent) believe more gaps in coverage will be created and 69 percent believe costs to employees will increase as a result of health care reform." (Aflac)  


Will Obamacare Help or Hurt the Economy?
"Is it really credible to think that ObamaCare will reduce the cost of health care? Consider that ObamaCare aims to insure an additional 27 million people. If economic studies are correct, once they are insured these people will try to double their consumption of health care. On top of that, millions of employees and their employers will be forced to upgrade their health insurance -- making it more generous (and more expensive) than it currently is.... Then there is a lengthy list of preventive services everyone is supposed to insure for, with no copayment or deductible.... What we are describing is a huge increase in the demand for care. But the [ACA] does nothing to increase supply." (John Goodman's Health Policy Blog)  


High-Deductible Health Plans Cause Men to Avoid Emergency Department Use for High-Severity Conditions
"Males whose employers switched them from a traditional HMO to a high-deductible health plan reduced their use of emergency department high-severity visits by 34 percent. That is, they did not go to the emergency department when the severity of their condition clearly warranted it. That was followed a year later by a 30 percent increase in hospitalizations." (Physicians for a National Health Program)  

Benefits in General; Executive Compensation

ERIC Releases Results of Poll on Benefits Offered to Same-Sex Couples
"ERIC President and CEO Scott Macey [said,] '[N]early 3/4 of the ERIC members who responded to our poll have not yet decided how to handle the benefits of spouses of same-sex marriages in states that do not recognize such marriages. For most of these employers, guidance from the government is crucial.'" (The ERISA Industry Committee [ERIC])  

Expected SEC Rulemaking Puts Pay Ratio, Pay for Performance Back Into Focus
"Expanding on comments by Chair Mary Jo White in late July, SEC Director of Corporation Finance Keith Higgins indicated in a recent speech that pay ratio will be one of the top three rules the Commission will propose this fall. However, he said that there were still many difficult issues to work through, especially whether the Commission will seek to define 'all employees' broadly or narrowly and how median employee compensation will be calculated." (HR Policy Association)  

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