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September 5, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Benefits Manager
Chugach Alaska Corporation
in AK

Benetech, Inc.
in CA

Pension Case Designer
American National Insurance Company
in TX

Internal Sales Consultant
The Newport Group
in NC

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Webcasts and Conferences

Voluntary Fiduciary Correction Program And Abandoned Plan Program Workshop
September 16, 2013 in IN
(Employee Benefits Security Administration (EBSA), U.S. Department of Labor)

Same Gender Marriage: Take 2
September 10, 2013 WEBCAST
(SunGard Relius)

Handling IRA Legal Issues
September 10, 2013 WEBCAST

Conducting Your Own Compliance Audit
September 12, 2013 WEBCAST

Rollovers Between Retirement Plans and IRAs
September 12, 2013 WEBCAST

View All Webcasts and Conferences

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official guidance, jobs, webcasts and more.
[Guidance Overview]

HIPAA Compliance Deadline Rapidly Approaching
"[E]mployer group health plans need to comply with the final regulations by September 23, 2013. Plans that are not in compliance could face penalties for each violation that range from a minimum of $100 to a maximum of $1.5 million ... [E]mployers should ... Revise existing Notice of Privacy Practices to incorporate new disclosure requirements.... Review plan providers and determine whether any providers are now business associates under the final rule's expanded definition of business associate.... Review and revise existing HIPAA policies and procedures to comply with changes required under the final regulations." (Dorsey & Whitney LLP)  


New HIPAA Rules Require Compliance by September 23, 2013

Sponsored by International Foundation of Employee Benefit Plans (IFEBP)

New HIPAA rules issued earlier this year require compliance by group health plans and business associated by September 23. The International Foundation's HIPAA Privacy e-learning course provides the training you need to ensure compliance. Enroll Now!

[Guidance Overview]

HHS Describes Employer Process to Undo Exchanges' Decisions
"If an employer does not like an exchange's appeal decision, it has no right to appeal to HHS, in contrast to individuals who may appeal their adverse eligibility determinations to HHS. However, states that run exchanges may set up an appeal arm [that] employers can use to contest exchange decisions. This may spell complexity for employers operating in several states ... The employer is supposed to be able to access the information used in making the initial determination that its coverage was inadequate or unaffordable. However, the law prohibits disclosure of the employee's tax return information in the course of an employer appeal." (Thompson SmartHR Manager)  

ACA Notice Requirements for Employers: What's Required, What's Coming and How to Make the Most of Them
"The notices ... are required by law, but they also present an opportunity to contact employees, explain the notices, share other messages and promote and expand the plan's electronic communications.... Using a required notice as an opportunity to provide employees with good, solid information upon which they can rely is a way to effectively answer questions and also to assure that the human resources department is not overrun with questions when the Health Insurance Marketplaces open for enrollment on October 1, 2013." (Sibson Consulting)  

2013 Benchmarking Study: How Companies Are Leveraging Employee Wellness Initiatives and Benefits Technology to Control Health Care Cost
"In 2013, more employers offered incentives to motivate employee participation in wellness programs. While large employers only experienced a slight increase from 76% to 78%, the use of incentives by smaller employers increased from 52% to 69%.... This year, 77% of large employers said they have biometric testing in place for employees compared to last year.... Most large employers (64%, up from 59% in 2012) use health insurance premium discounts or surcharges to motivate employees.... More than half of large employers, 54%, reported spending more than $250 annually per employee on wellness incentives compared to 49% in 2012." (bswift and Employee Benefit News; free registration required)  

An Early Look at Premiums and Insurer Participation in Health Insurance Marketplaces, 2014 (PDF)
"There are at least two insurers participating in each of the exchanges in the rating areas that we analyzed, and three or more insurers participating in most of the areas.... [T]he lowest cost bronze plan for a 40-year-old ranges from $146 in Baltimore, Maryland and $155 in Albuquerque, New Mexico to $308 in New York, New York and $336 in Burlington, Vermont.... While premiums will vary significantly across the country, they are generally lower than expected." (Henry J. Kaiser Family Foundation)  


Wellness Programs: Impact of the New HIPAA Nondiscrimination Regulations - October 21 Webinar

Sponsored by Lorman and BenefitsLink

This live webinar reviews new HIPAA nondiscrimination regulations, other regulatory developments, case law, and other developments, and requirements of wellness programs. Registration discount for BenefitsLink readers.

Technical Snafus Confuse Charges for Obamacare Plans
"An official from Florida Blue, a large insurer, was concerned that a health policy it plans to sell on the state's exchange would mislead customers: The preview website showed no charge at all for some medical services, rather than no charge after a deductible is met. An Aetna staffer was frustrated that policies the company once intended to sell in Ohio, but withdrew, were still showing up in the preview site. Delta Dental of Wyoming reported that its plan was showing zero deductible in policies that cover parents plus children.... Carriers were sanguine the snafus would get addressed." (Reuters)  

Two More Health Insurers Get Preliminary OK to Join Washington State's Exchange
"The two companies -- Community Health Plan of Washington and Kaiser Foundation Health Plan -- were originally rejected for the Healthplanfinder because they didn't meet all the federal regulations.... The Community Health Plan had set different rates for two tiers of doctors and has fixed that. Kaiser had to make its rate information more complete." (The Olympian)  

Maryland Health Connection Unveils Advertising and Outreach Campaign
"The statewide advertising campaign includes television, radio, print advertising, out of-home and digital media. Marylanders will experience the Maryland Health Connection campaign in each region of the state beginning in September through the open enrollment period ending in March 2014. Central to the campaign is custom music that reinforces the key benefits of health coverage, including peace of mind, convenience, financial security and access to health care. The custom music has been produced in four musical genres: contemporary, Latin, country and urban." (Maryland Department of Health and Mental Hygiene)  

Navigators Say GOP Lawmakers' Information Requests Are 'Shocking'
"'Was this an attempt by members of the committee to basically stop and slow down the navigator process?' [says Lisa Hamler-Fugitt, executive director of the Ohio Association of Foodbanks, which received a $1.9 million grant]. 'We're going to stop now and pull together voluminous documents to provide back to the committee?' Some of those documents don't yet exist, she says. 'We weren't required to provide position papers, salary ranges, privacy policies or procedures. You don't do that until you know that you got the award.'" (Kaiser Health News)  

Risk Adjustment: What Is the Current State of the Art and How Can It Be Improved?
"Prospective risk-adjustment models under-predict costs for high-cost patients and over-predict costs for very low-cost patients. Using a hybrid approach of concurrent and prospective risk adjustors may help alleviate this problem. Including prior year expenditures is the best way to increase the accuracy of risk-adjustment models, but it may weaken incentives to provide cost-effective treatment to patients. Risk adjustment has encouraged plans to provide coverage for high-cost patients, but these patients are still overrepresented among disenrollees in the Medicare Advantage program. Risk adjustment has had mixed success in discouraging risk selection." (Robert Wood Johnson Foundation)  

U.K. Competition Commission Provisionally Finds Anti-Competitive Features in Privately-Funded Health Care
"The [Competition Commission (CC)] provisionally found that there are anti-competitive features in the supply or acquisition of these services, mainly due to the market structure, certain incentive schemes used by private hospitals and information asymmetries. The CC found that these features ... were estimated to cost patients between 173 million GBP and 193 million GBP per year between 2009 and 2011, which is equivalent to approximately 10 to 11 per cent of the revenues of the three leading private hospital operators in the United Kingdom. In view of this finding, the CC proposed the imposition of a variety of structural and behavioural remedies." (McDermott Will & Emery)  

Wide Price Variation for Privately Insured Patients Underscores Hospital Market Power
"Across 13 selected U.S. metropolitan areas, hospital prices for privately insured patients -- especially for outpatient care -- are much higher than Medicare and vary widely within and across communities ... Based on claims data for 590,225 active and retired nonelderly autoworkers and their dependents, the study found that average hospital prices for privately insured patients in the 13 communities with large concentrations of autoworkers are about one-and-a-half times Medicare rates for inpatient care and two times what Medicare pays for outpatient services." (Center for Studying Health System Change)  

Value Based Purchasing by the Self-Insured Employer
"Self-insured companies are increasingly making the bold move to allow their employees more options by creating networks of Centers of Excellence across the country ... By forming partnerships with selected medical facilities renowned for particular services, these companies encourage their employees and covered dependents to pursue higher quality, lower cost treatments than would be available locally." (Healthcare Reform Magazine)  

The Value of Private Health Exchanges
"Private exchanges may not be a panacea for rocketing healthcare costs.... [E]mployers will seek approaches such as private exchanges to transition health benefits from an employer driven model to a more consumer driven one.... If executed thoughtfully and deliberately, launching or joining a private exchange could be a critical strategy for payers to adapt and thrive." (Healthcare Reform Magazine)  

Time for Defined Contribution Health Benefits?
"Adopting a defined contribution approach does not necessarily mean greater cost shifting or changing the benefits being offered ... Rather, instead of framing it as the organization and the employee both paying a percentage of the premium each month (which to most employees is far from transparent, as they tend to see just the deductions taken from their salary), companies tell their employees that now they will receive a set dollar amount to go toward monthly premiums." (Society for Human Resource Management)  


Medisave Accounts in Singapore: Private Saving and Private Insurance Do What Employers and Governments Do in Other Countries
"It's taken about almost three decades, but all of a sudden Singapore has come to the attention of a lot of other policy wonks ... In Singapore, people are required to save for health care, retirement income and other needs.... For individuals up to age 50, the required saving rate is 36% of income (nominally divided: 20% from the employee and 16% from the employer). Of this amount, 7 percentage points is for health care and is deposited in a separate Medisave account.... When a Medisave account balance reaches about US $34,100 (an amount equal to a little less than half of the median family income) any excess funds are rolled over into another account and may be used for non-health care purposes." (John Goodman's Health Policy Blog)  


Only the Beginning: What's Next at the Health Insurance Exchanges?
"After the exchanges are up and running, they will be in a position to make decisions that will help shape the organization, quality, and financing of all U.S. health care.... To limit information overload, they may limit the number of plans insurers can offer and require that plans differ meaningfully from one another. They can require insurers to offer certain standardized plans so that customers can more easily compare price and service. Exchanges can set additional standards for the quality of care paid for by plans, bar plans that do not meet quality or price standards, and selectively contract with those that do. In addition, to strengthen the position of exchanges within the health insurance markets, states may bar the sale of insurance to individuals and small businesses outside the exchanges or require that the same plans be sold inside and outside them. Few exchange administrators have used many of these powers so far." (Brookings)  


Big Insurers Take Different Approaches to the Exchanges
"If you want to understand the profit potential of the [ACA] -- without the obscurant of any political lens -- just follow the money. Look at what the publicly held insurers -- cold-eyed healthcare capitalists all -- are doing relative to the state healthcare exchanges, for example. Are they lining up to participate, or running away? The answer is: both." (HealthLeaders InterStudy)  


Some Big Insurers Leery of Exchanges
"UnitedHealthcare, Aetna, and Cigna -- three of the largest private insurers in the nation -- have decided to not participate in most of the state exchanges being established under Obamacare.... These big insurers aren't dumb. If they are going to sell plans in the exchanges, they want most of these low-cost individuals included in order to dilute the high costs of the sick who will enroll, thereby allowing the insurers to offer competitive premiums. Quite clearly, they are not convinced that will happen." (Physicians for a National Health Program [PNHP])  

Benefits in General; Executive Compensation

[Guidance Overview]

Post-Windsor Agency Guidance Means Some Plans Will Need to Apply Multiple Rules
"Since the SSA decided to recognize a same-sex marriage based upon the law of the couple's state of residence at the time of application for Social Security benefits, employers who sponsor defined benefit plans which have benefit forms that coordinate with Social Security benefits ... or other plans such as long term disability benefits which may offset for Social Security benefits, will also need to know the participant's state of residence at the time Social Security benefits were applied for ... to be able to understand and determine the impact of the marital status on the Social Security benefits which will then impact the calculation of the optional benefit form and/or the disability benefit plan offset." (Winstead PC)  

Compensation Paid to Outside Directors at Largest Public Companies Increased Last Year (PDF)
"[T]otal compensation paid to outside directors in the Fortune 250 increased by approximately 4% over the past year. While only a modest increase of 2% in total cash compensation was observed, total equity awarded increased by nearly 8%[.]" (Meridian Compensation Partners, LLC)  

Slight Increase in Rate at Which Large Companies Are Granting Equity Incentives (PDF)
"The median run rates are up slightly for Fortune 100, Fortune 250 and Fortune 500, as companies continue to shift from granting stock options to full value shares.... The median total overhang [is] up for Fortune 100 and Fortune 250, but slightly down for Fortune 500.... Among Fortune 500 companies ... the annual run rate at the 75th percentile was 2.4% and total overhang was 16.0%." (Meridian Compensation Partners, LLC)  


CEO Pay Disclosure Rule: About as Dumb as It Gets
"Forcing companies to disclose the gap between CEO pay and rank-and-file compensation is about as dumb as it gets.... [W]hat makes executives take wild risks in order to earn their incentive pay -- risks like the ones financial firms took that helped trigger the economic crisis that began in 2008, and later Dodd-Frank -- doesn't have a lot to do with how much money they make. Let alone how much their rank and file makes. It has far more to do with the short periods of company performance, usually no longer than three years, on which such compensation is based. You've got to show results in a hurry to get your money." (CFO)  

Press Releases

EBRI at 35 -- Fall 2013 President's Report
Employee Benefit Research Institute (EBRI)

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