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September 11, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs


Webcasts and Conferences

ESOP Distribution Policies
November 19, 2013 WEBCAST
(National Center for Employee Ownership)

Experience Synergies360
September 25, 2013 in PA
(Corporate Synergies)

ERISA Workshop 2013 - 24 Cities, October-November
October 23, 2013 WEBCAST
(SunGard Relius)

Health Reform - Beyond the Basics: What Counts as Income for Premium Tax Credits and Medicaid
September 25, 2013 WEBCAST
(Center on Budget and Policy Priorities)

View All Webcasts and Conferences


  LinkedIn   Twitter   Facebook Hand-picked links to the web's best news articles,
official guidance, jobs, webcasts and more.
[Guidance Overview]

Keeping it Straight: Essential Health Benefits and Annual, Lifetime, and Maximum Out-of-Pocket Limits
"[1] How does a self-funded health plan determine what is an essential health benefit? ... [It] appears that employers with self-funded health plans can use any state's definition of essential health benefits (though it is riskier to choose a state where the employer has no operations, especially if the employer operates in only one state)..... [2] We are a multi-state employer and have a self-funded plan. Which state's definition of essential health benefit should we use? [Answer:] Some informal, non-binding comments from an HHS official confirm that an employer with operations in a few states (e.g., California and Washington) could even choose a definition of essential health benefits, which is based on a state where the employer has no operations (e.g., Texas). The example below illustrates why this can be important." (Quarles & Brady LLP)  


[Advert.]

Achieve a New Level of Professional Growth With CEBS!

Sponsored by International Foundation of Employee Benefit Plans (IFEBP)

As the most respected designation in the industry, Certified Employee Benefit Specialist (CEBS) courses give you the knowledge and confidence to succeed in today's business environment. Learn More!



[Guidance Overview]

IRS Proposed Rules Address Health Insurance Information Reporting for Employers and Insurers
"In addition to health insurers, employers that self-insure are also subject to Section 6055 reporting. Under the proposed regulations, the employer is the plan sponsor and reporting entity for self-insured arrangements. However, the controlled group rules of IRC Section 414 do not apply ... This means that a self-insured group health plan covering employees of related corporations is treated as sponsored by more than one employer, and each employer must report under Section 6055." (Practical Law Company)  

[Guidance Overview]

New Guidance on Information Reporting Requirements Under the ACA
"The proposed rules describe a variety of options to potentially reduce or streamline information reporting, such as: [1] Replacing section 6056 employee statements with Form W-2 reporting on offers of employer-sponsored coverage to employees, spouses, and dependents. [2] Eliminating the need to determine whether particular employees are full-time if adequate coverage is offered to all potentially full-time employees. [3] Allowing employers to report the specific cost to an employee of purchasing employer-sponsored coverage only if the cost is above a specified dollar amount." (U.S. Small Business Administration)  

[Guidance Overview]

Skinny Plans Could Lead to Fat Bills
"A skinny plan will cover preventive services along with a limited number of doctor office visits and generic drugs. However, a skinny plan is unlikely to cover hospitalizations or surgeries.... Despite skinny plans' limited coverage, employers offering skinny plans will have fulfilled their obligation to offer full-time employees the opportunity to enroll in minimum essential coverage under an employer-sponsored plan.... The 4980H(b) penalty will still apply because the employer's skinny plan will not satisfy the minimum value requirement." (Moulder Law)  

[Guidance Overview]

HHS Publishes Final Rule on Exchanges, SHOPs, and Eligibility Appeals
"The final rule only finalizes those provisions that must be in effect when open enrollment for Qualified Health Plans begins on October 1, 2013. Those provisions serve to establish oversight and consumer protection policies relating to the implementation of [Exchanges] under the [ACA], through which qualified individuals and qualified employers will be able to purchase private health insurance coverage.... In addition, the final rule finalizes components of another proposed rule that relate to appeals processes." (Morgan Lewis)  


[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.



[Guidance Overview]

Year Two of Medical Loss Ratio Rebates: Tips for Insured ERISA Health Plan Sponsors
"Any MLR rebates that are considered plan assets must be handled according to ERISA's general standards of fiduciary conduct. ERISA's prohibited transaction and exclusive benefit rules require that plan assets be used solely for the benefit of participants and beneficiaries (or to defray reasonable plan administrative expenses). As long as the plan fiduciary (e.g., the plan sponsor) adheres to these standards, it has some discretion when deciding to whom the rebate should be allocated." (Proskauer's ERISA Practice Center)  

Fifth Circuit: No Error in Insurer's Reliance on Evidence from Participant's Acquaintance
"[T]he Fifth Circuit found that the district court erred by considering [the insurer's] alleged failure to investigate 'the accuracy of the information it gleaned from the emails' as a factor in finding procedural unreasonableness. The Fifth Circuit said that [the insurer] 'did not violate its duty to investigate' because 'no such duty exists.'" [Truitt v. UNUM Life Ins. Co. of America, No. 12-50142 (5th Cir. Sept. 6, 2013)] (Bloomberg BNA)  

Health Law Challenge Is Back to Supreme Court
"The new case poses a challenge, based on a variety of constitutional arguments, to the Affordable Care Act's mandate that employers provide a minimum level of health insurance for their workers, or pay a federal penalty. In 2012, the Court opted not to hear any challenge to that provision. But Liberty University and two women challengers are also making religious freedom arguments against the individual insurance mandate that the Justices had upheld Term before last -- arguments that were not before the Court then.... The Supreme Court will not examine the new petition until after the Obama administration has had a chance to file a formal response. The Court has the discretion of granting or denying review." (SCOTUSblog)  

Obamacare's Data Hub Insurance Network Is Completed, White House Officials Say
"Federal health officials said they have completed the 'data hub,' a complex system that will verify people's Social Security numbers, immigration status and other information when they log on to government Web sites to buy health plans and apply for government subsidies.... A government watchdog warned this month that a critical security test for the data hub had been delayed and was not scheduled to be completed until Sept. 30. But on Tuesday, officials said they managed to finish that testing on time Friday, calling it a major turning point." (The Washington Post; subscription may be required)  

Vendors Vow Health Insurance Exchanges Will Be Ready on Time
"Four vendors entrusted with getting the health insurance exchanges up and running told a House subcommittee on Tuesday that despite concerns heard in healthcare information technology circles and within the federal government, the exchanges will be ready to roll by Oct. 1." (HealthLeaders Media)  

Bill to Protect Patient Access to Medically Necessary Treatments Would Have Negligible Impact on Insurance Premiums
"[T]he bill would [increase] premium costs by an average of $3 per year for plans with specialty tiers, absent any other changes to the average benefit design ... H.R. 460, co-sponsored by Rep. David McKinley (R-WV) and Rep. Lois Capps (D-CA), would protect patient access to medically necessary treatments by lowering patient out-of-pocket costs for specialty drugs in commercial health plans.... [S]pecialty [drug] spending represents approximately 2% of overall health plan spending for commercial plans." (National Organization for Rare Disorders, Inc.)  

Obamacare Causes Oklahoma Health Insurance Rates to Skyrocket
"After filings were made by the insurers that plan to offer products in the marketplace, the Oklahoma Insurance Department has learned that health insurance rate increases in individual markets range from 30 percent to more than 100 percent. These changes affect both new policies effective in 2014 and existing policies as they are renewed in 2014 and amended to conform to the law's requirements." (Oklahoma Insurance Department)  

Most U.S. Employees Likely to See Changes When Enrolling in Health Benefits This Year; Workers Should Read the Fine Print and Take an Active Role in the Enrollment Process
"Some of the most notable changes employees may see include: A more expensive price tag ... A higher probability of being in a consumer-driven health plan ... More incentive opportunities for exhibiting healthy behaviors ... New eligibility rules... [Employees should:] Review coverage offered by your employer before making a decision about purchasing coverage through a marketplace in your state... Evaluate whether a CDHP is right for you....Take advantage of opportunities to improve your health and lower your health costs.... Consider any supplemental benefits your employer may offer.... Take a 'health and wealth' view to spend your dollars wisely." (Aon Hewitt)  

[Opinion]

Hacking the Affordable Care Act
"[The American Enterprise Institute (AEI) offers] a coherent and somewhat persuasive proposal ... and one which goes to some lengths to level the health insurance playing field.... Eliminating the tax preference doesn't guarantee that the inequities of employer coverage will go away. Given the proposed high deductibles, especially for higher-paid workers, many employers will almost certainly be forced to offer supplemental coverage. A national exchange with national regulation has the potential of replacing state control by a huge federal bureaucracy.... So why is the AEI proposal worth looking at? For all its considerable faults, it avoids the fundamental weakness of the ACA: perpetuating every complication of the existing system (and adding some more)." (Roger Collier in The Health Care Blog)  

[Opinion]

Deloitte Health Care Current, September 10, 2013
"Today's health care system is structured with the wrong incentives for today's operating environment and there are few connections to the patient or trading partners who are using closed proprietary systems that create lots of data but hardly any information.... Given the market needs and disruption taking place with reform, the level of mergers and acquisitions, affiliations, alliances and joint ventures continues to escalate.... Market leaders are investing in new ideas, technologies and capabilities not just to solve today's problems, but also to bring new ways to change the fundamental rules of the health care system." (Deloitte Center for Health Solutions)  

[Opinion]

How One Patient Saved $17,000: He Didn't Use His Health Insurance
"Most people are unaware that if they don't use insurance, they can negotiate upfront cash prices with hospitals and providers substantially below the 'list' price.... [T]he only way to make health care more affordable is to diminish the role of third-party payers. Let consumers and providers interact through market forces to drive down prices and drive up quality ... Drop the focus on prepaid health plans and return to the days of real health insurance -- that covers major, unforeseen events, leaving the everyday expenses to the consumer[.]" (The Wall Street Journal; subscription may be required)  

[Opinion]

Health Exchange Confusion: Why We're Getting the IBM Story Wrong
"The headline and subtext of [a recent] article are that IBM is ending health benefits for retirees, leaving them to fend for themselves.... This article ... equates being put on the exchange as a kind of punishment or abandonment. In fact, all else being equal (i.e., contributions levels staying the same) being on an exchange should be beneficial to retirees or employees due to the increased choice." (David Williams in The Health Care Blog)  

Benefits in General; Executive Compensation

[Guidance Overview]

IRS Releases Guidance on Treatment of Same-Sex Spouses and Domestic/Civil Union Partners
"The current IRS guidance does not explain how to treat a plan participant with a same-sex spouse who has already designated a non-spouse beneficiary without obtaining spousal consent (which was not required prior to the Windsor decision), nor does it obligate a plan to notify such participant that a current beneficiary designation form may no longer be valid." (Schiff Hardin LLP)  

Epstein Becker Green ERISA Litigation Update, Fall 2013 (PDF)
20 pages; articles include: 401(k) Plan Litigation Continues: Tibble V. Edison International; the Moench Presumption Revisited; IRS Provides Answers To Some of Windsor's Questions; Developments in the Continuing Litigation Over Obamacare; the Next Term: Heimeshoff & Plan-Imposed Limitations Periods for Benefit Claim Litigation; Supreme Court Supports Enforcement of Subrogation Provisions but Demands Clarity in Plan Language. (Epstein Becker Green)  

Employer Costs for Employee Compensation, June 2013 (PDF)
"In June 2013, average costs in private industry for retirement and savings benefits were $1.07 per hour worked, or 3.7 percent of total compensation. The average cost per hour worked for defined benefit plans ... was 47 cents or 1.6 percent of total compensation. The average cost for defined contribution plans ... was 60 cents or 2.1 percent of total compensation.... Private industry employer costs for paid leave averaged $2.00 per hour worked or 6.9 percent of total compensation ... [and] insurance benefits averaged $2.39 or 8.2 percent[.]" (U.S. Bureau of Labor Statistics)  

ERISA Claims, Litigation and Litigation Avoidance (PDF)
58 Presentation slides; topics include: ERISA'S Statutory Framework; ERISA Remedies; ERISA Parties: Impact on ERISA Actions; ERISA Preemption; ERISA Procedural and Evidentiary Issues; Examples of ERISA Claims (in wide variety of plan types); Avoiding and Preparing for ERISA Litigation. (Mazursky Constantine LLC)  

Bill to Create National Broker Licensing Bureau Passes House
"The bill to establish a national broker clearinghouse to cut through the red tape of state-by-state licensing [has] passed the U.S. House of Representatives ... A similar bill moved through committee in the U.S. Senate in June and is teed up for a full vote.... [T]he law would create the National Association of Registered Agents and Brokers, which would have a 13 member board appointed by the president and confirmed by the Senate. Members of organization would have a simpler time obtaining licenses to practice outside of their state of residence." (Employee Benefit Adviser)  

Protecting Deferred Comp with Credit Default Swap
"Credit risk is exactly what a credit default swap is designed to protect against. The client could buy a credit default swap against the company's bonds. Then, if the company went bankrupt or defaulted on the bonds, the payment from the swap would cover the value of the client's deferred compensation.... That swap acted as an insurance policy against a bond issued by the client's former employer, which would mature in 2015.... If the bond ... reaches maturity, the contract for the swap will expire and ... the transaction [could be repeated] by purchasing another swap on a bond with a later maturity. But since the retirement plan pays out over 10 years, there will be less deferred compensation to protect over time and the cost of doing so will drop." (The Wall Street Journal; subscription may be required)  

2013 Director Compensation Study Summary
"Total compensation paid to non-employee directors rose +4.5% over 2011 levels, to a median of $261,333.... Pay mix for non-employee directors has remained relatively unchanged since 2007. Directors continue to receive just over half of their total compensation in the form of equity (55% in 2012), in accordance with governance best practices.... Annual Cash Board Retainer increased $5,000 in 2012 to a median of $85,000 and the median Annual Equity Board Retainer increased $10,000 to $140,000." (Steven Hall & Partners)  

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