EmployeeBenefitsJobs.com logo BenefitsLink.com logo

BenefitsLink Health & Welfare Plans Newsletter

September 17, 2013          Get Retirement News  |  Advertise
         Past Issues  |  Search

Employee Benefits Jobs

Assistant Administrator
The Ryding Company
in CA

Benefits Associate II
Western University of Health Sciences
in CA

Director, Client Executive
Transamerica Retirement Solutions
in CA

Post Your Job

View All Jobs

RSS feed for jobs RSS Feed: All Jobs

Webcasts and Conferences

Washington & DOMA Update
October 10, 2013 WEBCAST
(National Tax Sheltered Accounts Association)

Best Practices in Designing Behavior Changing Financial Wellness Programs
October 10, 2013 WEBCAST
(Lorman Education Services)

The Roadmap to State and Private Exchanges
October 3, 2013 WEBCAST
(ABA Joint Committee on Employee Benefits)

The Roth 403(b) Option; The Opportunity With Both Ongoing Contributions & Conversions
November 7, 2013 WEBCAST
(National Tax Sheltered Accounts Association)

Plan Governance
October 3, 2013 in GA
(ASPPA Benefits Council of Atlanta)

HITECH and HIPAA Omnibus Final Rule - A Glimpse at Primary Changes
September 23, 2013 WEBCAST
(Bond, Schoeneck & King, PLLC)

The Two Main Components of a “Reasonable Arrangement” under 408(b)(2)
September 19, 2013 WEBCAST
(Pension Consultants, Inc.)

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-Provided Model Notices of HIPAA Privacy Practices
"Developed with input from consumers and key stakeholders, the model Notices are provided in three different styles and are customizable by users.... [1] Notice in the form of a booklet; [2] A layered notice with a summary of the information on the first page and full content on the following pages; and [3] A notice with the design elements of the booklet, but that is formatted for full-page presentation. Additionally, a text-only version is available for health care providers and health plans who only wish to use the content." (Office of the National Coordinator for Health Information Technology [ONC] and the Office for Civil Rights [OCR], U.S. Department of Health and Human Services)  


Easily administer your H&W plans with ftwilliam.com's innovative document software!

Sponsored by ftwilliam.com

Streamlined data entry, batch amendments, batch SBC, automatic updates, edit checking and more! These are just some of the features available in our software. Click here to learn more about the documents we offer and ask for a demo!

[Guidance Overview]

No Statutory Penalties If Employers Fail to Provide the Exchange Notice, But Significant Exposure Remains
"[A] blatant disregard of the requirement to provide the Exchange Notice could expose an employer to lawsuits if one or more employees are unhappy with their coverage situations. These lawsuits would likely not be preempted by ERISA and could, for example, be brought in state court based on tort or general common law theories. A purposeful and total failure to provide Exchange Notices would likely be viewed by a court as different from the situation in which an employer makes a good faith effort and just misses a few employees." (Mazursky Constantine, LLC)  

[Guidance Overview]

October 1 Health Care Reform Exchange Notice Deadline Approaches; Open Issues Remain
"It is not entirely clear who is going to obtain all the information necessary to determine whether an individual appears to be eligible for a credit on the exchange, to confirm after the year ends that he actually was eligible for subsidies, and to confirm whether employers are actually liable for any penalties (commencing in 2015). Nor is it clear how they are going to obtain this information.... [A]bsent more guidance, providing too much information in Part B could lead to inappropriate conclusions." (Porter Wright Morris & Arthur LLP)  

Census Bureau Report on Income, Poverty and Health Insurance Coverage in the United States: 2012
"The number of people with health insurance increased to 263.2 million in 2012 from 260.2 million in 2011, as did the percentage of people with health insurance (84.6 percent in 2012, 84.3 percent in 2011). The percentage of people covered by private health insurance in 2012 was not statistically different from 2011, at 63.9 percent. This was the second consecutive year that the percentage of people covered by private health insurance coverage was not statistically different from the previous year's estimate. The percentage covered by employment-based health insurance in 2012 was not statistically different from 2011, at 54.9 percent." (U.S. Census Bureau)  

Three Million People Gained Insurance in 2012. Don't Thank Obamacare.
"New Census data show that the country's uninsured rate fell from 15.7 percent in 2011 to 15.4 percent in 2012. Nearly all of that change appears to be attributable to enrollment in public programs such as Medicaid and Medicaid. Coverage in private health plans, like those that employers purchase, didn't budge." (Sarah Kliff in The Washington Post; subscription may be required)  


Compliance, Legislation and Litigation -- SWBA/IRS Annual Conference - Nov. 7-8 - Dallas, TX

Sponsored by SouthWest Benefits Association

Staying up to date in the challenging world of employee benefits has never been more critical to the success of benefits professionals and their companies. Attending the SWBA/IRS Employee Benefits Conference is the most cost-effective way to stay informed.

Small Business Advice: How to Navigate New Health Information Security Regs Starting Monday
"One nuance that has flown under the radar is that the HIPAA and HITECH privacy and security rules also apply to companies that self-insure all or a portion of their employee health insurance coverage and collect protected health information from their employees. These types of companies are generally considered to be 'health plans' under HIPAA and, as a result, must comply with HIPAA and HITECH." (The Washington Post; subscription may be required)  

District Court Rejects Installment Theory of Claim Accrual in Action for Ltd Benefits
"The participant alleged that MetLife erred in calculating his long-term disability benefits and owed him back benefits that had been underpaid. Although MetLife made this calculation in 2005, the participant argued that his 2012 lawsuit was timely under Massachusetts' six-year limitations period, because each underpayment of benefits constituted a separate violation with a separate limitations period. Judge Douglas P. Woodlock rejected this theory and awarded summary judgment to MetLife[.]" [Riley v. Metro. Life Ins. Co., No. 1:12-cv-10531-DPW (D. Mass. Sept. 11, 2013)] (Bloomberg BNA)  

Ask and Ye Shall Receive? The Dynamics of Employer-Provided Flexible Work Options and the Need for Public Policy
"[M]anagers were most likely to grant flextime to high-status men seeking flexible schedules in order to advance their careers. In contrast, flexible scheduling requests from women were unlikely to be granted irrespective of their job status or reason.... [E]mployees were unaware of these managerial biases: women assigned high-status jobs and requests for career advancement reasons were the most likely to think their requests would be granted, while men in the same scenarios were least likely to believe this. Organizational and policy implications are discussed." (The Society for the Psychological Study of Social Issues)  

Trader Joe's Cut Health Benefits Last Week. Here's Its Side of the Story.
"Stated quite simply, the law is centered on providing low cost options to people who do not make a lot of money. Somewhat by definition, the law provides those people a pretty good deal for insurance ... a deal that can't be matched by us -- or any company. However, an individual employee ... is only able to receive the tax credit from the exchanges under the act if we do not offer them insurance under our company plan." (The Washington Post; subscription may be required)  

Investors See Only Four Million Signing Up for Obamacare in 2014
"Investors expect 4 million Americans to initially enroll in the state insurance marketplaces created under [the ACA] ... as concerns mount that technical glitches could present obstacles to enrollment. The expectations of the investors -- hedge funds, institutional clients and other investors surveyed by Citigroup, 56 in total -- fall far short of a [CBO] forecast that 7 million Americans will seek subsidized health coverage through the online exchanges" (Reuters)  

Obamacare Will Be Both Ally And Rival To eHealthInsurance
"[Federal and state governments are] getting into a business that eHealthInsurance.com currently dominates. It's operated a clearinghouse-style online exchange since 1999 that's very similar to what state and federal governments plan to launch next month ... EHealth CEO Gary Lauer says he views his company as more of a partner than a competitor with the federal government as it works to get the [ACA] up and running." (The Washington Post; subscription may be required)  

Fifty-Six Percent of the Uninsured Could Pay $100 or Less Per Month for Coverage in 2014 (PDF)
"Of the estimated 21.9 million uninsured Americans eligible to purchase coverage in the Marketplace, 6.4 million may be able to pay $100 or less per person per month for the second lowest-cost silver plan in the Marketplace in their state in 2014, after taking into account their available premium tax credits. An additional 4.3 million may be able to pay $100 or less per person per month by using their premium tax credit to purchase the lowest-cost bronze plan available to them." (Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services)  

Hospitals Key to Insurance Exchange Enrollment
"[H]ospitals are ramping up their efforts to sign up consumers for coverage through the new online marketplaces ... Some hospitals are opening phone hotlines and conducting community outreach at churches, child-care centers, soup kitchens and health fairs to help uninsured Americans obtain coverage under healthcare reform.... However, consumer advocates worry hospitals could direct consumers to whatever insurance might give the organizations the best rates and not necessarily the plan that is best for patients." (FierceHealthPayer)  

For Workers Leaving Their Jobs, Health Exchanges Offer Insurance Choices Beyond COBRA
"Today, the only option for many laid-off workers is to continue their employer-provided coverage for up to 18 months under [COBRA]. Because they have to pay the entire premium plus a 2 percent administrative fee, however, the coverage can be a financial hardship for people who are scrambling to keep up with expenses after losing their jobs. Many of these people will likely be better off buying a plan on the state health insurance marketplaces, also called exchanges." (Kaiser Health News)  

The Cost & Benefits of Short-Term Individual and Family Health Insurance Plans (PDF)
"The average monthly premium paid for a short-term individual policy was $69, while the average monthly premium paid for a short-term family policy was $160. Between October 2011 and October 2012, the average premium increased 3% for individual short-term policies and increased 5% for family short-term policies.... Between October 2011 and October 2012, the average deductible increased 59% ($1,821 to $2,901) for individual short-term policies and 59% ($1,877 to $2,984) for family short-term policies." (eHealth)  

ML Strategies Health Care Reform Memo, September 16, 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)  


Verifying Eligibility For ACA Subsidies: Access To Employer-Sponsored Insurance
"Considerable attention has focused on the [CMS] one-year suspension of employer penalties and reporting requirements ... Some worry that, without the new employer reports, consumers who fail to meet such coverage requirements and fraudulently claim subsidies could escape detection. These worries are exaggerated." (Stan Dorn and Matthew Buettgens in Health Affairs Blog)  


Exchange Plans Have Sharply Limited Networks
"To hold down premiums, major insurers in California have sharply limited the number of doctors and hospitals available to patients in the state's new health insurance market opening Oct. 1.... Narrow provider networks reduce health care spending by limiting patient access to low cost providers -- taking away choice -- and by impairing access though supply-side contractions, that is, rationing care by limiting the supply of covered health care providers." (Physicians for a National Health Program [PNHP])  


If the Maryland Health Insurance Rates Are So Cheap, Why This Postcard From Maryland Blue Cross?
"[O]ne study or comparison after another from state to state [compares] the lowest, or second lowest cost Silver plans ... to existing health insurance rates and [brags] about how low they are. But what is often happening here is that these lowest cost and second lowest cost plans are likely the most limited access plans available.... What many health plans have done is to put their lowest cost plans on the exchanges and have often built new very narrow network plans just for the exchange.... What is also happening is that health plans are expecting that higher income people will not be eligible for a subsidy and will come directly to the health plan for the better coverage when it isn't available on the state exchange." (Health Care Policy and Marketplace Review)  

Benefits in General; Executive Compensation

[Official Guidance]

Text of IRS Notice Den-2013-28, Tax Relief for Victims of Severe Storms in Colorado
"IRS gives affected taxpayers until Dec. 2, 2013, to file most tax returns (including individual, corporate, and estate and trust income tax returns; partnership returns, S corporation returns, and trust returns; estate, gift, and generation-skipping transfer tax returns; and employment and certain excise tax returns), or to make tax payments, including estimated tax payments, that have either an original or extended due date occurring on or after Sept. 11 and on or before Dec. 2, 2013.... This relief also includes the filing of Form 5500 series returns, in the manner described in section 8 of Rev. Proc. 2007-56." (Internal Revenue Service)  

[Guidance Overview]

IRS Issues Guidance on Same-Sex Marriages
"Proof of marriage that may be required by employers should be the same for all marriages. In general ... requiring proof of marriage is not practical unless employees are required to update that proof periodically.... [A]necdotal evidence is that up to 20% of employees falsely claim individuals to be their spouses and dependents and a periodic audit may save the employer significant funds." (Blank Rome LLP)  

[Guidance Overview]

Same-Sex Spouses and Federal Law: Eight Key Answers on Employee Benefits
"Must benefit plans recognize same-sex marriages sanctioned in jurisdictions other than U.S. states? ... Should partners in civil unions or other state-sanctioned same-sex relationships short of marriage now be treated as spouses? ... Does this mean employers must provide the exact same benefits to same-sex couples as to opposite-sex couples? ... Do benefit plans have to be amended to reflect same-sex marriages? ... How will the employer know if an employee in a same-sex relationship has been married in another state? ... Are church plans and state governmental plans subject to these rules? ... May employees treat this new rule as a status change and allow mid-year cafeteria plan elections? ... When do we have to start implementing this change?" (Warner Norcross & Judd LLP)  

Fortune 500 Outside Director Pay Shows Modest Growth, Emphasis on Cash
"Total direct compensation for outside directors increased 3% at the median over the prior year. The typical Fortune 500 director receives almost $227,000 in total direct compensation, up from about $220,000 in last year's study. The median value of total cash compensation increased 8% over the last year, while median stock compensation remained flat.... The median retainer paid to compensation committee members increased 25% last year and now equals what audit committee members receive ($10,000)." (Towers Watson)  

Vast Majority of Healthcare CEOs Have Severance Agreements
"[A] clear majority (83%) of health care organizations have a written severance agreement with their CEO.... [S]everance benefits are most commonly triggered by involuntary termination without cause or a change-in-control. While just 5% of organizations provide service-based severance benefits, the majority of organizations continue benefits for a fixed period, typically 24 months. Moreover, most continue benefits during the severance period, including dental, vision, and life insurance." (Mercer)  

Expect the CEO Pay Ratio Disclosure Rules This Week
"Using the Summary Compensation Table method of calculating the total compensation of every employee ... will be literally impossible for most corporations. The big question ... is whether the SEC is comfortable taking advantage of recent court cases appearing to give it more interpretive authority in light of Congress' half-baked drafting of Section 953(b)." (Winston & Strawn LLP)  

SEC Schedules a Vote on the CEO Pay Ratio Rule
"As expected, the [SEC] has announced that it will consider proposing regulations this week to implement Section 953(b) of [Dodd-Frank] requiring public companies to disclose the ratio of the chief executive's compensation to the median compensation of all other company employees. The SEC will meet at 10:00 a.m. on Wednesday, September 18, to consider the CEO pay ratio rule and other matters." (Towers Watson)  

Press Releases

Connect   LinkedIn   Twitter   Facebook
BenefitsLink.com, Inc.
1298 Minnesota Avenue, Suite H
Winter Park, Florida 32789
Phone (407) 644-4146
Fax (407) 644-2151

Lois Baker, J.D., President
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager

Copyright © 2013 BenefitsLink.com, Inc. -- but feel free to forward this newsletter without further permission from us, if you do not modify the newsletter in any way (including this lower portion).

All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of that content. You may not alter or remove any trademark, copyright or other notice from copies of the content.

Links to Web sites other than those owned by BenefitsLink.com, Inc. are offered as a service to readers. The editorial staff of BenefitsLink.com, Inc. was not involved in their production and is not responsible for their content.

Useful links: