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September 25, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Pension Administrator
GF Pension Corp.
in PA

Attorney
Sullivan, Ward, Asher & Patton, P.C.
in MI

Relationship Manager
Retirement Alliance, Inc.
in NH

Legal Counsel - ERISA - Title I
T. Rowe Price
in MD

Client Relationship Manager
Alliance Benefit Group of Michigan
in MI

Vested Interest Relationship Manager
PNC
in KY

Conversion/Retirement Plan Administrator
Access Retirement Services, LLC
in TN

Retirement Education Specialist
The Newport Group
in NC

Employee Benefits Attorney ‎
Schwabe, Williamson & Wyatt
in OR, WA

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Webcasts and Conferences

10th Annual American Health Care Congress (AHCC)
December 2, 2013 in CA
(World Congress)

Employee Plans Technical Guidance Phone Forum
October 29, 2013 WEBCAST
(Internal Revenue Service (IRS))

ERISA Workshop 2013 - Nashville
October 24, 2013 in TN
(SunGard Relius)

2014 Regional Conference: Los Angeles
January 23, 2014 in CA
(American Society of Pension Professionals & Actuaries (ASPPA))

Year-End Retirement and Welfare Plan Issues and a Look Ahead to 2014: What to Do and Think About
October 29, 2013 WEBCAST
(ABA Joint Committee on Employee Benefits)

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]

HHS Report of Health Insurance Marketplace Premiums for 2014
"This report summarizes the health plan choices and premiums that will be available in the Health Insurance Marketplace. It contains new information, current as of September 18, 2013, on qualified health plans in the 36 states in which the Department of Health and Human Services (HHS) will support or fully run the Health Insurance Marketplace in 2014. Plan data is in final stages but is still under review as of September 18 and may be revised in HHS systems before being displayed for consumers, so this information is subject to change. This analysis also includes similar information that is publicly available from 11 states and the District of Columbia that are implementing their own Marketplace. This report focuses on the plans with the lowest premiums in each state, as consumers are expected to shop for low-cost plans. Nearly all consumers (about 95%) will have a choice of 2 or more health insurance issuers (often many more) and nearly all consumers (about 95%) live in states with average premiums below earlier estimates.... Individuals will have an average of 53 qualified health plan choices in states where HHS will fully or partially run the Marketplace.... Premiums before tax credits will be more than 16 percent lower than projected." (Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services)  


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Analyzing the HHS Report on Plan Choices and Premiums
"Premiums will in many places be higher than the lowest cost plans currently available. In Texas, for example, the lowest-cost bronze plan for a 27 year-old before tax credits will cost $139. This is significantly more that the premium of the lowest-cost 2013 plan, which, according to a recent GAO report, cost a 30 year-old Texas male $32 a month and a female of the same age $39 a month. After applying premium tax credits, the cost of the lowest-cost 2014 bronze plan for a 27 year-old (male or female) earning $25,000 a year drops to $83, but this is still more than the 2013 premium." (Timothy Jost in Health Affairs Blog)  

D.C. Court of Appeals Weighs Whether Businesses Can Be Exempt from Health Care Law's Contraceptive Mandate
"At a hearing on Tuesday, Judge Harry T. Edwards was skeptical of the Gilardis' argument. He told their lawyer, Francis Manion, that sometimes religious freedom has to yield to the greater good. Edwards stressed that the Giraldis' companies, Freshway Foods and Freshway Logistics of Sidney, Ohio, are not religious groups. 'I don't know see how the government doesn't prevail,' said Edwards ... The other two judges on the panel didn't indicate how they are leaning in the argument, but they had more pointed questions for Justice Department lawyer Alisa Klein than they did for Manion." (The Washington Post; subscription may be required)  

Nuns Challenge Obamacare's Contraception Rule
"The Becket Fund for Religious Liberty filed a lawsuit Tuesday in federal district court in Denver on behalf of the Little Sisters of the Poor, a Catholic religious order that operates homes with 13,000 poor elderly people.The suit says the order doesn't qualify for the exemption for houses of worship, and will have to start including birth control in the insurance coverage offered to their employees -- something the nuns view as immoral." (The Wall Street Journal; subscription may be required)  

Health Law Enrollment in U.S. to See Slow Start Next Week
"'We should not look at enrollment in October or November as the final measure of what enrollment in the marketplaces will be when the open-enrollment period closes,' said Juliette Cubanski, an associate director of Medicare policy analysis at the Kaiser Family Foundation. 'We need to give the outreach campaigns time to take effect, just as they did in 'Part D.' People got the message over a period of several months.'" (Bloomberg)  


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How Much Will Obamacare Premiums Cost? Depends on Where You Live.
"The low rates are possible in part because insurance companies created special plans that include fewer in-network doctors and hospitals than many current plans. This may not be a problem for healthy people who currently lack insurance. But those with illnesses may discover that their specialists are not covered by an exchange insurance plan. Low-income people accustomed to a certain community clinic may find that going there is no longer an option. And everyone may encounter long waits to see a doctor. In addition, many of the lowest-cost plans may carry high deductibles[.]" (Sandhya Somashekhar and Sarah Kliff in The Washington Post; subscription may be required)  

Administration Officials Detail Premium Costs of Health Plan
"'I can tell you right now that in many states across the country, if you're, say, a 27-year-old young woman, don't have health insurance, you get on that exchange, you're going to be able to purchase high-quality health insurance for less than the cost of your cellphone bill,' Mr. Obama said ... However, the data provided only a partial picture of the reality that consumers will face." (Robert Pear and Reed Abelson in The New York Times; subscription may be required)  

Average Obamacare Premiums Will Be Lower Than Projected
"The analysis showed huge variations among states: A family of four making $50,000 in Wyoming, for instance, would pay $1,237 a month on average for a midlevel plan before subsidies, compared to $584 a month on average in Tennessee. After subsidies are added in, however, the cost to both families would be $282 because the amount they pay is linked to their income, not to the cost of coverage." (Kaiser Health News)  

Open for Business: Insurers Prepare for New Consumer Market (PDF)
"For the 69% of insurers planning to offer some type of exchange coverage, staying competitive is a top priority.... Over half (54%) of overall respondents and 63% of executives of non-profit companies said public perception was an extremely important decision factor. And many, when interviewed, expressed a sense of duty to serve their communities.... One third of health insurance companies don't plan to participate in exchanges or remain undecided, reflecting uncertainty about who will enroll and what their health status will be." (PricewaterhouseCoopers Health Research Institute; free registration required)  

Obamacare: One Blow After Another Has Transformed the Original Plan
"The Obamacare that consumers will finally be able to sign up for next week is a long way from the health plan President Barack Obama first pitched to the nation. Millions of low-income Americans won't receive coverage. Many workers at small businesses won't get a choice of insurance plans right away. Large employers won't need to provide insurance for another year. Far more states than expected won't run their own insurance marketplaces. And a growing number of workers won't get to keep their employer-provided coverage." (Politico)  

Rules Sought for Workplace Wellness Questionnaires
"A federal lawmaker is asking the [EEOC] to investigate employer wellness programs that seek intimate health information from employees, and to issue guidelines preventing employers from using such programs to discriminate against workers. The request, by Representative Louise M. Slaughter, Democrat of New York [who is the author of the Genetic Information Nondiscrimination Act] and a staunch advocate for health privacy rights, came a few days after Pennsylvania State University suspended part of its new employee wellness program that had drawn objections from faculty members." (The New York Times; subscription may be required)  

Health Insurers Scramble to Keep Healthy Customers
"Several insurers ... have recently warned customers of big rate hikes if they don't immediately renew their policies for 2014. But some of those customers may be able to find cheaper policies on the insurance exchanges launching under the new federal health law. In some cases, the regulators say, insurers aren't making it clear to consumers that they may switch carriers or shop on the new exchanges. At issue is a battle for healthy policyholders." (The Wall Street Journal; subscription may be required)  

District Court Finds Deference to Plan Administrator's Claim Decision Should Increase When Partial Benefits Granted (PDF)
"Aetna determines whether claims for short-term disability benefits satisfy the terms of the Plan and Policy and also is liable for benefits payable under the Plan.... Therefore, a structural conflict of interest exists. However, a decision to award at least some benefits rather than deny benefits entirely 'manifest[s] an approach demonstrating an unbiased interest that favor[s the claim applicant], making the conflict factor "less important (perhaps to the vanishing point)."'" [Cannon v. Aetna, No. 12-10512-DJC (D. Mass. Sept. 17, 2013)] (U.S. District Court for the District of Massachusetts)  

How Many People Will Buy Obamacare on Day One?
"Many in the health policy world see Oct. 1 as a crucial date, when Obamacare's new exchanges open and, for the very first time, millions of uninsured Americans will shop in a completely overhauled insurance market.... Peter Lee sees Oct. 1 a whole lot differently. He is running Covered California, the Obamacare exchange that will serve the country's most populous state with over 7 million people who lack insurance coverage. And he expects that, on Oct. 1, exactly two people will buy coverage." (Sarah Kliff in The Washington Post; subscription may be required)  

Employee Notices of Health Insurance Marketplace Due October 1
"With only seven days left until health insurance marketplaces launch, employers need to act now. Have you sent out your health insurance marketplace employee notices yet? ... Employers, whether they offer health coverage or not, must provide the notice to all current part-time and full-time employees. Employees can receive the notice in writing or electronically and all new employees must receive the notice within 14 days of their start date." (Healthcare Trends Institute)  

Health Reform Weekly, September 23, 2013
A weekly compilation of health care-related developments in Washington, D.C. and the state legislatures. (Aetna)  

[Opinion]

What Your Employer Is Secretly Thinking as Obamacare Goes Live
"[W]hen communicating and educating, given the dynamics and contentious nature of Obamacare, employers must also take into consideration the political leanings of most employees and other key stakeholders, such as the board of directors and state and local leaders. This is not a factor in most employer benefit issues but the ACA is entirely different.... [M]any aspects of ACA are redistributional by design -- shifting costs from one group to another, thereby creating winners and losers among individuals and employers. To adapt to life under Obamacare, employers must understand this and make decisions accordingly." (The Health Care Blog)  

[Opinion]

Tell Us Again Why We Need Young People
"When is the last time you heard anyone say that life insurance won't work unless we mandate its purchase? Or that the life insurance market will fall apart unless we convince a lot of young, healthy people to buy it? Have you ever heard of a life insurance company spending millions of dollars on rock stars and sports icons and librarians and local civic associations to beg youngsters to buy the product? Why are things so different in the market for health insurance?" (John Goodman's Health Policy Blog)  

[Opinion]

What the Administration Didn't Tell You About Obamacare Exchange Plans
"What HHS didn't mention is that CBO also estimated in a November 2009 analysis that individually purchased insurance premiums would go up by an average $2,100 per family, due to the increased mandates and requirements included in Obamacare. So when HHS says that premiums are 'below projections,' it really means that premiums are still going up as a result of Obamacare -- just by less than originally advertised." (The Heritage Foundation)  

[Opinion]

Benefits Consulting Firms Move in for Their Cut of the Healthcare Action
"These consulting firms are not replacing the insurers, but they are inserting themselves as another layer of administration in our system already greatly overburdened with administrative waste. Their administrative costs are not counted in the 15 to 20 percent allowed for the insurers under Obamacare. No, these costs are in addition to the administrative waste of the insurers and the waste of the administrative burden that insurers place on physicians, hospitals and other health care providers." (Physicians for a National Health Program [PNHP])  

Benefits in General; Executive Compensation

[Guidance Overview]

More on the SEC's Proposed Rules on the CEO Pay Ratio Disclosure
"There are no more than 10 key points to understand in the proposed rules, divided between two components of the rule: (1) How to calculate the ratio and (2) How to report the ratio in the proxy statement.... Ironically, for 162 pages of proposed rules, most companies will likely disclose the CEO pay ratio in a single paragraph. The company must 'briefly disclose' the methodology and any material assumptions, adjustments or estimates used to identify the median, and clearly identify any estimated amounts as such." (Winston & Strawn LLP)  

[Guidance Overview]

SEC Proposes Dodd-Frank Pay Ratio Rules
"The proposal is controversial, and the final rule still may change. In a strongly worded dissenting statement, Commissioner Daniel Gallagher said: 'There are no -- count them, zero -- benefits that our staff [has] been able to discern [from the pay ratio disclosure].' ... He particularly criticizes the proposed rule's requirement of considering the company and all its subsidiaries (instead of only the 'issuer' as the statute requires) and of considering the global workforce, calling these interpretations of the statute 'unnecessary overkill.'" (Dentons)  

D.C. Circuit Signals Doubts on IRS Tax Preparer Regulations
"At oral argument before the federal appellate court, the IRS's counsel maintained that its regulation was lawful because it was not 'unambiguously foreclosed by the statute.' The panel of three judges, however, appeared to reject that standard, with Judge David Sentelle saying that the IRS's formulation would give agencies 'all the power in the world.' The proper standard, Judge Sentelle explained, was whether the IRS's action was supported by the statute, using the ordinary tools of statutory construction." (The Heritage Foundation)  

Settling ERISA Actions After a Decision on the Merits May Open the Door for Attorney's Fees
"The [Second Circuit Court of Appeals] explained that a party who obtains relief due to the voluntary conduct of another party after minimal litigation is unlikely to succeed in seeking attorney's fees. However, under this 'catalyst theory,' if the parties received a 'tentative analysis of their legal claims,' a party may recover attorney's fees if it is able to show that the court's discussion of the pending claims resulted in the obtained relief. This case demonstrates the importance of performing a careful risk analysis at the beginning of an ERISA action to determine whether a settlement can be reached." [Scarangella v. Group Health, Inc., No. 12-2750 (2d Cir. Sept. 10, 2013)] (Littler)  

[Opinion]

The CEO-To-Worker Compensation Ratio in 2012 Was Far Above That of the Late 1990s
"[F]rom 1978-2011, CEO compensation grew more than 876 percent, more than double the growth of the stock market and remarkably faster than the growth of annual compensation of a typical private-sector worker, up a meager 5.4 percent.... Though lower than in other years in the last decade following the stock market bubble, the CEO-to-worker compensation ratio in 2012 of 273 was far above that of the late 1990s and 14 times the ratio of 20.1 in 1965." (Economic Policy Institute)  

Press Releases

IRS Names Four New Members to ACT Panel
Internal Revenue Service (IRS)

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