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September 27, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Actuary Apps Systems Engineer 5
Wells Fargo Bank, NA
in MD

Integrated Marketing Retirement Product Development Manager
ASPire Financial Services LLC
in FL

Part-Time Client Care Representative
The Retirement Plan Company, LLC

Retirement Service Specialist
in TX

401(k) Administrator
Consulting Actuarial Group, Inc.
in IL

Pension and Benefits Specialist
City of Tacoma
in WA

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[Guidance Overview]

Health Care Reform: What Do Employers Need to Do Now?
"[E]mployers should plan for eventual application of the pay or play mandate to their workforce. This should include: For a smaller organization, confirming whether or not it will meet the threshold to be subject to the mandate in 2015 ... Confirming how the employer will comply with the mandate -- whether it will pay or play and how to implement its compliance strategy in 2015.... Identifying which employees are full-time, seasonal or variable hour employees.... Considering whether and how to utilize the safe harbor 'look-back measurement method' of determining full-time status of some or all ongoing employees or new variable hour and seasonal employees[.]" (Faegre Baker Daniels LLP)  


The new "Go-to Annual Event" | Registration now open!

Sponsored by HRE's Health & Benefits Leadership Conference

Make a difference in your organization and the lives of your employees. From healthcare reform to the changing definition of retirement, this event delivers meaningful solutions to many of today's plaguing issues. Learn more.

[Guidance Overview]

Participating in the Federally-Facilitated Marketplaces: Registration Process for Agents and Brokers (PDF)
61 presentation slides from CMS. Topics include: Registration Overview; Registration Process Steps; Assisting Consumers with Eligibility Determinations and Enrollment; and Additional Resources. (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

[Guidance Overview]

Summary of ACA Deadlines for All Employers; Special Focus on Massachusetts Issues (PDF)
"[C]overed Massachusetts employers are still supposed to sponsor MA 125 Plans and notify employees of their existence. In theory, employees without employer coverage can use a MA 125 Plan to convert salary dollars into pre-tax amounts, and then can buy individual policies with tax-free dollars.... Failure to comply can subject a covered Massachusetts employer to an uninsured person's hospital bills.... Although the Massachusetts law is still on the books, the IRS just announced its intention to take away the pre-tax treatment for plans like a MA 125 Plan, creating a dilemma for Massachusetts employers." (Davis, Malm & D'Agostine P.C.)  

As Some Companies Turn to Health Exchanges, G.E. Seeks a New Path
"One of the largest employers in the nation, [G.E.] spends more than $2 billion a year offering coverage to 500,000 employees and retirees and their families. And it is using its considerable clout in places like [Cincinnati] -- where its giant aviation business gives it a major presence -- to work directly with doctors and hospitals to improve care and reduce costs.... Over the last few years, G.E. has pushed for the creation of so-called medical homes, in which an individual medical practice closely coordinates a patient's care by having access to all of the patient's medical records." (The New York Times; subscription may be required)  


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.

Trends to Watch For in Employer Health Plans
"So far companies making such major changes remain in the minority. [W]ith so much in flux, it's wise to carefully review the options your employer is offering for next year.... Some trends to watch for include: [1] Higher costs for covering your spouse and children.... ..[2] Carrots and sticks to influence employee health behavior.... [3] Higher deductibles are here to stay." (The New York Times; subscription may be required)  

Lessons from the Obamacare Data Dump
"Competition equals lower prices.... The number of insurance companies selling through the subsidized marketplace varies hugely from one area to another.... The number of available plans, another indicator of choice, also varies.... There is a paucity of platinum plans.... There are wide variations in prices, even for similar policies sold in the same state." (The Washington Post; subscription may be required)  

Sixth Circuit Holds Blue Cross Blue Shield Is Fiduciary in Assessing Fee
"[Blue Cross Blue Shield of Michigan (BCBSM)] undertook to obtain funds to satisfy the Medigap Obligation by ... charging and retaining 1% of the cost of benefit claims it paid on behalf of the plan [the OTG Fee] ... The court emphasized that BCBSM had not assessed the OTG Fee against all of its self-funded plan customers, and had unilaterally decided to stop assessing the fee against the Pipefitters plan. Because its discretionary assessment of the fee against the plan benefitted BCBSM ... the court concluded that BCBSM had breached its fiduciary duties under ERISA." [Pipefitters Local 636 Ins. Fund v. Blue Cross and Blue Shield of Mich., No. 12-2265 (E.D. Mich. July 18, 2013)] (Goodwin Procter)  

Third Circuit Finds Life Insurance Retained Asset Accounts Are Not Plan Assets
"[The court] concluded that the insurer did not breach its fiduciary duty when it chose to settle claims via retained asset accounts because such accounts are not inconsistent with the beneficiary's interests and the insurer's potential to profit was 'wholly dependent' on the beneficiaries' actions." [Edmonson v. Lincoln National Life Insurance Company, No. 12-1581 (3rd Cir. Aug. 7, 2013)] (Goodwin Procter)  

Obamacare May Be Doubling the Cost of Health Insurance. But It's Hard to Verify That
"The Manhattan Institute has published an interactive map entitled 'ObamaCare: Know Your Rates' that it says 'illustrates how the Affordable Care Act (aka ObamaCare) affects health insurance premiums for people who buy coverage on their own.' It says that rates have gone down by 37 percent in Colorado. People actually paying premiums in the Colorado individual market may find this hard to believe.... This may be because its premium increase estimates are based on a composite rate that nobody actually pays." (John Goodman's Health Policy Blog)  

Spanish-Language Version of Healthcare.gov Will Not Be Equipped to Handle Online Enrollments on October 1
"Spanish speakers will have to wait until Oct. 21 to sign up online. [An Administration] official said the new signup date should not be considered a delay, but rather the administration is choosing to unveil the online enrollment tool to coincide with a 'week of action' around Hispanic Heritage Month, in which community organizations and local, state and federal government partners will highlight the importance of the [ACA} for Latinos." (Kaiser Health News)  

Another Obamacare Delay: SHOP Exchanges Won't Open October 1
"Small businesses looking to enroll in coverage on so-called SHOP exchanges run by the federal government can start their applications on Oct. 1 -- they just won't be able to enroll online until November. The one-month delay is not a major blow to the health care law ... But it's yet another PR headache for the White House as it ramps up a major Obamacare sales pitch just five days before open enrollment is scheduled to begin." (Politico)  

HHS Launching the Small Business Health Option Program (SHOP) Marketplace
"Beginning October 1, 2013 the dedicated SHOP small employer call center at 1-800-706-7893 will offer extended hours Monday through Friday, 9 a.m. to 7 p.m. EST. Employers may call the SHOP Small Employer call center for assistance when completing an application beginning October 1. This call center will also refer employers in states running their own SHOP Marketplace to the correct contact information for their state." (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

U.S. Health Coverage Edged Up in 2012; Employment-Based Coverage Levels Off (PDF)
"The working-age population (18-64) with health insurance coverage increased to 82.3 percent in 2012 (up from 82 percent in 2011 and 81.5 percent in 2010). The uninsured rate for that group was 17.7 percent last year, down from 18 percent in 2011. The EBRI report cites a leveling off in the decline of workers who get health insurance through their jobs in 2012 and flat enrollment in public-program health coverage as the major reasons for these changes." (Employee Benefit Research Institute [EBRI])  


Health Insurance Marketplace Premiums: Policy Considerations and Implications for Payers, Providers, and Patients
"[A] number of policy issues ... will have an important effect on how we look back on our nation's greatest expansion effort since 1965. They roughly fall into considerations that affect payers, patients and providers. Here are five ... Risk Pool Adequacy.... Provider Network Adequacy/Capacity.... Consumer Protections.... Premium Collections.... Spillover of Premium Cost Estimates." (Health Affairs Blog)  


If Your Fantasy Football Team Is Already in Last Place, Try Fantasy Health System
"The anticipated emergence of insurance products with narrow provider networks has prompted large health systems to launch their own health plans, which in turn will accelerate the trend of hospital consolidation, as well as integration with physicians via the accountable care organization mechanism. To market viable narrow-network products, these vertically integrated payer/providers must offer robust provider networks with region-wide geographic scope to compete against insurers offering broad network options, or against rival health systems with the same strategy." (HealthLeaders InterStudy)  

Benefits in General; Executive Compensation

Text of Initial 60-Day Report on the City of Detroit Employee Benefit Programs (PDF)
"[We] uncovered several inconsistencies in the General Retirement System, such as questionable interest rates applied to annuities, the probability of bonuses being included in annuity account holders balances and ultimately included in their refund/disbursement, and overtime pay included in their average final compensation calculation.... [We] question the wisdom of these policies along with the fiduciary responsibility of the Pension Board of Trustees.... Our review of the City's administration of employee benefits for health care underscores published reports, in that the process is poorly documented, highly transactional and extremely labor intensive." (City of Detroit Auditor General and Inspector General)  

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