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October 7, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Plan Compliance Specialist
Lincoln Financial Group

401(k) Plan Administrator
Pension & Benefits Associates, Inc.
in CT, MA

Health & Welfare Employee Benefits Attorney
in CO, DC, TX

Account Manager for University Services Division
Garnett-Powers & Associates, Inc.
in CA

DC Plan Administrator
Capital Retirement Plan Services, Inc.
in PA

Employee Benefits Sales Producer
Corporate Synergies Group, LLC
in NJ, NY

Defined Contribution Consultant
in NC

Specialist - Qualified Plan Administration
a Leading Global Employee Benefits and Consulting Firm
in CA

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Webcasts and Conferences

Examining the IRSís Role in Implementing and Enforcing ObamaCare
October 9, 2013 in DC
(U.S. House Committee on Oversight & Government Reform)

Joint Conference Call on Compliance and Cost Implications of Security Exchange Commission
October 10, 2013 WEBCAST
(HR Policy Association)

The U.S. Supreme Court's Decision on DOMA and Related Guidance
October 17, 2013 in CA
(Western Pension & Benefits Council - Orange County Chapter)

Current Developments & "What's New" In Pensions, Ethics and Professionalism Related to Employee Benefits Practice
October 25, 2013 in CT
(National Institute of Pension Administrators-CT Chapter)

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]

Changes Coming for Small Business Health Care Tax Credit
"In 2014, the credit will continue to be available, but with significant modifications. Employers will only be eligible for the credit if they purchase health insurance through the new Small Business Health Options Program (SHOP).... Other upcoming changes include: [1] The maximum credit increases to 50 percent (35 percent for tax-exempt organizations); [2] The $50,000 and $25,000 average annual dollar amounts will be indexed for inflation; [3] The credit is based on the lesser of the employer's actual premium payments or the average premiums in the small group market in its employees' rating area; [4] The credit is only available for two consecutive tax years after 2013, but it can be carried back or carried forward." (McGladrey)  


P&I West Coast Defined Contribution Conference Oct. 27-29 | San Fran

Sponsored by Pensions & Investments

Empower your employees to save and invest for retirement. Hear directly from DC experts discuss on the most pressing investment, legislative, plan design and education issues today.

[Guidance Overview]

Medicare Part D Notice Required Before October 15
"[T]he deadline to distribute the Annual Notice of Creditable Coverage required under Medicare Part D is about a week away. This notice informs participants whether the prescription drug coverage offered under your health plan constitutes creditable or noncreditable coverage. As the Medicare Part D annual enrollment period now runs from October 15 to December 7, you must distribute the notices before October 15.... The only employers exempt from this requirement are those that establish their own Part D plan or contract with a Part D plan." (Warner Norcross & Judd LLP)  

[Guidance Overview]

ACA Health Plan Coverage Reporting: Implications for Self-Insured Employers, Insurers and Their Vendors
"Electronic filings for calendar-year 2015 must be submitted by March 31, 2016, and taxpayer-specific information for 2015 must be provided to taxpayers by January 31, 2016. Self-insured employers and others responsible for filing under the proposed regulation will need to estimate the operational impact and IT resources required to meet the requirements. Comments are due by November 8, 2013, and employers have an incentive to suggest reporting approaches that would reduce their burden." (Towers Watson)  

Health Insurance Premiums More Than 8 Percent Lower in CO-OP States
"The Consumer Operated and Oriented Plans, with startup money loaned by the health care law, have zero or very few customers yet, given all the problems with the sign-up system. But they are going toe-to-toe with traditional insurers on the exchanges in 22 states, introducing new competition to insurance markets. And there's some early evidence that they may be helping to lower costs." (Politico)  

Federal Government Acknowledges It Needs to Fix Design and Software Problems of Healthcare Website
"The [healthcare.gov] website is troubled by coding problems and flaws in the architecture of the system, according to insurance-industry advisers, technical experts and people close to the development of the marketplace. Among the technical problems thwarting consumers, according to some of those people, is the system to confirm the identities of enrollees. Troubles in the system are causing crashes as users try to create accounts, the first step before they can apply for coverage." (The Wall Street Journal; subscription may be required)  

Bargaining in the Shadow of a Giant: Medicare's Influence on Private Payment Systems
"On average, a $1 change in Medicare's relative payments results in a $1.30 change in private payments. We find that Medicare similarly moves the level of private payments when it alters fees across the board. Medicare thus strongly influences both relative valuations and aggregate expenditures on physicians' services.... Medicare's price transmission is strongest in markets with large numbers of physicians and low provider consolidation." (National Bureau of Economic Research [NBER])  

Obamacare Poster Boy Chad Henderson and His Dad Didn't Really Buy Insurance
"Reporters struggled ... to find individuals who said they had been able to enroll in one of the law's 36 federally run health-insurance exchanges. That changed ... when they found Henderson ... But details of Chad's story proved difficult to verify.... Chad Henderson's story was picked up by the national media because of how difficult it was to find individual stories of successful enrollment in the federal health exchanges during the initial days of enrollment. It appears that reporters may have to keep looking." (Reason.com)  

Glitches Persist on Maryland Health Insurance Exchange
"State officials blamed the account creation process, in which people were routed to a federal questionnaire to verify their identity. The system, they said, became overwhelmed when so many people tried to access it.... Other states, including those with sites run by the federal government, have had similar problems that stem from servers and software that couldn't handle a large number of users." (The Baltimore Sun)  

Coverage for Breast-Feeding Services Lags Behind the Law
"Despite the law, many new mothers have found it nearly impossible to get timely help for breast-feeding problems since Jan. 1, when health insurers began updating their coverage. While a 2011 Surgeon General's report hailed lactation consultants as important specialists, few insurers have added them to their networks. Some insurers simply point women to pediatricians not necessarily trained in lactation." (The New York Times; free registration required)  

The Regulation of Prescription Drug Competition and Market Responses: Patterns in Prices and Sales Following Loss of Exclusivity
"Brands continue to raise prices after generics enter.... Cash customers and seniors generally pay the highest prices for brands and generics, third party payers and those under 65 pay the lowest prices, with Medicaid and Medicare Part D in between. The presence of an authorized generic during the 180-day exclusivity period has a significant impact on prices and volumes of prescriptions, but this varies across molecules." (National Bureau of Economic Research [NBER])  

Reaching and Enrolling the Uninsured: Early Efforts to Implement the ACA
"Differences in the intensity of efforts across the states are stark. Those that have chosen to establish their own state-based marketplace have developed state-specific marketing campaigns showcasing unique themes and concerns of residents, and have also targeted substantial resources to support enrollment assistance networks.... While federally facilitated marketplaces may work just as well as their state-based counterparts, they may not be supported by the same level of marketing and enrollment assistance. These distinctions may contribute to noticeably different experiences in enrollment during the first year of ACA implementation, and perhaps longer term." (Robert Wood Johnson Foundation)  


Exchanges Will Raise U.S. Healthcare Costs
"[T]he architects of the health-care exchanges ... have assumed that if insurers are prevented from competing on benefit design or on underwriting, they will compete on price. But why should they compete at all? ... [They] have also assumed that consumers, by shopping for the best deal, will drive down premiums. However, a major flaw in the design of insurance subsidies will insulate almost all of the initial customers ... from concern about how much their policies cost.... There's one more big assumption ... that the price of health insurance passively mirrors the price of health care. But there's plenty of evidence that insurance itself can drive up the cost of care[.]" (Bloomberg)  


Pent-Up Demand for Health Insurance
"In the first three days, there were 8.6 million unique visitors to the federal government Web site for health care exchanges, far more than had ever signed on at one time to a popular Web site serving Medicare patients. In New York, the state-run exchange had an astonishing 30 million visits in the first two days, although a large share almost surely consisted of repeat visits by people who were blocked by balky computer systems. Earlier surveys had shown that most Americans were unaware that the exchanges would open on Oct. 1 and ignorant of what the health care reform law could provide for them. Many thought it was still just a proposal, not a law." (The New York Times; subscription may be required)  


One Man's Quest to Sign Up for Obamacare: Day Four
"I had just entered my profile name. It sent me an email to my email address. I clicked on the link to take me back to the page ... and it 'couldn't find a Marketplace profile that matched information' that I provided? How in the world did it email me then? ... The 'invalid format' for answers of security questions that I provided were words. In English. No symbols. No sentences. Just simple words that I was pretty sure I could remember if asked again. Alas, I'm not sure I will ever be given that opportunity. At least millions are still visiting the website." (The Health Care Blog)  


Why the Federal Health Insurance Exchange and So Many State Exchanges Are Not Working
"[At] least one big mistake the federal exchange, and most state, developers made was to require everybody to go through a very intensive account creation process before going anywhere on the site.... [W]ould you ever even bother to use Amazon, or any other shopping site, if they required you to set up an account before you could even look at their products? But that is what the feds and most of the states have done." (Health Care Policy and Marketplace Review)  

Benefits in General; Executive Compensation

If You Think 'It's Not Worth the Paper It's Printed On' -- Think Again
"Estoppel claims and other attempts to get equitable remedies are rampant in the wake of the Supreme Court's Amara decision ... These claims frequently depend on oral communications with benefit plan staff or allegedly vague or misleading documents.... [T]he best defense to an ERISA estoppel claim often lies in clear plan documents and communications. Well drafted documents, distributed to participants at the right time, can undercut claims of reasonable reliance upon other inaccurate statements about benefits." (Seyfarth Shaw LLP)  

Deferred Compensation Provisions Not ERISA Plans Because No Ongoing Administration Required
"Under the Supreme Court's longstanding Fort Halifax test, a plan exists only when there is a commitment to pay benefits systematically, including an ongoing administrative responsibility or scheme to determine eligibility and calculate benefits. As the dissent in this case skillfully illustrates, this definition is easier to state than to apply to a particular set of facts. Employers maintaining deferred compensation arrangements should consider up front whether ERISA applies, keeping in mind the significant advantages ERISA can confer, like protection from otherwise applicable state-law claims and larger damage awards (including possible consequential and punitive damages)." [Cantrell v. Briggs & Veselka Co., 2013 WL 4523497 (5th Cir. 2013)] (Thomson Reuters / EBIA)  

U.S. Companies Planning Modest Executive Pay Raises Next Year
"[E]xecutives can expect fairly modest salary increases in 2014, generally consistent with the levels in recent years. The survey participants granted a 2.7% average annual increase to their executives this year. For 2014, projected salary budgets put the average executive pay increase at 2.9%." (Towers Watson)  

Retail Investors Seen as Key to Firms Struggling on Say on Pay
"On average, say on pay proposals this year were approved with 89 percent of shares voted in favor, a modest increase from 2012. Yet across market caps, there were some companies that received over 90 percent support for their pay plans last year that slipped to under 70 percent support in 2013. That's a reminder ... that companies must continue to reach out and engage with their shareholders every year." (Corporate Secretary)  

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