[Guidance Overview]
ACA Creates Compliance Challenges for HRAs and Other Arrangements
"Employers that currently offer stand-alone HRAs should consider whether to integrate the HRA with group health plan coverage that satisfies the annual dollar limit prohibition and the preventive services requirement. It may require some drastic changes depending on the nature of the existing plan.... Employers currently offering individual health plan coverage purchased through insurance marketplaces as a qualified benefit under a cafeteria plan will need to amend the plan to drop that option as of the first plan year that begins on or after January 1, 2014."
(Perkins Coie LLP)
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[Guidance Overview]
IRS Proposes Reporting Requirements for Plan Sponsors
"Although the proposed regulations allow reporting entities to use a date of birth if a SSN is not available, this alternative should not be used unless the reporting entity has made reasonable efforts to obtain the SSN. According to the preamble, this means that after an initial attempt to collect a SSN, a reporting entity must make two additional (consecutive) annual attempts.... Many employers have been backing away from requiring employees to report social security numbers when enrolling in health coverage. This new reporting requirement may require employers to ... require this information during their next open enrollment."
(Seyfarth Shaw LLP)
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Game On! New Technologies Deliver Much-Needed Excitement to Employee Wellness Initiatives
"Gamification can help provide positive rewards through constant feedback on performance and success. Sixty-two percent of surveyed employers reported using one or more game-like features to promote employee health engagement, and 31 percent said they expected to adopt one or more new elements in the coming year. More than 60 percent reported they sponsor contests such as weight-loss or walking competitions, and 37 percent incorporate game-like features such as raffles or lotteries in employee wellness initiatives."
(Communication World, a publication of the International Association of Business Communicators)
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The Future of Domestic Partner Benefits
"Although there is still much more guidance to come on the benefit changes employers must make as a result of the ruling, the decision itself raises a new question: Is there still a need for domestic partner (DP) offerings for unmarried couples in a post-Windsor landscape? ... [A]lthough many employers began offering DP benefits because same-sex couples had no option to marry, DP benefits now are often provided to unmarried opposite-sex couples as well."
(Society for Human Resource Management)
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Insurers Getting Faulty Data from U.S. Health Exchanges
"Insurers are getting faulty and incomplete data from the new U.S.-run health exchange, which may mean some Americans won't be covered even after they sign up for an insurance plan. While it's not clear how widespread the problem is, the reports from industry consultants are the first hint that the technical troubles faced by consumers trying to enroll in health plans under the Affordable Care Act may also be hitting the insurers. The companies are receiving electronic files that can't open or have so much missing information on new enrollees they're unusable, the consultants said."
(Bloomberg)
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Pennsylvania Blues Plan Offers Consumers Choice of 'Health-Care Tiers'
"With two new HMO plans introduced last week on the federal insurance exchange, Independence Blue Cross (IBC) is offering Philadelphia-area consumers a road map to cut out-of-pocket health-care costs. The trick for consumers who sign up for Blue Cross' HMO Proactive plans is to choose hospitals, primary-care physicians, and specialists in the least expensive of IBC's three price tiers of health-care providers. IBC is the largest health insurer in the Philadelphia area, serving more than two million people."
(Kaiser Health News)
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Health Exchange Delays Tied to Software Crash in Early Rush
"Todd Park, President Obama's top technology adviser, said the failure occurred in the part of the Web site that lets people create user accounts at the beginning of the insurance sign-up process. The crash prevented many people from viewing any of their insurance options or gaining access to information on what federal subsidies might be available. 'At lower volumes, it would work fine,' Mr. Park said of the Web site, healthcare.gov. 'At higher volumes, it has problems.'"
(The New York Times; subscription may be required)
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Voters to Consider San Francisco Retiree Health Care Shortfall Solution
"San Francisco voters will be asked next month to approve a measure that seeks to eliminate a projected $4.4 billion shortfall in the city's retiree health care fund over the coming decades, all without increasing employee or taxpayer contributions.... Just one city union opposes the measure, which would tackle the deficit by prohibiting the city from raiding a health care fund established in 2011. Prop. A effectively changes retiree health care from a pay-as-you-go model to a fully funded account by 2045."
(San Francisco Chronicle)
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Costliest One Percent of Patients Account for 21 Percent of U.S. Health Spending
"These patients are among the 1 percent whose ranks no one wants to join: the costly cohort battling multiple chronic illnesses who consumed 21 percent of the nearly $1.3 trillion Americans spent on health care in 2010, at a cost of nearly $88,000 per person.... Nearly all wind up in emergency rooms because they have enormous difficulty navigating the increasingly fragmented, complicated and inflexible health-care system."
(Kaiser Health News)
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Factors Linked to Creation of Accountable Care Organizations
"Researchers found wide variation in the geographic distribution of accountable care organizations, with large areas such as the Northwest essentially empty of the organizations. Meanwhile other regions, including the Northeast and the Midwest, are dense with the groups. Factors associated with formation of accountable care organizations include a greater occurrence of payment risk sharing at hospitals, larger integrated hospital systems and primary care physicians practicing in large groups."
(RAND Corporation)
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Access and Cost Barriers to Mental Health Care, by Insurance Status, 1999-2010
"Although access to specialty care remained relatively stable for people with mental illnesses, cost barriers to care increased among the uninsured and the privately insured who had serious mental illnesses. The rise in cost barriers among those with private insurance suggests that the current financing of care in the private insurance market is insufficient to alleviate cost burdens and has implications for reforms under the [ACA]."
(Health Affairs)
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Physicians Skeptical of ACA Exchanges
"A majority of physician practices (55.5%) hold an 'unfavorable' or 'very unfavorable' view of the impact the [ACA] health insurance exchanges will have on them ... Almost as many (40.2%) said they were still evaluating their options or planning not to participate with insurance products sold on the exchanges,... Those still weighing their options cited the risk of low reimbursement rates (85%), financial liability during a 90-day grace period for exchange plan enrollees (83%), and concerns about the financial burden of patient collections (82.5%) as barriers to participation."
(MedPage Today)
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Trends Underlying Employer-Sponsored Health Insurance Growth for Americans Younger Than Age 65
"Total per capita spending for employer-sponsored insurance grew at an average annual rate of 4.9 percent [between 2007 and 2011], with prescription spending growing at 3.3 percent and medical spending growing at 5.3 percent. Out-of-pocket medical spending increased at an average annual rate of 8.0 percent, whereas out-of-pocket prescription drug spending growth was flat.... [C]hanges in utilization contributed less than changes in price did to overall spending growth for those with employer-sponsored insurance."
(Health Affairs)
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[Opinion]
Measuring Obamacare Enrollment Is Actually Kind of Tricky
"The White House will not be releasing data on enrollment in the federal marketplace until November ... We do have some data trickling out from the states right now though -- but even with those initial numbers, deciding who counts as an Obamacare enrollee can be tricky business. That's because there are a number of steps in the application process for health insurance under the [ACA]. And states are using lots of different metrics to determine how well their new insurance marketplaces are going."
(The Washington Post; subscription may be required)
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[Opinion]
Obamacare Is a Continuation of the Business Model for Insurance
"Rather than taking us halfway to single payer, Obamacare is a continuation of many decades of government preference for the most wasteful health care financing scheme ever invented: the private, for-profit health insurance business model.... Federal tax policies and state regulations with bipartisan support over many decades have locked Americans into buying health insurance, despite the well documented fact that the health insurance business model features $400 billion per year excess administrative costs and still fails to hold down health care price inflation."
(Deseret News)
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Benefits in General; Executive Compensation
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2013 Talent Management and Rewards Study -- North America
"With health care reform underway, nearly half of U.S. employers (45%) are considering making changes to their total rewards programs or talent management strategies. Employers continue to take a conservative approach to funding their bonus pools and the average projected bonus funding for current-year performance is 87% of target."
(Towers Watson)
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Substantial Health and Economic Returns from Delayed Aging May Warrant a New Focus for Medical Research
"The economic value of delayed aging is estimated to be $7.1 trillion over fifty years. In contrast, addressing heart disease and cancer separately would yield diminishing improvements in health and longevity by 2060 -- mainly due to competing risks. Delayed aging would greatly increase entitlement outlays, especially for Social Security. However, these changes could be offset by increasing the Medicare eligibility age and the normal retirement age for Social Security."
(Health Affairs)
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Press Releases
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