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October 11, 2013          Get Retirement News  |  Advertise
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[Guidance Overview]

My Coverage Is Intermittent. Can I Do Better on the Marketplace?
"[If] your temp agency offers good coverage, you won't be eligible for subsidies as long as that insurance is available to you.... If you're willing to forgo your employer coverage altogether and sign up for an exchange plan for the whole year, you can. But you'll only be eligible for premium tax credits on the exchange during the months that you don't have access to employer coverage. Again, this is assuming your employer coverage is considered good under the health law." (Kaiser Health News)  


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[Guidance Overview]

COBRA or Exchange Coverage: Health Care Reform Subsidy Effect
"When may an individual change from COBRA coverage to marketplace coverage, and how might the individual's eligibility for a subsidy... be affected? ... [O]nce COBRA coverage is elected, may the individual drop COBRA at any time and enroll in subsidized coverage through a marketplace, or must the individual either exhaust COBRA or wait for a marketplace open enrollment period? The answer is not entirely clear." (Thompson SmartHR Manager)  

[Guidance Overview]

Check It Out and Check It Off: 2014 Group Health Plan Checklist (PDF)
"With 2014 just around the corner, numerous mandates under the Patient Protection [ACA] are about to become effective. [This article includes] a checklist of upcoming [ACA] mandates that employers must implement in 2014, as well as a list of existing enrollment and annual notice requirements that group health plan sponsors should consider during open enrollment." (Bryan Cave)  

[Guidance Overview]

No More Pre-Tax Premiums for Individual Insurance Policies?
"The IRS did not revoke the 1961 Revenue Ruling permitting pre-tax payment of employee premiums for individual market policies. Some employers are hoping that they can continue to allow employees to pay for individual market health insurance policies on a pre-tax basis through a cafeteria plan even if the employer provides no subsidy for the coverage. The recent guidance is not clear on that point. Small employers are permitted to subsidize policies on the Marketplace through the Small Business Health Option Program or SHOP that is part of the Marketplace. This will allow small employers to establish programs to subsidize coverage that employees choose, but employees will be limited to the plans available under SHOP." (Leonard, Street and Deinard)  

Tax Realities for Self-Employed Who Get Obamacare Subsidies
"If a self-employed individual gets a subsidy for an insurance purchase on the exchange, is that subsidy treated as income for tax purposes? Will I get a 1099 for that amount? Answer: Obamacare subsidies will not be treated as income and will not be taxable. The subsidies are designed to reduce out-of-pocket costs for individuals who don't have employer-based insurance. They can be taken either up front, as premium assistance credits to reduce your monthly insurance premiums, or after the fact, as tax credits on your 1040 return." (Bloomberg BusinessWeek)  

Ruling Alters Tennessee's Navigator Guidelines for ACA
"Churches, unions and social service organizations now can set up computer stations to help the uninsured sign up for coverage under the Affordable Care Act without fear of being fined by the state of Tennessee. U.S. District Judge Todd Campbell issued a temporary restraining order Monday blocking Tennessee from enforcing a portion of the state's controversial emergency rules for health law navigators. Campbell said the state rules defining a navigator contain language that is too broad." (The Tennessean)  

Healthcare.gov Offers New Shopping Feature -- Sort Of
"The new online tool allows users to find out the average monthly premium by different health plan and by coverage tier -- bronze, silver, gold and platinum ...The prices do not take into account the subsidies people may be eligible for based on their income, or specific price points related to age. The site offers only two age breakdowns -- younger than 50 or older than 50. Consumers also can't get any information on a plan's co-pays, deductibles and other benefit information. But at least they can access the information without getting an error message -- or being told to try again." (Kaiser Health News)  

Healthcare.gov's Flaws Found, Fixes Being Considered
"Government officials are considering rebuilding some parts of the federally run health-insurance marketplace ... Much of the problem stems from a design element that requires users of the federal site ... to create accounts before shopping for insurance ... The problems haven't yet been resolved, but ... officials are debating whether to replace parts of the registration system this weekend. By Thursday morning, a new tool that allows users to preview plans without registering appeared on the site with little fanfare." (The Wall Street Journal; subscription may be required)  

Blue Cross Health Plans Jump to an Early Lead
"The dominance of Blues plans and their aggressive stance illustrates just how little -- and how much -- the health insurance market is changing under the [ACA]. The nation's Blue Cross and Blue Shield plans have typically been the largest insurers providing coverage primarily to individuals and small businesses, and they remain a staple on the new exchanges." (The New York Times; subscription may be required)  

House Subcommittee Hearing on the Effects of the Health Law's Definitions of Full-Time Employee on Small Businesses
"The purpose of the hearing was to examine the potential effects of the health care law's definition of 30 hours a week as full-time employment and what this means for employment at small businesses." [Page includes list of witnesses and links to their testimony.] (Subcommittee on Health and Technology, Committee on Small Business, U.S. House of Representatives)  

Are Hospitals More Efficient Than They Seem?
"Hospitals practice medicine in drastically different ways, and the higher-spending ones don't seem to generate any better results than those that spend less. Because of third-party insurance and other distortions, though, the market doesn't punish the inefficient hospitals.... [A new study] found that hospitals with higher survival rates net of the cost of treatment were rewarded with more patients.... The team also found that the variation in survival rates was more important in driving market share than the variation in cost was. In other words, patients seem to seek out hospitals with better survival rates but not ones with lower costs." (Peter Orszag for Bloomberg)  

Cigna Tells Brokers to Halt Certain Health Insurance Exchange Sales
"Cigna has instructed brokers to halt selling insurance to individuals who are subsidy-eligible through its federal health care exchange broker portals.... Incorrect information from [CMS] led to the decision by Cigna ... [T]he carrier sent out a notice to brokers in the states where its product is offered on federal exchanges -- Arizona, Florida, Tennessee and Texas -- that instructed brokers to halt sales. Cigna's product in Colorado, which is a state-run exchange, is not affected." (Employee Benefit News)  

Text of GAO Report: CMS Needs to Pursue a Solution for Removing Social Security Numbers from Medicare Cards (PDF)
"The efforts made thus far by CMS and its stakeholders could provide some of the information needed to initiate an IT project to design and develop the system changes that would have to be made to address an agency-wide effort to better safeguard Medicare beneficiaries' identity. However, until the agency takes other critical steps, such as designating a business owner, establishing a business case, issuing a project charter, and conducting architectural and IT project selection reviews, it will not be in a position to design, develop, and implement the changes that would have to be made to systems affected by the removal of SSNs from display on Medicare beneficiaries' health insurance cards." (Committee on Ways and Means, U.S. House of Representatives)  

Health Prices Still Rising, but Very Slowly
"'Healthcare price inflation in August 2013, at 1.0% year-over-year, is growing at a historically low rate,' the latest [Altarum Institute] report said. 'The 12-month moving average, at 1.5% in August 2013, represents the lowest level in our data, and likely all-time.' ... [CMS] has reported 3.9% growth in national health spending -- different from prices -- from 2009-2011. The agency predicts that number to be 4% this year overall and 4.3% for physician services." (MedPage Today)  

[Opinion]

American Companies Should Stop Being Helicopter Parents
"This parenting style doesn't typically produce children who can look out for themselves. The same applies to employer helicoptering. Most companies provide a very small number of health-plan options, with the result that workers don't have to -- and never learn to -- make significant decisions about coverage." (HR Blog Network)  

[Opinion]

Obamacare Is Far from a Revolutionary Change in Our Health System
"The truth is the law will have limited impact on how most Americans receive medical care and pay for it. Far from a radical change, the ACA ... builds on parts of our health care system that have evolved over the last half-century.... [M]ost Americans will not experience any change in their health insurance; they will continue to receive coverage through their job and visit a physician or hospital as they have in the past." (Health Affairs Blog)  

Benefits in General; Executive Compensation

The Government May Be Shut Down, But Your Form 5500 Is Still Due!
"Many regulator functions will halt during the federal government shutdown, but plan sponsors shouldn't snooze. For those sponsors that may have filed an extension for their Form 5500, the tax filing for qualified retirement plans, the October 15th deadline is looming just ahead.... [P]lan sponsors can still make submissions and electronic systems are still running." (Fragasso Retirement Plan Consulting Solutions)  

Third Circuit: Proper Documentation Saves the Day for an ERISA Plan Sponsor
"The court emphasized: 'We have said that a participant's reliance on employer representations regarding benefits may never be "reasonable" where the participant is in possession of a written document notifying him of the conditional nature of such benefits.' The Court also rejected the plaintiffs' assertion that extraordinary circumstances required judgment in their favor, concluding that there was no misrepresentation about the benefits at issue, let alone a network of misrepresentations that would give rise to such extraordinary circumstances." [Jenkins et al. v. ULLICO, No. 12-4310 (3rd Cir. Sept. 10, 2013)] (Seyfarth Shaw LLP)  

Illinois Supreme Court Rejects Petition for Leave to Appeal in Restrictive Covenant Case
"[In July, the Illinois Appellate Court for the First District] ruled that there must be at least two years or more of continued employment to constitute adequate consideration in support of a restrictive covenant where no other consideration is provided.... [The] Illinois Supreme Court [has now] denied the employer's appeal ... For employers whose restrictive covenant agreements are or may be governed by Illinois law, choices will have to be made about how to account for the Appellate Court's ruling. What may constitute adequate consideration to support restrictive covenants of an at-will employee other than two years of employment is unsettled under Illinois law." (Vedder Price)  

[Opinion]

Text of Comments by International Brotherhood of Teamsters to SEC on Proposed Pay Ratio Disclosure Rule (PDF)
"We believe that the SEC's proposed CEO-to-worker pay ratio disclosures will help investors evaluate CEO pay levels in the context of a company's internal compensation system; monitor how the ratio changes over time; and, provide a basis for comparing compensation practices within peer groups.... We commend the SEC for balancing concerns of compliance costs for companies without sacrificing the benefits of the disclosure to investors." (International Brotherhood of Teamsters)  

Press Releases

Shutdown Closes IRS Health Care Program
Pension Benefit Guaranty Corporation (PBGC)

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