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October 30, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Account Manager, Employee Benefits
Lenox Advisors
in CT, NJ, NY

Plan Administrator
Verisight Inc.
in IL

Client Success Consultant
The Online 401(k)
in CA, NY

Retirement Planning Consultant
Transamerica Retirement Solutions
in ME, NH

Relationship Manager
Verisight Inc.
in IL

Pension Consultant
Boyce & Associates, Inc.
in AZ

Human Resources Specialist (Assistant Manager, Retirement Benefits)
Pennsylvania State University
in PA

HR Policy Analyst
Saudi Aramco

Account Specialist
Arista Consulting Group
in GA

Relationship Manager
Verisight Inc.
in CA

Relationship Manager
Verisight Inc.
in CA

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Webcasts and Conferences

Defined Contribution Plan Overview
November 5, 2013 WEBCAST
(NH Hicks)

New Rules for Health Reimbursement Arrangements Plan Sponsors Need to Take Action Now
November 7, 2013 WEBCAST
(International Foundation of Employee Benefit Plans)

Big Opportunities Marketing to Small Business Owners
November 19, 2013 WEBCAST
(American Society of Pension Professionals & Actuaries (ASPPA))

Required Minimum Distributions
November 20, 2013 WEBCAST
(American Society of Pension Professionals & Actuaries (ASPPA))

NAPA 401(k) Summit 2014
March 23, 2014 in LA
(National Association of Plan Advisors (NAPA) )

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]

Final Regulations Clarify and Expand Portland Sick Leave Law Requirements
"Beginning January 1, 2014, private-sector employers doing business in Portland [Oregon] that have six or more employees will be required to provide employees with a minimum of one hour of paid sick leave for every 30 hours of work performed by the employee.... [Those] that have five or fewer employees will be required to provide unpaid sick leave for every 30 hours of work performed by the employee.... [For purposes of determining whether the employer has six or more employees, all] employees who work for an employer are counted, including full-time, temporary and part-time employees, and employees who work outside Portland or outside Oregon." (Littler)  


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Obama Accused of Breaking Promise to Consumers as Health Insurers Cancel Policies
"If the accusations of broken promises stick, they could ultimately be more damaging than the glitchy Web site. Although some people are signing up and benefiting from federal subsidies to buy private insurance, the number is unknown because the administration has not revealed enrollment figures. Meanwhile, insurance companies have sent hundreds of thousands of termination notices in recent months to previously insured Americans, telling them that their health insurance plans are changing to meet the requirements of the health-care law." (The Washington Post; subscription may be required)  

Fact-Checking Obama's Pledge That 'No One Will Take Away' Your Health Plan: Washington Post Awards Four Pinocchios
"The administration is defending this pledge with a rather slim reed -- that there is nothing in the law that makes insurance companies force people out of plans they were enrolled in before the law passed. That explanation conveniently ignores the regulations written by the administration to implement the law. Moreover, it also ignores the fact that the purpose of the law was to bolster coverage and mandate a robust set of benefits, whether someone wanted to pay for it or not. The president's statements were sweeping and unequivocal -- and made both before and after the bill became law. The White House now cites technicalities to avoid admitting that he went too far in his repeated pledge, which, after all, is one of the most famous statements of his presidency. The president's promise apparently came with a very large caveat: 'If you like your health care plan, you'll be able to keep your health care plan -- if we deem it to be adequate.'" (The Washington Post; subscription may be required)  

Cancellation of Health Care Plans Replaces Website Problems as Prime Target
"The rising concern about canceled health coverage has provided Republicans a more tangible line of attack on the law and its most appealing promise for the vast majority of Americans who have insurance: that it would lower their costs, or at least hold them harmless. Baffled consumers are producing real letters from insurance companies that directly contradict Mr. Obama's oft-repeated reassurances that if people like the insurance they have, they will be able to keep it." (The New York Times; subscription may be required)  

Individual Mandate Deadline Extended; What's Behind The Policy Cancellation Stories?
"HHS has broad authority under the ACA to grant an exemption from the shared responsibility provision to any person who has 'suffered a hardship with respect to the capability to obtain coverage under a qualified health plan.' In the October 28 release, HHS recognizes a hardship exemption for individuals who purchase coverage through the exchange between February 15 and March 31, 2014, and extends until March 31 the last day of the open enrollment period[.]" (Timothy Jost in Health Affairs Blog)  

Testimony of HHS Secretary Sibelius at House Committee Hearing on Healthcare.gov Status
The committee hearing is presented as a live webcast on Wednesday morning, October 30. A recording will be available thereafter. (House Committee on Energy and Commerce)  

Statement of CMS Administrator to Congressional Hearing on Status of Healthcare.gov (PDF)
"The fact is that the [ACA] delivered on its product: quality, affordable health insurance. The tremendous interest shown in HealthCare.gov shows that people want to buy this product.... [I]t is important to remember that the [ACA] is much more than purchasing insurance through HealthCare.gov. Most Americans -- 85 percent -- already have health coverage through an employer-based plan, or health benefit, such as Medicare, Medicaid, or the Children's Health Insurance Program (CHIP)." (Marilyn Tavenner, Administrator, Centers for Medicare & Medicaid Services)  

District Court in Florida Further Defines Parameters of Medical Provider's Standing to Sue under ERISA
"The boundaries of the medical provider's standing under ERISA were recently tested in the United States District Court for the Southern District of Florida. In MRI Scan Center v. MedSolutions/CIGNA ... the Plaintiff, MSC, provided imaging services to patients, including participants of employee health benefit plans insured by CIGNA.... Plaintiff alleged that CIGNA had improperly inflated the cost of services by adding its own administrative fees, in order to charge higher premiums. MSC alleged that this practice was a breach of CIGNA's fiduciary duty ... [The court disagreed]." (Womble Carlyle)  

Insurance 'Savings Clause' Still Threatens ERISA Plan Limitations
"[The case of Francis v. Anacomp, Inc. Accidental Death and Dismemberment Plan, No. 13-55648 (9th Cir.; appeal filed April 18, 2013)] involved the question of whether the interpretation of a policy provision limiting accidental death coverage to loss 'resulting directly and independently of all other causes' from a covered accident was preempted by state law.... Plaintiff argued that Ward and Miller, which hold that state laws are saved from preemption if they 'regulate insurance' and 'substantially affect the risk pooling arrangement between insurer and insured,' required the district court to apply a state law analysis to the limiting language. California law would have substituted a proximate cause test for the policy requirements, effectively writing the clear limiting language out of the policy." (Wilson Elser)  

ACA Rules Squeezing Some Part-Timers at Governmental Employers
"This month in Delaware, which has embraced the health law, officials decided to limit all casual and seasonal employees, including substitute teachers, to fewer than 30 hours a week to save on health insurance.... In Pennsylvania, at least 10 school districts have slashed hours or outsourced their workers, including bus drivers, food service workers, and instructional aides." (Kaiser Health News)  

New California Law Affects State Taxation of Employer Tax Gross-Ups for Domestic Partners
"Post-Windsor, same-sex married couples in California no longer need a tax gross-up for either state or federal tax purposes because they no longer have to be taxed on the value of the coverage provided to their spouse. Because of this treatment, application of California AB 362 would be limited to a situation where an employer provides a federal tax gross-up to an employee who is in a California-registered domestic partnership. Such a gross-up, which would have been taxable under prior state law, is now no longer taxable in California." (McDermott Will & Emery)  

Deloitte Health Care Current, October 29, 2013
"Health plans have entered the age of the consumer. And now the overriding question for the industry is, 'Are you ready to retail?' Health plans' business-to-business (B2B) competencies of sales and delivery to group health insurance purchasers (e.g. employers) will remain at the core ... But it also seems the need for health plans to have a robust business-to-consumer (B2C) toolkit has reached a tipping point. So, what constitutes this retail megatrend? ... The first is employers' interest in defined contribution.... And last but not least: public HIXs." (Deloitte Center for Health Solutions)  

Self-Insured Plans to Get Fee Reprieve in 2015 and 2016 But Not 2014
"In a large batch of final rules covering about half a dozen [ACA] policies, [HHS] is giving some self-insured health plans a two-year exemption from reinsurance fees. 'We...intend to propose in future rulemaking to exempt certain self-insured, self-administered plans from the requirement to make reinsurance contributions for the 2015 and 2016 benefit years,' HHS officials wrote in a preamble to [recent] regulations ... in the Federal Register. Employers that self-insure still have to pay the ACA's transitional reinsurance fee for 2014, set at $63 per plan participant and intended to raise a fund of $25 billion to help cover high claims in state exchange pools." (Healthcare Payer News)  

Domestic Medical Tourism is Taking Off
"[The Associated Press reports that] Premera Blue Cross Blue Shield, Alaska's biggest health insurer, started a program in January that will pay expenses for some of its members to fly to Seattle for some procedures that come with huge price breaks. For instance, a knee surgery that costs $27,100 in Alaska can be performed for $13,000 in Seattle, according to the insurer[.]" (John Goodman's Health Policy Blog)  

How the Court Case Against Obamacare Subsidies Stacks Up
"Last week, the most important case that you've never heard of survived its first legal hurdle. Judge Paul Friedman of the United States District Court for the District of Columbia ruled that plaintiffs had standing to advance a broadside attack on the subsidy system at the heart of the [ACA]. Although the Clinton appointee refused the plaintiffs' requests to temporarily enjoin -- that is, block -- the subsidies, he did so because there would be no harm to delaying an injunction until the conclusion of the case; he did not directly speak to the merits of the underlying claim ... Friedman promised to rule by Feb. 15, and if he does enjoin the subsidies to the federal exchanges -- or if any judge in three other pending cases does so -- the law might well prove unworkable." (RealClearPolitics)  

The Role of Retiree Health Insurance in the Early Retirement of Public Sector Employees
"[M]ost government employees have access to retiree health coverage, which allows them access to group health coverage even if they retire before Medicare eligibility. [The authors] study the impact of retiree health coverage on the probability of stopping work among public sector workers between the ages of 55 and 64.... [F]or state and local government employees, retiree health coverage raises the probability of stopping work by 5.1 percentage points (around 28 percent) between ages 60 and 64." (John B. Shoven and Sita Slavov via the National Bureau of Economic Research [NBER])  

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