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November 1, 2013          Get Retirement News  |  Advertise
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Fiduciary and Legal Review
November 7, 2013 WEBCAST
(NH Hicks)

FSA Rollover Provision: What You Need to Know
November 7, 2013 WEBCAST
(Alegeus Technologies, LLC)

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official guidance, jobs, webcasts and more.
[Official Guidance]

Text of CCIIO Sub-Regulatory Guidance: Process for Obtaining Recognition as Minimum Essential Coverage (PDF)
"The final regulations ... outline a process by which other types of coverage not statutorily specified and not designated through regulation as minimum essential coverage may apply to [HHS] to be recognized as minimum essential coverage.... Plans or policies that fall into the categories set forth in the statute or designated as minimum essential coverage in HHS regulations do not have to submit an application to be recognized as minimum essential coverage. Applications from these plans or policies will not be reviewed or processed." (Center for Consumer Information & Insurance Oversight, Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  


10th Annual American Health Care Congress - Dec. 2-3 - Anaheim, CA

Sponsored by World Congress

Senior health care executives from hospitals, health systems, health plans, and medical groups gather to address meaningful change in our system - policy, business strategy, and care delivery transformation.

[Official Guidance]

Text of CMS FAQ #6 for FF-SHOP, Premium Calculations and Payment (PDF)
18 Q&As, plus detailed examples of calculations. Questions include: How will premiums be calculated in the Federally-facilitated SHOPs (FF-SHOPs)? If a qualified employer has multiple worksites in a state, which address will be used to adjust premiums for the qualified employer's qualified employees and their dependents using the geographic rating area premium rating factor? When an employer group moves its headquarters (a change in primary business location) and that move is to a different rating area, will the FF-SHOPs apply the new geographic rating factor to the coverage when the move occurs? Can composite (or average) premiums be used in the FF-SHOPs? How will employers know which issuers will accommodate composite rating? How will employers contribute to employee and dependent premiums in the FF-SHOPs? How will employees be allowed to contribute towards their premiums in the FF-SHOPs? (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

[Official Guidance]

Text of IRS Rev. Proc. 2013-35: Various Tax Benefits to Increase in 2014 Due to Inflation Adjustments (PDF)
[Excerpt from IRS press release:] "For tax year 2014, the Internal Revenue Service announced today annual inflation adjustments for more than 40 tax provisions, including the tax rate schedules, and other tax changes. Revenue Procedure 2013-35 provides details about these annual adjustments. The annual dollar limit on employee contributions to employer-sponsored healthcare flexible spending arrangements (FSA) remains unchanged at $2,500.... The small employer health insurance credit provides that the maximum credit is phased out based on the employer's number of full-time equivalent employees in excess of 10 and the employer's average annual wages in excess of $25,400 for tax year 2014, up from $25,000 for 2013." (Internal Revenue Service)  

[Guidance Overview]

Trick and Treat: IRS Modifies FSA Use-it-or-Lose-it Rule to Allow $500 Carryover
"Under applicable regulations, a health FSA is exempt from HIPAA portability rules and health reform if the maximum amount that can be reimbursed under the health FSA is the greater of (1) two times the participant's salary reduction or (2) the participant's salary reduction plus $500 and other major medical coverage is available. So assume a participant elects $200 of salary reductions and receives a $500 carryover and a $100 nonelective contribution from the employer. Does this make the health FSA subject to HIPAA portability and health reform? The Notice does not address this issue[.]" (Benefits Bryan Cave)  

[Guidance Overview]

IRS to Allow Limited Carry Over in Healthcare Flexible Spending Arrangements
"[T]he Agencies also provided that the $500 carryover will not impact the ability of an individual to contribute the full salary reduction amount of $2,500 for the next plan year. However, there is one caveat. While the Agencies have not changed the ability of an employer to utilize the allowed grace period for use of health FSA funds, this new guidance does clarify that an employer may use the grace period or the carryover, but not both." (Hill, Chesson & Woody)  


How Will Health Care Reform Impact You in 2014? - November 13 Webinar

Sponsored by Lorman and BenefitsLink

Health care plans are changing - coordinate now for 2014. Registration discount for BenefitsLink readers.

[Guidance Overview]

2013 ERISA Welfare Plan Automatic Participant Disclosures Checklist (PDF)
Nine-page checklist provides detailed list of disclosure items with links to model notices, a description of initial disclosure requirements, and a further description of annual or other periodic follow-up requirements. (Bass, Berry & Sims)  

[Guidance Overview]

Proposed Rules Issued for Small Employer Health Insurance Premium Credit
"The proposed rules incorporate the provisions of Notices 2010-44 and 2010-82, modified to reflect the statutory changes starting in 2014, notably, a higher credit amount, the fact that employers must obtain the insurance coverage through an exchange, and a two-year limit on taking the credit." (Journal of Accountancy)  

D.C. Court of Appeals Grants Injunction in Contraceptive Mandate Case (PDF)
71 pages; one concurring opinion, one dissent. Excerpt: "[The court] must determine whether the contraceptive mandate imposed by the Act trammels the right of free exercise -- a right that lies at the core of our constitutional liberties -- as protected by the Religious Freedom Restoration Act. We conclude it does.... The burden is too remote and too attenuated, the government says, as it arises only when an employee purchases a contraceptive or uses contraceptive services. We disagree with the government's foundational premise. The burden on religious exercise does not occur at the point of contraceptive purchase; instead, it occurs when a company's owners fill the basket of goods and services that constitute a healthcare plan. In other words, the Gilardis are burdened when they are pressured to choose between violating their religious beliefs in managing their selected plan or paying onerous penalties." [Gilardi v. HHS, No. 13-5069 (D.C. Cir. Nov. 1, 2013)] (U.S. Court of Appeals for the District of Columbia Circuit)  

Hospitals May Assist with Premium Payments for Patients Who Purchase Insurance Through a State or Federal Exchange/Marketplace Without Fear of Anti-Kickback Liability
"The affordability of this coverage has prompted hospitals to consider paying premiums for low-income individuals who have trouble paying their premiums, either initially or in order to maintain their insurance coverage. The hospital stands to gain far more in commercial insurance reimbursement for their services than it would pay out in premium assistance.... [HHS concluded] that the QHPs (and certain other programs related to the exchanges) are not 'federal health care programs' for the purposes of the [Anti-Kickback Statute] ... after a careful analysis of the definition of 'federal health care program' in consultation with the Department of Justice." (Quarles & Brady LLP)  

Consultants Such as Xerox, Deloitte Cash In on Obamacare
"The news recently has focused on the few dozen companies responsible for building the disastrous federal health-care exchange website; but they're just a handful of the hundreds of companies quietly cashing in on Obamacare. Consultants such as Deloitte and tech companies including Dell and Hewlett-Packard are advising government agencies, hospitals, doctors, pharmaceutical companies, and employers on implementing the law. Thanks in part to the [ACA], health-care advice is now a $10.2 billion industry that's expected to grow 6 percent annually over the next five years[.]" (Bloomberg BusinessWeek)  

Which Plans Cover Abortion? No Answers on HealthCare.gov
"How the various health plans in the exchanges would or would not pay for abortion was one of the before the bill was passed in 2010.... At least for now, though, it's not clearly identifiable, those on both sides of the abortion debate agree.... [N]ot only is the information not on the website, sometimes it's not easily available by calling, either." (National Public Radio)  

Notes from October 2 Healthcare.gov Meeting: '6 Enrollments Have Occurred So Far'
"House Oversight and Government Reform Committee Chairman Darrell Issa, R-Calif., today released new HealthCare.gov meeting notes stating that as of 10/2/2013, there were '248 enrollments.' According to meeting notes from the day before, '6 enrollments have occurred so far with 5 different issuers.' The numbers come from notes taken during 'War Room' meetings ... comprised of Administration officials and contractors discussing the standing issues and problems with the disastrous launch of HealthCare.gov." (Committee on Oversight and Government Reform, U.S. House of Representatives)  

New Documents, Lack of Testing Raise Concerns About Security of Healthcare.gov
"House Energy and Commerce Committee Leaders [have] sent letters to [HHS] Secretary Kathleen Sebelius and four government contractors involved with implementation of the exchanges regarding rising security concerns surrounding the Federally Facilitated Marketplace [FFM].... The members request several documents from the administration and the companies 'in order to better understand the implementation of the PPACA, including whether the failure to conduct a complete Security Control Assessment increases the risk to the FFM.'" (House Committee on Energy and Commerce)  

Another Delay for Small-Business Health Exchanges?
"[S]mall businesses in some states that are logging on to the federal SHOP site for the available overview are finding few options, according to insurance brokers in those states. In Texas, for example, only two insurers are participating in the exchange, and only one, BlueCross BlueShield of Texas, is offering SHOP plans statewide.... Brokers in Georgia, North Carolina, and New Jersey ... reported fewer plans and smaller networks within the exchanges than outside of them." (The New York Times; free registration required)  

Florida Insurer Says It Didn't Drop Customers, Just Insurance Plans
"'We're not terminating anyone's coverage,' said Jon Urbanek, Florida Blue's senior vice president of commercial markets. 'We're essentially going to go through a transition to qualified plans.' It's a distinction that some Florida Blue members have a hard time seeing -- especially when the new plan costs more and offers benefits they don't necessarily want." (Kaiser Health News)  

The Uninsured: An Interactive Tool
"Through its coverage expansions, the [ACA] has the potential to reach a broad range of groups. [This] interactive tool examines how the ACA may affect various groups of uninsured people by analyzing how many are uninsured, the main reasons why they lack coverage, and how they may gain coverage under the ACA." (Kaiser Family Foundation)  

Why Has ACO Growth Slowed?
"[T]he number of [Accountable Care Organizations (ACOs)] has grown from a few dozen at the end of 2010 to nearly 500 as of the end of September 2013. After significant growth through the end of January of this year, only 35 new ACOs have been announced ... [The author estimates] an increase of less than 3 million covered lives in all of 2013, from 17.4 million lives in December 2012 to 20.1 million through the end of September ... This recent slowed growth has raised the question of what this means for the accountable care movement." (Health Affairs Blog)  

Navigators and Assisters: Roles and Differences Clarified
"Navigators and assisters can perform the same functions, but there are subtle differences between the two. The [ACA] authorized grant money to assist states to plan and establish their own Marketplaces. A state can use establishment grant money to plan and administer its navigator program, but navigators cannot be paid out of these grants.... [A]ssisters ... can be funded out of establishment grants. In a state-based exchange, assisters are optional but encouraged, whereas navigators are required." (Health Affairs Blog)  


'Substandard Plans' Offered by 'Bad Apple Insurers' -- Does the Obama Administration Understand How the Health Insurance Market Works?
"Are health insurance plans in the individual market substandard? Not the overwhelming bulk of them. How do I know that? Because individual health insurance policies have been regulated for decades by the states.... This whole issue over whether the states regulate these policies too much has been at the heart of Republican calls for insurers to be able sell individual health insurance plans across state lines -- to be able to buy individual health plans from states with fewer regulations." (Health Care Policy and Marketplace Review)  


If They Ever Fix the Obamacare Website, the Worst May Be Yet to Come
"Despite so much deserved scrutiny over the health insurance website, the weakest cog, perhaps, is the law's individual mandate. The purpose of the mandate is notoriously simple: to cajole or compel tens of millions of healthy young people to greatly overpay for health insurance so that older, sicker, and (for the most part) wealthier people can greatly underpay. To pass the law, Congress stripped this cog of its teeth, and the Supreme Court later removed its linchpin.... With the moral implications stripped away by the Court, failing to buy insurance is no more immoral than declining to eat a plate of liver." (Forbes)  


Tom Scully's Message on Privatizing Health Care
"Former CMS administrator Thomas Scully has been a major player in injecting more capitalism into health care. [A recent New York Times] article describes his mindset, including the fact that he intends to get his share of the mega-wealth that health care privatization is creating.... We need to understand what Scully is trying to say: The law is going to make some people very rich. Is that what we what from the most expensive and most dysfunctional health care system of all wealthy nations? We have been warned." (Physicians for a National Health Program [PNHP])  

Benefits in General; Executive Compensation

Perpetual Shortfall: Maryland's Pension and Benefit Funds (PDF)
"[In 2008,] Maryland's state ... pension system faced an $11 billion long-term shortfall, and cost estimates for retiree healthcare ranged from $8 billion to $15 billion. This report updates the 2008 report with new data from the 2012 fiscal year ... Currently the state's pension system faces a long-term shortfall estimated at over $19 billion. The long-term shortfall for state retiree healthcare is estimated to be $9.4 billion. With a few exceptions, the situation in many Maryland counties is just as dismal." (Maryland Public Policy Institute)  

Oracle Shareholders Reject Executive Pay, Again
"[CalSTRS and two other large pension fund managers] sent a letter to Oracle shareholders, saying they have 'severe concerns about executive compensation and proper board accountability at Oracle.' [CalPERS] also said it was voting against Oracle's pay plan and Mr. Chizen, chairman of the board's compensation committee. It's the second straight year shareholders have rejected executive pay packages; the vote is non-binding." (Pensions & Investments)  

Press Releases

Judge Orders Restoration of More than $1.6 Million to Sunkist Growers Inc. Retirement Plans
Employee Benefits Security Administration (EBSA), U.S. Department of Labor

CalSTRS Releases RFP for 403(b)/457(b) Recordkeeper
California State Teachers' Retirement System (CalSTRS)

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