EmployeeBenefitsJobs.com logo BenefitsLink.com logo

BenefitsLink Health & Welfare Plans Newsletter

November 5, 2013          Get Retirement News  |  Advertise
         Past Issues  |  Search

Employee Benefits Jobs

Retirement Planning Consultant
Transamerica Retirement Solutions
in ME, NH

Defined Benefits Pension Administrator
Industry TPA
in OR

Plan Administrator
Nationwide Financial
in OH

Regional Director
Unite Here Health
in IL

Retirement Plan Analyst
United Retirement Plan Consultants
in WA

ERISA Attorney
Cary Kane LLP
in NY

Post Your Job

View All Jobs

RSS feed for jobs RSS Feed: All Jobs

Webcasts and Conferences

401(k) Essentials Plus Series
November 12, 2013 WEBCAST
(McKay Hochman Co., Inc.)

Benefits Education: The Time is Right
December 3, 2013 WEBCAST
(Kushner & Company)

11th Annual Made In America: Taft-Hartley Benefits Summit
February 10, 2014 in FL
(Financial Research Associates)

View All Webcasts and Conferences

  LinkedIn   Twitter   Facebook Hand-picked links to the web's best news articles,
official guidance, jobs, webcasts and more.
[Official Guidance]

Text of CCIIO Q&A Discouraging Third Party Payments of Premiums for Qualified Health Plans in the Marketplaces (PDF)
"It has been suggested that hospitals, other healthcare providers, and other commercial entities may be considering supporting premium payments and cost-sharing obligations with respect to qualified health plans purchased by patients in the Marketplaces. HHS has significant concerns with this practice because it could skew the insurance risk pool and create an unlevel field in the Marketplaces. HHS discourages this practice and encourages issuers to reject such third party payments. HHS intends to monitor this practice and to take appropriate action, if necessary." (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 Corrections to ACA Benefit and Payment Parameters for 2014
"In the March 11, 2013 issue of the Federal Register, [CMS] published a final rule entitled, 'Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2014.' This correcting amendment corrects several technical and typographical errors identified in the March 11, 2013 final rule." (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

[Guidance Overview]

IRS Loosens Health FSA Carryover Rules
"[The carryover] is an alternative to the option of granting employees a 2.5 month 'grace period' for incurring covered claims. The two options may not be offered during the same plan year. Moreover, the prohibition on offering both options during the same year applies on a plan-wide basis, and not merely employee-by-employee. A health FSA could not allow employees to elect between the two options (or even give each employee whichever option would be most advantageous for that employee). Each sponsor must thus consider which option (if either) makes the most sense for its overall workforce." (Spencer Fane)  

[Guidance Overview]

New IRS Guidance Modifies the 'Use-It-Or-Lose-It' Rules for Health Flexible Spending Accounts
"The change is intended to make health FSAs more attractive to low-to-moderate-income employees who may have been reluctant to contribute, fearing they would be unable to fully use the account and lose any dollars they have contributed.... In addition, the change is intended to reduce incentives for unnecessary spending, such as the common phenomenon of a year-end rush by health FSA participants to use up their health FSA accounts on such items as eyeglasses." (Ballard Spahr)  

[Guidance Overview]

CMS Vendor Management Presentation, November 4, 2013 (PDF)
68 presentation slides. Excerpt: "This session provides a comprehensive overview of the Vendor Management process for payment purposes, including the creation of Payee Groups and submission of financial information on the Financial Information Template, and verification of banking information." (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  


Register for IHC FORUM WEST Dec 5-6th in Las Vegas – Super Saver Rates!

Sponsored by The Institute for HealthCare Consumerism

IHC FORUM West 2013 -- HealthCare Consumerism: The First Real Time Look-in at this Critical Open Enrollment Period.
Learn. Connect. Share. With ALL Industry Stakeholders.
Register today!

IRS Permits $500 Health FSA Carryover
"Advantages of carryover: Reduction of forfeitures ... Elimination of year-end expenses incurred solely to use up account balances; Increased participation, resulting in additional FICA savings for the employer. Disadvantages of carryover: Additional administrative complexity; Loss of health savings account eligibility; Increased costs to the employer if employees recover more in reimbursements than they contribute by payroll deductions for a year." (Oppenheimer Wolff & Donnelly LLP)  

Text of Letter from HHS to Rep. McDermott on Whether QHPs Are 'Federal Health Care Programs' (PDF)
"The Department of Health and Human Services does not consider QHPs, other programs related to the Federally-facilitated Marketplace, and other programs under Title I of the Affordable Care Act to be federal health care programs [under section 1128B of the Social Security Act, sometimes called the "Anti-Kickback Statute"]. This includes the State-based and Federally-facilitated Marketplaces; the cost-sharing reductions and advance payments of the premium tax credit; Navigators for the Federally-facilitated Marketplaces and other federally funded consumer assistance programs; consumer-oriented and operated health insurance plans; and the risk adjustment, reinsurance, and risk corridors programs." (U.S. Department of Health and Human Services)  

Text of Letter from U.S. Rep. McDermott to HHS Requesting Guidance on Whether QHPs Are Considered Federal Health Care Programs (PDF)
"In providing the requested guidance on this issue, I am hopeful that HHS will specifically address the following related issues: [1] In the event a QHP is deemed a federal health care program, will a QHP offered on the Exchange then be permitted to offer certain beneficiary inducements, such as nominal rewards for maintaining blood pressure within a certain range, which would otherwise be proscribed under the Anti-Kickback Statute and/or the. Civil Monetary Penalty statute? [2] In the event a QHP is deemed a federal health care program, will this status impact downstream contractual arrangements?" (U.S. Representative Jim McDermott)  

In Victory for Drug Manufacturers, Copay Coupons Will Be Allowed on Exchanges
"The anti-kickback statute forbids copay coupons in Medicare, Medicaid and Tricare. [This author had written] that because exchange plans are in a grey area -- they are commercial, but provide federal subsidies to most enrollees -- they would likely not qualify for copay coupons. But [HHS Secretary] Sebelius says otherwise.... The issue may not be entirely settled.... [T]he Pharmaceutical Care Management Association plans to challenge the HHS determination on copay coupons." (HealthLeaders InterStudy)  

For Many Workers, It's Time to Consider Insurance Options under Employer-Sponsored Plans
"Although news reports have fixated on the problems with the online health marketplaces that launched Oct. 1, for the vast majority of people that's a nonissue. If they get insurance through a job at a company that has at least 50 employees, they probably won't be using the marketplaces ... That doesn't mean people with employer-based plans are unaffected by the health law. As employers adjust plans to meet new requirements and try to reduce their costs, people can expect to see changes next year." (Kaiser Health News)  

Young People Avoiding New Health Plans
"Insurers say the early buyers of health coverage on the nation's troubled new websites are older than expected so far, raising early concerns about the economics of the insurance marketplaces.... The average enrollee age at Priority Health, a Michigan insurer, has ticked up to age 51 for newcomers, from about 41 years old for plans offered for the current year, said Joan Budden, chief marketing officer. Arise Health Plan, Wisconsin's largest nonprofit insurer, said more than half its 150 signees are over 50, a higher proportion than expected, while declining to be specific on its target age." (The Wall Street Journal; subscription may be required)  

Blue Shield of California Delays Cancellations for Some Individual Policyholders
"Blue Shield of California agreed to the extension after the California Department of Insurance threatened legal action, insurance company spokesman Steve Shivinsky said. The state argued that the company should have given a 180-day notice rather than 90 days, he said. Shivinsky added, however, that the delay could cause significant confusion for consumers and affect their eligibility for subsidies if they eventually move to a policy on the state insurance marketplace." (Kaiser Health News)  

Court of Appeals Rules Contraception Mandate Infringes on Religious Freedom
"The ruling was largely in line with most others around the country so far. Of nearly 40 challenges, only a handful of courts have upheld the government's requirement that employer health plans provide free birth control, emergency contraception and sterilization.... On Monday, Luther Strange, Alabama's Republican attorney general, joined the Catholic broadcaster Eternal World Television Network as a plaintiff in its challenge against the mandate in United States District Court in the Southern District of Alabama." (The New York Times; subscription may be required)  

Birth-Control Mandate: Which Case to Review?
"With lawyers in different cases arguing that theirs is the best one for the Supreme Court to use in deciding the legality of the birth-control mandate in the new federal health care law, the Court on [November 4] indicated that it will examine all four pending cases together ... on November 26. If any are granted then or soon afterward, the Court probably would hear and decide them in the current Term.... At least one of the cases has a strong likelihood of being heard by the Justices, because the federal appeals courts have reached conflicting rulings on the mandate, and two of those courts have indicated that the mandate cannot survive the legal challenges by the business itself, or by its owners as individuals." (SCOTUSblog)  

The Memo That Could Have Saved Obamacare's Rollout
"David Cutler, a Harvard health economist and an advisor to President Obama's 2008 campaign, sent [a letter] in 2010 arguing that the White House had the wrong team in charge of health reform and they needed to completely overhaul their implementation strategy.... [T]he process the White House chose was clearly a failure. And it can't all be blamed on Republicans. It's not Speaker John Boehner's fault that the IT contractors were badly managed, the Web site badly built and inadequately tested, and the bad news on all these fronts kept from the White House. Those are problems of management, not political opposition." (Ezra Klein in The Washington Post; subscription may be required)  

State-by-State Estimates of the Number of People Eligible for Premium Tax Credits Under the ACA
"We estimate that over 17 million people nationally will be eligible for tax credits in 2014.... Three states (Texas, California, and Florida) each have more than 1 million tax-credit-eligible residents, and another seven states have more than 500,000 tax-credit-eligible residents. At the lower end, seven states have fewer than 50,000 tax-credit-eligible residents, with the District of Columbia (9,500) and Vermont (27,000) having the fewest. The five states with the most tax-credit-eligible individuals account for about 40 percent of all such individuals nationally." (Kaiser Family Foundation)  

Senate Committee Hearing on the Online Federal Health Insurance Marketplace: Enrollment Challenges and the Path Forward
Page includes recorded video with testimony of CMS Administrator Marilyn Tavenner, and link to statement of Committee Chair Sen. Tom Harkin. (Committee on Health, Education, Labor and Pensions, U.S. Senate)  

Middle-Income Retirees Weigh In on the ACA
"Most middle-income retirees feel that the following program benefits are one of the best aspects of the ACA law: [1] Eliminates pre-existing condition exclusions (68%) Offers a free Medicare annual wellness screening (60%) [2] Includes initiatives to make Medicare more efficient (60%). Half of all retirees (52%) say the worst aspect of ACA is the law's requirement that individuals own health insurance or pay a penalty." (Bankers Life Center for a Secure Retirement)  

ML Strategies Health Care Reform Update, November 4, 2013 (PDF)
"[HHS] clarified that health coverage obtained through the exchanges were not considered 'federal health care programs' with respect to the Anti-Kickback Statute.... Members of the Senate Finance Committee and the House Ways and Means Committee released a bipartisan discussion draft proposal ... [that] would permanently repeal the SGR update mechanism, reform the fee for service payment system, encourage participation in alternative payment models, and provide performance-based incentive payments to physicians and other health care professionals." (ML Strategies, LLC)  

Obamacare 'War Room' Docs: Concern About Consumers Finding Fewer Options, Higher Prices
"Officials expressed concern that the next shoe to drop in the evolving story about the [ACA] would be disappointment from consumers once they are able to get on the troubled HealthCare.gov website -- disappointment because of sticker shock and limited choice ... Other notes from the war room meeting describe specific 'problem plans,' and a problem with the site that prevents certification, perhaps due to a misspelling on the website." (CNN)  

The Marketplace Experience: Month One
"[A Commonwealth] survey indicates that 17 percent of those potentially eligible for the law's new coverage options ... have gone to the marketplaces in the past month.... [A]wareness of the ACA's marketplaces has climbed to 60 percent among potential users, from about one-third in early 2013.... [T]he age and health status of marketplace visitors is consistent with the general demographics of the eligible population." (The Commonwealth Fund)  

Oregon's State Exchange May Be Worse Than Healthcare.gov
"As the federal government consumes humble pie over failures in the health insurance exchanges, some states that have set up their own exchanges are also struggling. Oregon has yet to enroll one single person, and it's been reduced to pawing through paper applications to figure out eligibility." (Kaiser Health News)  


Healthcare Reform: Does Finger Point at You?
"Even though it's apparent the increased cost for insurance has been shifted on the shoulders of working Americans, CEOs and the benefits managers charged with designing coverage plans outside of the health insurance exchanges are beginning to question and identify future strategies that reconcile healthcare offerings with financial goals of the business.... [I]nstead of looking for a scapegoat and pointing blame, insurance entities and the companies they provide for are learning how to move from denial and deception to reshape the healthcare conversation into benefits and even expanded employee coverage they can both boast about." (Healthcare Reform Magazine)  


HHS Blames 'Software Code' for Healthcare.gov Privacy Breach
"'An incident involving the personal information of one consumer was reported to [CMS] and we took immediate steps to address the issue,' [CMS] spokesman Fabien Levy said. 'We identified a piece of software code that needed to be fixed and that fix is now in place.' Levy's characterization of 'immediate' is highly suspect. Justin Hadley, the website user who discovered the privacy breach, said he was still able to access another man's eligibility letter [Sunday] night -- after first discovering it Thursday night." (The Heritage Foundation)  

Benefits in General; Executive Compensation

Text of IRS Chief Counsel Memorandum 20134301F on Timing of Deduction under Cash Bonus Plan (PDF)
"All of the bonuses are paid after the end of the taxable year but no later than the 15th day of the third month following the end of the taxable year.... The principal question in this case is whether the Taxpayer's reservation of the right to unilaterally modify or eliminate the bonuses presents the fact of liability and amount of liability prongs of the all events test from being met with respect to amounts paid under the Plans any earlier than the date the bonuses are paid. [The Office of Chief Counsel concludes that] neither prong of the all events test is satisfied as of year-end." (Internal Revenue Service)  

CFO Pay Trend Strong, but Slowing
"Median total compensation for chief financial officers in large U.S. companies grew almost 7% last year ... Last year's growth is down from the 8.7% increase in median total CFO compensation reported for 2011. While median salaries for CFOs grew 3.3% in 2012, cash bonuses declined slightly at the median (-1.3%) and median stock awards grew by 7.2%, down from just over 10% the prior year." (Towers Watson)  

Deadline Looming for Comments on SEC Proposed Rules on CEO Pay Ratio Disclosure
"The deadline for submitting comments is December 2, 2013. This client alert summarizes the proposed rules and includes ... ten categories of questions for which the SEC is seeking comments. A review of the SEC's questions evidences the many opportunities for providing comments and possibly influencing drafting of the final rules." (Proskauer Rose LLP)  

Press Releases

Protecting Pennfield’s Pensions
Pension Benefit Guaranty Corporation (PBGC)

Connect   LinkedIn   Twitter   Facebook
BenefitsLink.com, Inc.
1298 Minnesota Avenue, Suite H
Winter Park, Florida 32789
Phone (407) 644-4146
Fax (407) 644-2151

Lois Baker, J.D., President
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager

Copyright © 2013 BenefitsLink.com, Inc. -- but feel free to forward this newsletter without further permission from us, if you do not modify the newsletter in any way (including this lower portion).

All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of that content. You may not alter or remove any trademark, copyright or other notice from copies of the content.

Links to Web sites other than those owned by BenefitsLink.com, Inc. are offered as a service to readers. The editorial staff of BenefitsLink.com, Inc. was not involved in their production and is not responsible for their content.

Useful links: