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November 8, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Large Group Benefit Consultant
Northwestern Benefit Corporation of Georgia
in GA

TPA Regional Marketing Director
John Hancock Financial Services
in AL, AR, AZ, IL, KY, LA, MO, MS, NM, OK, TN, TX

Director, Participant Communications
Transamerica Retirement Solutions
in CA

Sr. Retirement Specialist
Federated Investors, Inc.
in PA

DC Compliance Specialist
Benetech, Inc.
in CA

Pension Administrator
Scott, Tellier & Co., Inc.
in AZ

President, Employee Benefits #7618
Johnson Financial Group
in WI

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Webcasts and Conferences

Half-Day Seminar with Adam Pozek
November 12, 2013 in IN
(ASPPA Benefits Council Of Northern Indiana)

Internal Controls for Qualified Retirement Plans
November 14, 2013 WEBCAST
(Multnomah Group)

How the FSA Rollover Impacts Your Business
November 14, 2013 WEBCAST
(ConnectYourCare)

Quality Care: Getting More Bang for the Buck?
November 15, 2013 in DC
(Alliance for Health Reform)

Current Issues Impacting Qualified Retirement Plans
December 11, 2013 in OH
(ASPPA Benefits Council of Central Ohio)

Advanced Cash Balance Topics
December 17, 2013 WEBCAST
(American Society of Pension Professionals & Actuaries (ASPPA))

Just for ERPAs Workshop
February 4, 2014 in FL
(SunGard Relius)

Advanced Pension Conference
February 5, 2014 in FL
(SunGard Relius)

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]

Administration Issues Final Mental Health and Substance Use Disorder Parity Rule
"The Departments of Labor, Health and Human Services and the Treasury today jointly issued a final rule increasing parity between mental health/substance use disorder benefits and medical/surgical benefits in group and individual health plans. The final rule issued today implements the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act, and ensures that health plan features like copays, deductibles and visits limits are generally not more restrictive for mental health/substance abuse disorders benefits than they are for medical/surgical benefits." (U.S. Department of Labor)  


[Advert.]

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[Official Guidance]

Text of ACA FAQs (Set 17): Implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as Amended by the ACA
"When are the final rules effective for group coverage? ... When do the final rules apply to individual health insurance coverage?... What new protections do the final rules provide for individuals?... What are the Departments doing to promote compliance?... Do the final rules address multiple provider network tiers?... Are there plans that are exempt from MHPAEA?... For a plan or issuer claiming the increased cost exemption, where should the plan or issuer send its notice to the Departments?" (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

[Official Guidance]

Text of Final Regs Under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA)
[206 pages.] "The mental health parity provisions of these final regulations apply to group health plans and health insurance issuers for plan years (or, in the individual market, policy years) beginning on or after July 1, 2014. Until the final rules become applicable, plans and issuers must continue to comply with the mental health parity provisions of the interim final regulations.... In general, these final regulations incorporate clarifications issued by the Departments through FAQs since the issuance of the interim final regulations, and provide new clarifications on issues such as NQTLs and the increased cost exemption. The HHS final regulation also implements the provisions of MHPAEA for the individual health insurance market." (U.S. Department of Labor, U.S. Department of Health and Human Services, and Internal Revenue Service)  

[Guidance Overview]

Consistency of Large Employer and Group Health Plan Benefits with Requirements of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008
"Although we document substantial changes since the enactment of MHPAEA, a substantial minority of large employers and health plans still offer some benefits that appear to be inconsistent with MHPAEA and the IFR. Data from 2011 suggests that one out of five large employers required higher copays for in-network outpatient MH/SUD services than for equivalent medical/surgical treatments. Coinsurance rates were still higher for in-network outpatient MH/SUD services than for medical/surgical services in 4% of large employers' plans." (Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services)  

[Guidance Overview]

Health FSA $500 Carryover May Increase Employee Participation
"The carryover feature may provide assurance to employees who have up to now been hesitant to participate in your health FSA. With the addition of a carryover feature, a $500 health FSA is practically a no-lose election for an employee. Of course, the flip side of the reduction of employee forfeiture of health FSA balances is that, if you have been relying on employee forfeitures to offset the cost of FSA administration, your expenses for FSA administration will increase." (Vorys)  

[Guidance Overview]

Plan Design Implications of the IRS Changes to FSA Rules (PDF)
"Another concern with adopting the carryover rule retroactively, for 2013 or 2014, is the IRS's statement in the Notice that 'The ability to eliminate a grace period provision previously adopted for the plan year in which the amendment is adopted may be subject to "non-Code legal constraints"'.... Participants might claim what amounts to a right under the plan to have the grace period for 2013, rather than having that replaced with a $500 carryover.... This suggests what amounts to a 'vested right' to the welfare benefit of the grace period. Whether or not such a right exists will depend largely on the content of existing plan documents and communications to participants." (Stevenson Keppelman Associates)  

[Guidance Overview]

Healthcare Flexible Savings Accounts: 'Use-It-or-Lose-It' Rule Modified
"The employer should consider the impact of a potential reduction in the amount of unused contributions previously being forfeited back to the company as a result of the 'use-it-or-lose-it' rule, and weigh the benefits of each option on its employees. Similarly, if the employer does not currently allow a grace period, but is thinking about providing its employees with the new carryover option, the employer should consider the potential administrative and loss of forfeiture costs, as well as the potential benefit to its employees, of providing this new option." (McDonald Hopkins LLC)  

Substantial Improvements to Mental Health and Substance Use Disorder Coverage in Response to the Mental Health Parity and Addiction Equity Act of 2008 Research Brief
"[L]arge employer-based plans made substantial changes to their benefit designs in response to enactment of the Wellstone-Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 and issuance of the interim final rule (IFR). Most plans removed most financial requirements that did not meet the requirements of the federal parity statute and its implementing the IFR. In addition, the number of plans that applied unequal inpatient day limits, outpatient visit limits or other quantitative treatment limits for mental health or substance use disorder (MH/SUD) coverage had dropped significantly by 2011. Differences in cost-sharing for prescription medications and emergency care also declined, and by 2011 practically all large employer-based plans studied appeared to comply with MHPAEA for those benefits." (Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services)  

Why Employers Need to Pay Attention to ACA's Insurance Exchanges
"Employers do need to pay attention to the exchanges that have launched in their states -- either by the state or the federal government -- because even if their employees don't use them, the functioning of the exchanges depends pretty heavily on some critical interactions among exchanges, employers, and their employees.... [E]mployers are starting to realize that they really do need a communications strategy for how to tackle exchange education with their employees. Simply mailing the required notification form to all employees and calling it a day won't cut it." (Employee Benefit News)  

How Obamacare Will Change Employer-Provided Insurance
"The administration's argument for the individual market applies to the employer-based market: No one with health insurance should expect to keep their current plan forever.... 'The clear expectation was and is that the "Cadillac tax" ... will cause those [employers offering] highly generous plans to pare back benefits somewhat ...' [said] Paul Van de Water, a senior fellow at the Center on Budget and Policy Priorities ... 'It's not going to affect a large number of people to begin with, but it is significant in the longer run in terms of its potential to hold down health care costs.'" (CBS MoneyWatch)  

Eleventh Circuit Finds Plan Assignment of Rights Insufficient to Enable Providers to Assert Claims of Fiduciary Breach (PDF)
"The plaintiffs' contention stretches beyond its breaking point the plain meaning of the agreement, which assigns only the right to receive benefits and not the right to assert claims for breach of fiduciary duty or civil penalties. Because the agreements do not support the plaintiffs' position, they lack standing to bring claims under [ERISA Sections] 502(a)(3) and 502(c)." (U.S. Court of Appeals for the Eleventh Circuit)  

En Banc Seventh Circuit Finds Breach of Fiduciary Duty When Inaccurate Information Provided in Response to Participant Inquiry
"ERISA does not require a fiduciary to set out on a quest to uncover some kind of harm that might befall a beneficiary. But this case requires no such expedition. It simply requires an application of the rule, articulated in Kenseth, that an insurance company cannot defeat a breach of fiduciary duty claim by asserting that it was unaware that an insured was seeking certain material plan information when the insured called two different numbers that the insurance company itself established to provide the sort of information in question. This is particularly true when the representatives tell an insured to 'go ahead with whatever ha[s] to be done' while knowing (or at least having reason to know) that the insured is confused about this aspect of his plan and is about to undergo a costly procedure that will not be fully covered." [Killian v. Concert Health Plan, No. 11-1112 (7th Cir. Nov. 7, 2013)] (U.S. Court of Appeals for the Seventh Circuit)  

Apologizing, Obama Yields to Criticism of Health Law
"Senator Mary L. Landrieu, Democrat of Louisiana, introduced legislation this week to force insurance companies to reissue the health plans they have been canceling by the thousands. And officials in several states have sought assurances from insurance companies that people will not be dropped until the federal health insurance website is working. The president did not endorse those specific efforts and did not elaborate on how he intended to help people who were faced with paying higher premiums for a new insurance plan." (The New York Times; subscription may be required)  

Obama's Former Exchange Czar Defends the Insurance Cancellations
"[It] still remains true that if an insurer did not change a plan since the law passed in March 2010, it can stay.... [But] it's a good thing that they are changing these policies. That's the nature of improvement, where the insurance industry learns more about what subscribers like and don't like. So, yes, it's true they did not have to take their policy out of grandfathering, but it's a good thing that they are, not a bad thing." (Sarah Kliff in The Washington Post; subscription may be required)  

Uninsured Americans Are Ignoring Healthcare.gov -- for Now
"Only about one in five uninsured adults has attempted to log on to the embattled HealthCare.gov Web site, according to a new poll from Gallup.... On the plus side, the vast majority of those who plan to obtain insurance through the exchanges haven't been subject to the myriad problems on the Web site. On the minus side, it suggests traffic on the Web site is set to increase -- traffic that could further test the Web site's readiness -- as the deadline for obtaining insurance nears." (The Washington Post; subscription may be required)  

Could Daily Coffee Habit Cost More Than Health Insurance for Young Adults?
"A cup of coffee for around $3 a day doesn't seem like a big expense. And if you buy one every day for a month, you're spending about $90. That's still not a lot of money, but would you be surprised to learn that some young adults could get health insurance for less than that amount?" (Wolters Kluwer Health Reform Talk)  

AMA Analysis Lists States Where One Private Health Insurer Rules
"The 10 states with the least competitive commercial health insurance markets were: 1. Alabama, 2. Hawaii, 3. Michigan, 4. Delaware, 5. Alaska, 6. South Carolina, 7. North Dakota, 8. Nebraska, 9. Louisiana and 10. Rhode Island. Fifteen states had a single health insurer with a commercial market share of 50 percent or more. Forty-Five states had two health insurers with a combined commercial market share of 50 percent or more." (American Medical Association [AMA])  

Obamacare Sign-Up Concerns Congressional Staff
"'I think the federal government needs to seriously look at whether it is contributing to age discrimination (by forcing staff onto the exchange),' one women said. 'The monthly formula for older workers is a serious, serious hit,' she went on. 'In addition to what I'm paying now, it will be another $300 to $400 a month.'" (CNN)  

Can Adult Children with an Offer of Family Coverage Instead Get Subsidies?
"[If] a young person isn't claimed as a dependent on his parents' income tax, he wouldn't be considered part of the household. So if his own income is within those income guidelines, he may be eligible for subsidized coverage even if he has access to his parents' health insurance. The situation would be different, however, if his own job offers good health insurance coverage." (Kaiser Health News)  

Ten Republican Senators Formally Ask President Obama to Relieve HHS Secretary Sebelius of Her Duties
"There is bipartisan agreement that accountability is paramount.... [F]ormer White House Press Secretary Robert Gibbs said, 'When they get it fixed, I hope they fire some people that were in charge of making sure that this thing was supposed to work.' While assurances have been made that solutions are forthcoming, we have little confidence that immediate resolution is imminent. After spending more than $400 million on the failed website, taxpayers should not trust the same failed leadership to fix it." (Committee on Health, Education, Labor and Pensions, U.S. Senate)  

House Oversight Committee to Hold Hearing on Obamacare Implementation: The Rollout of Healthcare.gov
"The Committee will examine the operational challenges in the development of Healthcare.gov and the extent to which recognized Information Technology (IT) best practices were followed." The hearing will be held Wednesday, November 13. Witnesses to include: [1] Mr. Frank Baitman, Deputy Assistant Secretary for Information Technology, HHS; [2] Mr. Henry Chao, Deputy Chief Information Officer and Deputy Director of the Office of Information Services, CMS; [3] Mr. Todd Park, U.S. Chief Technology Officer Office of Science and Technology Policy, The White House; [4] Mr. Steve VanRoekel, U.S. Chief Information Officer and Administrator, Office of Electronic Government, OMB; and [5] Mr. David Powner, Director, Information Technology Management Issues, GAO. (Committee on Oversight and Government Reform, U.S. House of Representatives)  

A Proposal: Push Current March 31 Health Insurance Enrollment Deadline to April 15
"[Brian Haile, senior vice president for health policy at tax preparation firm Jackson Hewitt] says pushing the current March 31 deadline to April 15 would ensure more people have cash from tax refunds to buy insurance -- and would not really change the effective date of coverage beyond the current deadline. That's because there is a mid-month cutoff for coverage to begin on the first day of the following month. Policies for those who sign up at the end of March or on tax day would be the same: May 1." (Kaiser Health News)  

Shifting FSAs: The Impact on HSAs, and Fighting an ACA Change
"Only those in high-deductible health plans can elect to include a Health Savings Account as part of their insurance, so usually a participant won't have both an HSA and an FSA, unless the latter is directed at 'limited-scope benefits,' such as vision or dental. And originally, when the rules allowed for a two-and-a-half-month grace period on FSA expenses into the new year, that would preclude HSA contributions for that period. Could it now block them for an entire year if funds are carried over?" (Employee Benefit News)  

[Opinion]

Obama Shouldn't Apologize for Blowing Up the Terrible Individual Market
"Obama was wrong to promise that everyone who liked their insurance could keep it. For a small minority of Americans, that flatly isn't true. But the real sin would've been leaving the individual insurance market alone. The individual market -- which serves five percent of the population, and which is where the disruptions are happening -- is a horror show." (Ezra Klein and Evan Soltas in The Washington Post; subscription may be required)  

[Opinion]

The Hidden Side of Health Care Costs
"61% of workers report an increase in health care costs. But, the bigger story is that most of them say that this increase is affecting them in other ways." (Benefits and Compensation with John Lowell)  

Benefits in General; Executive Compensation

[Official Guidance]

Some Form 5500 Filers Get Notices of Late Filing Penalties Despite Having Filed Form 5558 Extension of Time to File
"Form 5500 filers that file their return before their extension Form 5558 has had a chance to post are receiving CP 283s assessing them a late filing penalty. Proposed changes to the penalty program would allow time for extensions to post before penalty notices are generated. However, until these changes can be implemented, tax examiners and telephone assistors should abate these penalties as Service Errors using the guidance [in this document]." (Internal Revenue Service)  

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