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November 11, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Client Service Representative
Associated Pension Consultants
in CA

Pension Administrator
Metro Benefits, Inc.
in PA

Pension Administrator
Metro Benefits, Inc.
in WV

Retirement Plan Consultant
Retirement Solution Group
in IL

Project Manager (SAS)
in TX

Defined Benefit - Client Service Analyst
in TX

Project Manager (CST)
in TX

Defined Benefit - Data Analyst
in TX

Defined Benefit - Client Service Manager
in TX

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Webcasts and Conferences

Affordable Care Act 101
December 5, 2013 WEBCAST
(U.S. Small Business Administration (SBA))

Welfare Wraps - Why and How to Wrap ERISA Welfare Plans
December 5, 2013 WEBCAST

EBIA’s 16th Annual Advanced Benefits Conference 2014
July 15, 2014 in WA
(Thomson Reuters / EBIA)

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]

California's 60-Day Eligibility Waiting Period Applicable to All Group Health Plans (PDF)
"While the [ACA] prohibits group health plans from imposing a waiting period that exceeds 90 days, a California law prohibits waiting periods of more than 60 days.... Plan sponsors should work with their California group policy issuers to ensure compliance for policies beginning on or after January 1, 2014... While neither DMHC nor the California Department of Insurance has explicitly acknowledged through formal guidance that the 60-day limit applies to large group plans, the insurance industry and other stakeholders appear to accept this position.... [T]his law does not apply to self-funded plans." (Buck Consultants)  


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[Guidance Overview]

Mental Health Parity Rules Remove 'Appropriate' Exemption
"Changes that DOL, HHS and Treasury made in the final rules include: ensuring that parity applies to intermediate levels of care received in residential treatment or intensive outpatient settings; clarifying the scope of the transparency required by health plans, including the disclosure rights of plan participants; clarifying that parity applies to all plan standards, including geographic limits, facility-type limits and network adequacy; and eliminating the 'clinically appropriate' exemption for differences in nonquantitative treatment limitations." (Thompson SmartHR Manager)  

[Guidance Overview]

HHS, Labor and Treasury Departments Release Final Mental Health Parity Rules
"The finalization of these rules is more significant because of the new federal 'essential' benefit mandate for mental health and substance abuse coverage in the [ACA].... The rules require health plans to cover the treatment of mental illness or drug or alcohol abuse at the same level (co-payments, deductibles and limits on visits to health care providers cannot be more restrictive or less generous) as they cover other health care treatment, although it does not mandate mental health benefits. States may choose to mandate specific mental health benefits, and MHPAEA requires that such benefits must be in parity with medical/surgical benefits in the same policy. The rules state that the general parity requirement applies separately for each type of financial requirement (deductibles, co-payments, co-insurance and out-of-pocket maximums) or treatment limit." (Faegre Baker Daniels LLP)  

[Guidance Overview]

Aspects of Healthcare Reform: The Individual Market; Mental Health and Substance Abuse Parity
"[It] seems that insurers have set their rates based on projections that the 2014 risk pool is going to be pretty expensive, and that state regulators have allowed them to do so.... [T]he proposed solutions may simply make matters worse... The basic rule is that where plans or issuers offer mental health or substance use disorder benefits in one of six classifications, they cannot impose financial requirements or quantitative treatment limitations on those benefits that are more restrictive than the predominant requirements or limitations that apply to substantially all medical surgical benefits in the same classification.... Plans or issuers are required to perform the parity analysis annually in years when a change in benefit design, cost-sharing structure, or utilization affects the analysis within a classification." (Timothy Jost in Health Affairs Blog)  

Health Care Reform in the United States: Implications for Multinational Organizations [Video]
Archive of slides and audio presented on November 6, 2013. (Towers Watson)  

Text of Seventh Circuit Opinion Finding ACA Contraceptive Mandate Violates Religious Rights of Closely-Held Corporations (PDF)
[154 pages.] "Compelling a person to do an act his religion forbids, or punishing him for an act his religion requires, are paradigmatic religious-liberty injuries ... A corporation is just a special form of organizational association. No one doubts that organizational associations can engage in religious practice. The government accepts that some corporations -- religious nonprofits -- have religious-exercise rights under both RFRA and the Free-Exercise Clause. As evidence of this, the contraception mandate exempts a class of religious organizations -- i.e., churches and their integrated auxiliaries ... whether or not they conduct their activities in the corporate form.... [We] take it as both conceded and noncontroversial that the use of the corporate form and the associated legal attributes of that status -- think separate legal personhood, limitations on owners' liability, special tax treatment -- do not disable an organization from engaging in the exercise of religion within the meaning of RFRA (or the Free Exercise Clause, for that matter).... If Congress intended a nonprofit limitation in RFRA, surely there would be some hint of it in the statutory text." [Korte et al. v. Sebelius, No.12-3841, consolidated with Grote v. Sebelius, No. 13-1077 (7th Cir. Nov. 8, 2013)] (U.S. Court of Appeals for the Seventh Circuit)  

IRS Guidance Permits Carryover of Up to $500 of Unused Health FSA Balances (PDF)
"[The authors have] discussed informally whether an employer may amend its cafeteria plan to provide that amounts remaining in participants' FSAs who want to participate in the employer's HSA program the next year may be carried over to a limited-purpose or post-deductible FSA. The IRS staff agreed that the amount could be a carried over to an HSA-compatible FSA and reminded us that the FSA plan could provide that a participant who wanted to be eligible for an HSA in the following year could also opt out of the carryover." (Groom Law Group)  

Exchange Health Plans Subject to Anti-Kickback Laws?
"The only thing for certain in the past several days is that stakeholders, lawmakers, and industry analysts alike are still unclear as to whether QHPs are, indeed, not 'federal health care programs,' and what activities will be permissible that would otherwise have been illegal under the anti-kickback statute. It is also not widely settled that the Secretary of HHS necessarily has the power to decide what 'is' or 'is not' a federal health care program as defined, which means this issue could be decided by the courts." (Mintz Levin)  

Can Employers Create a Goldilocks Zone?
"As a result of elective deferrals not being accounted for in the rate of pay safe harbor there is an opportunity for an employer to offer affordable coverage under the rate of pay safe harbor that is in fact not affordable to the employee when determining eligibility for a premium tax credit. If the employer with the assistance of the employee can create this scenario, the employer will not be liable for the employee under section 4980H and the employee could be eligible for a premium tax credit. The goldilocks zone puts each party in a better position.... Using the rate of pay safe harbor to create a goldilocks zone will only be viable for single income salaried households." (Moulder Law)  

Determining State Income Tax Treatment of Same-Sex Couples Post-Windsor (PDF)
"Whether same-sex spouse benefits can be provided on a pre-tax basis will depend upon how each state defines income for income tax purposes. Unfortunately, many states have not addressed this issue and instead have simply issued guidance as to whether a same-sex married couple may file a joint state income tax return ... [which] does not provide a definitive answer to employers ... [It] may be reasonable for employers to assume that benefits cannot be provided on a pre-tax basis [for state tax law purposes] and leave it to the employee to sort out the ability to obtain an exclusion on his or her own state tax return." (Wilkins Finston Law Group)  

IRS Releases 2013 Version of Publication 521 on Moving Expenses
"Publication 521 provides an overview of some of the choices available to employers when designing moving expense benefits for employees, but its main purpose is to help individuals determine which of their moving expenses may qualify for a deduction and how to account for any employer reimbursements." (Thomson Reuters / EBIA)  

Estimates of the Potential Insurance Value of Disability Insurance for Individuals with Mental Health Impairments
"[E]ven after controlling for health and demographic characteristics, DI beneficiaries were substantially worse off than rejected applicants in terms of wealth and income. While these rejected applicants with mental illness were worse off than those with physical impairments, our findings suggests that the programs successfully select applicants with the greatest income needs, and that retrenchment could result in significant hardship." (University of Michigan Retirement Research Center)  

Con Men Prey on Confusion Over Health Care Act
"With millions of Americans frustrated and bewildered by the trouble-prone federal website for health insurance, con men and unscrupulous marketers are seizing their chance. State and federal authorities report a rising number of consumer complaints, ranging from deceptive sales practices to identity theft, linked to the Affordable Care Act." (The New York Times; subscription may be required)  

White House Relying More on Insurance Carriers to Help Fix Healthcare.gov
"The Obama administration's broader cooperation with insurers is a tacit acknowledgment that the federal insurance exchange ... might not be working smoothly by the target date of Nov. 30 ... The government has said for months that consumers would be able to go directly to insurance companies to buy the health plans offered on the exchange. But this was always imagined as a secondary route, along with call centers and in-person enrollment assistants. If insurers' sites became a main way to buy coverage, it would undermine the side-by-side comparison shopping ... that HealthCare.gov is meant to promote." (The Washington Post; subscription may be required)  


None Dare Call It ...
"For the past six years President Obama and the Democrats in Congress have waged a relentless attack on the health insurance industry. In the most recent iteration, the president assures us he is not responsible for the wave of health insurance policy cancellations. The insurance companies are. Okay, so where is the other side? When is the last time you saw an insurance industry executive interviewed on a TV talk show, presenting the industry's answer to all these attacks?" (John Goodman's Health Policy Blog)  

Benefits in General; Executive Compensation


Text of Comments by McGuireWoods to SEC on Proposed Pay Ratio Rules (PDF)
"Registrants should be allowed to identify the median employee by using statistical sampling based on a definition of compensation other than 'annual total compensation' under Item 402.... We recommend that the final rule follow the proposed rule by not including leased employees, independent contractors or other individuals who are not statutory employees of the registrant in the determination of the median employee.... We recommend that the final rule give companies the flexibility to choose a date other than the last day of the company's most recent completed fiscal year for identifying the company's employees for purposes of calculating the pay ratio." (McGuireWoods LLP)  

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