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November 12, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs


Webcasts and Conferences

New Use-or-Lose Rule for Health FSAs: Timing and Administration of Permitted Carryovers
November 11, 2013 WEBCAST
(Thomson Reuters / EBIA)

IRS and DOL Audit and Enforcement Update
November 14, 2013 WEBCAST
(ABA Joint Committee on Employee Benefits)

Reference Pricing: Will Price Caps Help Contain Healthcare Costs?
November 18, 2013 in DC
(Alliance for Health Reform)

Guaranteed Lifetime Income Solutions: Solutions for Providing Employee Retirement Income Security
November 20, 2013 WEBCAST
(Dietrich & Associates, Inc.)

Anatomy of a Correction Program
November 21, 2013 in CA
(Western Pension & Benefits Council - Orange County Chapter)

Preparing for the 2014 Proxy Season
November 21, 2013 WEBCAST
(Winston & Strawn)

Health Care Reform for Employers: Now What? - Reno
December 10, 2013 in NV
(Lorman Education Services)

Voluntary Fiduciary Correction Program And Abandoned Plan Program Workshop
December 12, 2013 in IN
(Employee Benefits Security Administration (EBSA), U.S. Department of Labor)

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 Mental Health Parity Rules Clarify Plan Disclosure Requirements
"[T]he final regulations (consistent with earlier FAQs) exempt group health plans and insurance coverage of employers with 50 or fewer employees from the MHPAEA. For non-federal governmental plans, the exemption generally applies for plans and coverage sponsored by employers having 100 or fewer employees. However, under HHS final regulations addressing essential health benefits (EHBs)... all insured, non-grandfathered small group plans must cover EHBs in compliance with the MHPAEA regulations, regardless of the MHPAEA's small employer exemption[.]" (Practical Law Company)  


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[Guidance Overview]

ACA Review: Timeline of Effective Dates
"Even though the Employer Shared Responsibility mandate ... has been delayed until January 1, 2015, other provisions of the [ACA] are still in effect.... The delay is an opportunity to properly prepare for the requirements in 2015. Employers should use these additional twelve months to determine whether the Play or Pay mandate will apply to them (Counting Period for Play or Pay) and which employees will be affected (Measurement Period for Play or Pay). In an effort to prepare for ACA Requirements in 2014 and 2015, [this article sets out] a summary of provisions that have been delayed and those that remain in effect." (William Gallagher Associates)  

[Guidance Overview]

Delay in Employer Mandate Offers Only Temporary Relief
"[C]ertain employers who wish to avoid penalties assessed in 2015 by using a safe harbor method to calculate their number of full-time employees may need to track the average hours worked by certain employees for a one year period beginning as of October 2013. Employers should also be closely monitoring the Proposed Rules to determine the mechanics of reporting as soon as possible so that they can put appropriate information systems in place." (Wolff & Samson)  

Insurers Press for Way Around Healthcare.gov
"[I]nsurers said a bypass giving them direct access to the federal platform that determines a consumer's eligibility for a subsidy would ... provide more breathing room to fix complicated technical problems that threaten to persist beyond a crucial, self-imposed Dec. 1 deadline. But ... federal officials are concerned about protecting personal data, such as confidential financial and tax information and immigration status. The security and privacy issues are likely to overshadow any possible compromise ... A more likely solution is for consumers to be able to work directly with an insurer to estimate their qualifications for a subsidy, leaving federal verification to a later date[.]" (The New York Times; subscription may be required)  

The Obamacare Trick Early Retirees Should Know
"If a household income exceeds 400 percent of the federal poverty level by even one dollar the subsidy is lost.... For those just over the 400 percent threshold, MAGI holds some interesting options. For example, anyone who has opened a CD may be able to close it early, incur the early withdrawal penalty and thereby bring household income under the threshold. Similarly, those with some level of income may reduce household income by increasing retirement contributions. Those fully retired may consider taking a retirement distribution this year instead of waiting until 2014." (U.S.News & World Report)  

November 30: D-Day for Health Insurance Exchanges
"Why Nov. 30? That's the self-imposed deadline set by Obama officials for having HealthCare.gov functioning 'smoothly' for the vast majority of users. But it's not an arbitrary date, a neat spot on the calendar that rolls off the tongue in speeches and media reports. Nor is it a reasonable amount of time to correct what we now know are widespread problems embedded in the site's core program, not mere technical glitches in need of a reboot. In fact, Nov. 30 holds important and long-term implications for consumers, payers and providers." (HealthLeaders InterStudy)  

Who Counts as an Obamacare Enrollee? Administration Settles on a Definition.
"Health insurance plans only count subscribers as enrolled in a health plan once they've submitted a payment. That is when the carrier sends out a member card and begins paying doctor bills. When the Obama administration releases health law enrollment figures later this week, though, it will use a more expansive definition. It will count people who have purchased a plan as well as those who have a plan sitting in their online shopping cart but have not yet paid." (The Washington Post; subscription may be required)  

Healthcare.gov Enrollment Falls Far Short of Target
"In some cases, insurers have reported receiving duplicate enrollment forms and other data-integrity problems, but the people familiar with the matter said they believed the 40,000 to 50,000 figure reflected an accurate count of enrollments through late last week. The number reflects enrollment data sent to insurers from the marketplace. The figure doesn't include people in the 36 states who used the federal website to learn if they qualified for Medicaid ... The federal website cannot yet transfer information to the states about people who discover on HealthCare.gov that they are Medicaid-eligible." (The Wall Street Journal; subscription may be required)  

The Truth About Navigators
"'You lie because your premiums will be higher,' one navigator advises an investigator for O'Keefe's Project Veritas, who tells the worker he sometimes smokes. 'Don't tell them that. Don't tell 'em.' The investigator then poses as a low-income worker at a university who has unreported cash income on the side, worrying about how that might affect his premium subsidies. That's no problem for a navigator, who says, 'Don't get yourself in trouble by declaring it now.'" (National Review)  

ML Strategies Health Care Reform Update, November 11, 2013 (PDF)
Update on developments in federal and state health care reform legislation and regulations, including summaries of recent announcements and regulatory activity by HHS, CCIIO, IRS and CMS. (ML Strategies, LLC)  

Washington State to 8,000 Obamacare Enrollees: 'We Goofed on Cost Estimate'
"About 8,000 Washington residents will soon receive letters informing them that the price they are expecting to pay for health insurance purchased on the new online exchange marketplace is incorrect. The letters are part of an effort ... to correct a major error that resulted in the miscalculation of tax credits that help qualified enrollees pay for insurance premiums. The exchange identified the root cause of the miscalculation in late October -- by the third week of open enrollment on the exchange website[.]" (Kaiser Health News)  

State-Run Obamacare Exchanges Report 49,100 Enrollees
"About 49,100 people have enrolled in Obamacare plans through 12 state-run insurance exchanges ... Enrollment through Nov. 10 represents 3 percent of the 1.4 million people projected to sign up in those states by the end of 2014 ... The data don't include California, the most populous U.S. state, Massachusetts or Oregon. It also doesn't account for those enrolled through the federal website serving 36 states." (Bloomberg)  

[Opinion]

Do We Really Want Mental Health Parity?
"One way to keep insurance costs down is through incentives. Patients should pay more of their bill when they exercise discretion and especially where patient discretion is appropriate. In mental health, this principle applies in spades because: [1] the illness is often experienced subjectively, [2] there are often no objective standards for diagnosis or treatment, [3] doctors often exercise enormous discretion, [4] patients also exercise a lot of discretion and [5] patient cooperation is often crucial to any cure." (John Goodman's Health Policy Blog)  

[Opinion]

Mental Health Parity and the Affordable Care Act
"There is an alternative explanation for the lack of parity, one rooted in the dismal science. Basic economic theory offers a story that is less depressing, but perhaps more complicated, than the popular rhetoric. In this story, insurers are trying to do what is best for their entire enrolled population, saving money only when it makes sense to do so." (The Health Care Blog)  

[Opinion]

Obamacare Insurance Exchanges and the Lack of Competition
"In the vast majority of states, the number of insurers competing in the state's exchange is actually less than the number of carriers that previously sold individual market policies in the state.... [In] over half of the 3,135 counties in the U.S., consumers will face an exchange market that is either a duopoly or monopoly. In 78 percent of U.S. counties, exchange enrollees will have a choice of coverage from three or fewer carriers. The exchange market in over 94 percent of U.S. counties will feature competition among five or fewer companies. In Alabama, about 96 percent of that state's counties will have only one insurer offering coverage in the exchange." (The Heritage Foundation)  

[Opinion]

Deloitte Health Care Current: November 12, 2013
"The [ACA] has served as a catalyst to accelerate the consolidation movement [in the U.S. health care industry] ... Several trends are beginning to emerge ... [1] As reimbursement rates continue their downward trend and the costs of maintaining infrastructure and regulatory compliance march ever higher, the acute care industry seeks scale to better manage costs.... [2] The stand-alone hospital may be an endangered species ... [3] Health plans, which also continue to consolidate, are dipping their toes into the provider business through the acquisition of medical groups." (Deloitte Center for Health Solutions)  

[Opinion]

Understanding the Death Spiral in the Obamacare Exchanges
"After one month, there are signs that insurers got their pricing significantly wrong. Because it is so hard to enroll in the ObamaCare exchanges, only the most persistent (that is, those who expect the highest medical claims) are wasting hours navigating the website to sign up.... It certainly looks like health insurers' ObamaCare exchange adventure will be very expensive. By 2015, they will likely be asking the federal government for a bail out." (John R. Graham in John Goodman's Health Policy Blog)  

Benefits in General; Executive Compensation

Social Security and Medicare Taxes and Benefits Over a Lifetime: 2013 Update
"These tables update to 2013 previous estimates of the lifetime value of Social Security and Medicare benefits and taxes for typical workers in different generations at various earning levels based on new estimates of the Social Security Actuary.... All amounts are presented in constant 2013 dollars." (Urban Institute)  

Text of Sixth Circuit Ruling That Remand Alone Is Not Sufficient to Support Award of Attorney's Fees (PDF)
"To conclude that the degree-of-culpability factor always favors an award of attorney fees when a case is remanded to address an inadequate review of the record would essentially equate the first King factor with a litigant's degree of success on the merits. The law of this circuit makes clear that these are separate inquiries.... Geiger urges a result that would essentially require a presumption in favor of attorney's fees to the party that achieves some success. This Circuit has explicitly rejected that position[.]" [Geiger v. Pfizer, No. 13-3519 (6th Cir. Nov. 5, 2013)] (U.S. Court of Appeals for the Sixth Circuit)  

Identifying an ERISA Plan Made Simple Again
"[The Puerto Rico federal] District Court found that because there was nothing discretionary about the timing, amount, or form of the benefit payments, Pfizer's severance program did not 'rise to the level of an ongoing administrative scheme.'" [Aguirre-Santos v. Pfizer Pharm., LLC, CIV. 12-1393 JAF, (D.P.R. Oct. 21, 2013)] (Verrill Dana LLP)  

Annual Reminder: Do You Need to Seek Shareholder Approval of your Stock Incentive Plan in 2014?
"[U]nder Code Section 162(m), if the Compensation Committee has the authority to change performance goal targets under the Corporation's stock incentive plan from year to year after shareholder approval of the goals, then the material terms of the performance goal must be disclosed to and reapproved by shareholders every five years.... ESPPs do not need to be reapproved by shareholders every five years for Code Section 162(m) purposes, but they can run out of authorized and registered shares." (Winston & Strawn LLP)  

Equity Compensation Plan Participants Value Education
"Eighty-nine percent of those surveyed feel it is important that an employer provide education and guidance about how a stock plan works, according to [a recent] poll ... Only 50% feel their employer has done an excellent or very good job of providing such education and guidance. While 59% of respondents describe their stock plan as a key part of their compensation package, 82% believe having a stock plan is a sound business strategy for employers." (PLANADVISER.com)  

Press Releases

FINRA Releases Enhanced Version of BrokerCheck
Financial Industry Regulatory Authority (FINRA)

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