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December 3, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Director of Operations
IUPAT Industry Pension Fund
in MD

Pension Administrator
Al Minor & Associates, Inc.
in OH

Associate Attorney
Ferenczy + Paul LLP
in CA, GA

Pension Automation Specialist
Kravitz, Inc.
in ANY STATE

You are Catching Fire: DC Retirement Plan Consultant
A Consulting Third Party Administrator
in ANY STATE

ERISA Compliance Associate
MBM Advisors, Inc.
in TX

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Webcasts and Conferences

Ethics
December 5, 2013 WEBCAST
(National Institute of Pension Administrators)

End of the Year Tax Planning for Tax Advisors using 412(e)(3) Plans
December 5, 2013 WEBCAST
(National Pension Partners)

Defined Contribution Plan Overview
December 10, 2013 WEBCAST
(NH Hicks)

U.S. v. Windsor on DOMA: How Does It Affect FSAs, HRAs, and Other Employee Benefit Programs?
December 11, 2013 WEBCAST
(Employers Council on Flexible Compensation (ECFC))

Qualified Plan Essentials Plus Series
December 11, 2013 WEBCAST
(McKay Hochman Co., Inc.)

Form 1099-Rs - A Reality Check
December 17, 2013 WEBCAST
(National Institute of Pension Administrators)

Getting It Right Know Your Fiduciary Responsibilities
January 7, 2014 in NY
(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.
[Official Guidance]

CMS Process for Marketplace Payments to Insurers and Other Issuers, December 2, 2013 (PDF)
39 presentation slides. Excerpt: "CMS will be using a temporary payment process for payment of [advance payments of the premium tax credit (APTC) and cost sharing reduction (CSR)] in the initial months. We believe this is the best option to make timely payment to issuers. We are committed to ensuring that issuers receive timely payments on behalf of enrollees. CMS will reconcile these payments to confirmed enrollment data when available.... CMS will make estimated payments to issuers beginning in January 2014 based on data provided by submitters by the December deadline ... CMS developed an Enrollment and Payment Data Template [XLS] that should be submitted during testing and production." (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  


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[Guidance Overview]

CMS Announces Temporary System for Paying Insurers for Plans Purchased Through Healthcare.gov
"Insurers that participate in the federal or state exchanges, as well as state exchanges that pay insurers directly, will complete and submit to CMS an enrollment and payment template estimating advance premium tax credit and cost-sharing reduction payments due. The template will include insurer identification numbers, aggregate premium amounts, aggregate advance premium tax credit and cost-sharing reduction payments due, aggregate federal exchange user fees due (which will be offset against payments due the insurer), and aggregate enrollment group and enrollee counts. CMS will validate the data submitted by insurers for reasonableness. Once data are validated, Treasury will make payments to the insurers based on these reports using the Medicare payment system. Finally, CMS will send a payment report detailing plan-level payment amounts to insurers." (Timothy Jost in Health Affairs Blog)  

[Guidance Overview]

Many Annual Notice Requirements Apply to Employer Group Health Plans in 2014
Checklist and discussion of health plan notice requirements, including those under: Women's Health and Cancer Rights Act (WHCRA); Medicare Part D Notice of Creditable or Non-Creditable Coverage; HIPAA Notice of Privacy Practices; Children's Health Insurance Program Reauthorization Act (CHIPRA); Summary of Benefits and Coverage; and Notice Regarding Grandfathered Plan Status. (Miller Johnson)  

[Guidance Overview]

Health and Welfare Plan Sponsors Have Long Year-End 'To Do' List for 2013
Extensive checklist covering ACA-required plan changes, as well as ongoing administrative issues, with discussion and issues to consider for each. Items include: [1] Review health plan grandfathered status; [2] Comply with no annual limit for Essential Health Benefits; [3] Comply with prohibition on waiting periods in excess of 90 days; [4] Limit cost-sharing (out-of-pocket maximums) in non-grandfathered health plans; more. (Snell & Wilmer L.L.P.)  

[Guidance Overview]

Final Regs Issued on Mental Health Parity and Addiction Equity Act of 2008
"Employers should review their provisions in their plans to confirm that there is parity between mental health/substance use disorder benefits and medical/surgical benefits in the six benefits classifications and permissible subclassifications. In particular, if the employer relied on the exception for clinically appropriate standards of care, which has been eliminated, the employer should revisit the variation in benefits and determine whether it is permissible under the final regulations. If an employer contracts with a managed behavioral health organization (MBHO) to provide mental health/substance use disorder benefits, the employer should ensure that it provides the information necessary to the MBHO to ensure compliance with the parity requirements of the MHPAEA. The preamble to the final regulations notes that it is the responsibility of the plan and the issuer to ensure compliance and that the use of an MBHO does not relieve the plan or issuer from their obligations under the MHPAEA." (Proskauer Rose LLP)  


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Insurers Are Offered Assistance for Losses
"In a notice published on [December 2] in the Federal Register [see HHS Benefit and Payment Parameters for 2015], the administration acknowledged that insurers had a valid concern: They may be stuck with sicker, higher-cost customers in the new insurance exchanges because healthier Americans will stay on their existing health plans for another year.... If they do not enroll in the new health plans, the administration said, the average cost of claims for people in those plans may be higher than expected, and this increase in costs could lead to unexpected financial losses for insurance companies. To reduce this risk, the administration said it could provide financial assistance to certain insurers through a program under which the government will share in their losses and profits for the next three years." (The New York Times; subscription may be required)  

CMS Says Main Source of '834' Errors on Healthcare.gov Has Been Fixed
"Medicare spokeswoman Julie Bataille ... announced Monday that about 80 percent of those errors stemmed from 'one bug that prevented a Social Security number from being included. That caused the system not to generate an 834.' 'That bug has now been fixed and [that part] is now working properly,' Bataille said, adding that [CMS] has also addressed smaller bugs, including one that caused family relationships to be coded inaccurately (a child, for example, might show up as a spouse.)." (The Washington Post; subscription may be required)  

Four Details Employers Should Know About FSA Carryover Rules
"The carryover essentially cancels out the 'grace period.' ... The FSA carryover must be offered on a plan-wide basis.... The timing could cause administrative headaches.... Plan docs must be amended." (HR Benefits Alert)  

Plan Sponsors Wise to Keep an Eye on Health Plan Nondiscrimination Rules
"PPACA extends non-discrimination rules similar to those in Code Section 105(h) to non-grandfathered, fully-insured health plans. While Code Section 105(h) ... simply strips highly compensated employees of the tax-favored treatment derived from their receipt of discriminatory benefits, the new PPACA non-discrimination rule will carry with it much stiffer penalties. Under the PPACA rule, a plan sponsor may be subject to an excise tax of $100 per day for each non-highly compensated employee who is not eligible for the discriminatory benefit, up to a maximum penalty of $500,000. The good news is that plans are not required to comply with these non-discrimination rules until further guidance is issued." (Winston & Strawn LLP)  

2014 Federal Insurance Exchange: Evaluation of Insurer Participation and Consumer Choice (PDF)
18 pages. Excerpt: "2014 exchange participation is strongly correlated with 2012 market share for both the individual and SHOP exchanges.... 22% and 14% of exchange insurers are new to the individual and SHOP exchanges, respectively... The median number of insurers available to consumers in the individual and SHOP exchanges across all states is estimated at three and two, respectively... The average number of qualified health plans (QHPs) offered in the federally facilitated exchanges is approximately 48 in the individual market, but is only 24 in the SHOP exchanges... Silver QHPs are most common, while few insurers offer platinum QHPs in both the individual and SHOP exchanges." (Milliman)  

California's Small Business Insurance SHOP Opens: A Contrast to Feds
"On the Covered California website, firms [with under 50 employees] can compare health insurance plans and choose what to offer to employees. Their workers can then select from among different plans.... Many companies will be able to receive a tax credit, meaning the federal government will help cover their portion of the employee premiums. To be eligible for tax credits, businesses must have fewer than 25 full-time employees, pay employees less than $50,000 a year and cover at least half of the full-time employees' premiums." (Kaiser Health News)  

Would You Move for Better Health Insurance?
"More than 1 in 4 Americans would vote with their feet and relocate to another county or state to obtain better or cheaper health coverage ... Health insurance would be a reason for 28 percent to move, with 9 percent saying it would be a major reason and 19 percent identifying it as a minor reason. Interest was even keener among the young and those with lower incomes." (Bankrate)  

Is Health Care Spending Finally Falling?
"What all these initiatives have in common is the idea that health-care providers are going to be paid based on the value they deliver, rather than on the services they perform. We're in the early stages of that process: ... fee-for-service likely still accounts for more than ninety per cent of health-care spending." (The New Yorker)  

As Hospital Prices Soar, Charges for a Single Stitch Tops $500
"A day spent as an inpatient at an American hospital costs on average more than $4,000, five times the charge in many other developed countries ... The most expensive hospitals charge more than $12,500 a day. And at many of them ... emergency rooms are profit centers. That is why one of the simplest and oldest medical procedures -- closing a wound with a needle and thread -- typically leads to bills of at least $1,500 and often much more." (The New York Times; subscription may be required)  

House Committee Chairman Presses Insurance Companies on Administration's Promise that Americans Can Keep Their Doctors
"House Oversight and Government Reform Committee Chairman Darrell Issa sent letters to 15 top insurance companies requesting documents about information related to President Obama's assertion that 'if you like your doctor, you will be able to keep your doctor.' Documents requested include those related to the reevaluation of provider networks and payment rates, as well as communications with the Administration about potential changes to health plans limiting or changing health care access." (Committee on Oversight and Government Reform, U.S. House of Representatives)  

[Opinion]

The December 1 Obamacare Relaunch: Nobody Can Spin the Main Event
"Maybe the best news for HealthCare.gov is that you can finally look at actual plans and prices for your age and family in your community without having to open an account and sign-in. Finally, people can easily see for themselves just what kind of plan is available for them and at what pre-subsidy cost. They can also access a chart telling them if they are eligible for a subsidy or reduced cost sharing but not calculate it for themselves." (Bob Laszewski's Health Care Policy and Marketplace Review)  

Benefits in General; Executive Compensation

Certain Benefit Plan Changes Best Addressed Prospectively
"Perhaps the most significant change to address prospectively is the acquisition or sale of an entity or its assets. This can be a PBGC reportable event and may require fully funding a pension plan. It can be a COBRA event that affects group health coverage. Also, it can impact retirement plan nondiscrimination testing, design and reporting. If seller and buyer don't plan for the transition prospectively, it can adversely affect either or both of their plans." (Warner Norcross & Judd LLP)  

Attention Nasdaq Listed Companies: Compensation Committee Certification Required
"[An] executive compensation-related requirement for 2014 that has flown under the radar screens of many companies is that listed companies must file with Nasdaq a required form of Compensation Committee Certification.... Note, that even if company is exempt from the key independence requirements as a 'Smaller Reporting Company' or 'Foreign Private Issuer,' it must file the certification form to indicate that it is exempt." (Winston & Strawn LLP)  

CEO Pay Ratio Disclosure: Eight Things Human Resource Professionals Need to Know Now
"[1] CEO pay ratios may be surprisingly large.... [2] Companies face significant data collection challenges.... [3] There is flexibility in calculating the median employee compensation.... [4] Employees may have more access to pay information.... [5] Global employers must address data privacy concerns.... [6]  The calculation of the CEO pay ratio could have the unintended consequence of workforce manipulation.... [7] Business disruption.... [8] Uncertain Future." (Littler)  

The Great Pay Ratio Debate
"Dissenting comments from two of the SEC's five commissioners make plain the agency's ambivalence about moving forward with a rule that has drawn growing criticism for what many perceive as a departure from the agency's investor protection mandate.... Some of the commission's queasiness about the adverse impact the rule could have on competition is based on the 'potentially significant' costs it would entail for the 4,000-odd companies that it covers.... Any notion that pay ratio disclosure might compensate for benchmarking is further undermined by the fact that it would only apply to public companies' CEOs." (Corporate Secretary)  

[Opinion]

Text of Comments from Hay Group to SEC on Proposed Pay Ratio Rules (PDF)
"[T]he Commission should give further consideration to the substantial economic costs and burdens that compliance with the proposed rule will impose on small businesses (in relation to their size) and weigh these against the unknown and unsupported benefits that compliance might provide.... [T]he usefulness of disclosure would be improved and the burden on employers would be lessened by the exclusion of part-time and seasonal workers from the pay ratio calculations .... If the Commission nevertheless determines that part-time and seasonal workers should be included, the Commission should take the logical step of permitting companies to annualize the compensation of such workers." (U.S. Securities and Exchange Commission)  

Press Releases

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