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December 11, 2013          Get Retirement News  |  Advertise
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Webcasts and Conferences

Power Up Your Practice - Rockville, MD
January 9, 2014 in MD
(Rekon Event Management)

6th Annual Leadership Summit on Consumer Engagement through Health Plan Innovation
March 25, 2014 in FL
(World Congress)

2014 Regional Conference: Philadelphia
May 1, 2014 in PA
(American Society of Pension Professionals & Actuaries (ASPPA))

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

Text of CMS ANPRM on Civil Money Penalties Under the Medicare, Medicaid, and SCHIP Extension Act of 2007
"This advance notice of proposed rulemaking (ANPRM) solicits public comment on specific practices for which civil money penalties (CMPs) may or may not be imposed for failure to comply with Medicare Secondary Payer reporting requirements for certain group health and non-group health plans arrangements.... We are interested in comments and proposals to specifically define 'noncompliance' in the context of the phrase, 'for each day of noncompliance with respect to each claimant' in sections 1862(b)(7) or (b)(8) of the Act. We are seeking public comment and proposals on mechanisms and criteria that we would employ to evaluate whether and when the agency would impose CMPs. In addition, we are we are soliciting comments and proposals for methods to determine the dollar amount of a CMP that would be levied for each day that NGHP is a responsible reporting entity noncompliance under section 1862(b)(8) of the Act. We are also soliciting comments on how we might devise a method(s) and criteria to determine which actions would constitute 'good faith effort(s)' taken by an entity to identify a Medicare beneficiary for the purposes of reporting under section 1862(b)(8) of the Act. We are specifically soliciting comments and proposals from insurers, third party administrators for GHPs, other applicable plans, and the public." (Centers for Medicare & Medicaid Services, U.S.Department of Health and Human Services)  


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[Guidance Overview]

Final Wellness Regs Create New Program Categories and Complications (PDF)
"The regulations retain the existing distinction between participatory and health-contingent wellness programs, but clarify that many wellness programs have been incorrectly classified as participatory. The regulations also split health-contingent wellness programs into two subcategories subject to new requirements. While reviewing programs for consistency with these regulations, plans must simultaneously track Equal Employment Opportunity Commission (EEOC) and state regulatory efforts." (Pillsbury Winthrop Shaw Pittman LLP)  

The ACA End Game: What if an Employer Neither Pays Nor Plays?
"Inevitably there will be employers who fail to comply with the ACA's Play or Pay Mandate through ignorance or even despite their best efforts.... What [is not clear] is the government's end game when this situation occurs.... When the proposed shared responsibility regulations were released there was strong support for a corrections program. However, there has been little discussion of any sort of program in the past six months." (Moulder Law)  

Planning for ERISA Health and Welfare Benefit Plan Operations in 2014 (PDF)
"Are my group health plans HIPAA-compliant? ... Am I ready if the DOL comes calling? ... How am I addressing the impact of the Windsor decision? ... Is my cafeteria plan document up-to-date? ... Have I made sure my plans are not discriminatory? ... Will my plans comply with the final mental health parity regulations? ... What should I be doing to get ready for 2015?" (Buck Consultants)  

2013 Form 5500 Expands Information Reporting Obligations for Welfare Plans
"Among other things, the instructions: [1] Address new reporting obligations regarding Form M-1 compliance that apply to all welfare plans. [2] Reflect expanded reporting requirements for multiple employer welfare arrangements (MEWAs) under health care reform, which were implemented earlier this year in final regulations[.]" (Practical Law Company)  


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10th Annual Rewarding Healthy Behaviors Forum - Feb. 4-5 - Las Vegas

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The November Exchange Enrollment Report
"Overall, 83 percent of completed applications were submitted online; 17 percent were on paper. HHS was unable to determine how many were submitted through direct enrollment through insurers, although the number is likely to be small. Sixty percent of applications were submitted through the federal exchange, 40 percent through state-based exchanges." (Timothy Jost in Health Affairs Blog)  

Health Insurance Marketplace Enrollment Report, October 1 through November 30 (PDF)
"Visitors on the [State-Based Marketplace (SBM)] and [Federally-Facilitated Marketplace (FFM)] websites: 39.1 million; Calls to the SBM and FFM call centers: 5.2 million. Completed Applications submitted to the SBMs and FFM: 1.8 million; Total Persons Applying for Coverage in Completed Applications submitted to the SBMs and FFM: 3.7 million. Total Persons Determined Eligible to Enroll in a Marketplace plan by the SBMs and FFM: 2.3 million; Number of Eligible Persons who have Selected a Plan through the SBMs and FFM: nearly 365,000." (Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services)  

365,000 People Selected Plans in the Health Insurance Marketplace in October and November
"Enrollment in the federal Marketplace in November was more than four times greater than October's reported federal enrollment number. Since October 1, 1.9 million have made it through another critical step, the eligibility process, by applying and receiving an eligibility determination, but have not yet selected a plan. An additional 803,077 were determined or assessed eligible for Medicaid or the Children's Health Insurance Program (CHIP) in October and November by the Health Insurance Marketplace." (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

Sebelius Launches Review of Botched Launch of Obamacare's Healthcare.gov
"[HHS Secretary Kathleen Sebelius] has asked her department's inspector general, Dan Levinson, to review the development of the Web site with a particular focus on [CMS], the agency that oversaw the creation of the Web site, and the private firms that were contracted to work on the project. She also announced the creation of a permanent new full-time position within the Medicare agency to head off similar stumbles in the future. This 'chief risk officer' will report to the agency's administrator, Marilyn Tavenner, and the officer's first task will be to review acquisition and contracting related to information technology." (The Washington Post; subscription may be required)  

Judge's Medicare Advantage Order Could Have National Impact
"The judge criticized the strategy to terminate the doctors: unilaterally amending the doctors' contracts with a provision that canceled them.... [CMS], which oversees the Medicare Advantage program, is reviewing the provider changes by UnitedHealthcare to determine whether its plans have sufficient doctors to meet federal requirements." (Kaiser Health News)  

Reversing Decades of Precedent, Sixth Circuit Orders Disgorgement of Profits in Long Term Disability Case
"The decision makes no sense when viewing the historical precedent on availability of equitable relief under ERISA. Besides that, denying a benefit should not be viewed, on its own, as a breach of fiduciary duty. But that is what this majority seems to allow. Look for the Plaintiff's bar to grab this case and add another cause of action for disgorgement." [Rochow v. Lina, No. 12-2074 (6th Cir. Dec. 6, 2013)] (Lane Powell PC)  

Hard to Believe: ERISA Benefit Claimant Recovers Millions of Dollars in Disgorged Profits
"[T]he majority held that where section 502(a)(3) allows equitable relief 'to redress' violations of ERISA, such relief extends not only to relief designed to 'set right' the alleged wrong, but also to relief designed to 'avenge' the alleged wrong. Amazingly, the majority then went on to suggest that the $3.8 million disgorgement remedy was not 'punitive.' The majority also affirmed the district court's application of a return-on-equity analysis to the disgorgement claim, rather than an analysis offered by LINA that would have equated disgorgement of profits to an award of prejudgment interest on the withheld benefits. The rationale for the more generous disgorgement award was the fact that LINA did not retain the unpaid benefits in a segregated account, but rather retained the money in its general assets." [Rochow v. Lina, No. 12-2074 (6th Cir. Dec. 6, 2013)] (Ogletree Deakins)  

Benefits in General; Executive Compensation

25 Employee Benefit Trends for 2014, Part 2
"Know and Learn what the new benefits strategy lingo means.... Open and proactive employee communication.... Personalized employee retirement guidance and advice.... Satisfy same-sex marriage compliance.... Very important look-back measurement periods." (Employee Benefit News)  

A Look at the Year Ahead in Executive Compensation: Key Themes and Issues for 2014
"[A] recent analysis of the S&P 1500 ... showed that almost half of the CEOs in large U.S. companies received no salary increase last year, and a third haven't received one over the past three years.... Despite all of this, the continuing perspective outside those of us who work in this space seems to be that the executive pay model in the U.S. is still broken and, in particular, that absolute pay levels are too high and performance expectations too low. And this isn't just some populist, media-driven perspective. Many corporate directors and investors share these views. This suggests to us that while the underpinnings of the current U.S. executive pay model are relatively solid, pay practices continue to call for careful calibration heading into 2014." (Towers Watson)  

A Sea Change for ERISA Litigation: The End of Class Actions? (PDF)
"Twenty years from now there may no longer be [ERISA] class actions.... A series of recent U.S. Supreme Court decisions ... indicate that ERISA plan sponsors who adopt mandatory arbitration provisions with class action waivers for employee benefit plan disputes may be able to eliminate all future ERISA class actions. Accordingly, every employer should assess whether the protections afforded by arbitration agreements coupled with class and collective action waivers outweigh the potential disadvantages." (Baker & McKenzie)  

Employer Costs for Employee Compensation (PDF)
"Employer costs for employee compensation averaged $31.16 per hour worked in September 2013 ... Wages and salaries averaged $21.54 per hour worked and accounted for 69.1 percent of these costs, while benefits averaged $9.61 and accounted for the remaining 30.9 percent. Total employer compensation costs for private industry workers averaged $29.23 per hour worked in September 2013." (U.S. Bureau of Labor Statistics)  

IRS Issues 'Additional Medicare Tax' Final Rules
"In order to correct an overpayment of income tax or Additional Medicare Tax, an employer may make an interest-free adjustment on the appropriate corrected return, but only if the employer repays or reimburses the employee before the end of the calendar year in which the compensation was paid. In the same vein, in the event of an underpayment of income tax or Additional Medicare Tax, an employer may make an interest-free adjustment on the appropriate corrected return, but only to the extent the error is discovered within the calendar year in which the compensation was paid." (Benefits Bryan Cave)  

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