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January 9, 2014          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Retirement Plan Relationship Manager/Business Development
AEPG Wealth Strategies
in NJ

401(k) Administrator
TPS Group
in MA, ME, NY

Customer Service Representative
BlueStar Retirement Services
in FL

Employee Benefits Recordkeeper
First American Bank
in IL

Retirement Plans Regional Sales Manager
Mutual of Omaha
in OK, TX

Retirement Plans Regional Sales Manager
Mutual of Omaha
in KS, MO

5500 Specialist
Plante Moran
in MI

Client Manager
Hill, Chesson & Woody
in NC

403b/401k Administrator
Farmer & Betts
in OR, WA

Plan Administrator
Howard Simon & Associates
in IL

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Webcasts and Conferences

"Don't Be Caught Short: Understanding Short Plan Years" Web Seminar
January 14, 2014 WEBCAST
(SunGard Relius)

"403(b) Plans: Understanding Universal Availability" Web Seminar
January 21, 2014 WEBCAST
(SunGard Relius)

Ethical Standards of Employee Benefits Practice – What to Ask and Say to Clients, and What to Tell the IRS Phone Forum
January 29, 2014 WEBCAST
(Internal Revenue Service (IRS))

Top 10 Plan Designs for the Small Employer, and Creative Plan Corrections – St. Louis
January 30, 2014 in MO
(SunGard Relius)

Ethical Standards of Employee Benefits Practice – What to Ask and Say to Clients, and What to Tell the IRS Phone Forum (Rebroadcast)
February 6, 2014 WEBCAST
(Internal Revenue Service (IRS))

Voluntary Fiduciary Correction Program Workshop
February 11, 2014 in CA
(Employee Benefits Security Administration (EBSA), U.S. Department of Labor)

IRA Academy
April 29, 2014 in TX
(PenServ Plan Services, Inc.)

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]

Text of DOL, HHS and IRS FAQs About Affordable Care Act Implementation (Part XVIII) and Mental Health Parity Implementation
12 Questions and Answers, including: "On September 24, 2013, the [United States Preventive Services Task Force] issued new recommendations with respect to breast cancer. What changes must plans make to comply with the new recommendations? ... If a plan includes a network of providers, is the plan required to count an individual's out-of-pocket expenses for out-of-network items and services toward the plan's annual maximum out-of-pocket limit? ... Is a plan required to count an individual's out-of-pocket costs for non-covered items or services (such as cosmetic services) toward the plan's annual maximum out-of-pocket limit? ... Can the Departments provide any additional clarification of the definition of an insured expatriate health plan for purposes of the temporary transitional relief, as well as additional clarification of the scope of the relief provided? ... A plan participant's doctor advises that an outcome-based wellness program's standard for obtaining a reward is medically inappropriate for the plan participant. The doctor suggests a weight reduction program (an activity-only program) instead. Does the plan have a say in which one? ... If insurance labeled as fixed indemnity insurance provides benefits other than on a per-period basis, may the insurance nonetheless qualify as excepted benefits? ... What was the effect of the Affordable Care Act on [the Mental Health Parity and Addiction Equity Act of 2008]?" [Also available on the CCIIO website.] (U.S. Departments of Labor [EBSA], Health and Human Services [CCIIO], and the Treasury [IRS])  


[Advert.]

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[Guidance Overview]

HHS Proposed Regs Require Health Insurers to Certify Compliance with HIPAA Electronic Transaction Requirements
"Under the proposed rule, a Health Plan that is a controlling health plan (CHP) would certify compliance with the standards and operating rules for the three electronic transactions by obtaining one of two credentials ... A CHP that obtains a Health Plan Identifier ... before January 1, 2015, would be required to submit documentation of the credentials to HHS on or before December 31, 2015. A CHP that obtains a Health Plan Identifier on or after January 1, 2015 (and on or before December 31, 2016), would have 365 days to submit documentation to certify compliance. The health plan identifier final rule requires an existing Health Plan ... to obtain a health plan identifier by November 5, 2014. Small health plans must obtain an HPID by November 5, 2015." (McDermott Will & Emery)  

'Pay or Play' Delay Puts Employers in a Precarious Situation
"Given [hypothetical employee] Stan's income and location Stan would be able to purchase the lowest cost bronze plan with the assistance of a premium tax credit for $19 per month. Therefore, in 2014 Stan will pay 1.1 percent of his income to receive the cheapest bronze plan ... In 2015, if the manufacturing plant decides to avoid the penalties associated with the Play or Pay Mandate, the employee's payment for a bronze plan cannot exceed 9.5 percent of the employee's household income.... [An] employer doing the bare minimum can comply with the Play or Pay Mandate by charging an employee like Stan $158 per month for bronze coverage. Put another way, Stan will have to pay $139 more dollars per month for essentially the same bronze coverage he had in 2014." (Moulder Law)  

Private Companies Providing Tools to Help Patients Navigate the Minefield of Health Care Pricing
"There are multiple efforts underway to improve price transparency including state and federal government efforts, health plan websites, and consumer-oriented websites. However, private companies have also emerged to provide pricing tools. These companies play a key role, yet have been rarely mentioned or studied in the academic literature.... These 'third-party vendors' work with self-insured employers to aggregate price information from past claims and make it available to employees." (Health Affairs Blog)  

HHS Inspector General Finds CMS and Its Contractors Have Adopted Few Program Integrity Practices to Address Vulnerabilities in Electronic Health Records
"CMS and its contractors had not changed their program integrity strategies in light of [electronic health record (EHR)] adoption. Few CMS contractors had adopted few program integrity practices specific to EHRs. Specifically, few contractors were reviewing EHRs differently from paper medical records. In addition, not all contractors reported being able to determine whether a provider had copied language or overdocumented in a medical record. Finally, CMS had provided limited guidance to Medicare contractors on EHR fraud vulnerabilities." (Office of Inspector General, Department of Health and Human Services)  


[Advert.]

23rd Annual National Health Benefits Conference & Expo - Jan. 28-29, FL

Sponsored by HBCE- Health Benefits Conference & Expo

Hear Here: Sprint, L.L. Bean, We Energies, City of Houston, Eastman Chemical, Univ. of IA, AL & S.FL, Palm Beach Co Schools, Crowley Maritime Corp, Anoka Co, S. Shore Hospital, more. Jan 28-29 - Hi quality, moderate cost. Complete Program brochure online now!



HHS OIG Report Finds More Flaws in Digitizing Patient Files
"Despite spending 'considerable resources to promote widespread adoption of [electronic health records (EHRs)], the government has 'directed less attention to addressing potential fraud and abuse,' according to the report.... While the report did not estimate the amount of fraud that may be occurring, earlier government estimates have said it could run in the hundreds of millions of dollars. Although the amount is a fraction of the trillions of dollars spent annually on health care, the lack of safeguards at a time when the new technology is becoming pervasive could allow the fraud to balloon." (The New York Times; subscription may be required)  

Medigap Plans Boosted Medicare Costs 22 Percent
"Supplemental 'Medigap' plans shield millions from Medicare's deductibles and other out-of-pocket costs.... [Recent] research did suggest that wider Medigap coverage encouraged the use of non-crucial procedures ... Areas with wider Medigap enrollment showed 'a particularly large increase' in tests and imaging such as MRI scans that are often thought to be overused[.]" (Kaiser Health News)  

Massachusetts Wastes One Third of Health Spending, State Report Concludes
"Main drivers of excess spending included patients returning to hospitals for preventable reasons and emergency-room visits that better primary care could have warded off, the state's Health Policy Commission concluded, citing data from 2012. The commission estimated between $14.7 billion and $26.9 billion in wasteful spending that year, representing between 21% and 39% of total health expenditures. The commission said the numbers were in line with waste at the national level, underscoring the challenges for a complex national health system that is stretching coverage to millions more people under the Affordable Care Act." (The Wall Street Journal; subscription may be required)  

Consumers Active in Their Own Health Care but Face Financial Pressures and Are Unprepared for Health Care Costs in Retirement
"The nation appears to be shifting away from the traditional model of health care, in which doctors have most of the decisionmaking authority.... 9 out of 10 people want to have a say in important decisions regarding their health care. One-third would like to make a shared decision with their doctor, 43 percent want to make the final decision with some professional input, and 16 percent prefer to be completely in charge of their medical decisions.... [O]nly 5 percent of people are certain that they will have the recommended amount of savings needed to cover health expenses after they retire, while more than 80 percent are either unsure or unlikely to have enough money set aside for health care in retirement." [Full study report available here.] (Altarum Institute)  

Insurers Push Obamacare Payment Deadline to Late January
"Blue Cross Blue Shield of Texas, Blue Cross Blue Shield of Illinois and three more BCBS plans that are part of the privately held Health Care Service Corp chain have moved the first payment deadline to January 30 from January 10. All of the plans are sold through the federal website HealthCare.gov, which had a December 24 deadline for customers to enroll and be guaranteed coverage by January 1 in 36 states. Others, including Aetna Inc, said they were still considering [January 10] to be the payment deadline." (Reuters)  

Confessions of a Medicare Supplement Salesman
"For those who can afford it and can meet medical underwriting standards, seniors can also buy Medicare supplements, (aka, Medigap policies), or a competing product called Advantage plans.... While advertising claims intentionally try to paint these two competing programs as similar, they are vastly different in terms of their coverage, costs, structures, potential quality of care provided, and organizational structures.... [The] majority of seniors do not know the differences, what they are buying or how the programs work for or against them over time." (MutualFundReform.com)  

Medical Debt Among People with Health Insurance (PDF)
"[A]nalysis of 2012 National Health Interview Survey (NHIS) data ... finds the problem of medical debt is widespread.... 20 percent of non-elderly adults reported difficulty paying medical bills in the previous year. When the question is broadened to include problems paying medical bills over a longer period of time, or inability to pay some medical bills at all, nearly one in three non-elderly adults (32 percent) report having medical bill problems." (Henry J. Kaiser Family Foundation)  

[Opinion]

Obamacare Hasn't Made Health Care More Affordable ... But It's Raised Taxes a Lot
"Ironically, [the ACA] was sold as a salvation for ever-rising health care costs. But ... growth in health care spending has been declining since 2002, long before Obamacare became law.... [H]ealth care spending growth started to stabilize in 2009 in the midst of Obamacare's Congressional debate and upon passage of the law ... [H]ealth care spending growth has fluctuated over the last 50 years.... While Obamacare is doing little to make health care more affordable, it is imposing a host of new taxes, more of which went into effect in January 1, 2014[.]" (U.S. Chamber of Commerce)  

[Opinion]

Senators Express Concern Over HHS IG Report Citing Insufficient Oversight of Electronic Health Record Program
"The IG found that few, if any, protections have been put in place at CMS or with government contractors to detect or prevent fraud from occurring in the EHR program, and suggested that CMS is still using the outdated practices that were used to review and audit paper health records.... 'The Inspector General's office has offered an important warning that CMS is failing to adequately oversee the program integrity of its electronic health records program,' said Dr. Coburn, the senior Republican on the Senate Homeland Security and Governmental Affairs Committee.... 'CMS has a fundamental responsibility to do a better job of policing and enforcing basic security requirements.'" (Committee on Health, Education, Labor and Pensions, U.S. Senate)  

Benefits in General; Executive Compensation

Employee Stock Compensation: 2013 SEC Comment Letter Trends
"There were 34 companies that received comments related to stock compensation [between January 1 and September 15, 2013], and a total of 118 stock compensation comments.... 81% of the total number of comments received related to Management's Discussion & Analysis of Financial Condition and Results of Operations in all the filings reviewed; 75% of the comments received related to S-1 filings; 50% of the comments received related to disclosure, 41% related to valuation and only 9% related to accounting recognition; 47% of the comments received related to companies in the technology industry and 32% related to the pharmaceutical and life science industry, with the remainder across a variety of sectors." (PricewaterhouseCoopers)  

2014 New Year's Resolutions: Executive Benefits
"[1] Offer an executive benefits program.... [2] Offer compelling plan designs... [3] Beat the competition... [4] Educate your people -- in person... [5] Informally fund the plan... [6] Eliminate the tax cost from informal funding." (Fiduciary Plan Governance, LLC)  

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