Benefit Planning Counselor
Principal Financial Group
in NY

RetireSecure Employee Benefit Specialist
Principal Financial Group
in MA

Retirement Plan Sales & Support Specialist
The R.O.W. Group
in TN

Senior Investment Advisor
The PrivateBank
in IL

Business Development Officer
The PrivateBank
in IL

Vice President, Information Technology
Pentegra Retirement Services
in NY

Plan Document Analyst
T. Rowe Price
in MD

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Special Training Session – New Information for the February Marketplace Payment Processing Cycle
January 13, 2014 WEBCAST
(Centers for Medicare & Medicaid Services (CMS))

Education Session
January 15, 2014 WEBCAST
(Financial Accounting Standards Board (FASB))

"401(k) Testing Techniques 2014" Web Seminar
January 29, 2014 WEBCAST
(SunGard Relius)

Top 10 Plan Designs for the Small Employer, and Creative Plan Corrections – Minneapolis
January 31, 2014 in MN
(SunGard Relius)

Plan Administrator Skills Workshop
March 7, 2014 in TX
(SouthWest Benefits Association)

View All Webcasts and Conferences

[Official Guidance]

Text of CMS Proposed Medicare Regs: Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs
"The proposed rule would revise the Medicare Advantage (MA) program (Part C) regulations and prescription drug benefit program (Part D) regulations to implement statutory requirements; strengthen beneficiary protections; exclude plans that perform poorly; improve program efficiencies; and clarify program requirements. The proposed rule also includes several provisions designed to improve payment accuracy." (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

[Advert.]

Do you know how to simplify compliance?

Compliance awareness is key to staying on track with ERISA, HIPAA, Health Care Reform and 401(k) regulations. We take the time to learn about your clients' benefit plans, then create a customized compliance process specific to their legal obligations.

[Official Guidance]

Text of CMS Announcement of New Medicare Rate-Setting Initiative for Maryland Hospitals
"[CMS] and the state of Maryland are partnering to modernize Maryland's unique all-payer rate-setting system for hospital services that will improve patients' health and reduce costs. This initiative will update Maryland's 36-year-old Medicare waiver to allow the state to adopt new policies that reduce per capita hospital expenditures and improve health outcomes as encouraged by the Affordable Care Act." [Announcement includes a Fact Sheet with more details.] (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

[Guidance Overview]

Guidance on Cost-Sharing Limits, Wellness, and Mental Health Parity in New ACA FAQs
"The new FAQ makes clear that the transition relief [for out-of-pocket cost limits] is only available for plan or policy years beginning in 2014. For plan or policy years beginning on or after January 1, 2015, all essential health benefits (EHB) are subject to the individual and non-individual out-of-pocket limits, regardless of the number of service providers used.... The FAQ provides that employers and insurance providers may modify the sample notice of reasonable alternative standards that is provided in the wellness regulations so long as the modified version contains all of the required content described in the regulations." (E is for ERISA)  

Understanding New Rules That Widen Mental Health Coverage
"While many plans are already complying with certain aspects of parity, the final rules fill in gaps about how the law must be applied ... For instance, plans cannot limit mental health care to a specific geographic region, if they do not do so for physical illnesses. And the rules clarify that the law also applies to 'intermediate' treatment options for mental health and addiction disorders, like residential treatment or intensive outpatient therapy." (The New York Times; subscription may be required)  

Noteworthy Developments of Interest to Sponsors of Multiemployer Health Plans, First Quarter 2014 (PDF)
This report includes: [1] information on how Medicare Part D is impacted by the ACA, and implications for plan sponsors that provide prescription benefits to Medicare-eligible retirees; [2] information on the 2018 excise tax on "cadillac plans" and how sponsors should consider its implications while changing plan design to comply with the current ACA guidelines; and [3] news on the grandfathered group health plan requirements. (Segal)  

[Advert.]

Weight Loss at the Workplace: Legal Issues in Reducing Health Care Costs and Promoting Wellness

January 17 webinar - learn the issues to address when formulating and implementing a corporate wellness program that is aimed at weight loss. Potentially applicable federal and state laws require careful consideration. Special BenefitsLink discount.

DOL Issues FAQ Part 18 on ACA Compliance
"[T]he notice provides a reminder that even though the employer mandate does not occur until 2015, the cost sharing limits are in effect for plan years beginning on or after January 1, 2014.... [W]ith respect to smoking cessation programs, if a participant declines to enroll in the program at the beginning of the year but then subsequently enrolls later in the year, the plan can, but is not required to, provide the incentive offered had they enrolled at the beginning of the plan year. So there is a potential 'penalty' option for late enrollment into the program." (Fox Rothschild LLP)  

For High-Risk Women, ACA Now Requires Some Breast Cancer Drugs to Be Free
"Insurers are given a year to make the change.... A spokesman for the insurance industry noted that while helping breast cancer patients get care is 'a top priority for health plans,' prescription drugs are not 'free,' and the costs of those drugs would be reflected in the premiums that all consumers pay for coverage. In addition, 'we are concerned about the precedent of expanding the definition of prevention to now include some treatments that must be covered with no cost-sharing,' said ... Robert Zirkelbach of America's Health Insurance Plans (AHIP)." (Kaiser Health News)  

Do Workplace Wellness Programs Save Employers Money? (PDF)
"Considering the ratio of reductions in health care costs to program costs, including the fees of the program vendors and the cost of screening employees for health risks, the overall ROI was ... $1.50 for every dollar that the employer invested in the program. But the returns for the individual components differ strikingly: $3.80 for disease management but only $0.50 for lifestyle management for every dollar invested." (RAND Corporation)  

Balancing Wellness Programs and Employee Privacy
"From the beginning of any wellness campaign, an employer has to answer three important questions: [1] Why are employees being asked to share private health information? [2] How is the information protected? [3] What, if anything, will the employer do with the information once it is shared? ... [It] is the employers' imperative to clearly communicate how information will be used and for what purposes. If employers are not proactive with this communication, distrust around the program, and ultimately the employer, will develop." (Idaho Business Review)  

Gender Could Be as Big a Problem as Age for the Affordable Care Act
"Younger enrollees are needed in large numbers to subsidize the premiums of the older enrollees.... The lesser studied potential source of adverse selection problems, however, is the fact that medical expenses of women for many ages are essentially double those of men and yet the ACA forbids rating based on gender.... [S]ince the women have higher than average expenses than men, premiums based on the average expenses of men and women will prove too low, creating pressure on insurers to raise prices." (The Health Care Blog)  

Maryland's Plan for Hospital Prices: Can Aggressive Government Regulation Dramatically Cut Health Spending?
"Maryland will cap hospital spending and set prices -- and, if all goes as planned, cut $330 million in federal spending. The new plan ... could serve as a model -- or cautionary tale -- for other states looking to follow in its footsteps.... The state will limit hospital spending growth to 3.58 percent for the next five years, largely by giving each of the state's 46 hospitals a firm budget to work within. That level of growth would be tied to the projected, overall growth of the state economy." (Sarah Kliff in The Washington Post; subscription may be required)  

What Motivates Wellness Program Participation? (PDF)
"[T]he main reasons current enrollees participated in workplace wellness programs were 'positive,' either to improve or maintain health, a trend that carried across health coverage plan types. The survey also asked respondents their reasons for not participating in their employer's wellness program, and found that nearly 70 percent responded that they did not participate because they could make changes on their own, split between those who cited it as a major reason (31 percent) and minor reason (38 percent) for not participating." (Employee Benefit Research Institute [EBRI])  

Bigger Footprint Could Be Saving Grace for CO-OPs
"Some crafty maneuvers worthy of the nation's private-sector insurers may give CO-OPs staying power and a number of them are looking at expansion in 2015. Early enrollment figures for one CO-OP signal that a multi-state approach might be the way to go.... If those expansions take hold, there's a high probability of further moves into other states to position themselves as true regional players." (HealthLeaders InterStudy)  

[Opinion]

The Fundamental Problem with Obamacare
"The problem with Obamacare is it's product driven and not market driven. They didn't ask the customer what they wanted. And I think that's the fundamental problem with Obamacare. It meets the needs of very poor people because you're giving them health insurance for free. But it doesn't really meet the needs of healthy people and middle-class people." (Bob Laszewski and Ezra Klein in The Washington Post; subscription may be required)  

[Opinion]

The Medicare 'Doc Fix' Is Fixed -- Until March 31
"The three-month fix will increase Medicare spending by $7.3 billion versus previous scores of Medicare spending. But, politicians assert that this will not increase government spending, because ... this $7.3 billion will be paid for by reducing certain payments to hospitals -- in 2023, the last year of the [CBO]'s scoring window. Almost zero savings take place in earlier years. Nobody can take this game seriously. Both doctors and taxpayers will continue to suffer as long as they accept the notion that politicians should decide how much to pay for our medical care." (John Goodman's Health Policy Blog)  

Handicapping the CEO Pay Ratio Comments: Odds on Which Suggestions the SEC May Adopt
"Our review of the public comment letters to the [SEC] on the CEO pay ratio proposal found widespread support for the rules among public pension funds and other activists -- and strong opposition from the various business organizations, many of which called for the proposal to be scrapped entirely. This article focuses on the more technical comments received by the SEC to review suggestions that may relieve compliance burdens and costs if adopted. We also offer our take on the odds of these recommendations being adopted, with the caveat that these are purely guesses and reflect no insight into the thought process of the SEC staff or the commissioners." (Towers Watson)  

Employee Attitudes and Behavior About Equity Compensation (PDF)
"When asked how they view their equity compensation, nearly half of participants (47%) see it as a way to build wealth. However, one out of five view their award as a 'lottery ticket,' largely devoid of meaningful value. Vesting experience plays a significant role in the view of equity compensation: A majority of those who have experienced six or more vestings consider equity as a way to build wealth." (UBS Global Asset Management)  

[Opinion]

Text of Comments by American Benefits Council to SEC on Proposed Pay Ratio Rules (PDF)
"We believe supporters of the Proposed Rule underappreciate the compliance challenges that issuers face and the substantial costs that will be borne by their shareholders, especially on a multinational level ... [M]any of our members (especially those with large multinational operations) are unwilling to incur significant costs for their shareholders now to analyze the information technology changes, consolidation of payroll systems, and application of foreign data privacy laws that the Proposed Rule will impose on them. As a result, the Proposed Rule poses significant risks of unforeseen costs and complications for issuers and their shareholders." (American Benefits Council)  

Prudential Simplifies Offering In-plan Guaranteed Retirement Income Solutions
Prudential Retirement

PenSys, Inc. Acquires California Central Coast TPA, San Luis Pension Consultants
PenSys, Inc.

MassMutual Retirement Services’ Taft-Hartley Business Reaches New Milestone
MassMutual

View All Press Releases