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CUNA Mutual Group
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The Newport Group
in NC

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Cornerstone Group
in RI

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New York Life Retirement Plan Services
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Legislative And Regulatory Outlook For 2014: What’s On The Agenda for Flex, FSAs, Defined Contribution And Exchanges, And Account Based Plans
February 12, 2014 WEBCAST
(Employers Council on Flexible Compensation (ECFC))

IRA Frontline Fundamentals – Part 2
February 13, 2014 WEBCAST
(Ascensus)

Everybody's Talking About 3(16) Administration
February 19, 2014 in GA
(ASPPA Benefits Council of Atlanta)

2014 Webinar: IRA Required Minimum Distributions
February 20, 2014 WEBCAST
(Ascensus)

Compliance Checkup for Employers and Advisors
February 26, 2014 WEBCAST
(Thomson Reuters / EBIA)

DOL Audits with Craig J. Davidson, CEBS
March 18, 2014 WEBCAST
(FutureOffice Network)

ERISA Compliance for Health & Welfare Plans
March 26, 2014 in WA
(Thomson Reuters / EBIA)

Health Care Reform
March 27, 2014 in WA
(Thomson Reuters / EBIA)

Meeting Your Fiduciary Responsibilities Under ERISA
April 9, 2014 WEBCAST
(Lorman Education Services)

Portfolio Concepts and Management
May 5, 2014 in PA
(International Foundation of Employee Benefit Plans)

International Investing and Emerging Markets
July 28, 2014 in CA
(International Foundation of Employee Benefit Plans)

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[Guidance Overview]

Mental Health Parity and Health Care Reform
"Although self-insured and insured plans in the large group market are not required to offer mental health benefits, the [interim final regs] provided that if a plan provides mental health benefits in any classification, they had to be provided in every classification in which medical/surgical benefits were provided. The ACA, however, requires non-grandfathered group health plans to provide coverage for certain preventive services without cost sharing, including, among other things, alcohol misuse screening and counseling, depression counseling, and tobacco use screening. According to the final rule, the provision of these limited mental health benefits by a group health plan as required by ACA will not trigger a broader requirement to provide additional mental health benefits in any classification." (Seyfarth Shaw LLP)  

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Text of Seventh Circuit Opinion Finding No Contractual Obligation for Hospital to Reimburse Health Plan Due to Plan's Error (PDF)
"The plan took almost eleven months to determine that the child of its insured was not a plan beneficiary. It's one thing for a seller to refund money or take other reparative measures because of a mistake it's made, and another to do so because the buyer has made a mistake.... the fact that the hospital may on occasion have made refunds in circumstances similar or even identical to this case neither establishes a contractual obligation on the hospital's part to make such refunds, nor could have lulled the Kolbe plan into thinking it took no risk in conducting a dilatory investigation of the eligibility of a child with a very serious medical condition bound to cost a great deal to treat." (U.S. Court of Appeals for the Seventh Circuit)  

Beware of GINA When Asking Employees for Medical Information or Family Histories
"[W]ellness programs are treated a little differently under GINA when it comes to health risk assessments. Although there is an exception that allows employers to ask employees about their family medical history as part of an employer-provided wellness program, that information has to be voluntary. Therefore ... financial incentives for employees who fill out their HRA must not be based around family medical-history information." (Human Resource Executive Online)  

Health Savings Accounts See Healthy Growth (PDF)
"In 2006, there were 1.3 million accounts with $873 million in assets, and by 2012, 11.7 million accounts held $18 billion in assets.... [T]here was $23.8 billion in HSAs and HRAs in 2013, spread across 11.8 million accounts. In 2007, assets nearly tripled (282 percent) and the number of accounts doubled (101 percent) from the year before, and while growth slowed in 2008-2010, it continued at relatively high rates, accelerated in 2011, and continued to increase at nearly 40 percent for both assets and the number of accounts in 2012." (Employee Benefit Research Institute [EBRI])  

2014 Segal Health Plan Cost Trend Survey
"All medical plan types are projected to experience trend rate declines in 2014. Health maintenance organization (HMO) trend rate projections for 2014 are a full percentage point lower than HMO projections from 2010. Prescription drug benefit trends for retail and mail order combined are forecasted at 6.3 percent for active participants and early retirees. These projections are relatively consistent with last year's trend rate projections of 6.4 percent." (Segal)  

[Advert.]

Health Savings Accounts - February 19 webinar

Focusing on final comparability rules for employer contributions and new contribution limits and IRS guidelines, this webinar will explore new design opportunities for employers. Special BenefitsLink discount.

Understanding Small Business Insurance Exchanges
"To be successful, SHOP exchanges need to attract sufficient participation among small businesses to establish a broad, stable risk pool and to be self-sustaining. To this end, they will need to demonstrate value by relieving employers of some administrative burdens and, more important, by moderating cost increases. States will also need to ensure that there is a level playing field in terms of regulations and premium rating for plans sold both inside and outside of the exchange." [This is a February 2014 revision of a health policy brief originally published in February 2012.] (Robert Wood Johnson Foundation)  

Employer Health Coverage in Jeopardy
"[I]ncreased administrative burdens, taxes, and fees will cost manufacturers over $22.2 billion in just the next three years. This estimate does not include increases in premiums for the coverage manufacturers already provide.... The CBO report ... stated very clearly that employer-sponsored health coverage will decrease by millions each and every year from 2015 onward. According to the report, by the time we get to the 2024, 63 million people will have lost the coverage their employer used to offer." (National Association of Manufacturers)  

Economists Explain Why Obamacare Probably Will Downsize the Workforce
"When Tennessee ended Medicaid coverage for tens of thousands of residents, Google searches for 'job openings' increased. And Tennessee's employment rate began to tick up, in a way that was distinct from its neighboring states. The type of jobs they were finding ... were over 20 hours per week, suggesting they were more likely to provide health insurance benefits.... The [ACA] took down a lot of the barriers to purchasing health insurance in an individual market.... All of a sudden, employment isn't such a key ticket to accessing affordable health insurance." (Sarah Kliff in The Washington Post; subscription may be required)  

Insurers Eye Market for Supplemental Health Coverage to Fill Gaps Left by Obamacare, Employer Plans
"Insurers are increasingly marketing these limited policies that pay cash after a hospital stay or specific disease diagnosis, such as cancer.... The policies are promoted as helping cover out-of-pocket expenses that can reach thousands of dollars in plans offered by employers and the health law's online marketplace.... Some experts, however, see risk for policyholders in the lightly regulated plans, which tend to be highly profitable for insurers and might be mistaken for more generous coverage." (Kaiser Health News)  

Half the Nation's Uninsured Live in Just 116 Counties
"Those without health insurance have less than two months to enroll in new plans before penalties kick in, and the Obama administration is racing the clock to get them signed up.... [T]he administration is best off focusing on a relatively narrow geographic area: Half of those under 65 without insurance live in just 116 of the nation's 3,143 counties. And half of all 19-39 year olds without insurance -- the most coveted demographic as health-care providers look to expand their risk pools -- live in 108 counties." (The Washington Post; subscription may be required)  

Colorado State Regulator Wants to Help Residents Facing Nation's Highest Premiums
"For some more middle class residents of [Vail and other] resort towns, the high prices can feel like they've 'traded a pre-existing condition for a pre-existing zip code,' as one rancher told the insurance commissioner at a public hearing. In response, the Colorado Division of Insurance is launching a statewide study that among other aims will try to understand insurance and health cost variation across the 11 rating regions for individual and small group plans." (Healthcare Payer News)  

Insurers Face New Pressure Over Limited Doctor Choice
"Under the new federal proposal, insurers selling plans in the federally run marketplace would be required to submit to [CMS] a full list of providers in a network before their plans are approved for listing in the exchanges. In the future, regulators also plan to develop federal standards for the required number of providers.... A spokesman for America's Health Insurance Plans ... said narrower provider networks are 'one way health plans can help to preserve benefits and mitigate cost increases for consumers' as health-law changes take effect." (The Wall Street Journal; subscription may be required)  

Pioneer ACOs' First-Year Results Leave a Lot of Room for Improvement
"Altogether, the Pioneers produced savings of about $147 million, a drop in the bucket for the entire Medicare budget, and certainly much less than the amount spent to develop the infrastructure to support the ACOs. Officials with [CMS] -- which is managing the Pioneer and the Medicare Shared Savings Program (MSSP) ACOs -- said some progress is better than none, and the program will take time to produce more significant savings." (HealthLeaders InterStudy)  

New Exchange Grants Flow to States, But Not for Long
"On Jan. 22, CMS awarded more than $355 million in new exchange grants to 10 states -- Arkansas, California, Delaware, Mississippi, Nevada, New Hampshire, New Mexico, Rhode Island, Utah and Washington. These second-, third-, fourth-, and even fifth-generation establishment grants will be used to increase support staff, implement IT advancements, enhance website usability, fund targeted outreach and education efforts and, in Arkansas' case, facilitate the transition to a state-based marketplace by 2016." (HighRoads)  

Humana ACA Enrollees Younger Than Expected
"About 35 percent of those who enrolled by the end of January were between 21 and 40, Humana said. That's still below the portion of consumers that age in the general population. About 82 percent of Humana's new members are getting federal tax credits to help pay the premiums ... many of them probably younger and with lower incomes. More than 200,000 people had applied to Humana plans offered through the exchanges by the end of January, the company said." (Kaiser Health News)  

Are Young People Better Off Being Uninsured?
"In 2014, 86 percent of young people would be better off opting out. As the penalty rises, that number will drop, down to 66 percent in 2019. By reducing the sample down to only those households who had medical expenditures in 2011, the study determined that 72 percent of those young adult households would be better off opting out of health coverage, with that number dropping to 59 percent in 2019." (John Goodman's Health Policy Blog)  

Use of Telemedicine Can Reduce Hospitalizations of Nursing Home Residents and Generate Savings for Medicare
"After the introduction of the telemedicine service, hospitalization rates declined 9.7 percent among the intervention facilities and 5.3 percent among the comparison facilities ... There was a significant decline in hospitalization rates at facilities that were deemed 'more engaged' with the telemedicine service; hospitalization rates for this group declined 11.3 percent. Based on the reduced hospitalization rates of the more-engaged facilities, Medicare could expect an average of about $151,000 in savings per nursing home per year. The annual cost of the telemedicine service was $30,000 per nursing home, suggesting that there could be $120,000 in net savings per year." (The Commonwealth Fund)  

[Opinion]

Judging Hospital Quality and Narrow Networks: Barking Up the Wrong Tree?
"With a big majority of the lowest cost Obamacare exchange plans offering narrow provider networks, understanding the quality of the providers in them compared to the rest of the market is a bigger deal than ever. These studies would seem to suggest narrow networks don't matter as long as a hospital's short-term quality data is comparable -- that there isn't a measurable value in going to what has historically been thought by consumers to be the 'best' place. Baloney." (Bob Laszewski's Health Care Policy and Marketplace Review)  

Supreme Court Affirms Contractually Reduced Limitations Periods for ERISA Benefit Claims
"[I]mplicit in the Court's decision is the recognition that 'reasonable' contractual limitations periods are generally enforceable for ERISA claims.... [T]he decision also appears to assume, if not specifically hold, that contractual limitations periods for insured ERISA plans (at least where the limitations period is in the insurance policy) are subject to state laws that expressly prohibit contractual limitations periods shorter than a defined period ... Finally, the decision overturns the law in certain circuits holding a contractual limitations period cannot begin to run until available administrative remedies have been exhausted." [Heimeshoff v. Hartford Life & Accident Ins. Co., No. 12-729 (S. Ct. Dec. 16, 2013)] (Jackson Lewis LLP)  

DOL Recovers More Than $490,000 For Ky.-based Pension Plan And Obtains Judgments Against Plan Fiduciaries
Employee Benefits Security Administration (EBSA), U.S. Department of Labor

BrightScope Appoints Joan Wallace to Lead New Data Solutions Group
BrightScope

OneAmerica Introduces Pension Risk Transfer Buy-out Product
OneAmerica Financial Partners

Wilkins Finston Law Group LLP Is Pleased To Welcome Its New Partner Jay Friedman And The Opening Of Its San Antonio Office
Wilkins Finston Law Group LLP

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