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National Automobile Dealers Association (NADA)
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How to Improve Drug-Related Star Ratings: Winning Strategies for MA-PD and PDP Plans
April 29, 2014 WEBCAST
(Atlantic Information Services, Inc)

How to Comply With CMS’s Two-Midnight Rule: Tackling the Operational Challenges
April 30, 2014 WEBCAST
(Atlantic Information Services, Inc)

2014 Regional Conference: Boston
July 10, 2014 in MA
(American Society of Pension Professionals & Actuaries (ASPPA))

2014 Fall Forum
September 22, 2014 in IL
(Ascensus)

View All Webcasts and Conferences

[Guidance Overview]

Proposed Standards for Navigators and Consumer Assistance Counselors: Preemption of Certain State Navigator Regulatory Laws
"How do these standards get enforced? Should the proposed rules be expanded to spell out a more detailed method of federal oversight? Will HHS undertake an independent review of state Navigator and consumer assistance counseling requirements to determine whether state laws directly conflict with federal requirements? Will HHS establish a system by which individuals can seek HHS review of state laws that potentially may conflict with federal law? The ambiguity regarding enforcement is magnified by the fact that HHS notes that its list is non-exhaustive, meaning that there may be other state requirements that are considered to prevent the application of federal law." (Health Reform GPS)  

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[Guidance Overview]

Final Rules Issued on 90-Day Waiting Period Limitation for Health Benefits
"Under the Final Rules, all calendar days (including weekends and holidays) are counted. If the 91st day is a weekend or holiday, the plan or issuer may choose to permit coverage to become effective earlier than the 91st day, but not later. The eligibility date cannot be the first day of a month or of a payroll period after the 90 days. Accordingly, plans that provide for coverage to start at the beginning of a calendar month or pay period will have to use a waiting period [of] less than 90 days." (McGuire Woods LLP)  

[Guidance Overview]

The Waiting Is the Hardest Part: Final Regs on the ACA's 90-Day Waiting Period
"The final regulations allow a plan to treat a rehired former employee as newly eligible for coverage and thus may require the employee to satisfy the waiting period again. The final regulations state that such a requirement must be reasonable and must not be used to avoid compliance with the 90-day waiting period rule. Similarly, an employee who transfers to a job classification that is not eligible for coverage, and later is reassigned to a job classification which is eligible for coverage, may be required to satisfy a waiting period." (Ogletree Deakins)  

[Guidance Overview]

CMS Eyes Plan Ratings, Intervenes in Drug, Network Access
"Federal regulators are starting to finalize simmering ideas for public exchanges and also responding to consumer concerns, outlining a new quality rating system and proposals covering everything from narrow networks to loss ratios.... Of all the proposals, the quality rating system has some of the most potential to impact sales of health plans. It also mirrors regulators' goals in the Medicare Advantage program to weed out underperforming plans by offering consumers clear signals." (Healthcare Payer News)  

[Guidance Overview]

HHS Extends Health Plan Certification of Compliance Comment Period
"HHS says the goal of the extension of the comment period is to provide self-insured health plans and their TPAs time to understand and offer feedback on the business impacts of the Certification of Compliance proposed rule.... The proposed rules will require self-insured health plans and their TPAs to incur financial and operational expense to implement the necessary technology, data collection and other arrangements to come into compliance with the proposed rules." (Solutions Law Press)  

Administration Tightens Health Plan's Standards After Consumers Complain
"In deciding which products can be sold in the federal marketplace next year, officials said, they will scrutinize health plans more closely and rely less on evaluations by state insurance regulators and private groups that accredit health plans. Consumer advocates welcomed the standards and said they should have gone further. But insurers and employer groups complained of burdensome overregulation and said the White House should focus first on getting the online exchanges to work properly." (The New York Times; subscription may be required)  

Obamacare Premiums to Skyrocket for 2015
"Health industry officials say ObamaCare-related premiums will double in some parts of the country, countering claims recently made by the administration.... The industry complaints come less than a week after [HHS] Secretary Kathleen Sebelius ... told lawmakers rates would increase in 2015 but grow more slowly than in the past.... Her comment baffled insurance officials, who said it runs counter to the industry's consensus about next year.... [One] insurance official, who hails from a populous swing state, said his company expects to triple its rates next year on the ObamaCare exchange." (The Hill)  

Unmarried Employee Not Entitled to FMLA Leave to Care for Hospitalized Partner or Unborn Child
"Under the FMLA, a wife is included in the meaning of the word 'spouse' but whether or not the employee's partner was his wife was a matter of state law. Kentucky, however, did not recognize common-law marriages. Therefore, the employee's partner was not his 'spouse' for purposes of the FMLA.... Further, the employee was not entitled to FMLA leave in order to care for his son because his termination came one week before his son was born. It was 'impossible' for the employee to be entitled to leave for the birth of his son and to care for that son when the child had not been born." [Lukudu v. JBS USA, LLC, NO. 3:12-C V-00704-TBR (W.D. Ky. Mar. 14, 2014)] (Wolters Kluwer Law & Business)  

How Health Plans Can Optimize Social Media
"Social networks are changing the way people manage their healthcare. Many healthcare consumers are using social media as a way to find information and make decisions about their health coverage options. This means they're sharing their experiences with an extended, online network of friends and family -- as well as their healthcare providers, making social networks important venues for health plan member communications." (Healthcare Trends Institute)  

Newark Enacts Paid Sick Leave Law (PDF)
"Newark's ordinance is largely similar -- but not identical -- to Jersey City's sick leave law, which took effect on January 24, 2014.... Employers with a paid leave policy, such as a paid time off (PTO) policy, will not have to provide additional paid sick time if they already provide sufficient leave to satisfy the ordinance's annual accrual requirements and allow employees to use the time for the same purposes and under the same conditions as paid sick time under the ordinance." (Buck Consultants)  

Final Rule Details Provisions of 2015 Stabilization Programs
"[T]he final rule establishes for 2015 a uniform reinsurance contribution rate of $44 annually per capita. Uniform reinsurance payment parameters for 2015 are also established in the final rule, with a $70,000 attachment point, a $250,000 reinsurance cap, and a 50 percent coinsurance rate. The attachment point for 2014 has also been finalized, decreasing from $60,000 to $45,000." (Wolters Kluwer Law & Business)  

Four Paths a Small Business with Group Benefits Should Consider in 2014
"Employers who currently sponsor group benefits plans may take one of four paths for maintaining employees' health coverage in 2014.... [1] Stay Group: Enroll or Renew With a Carrier ... [2] Enroll ... via SHOP Marketplace... [3] Move Individual: Employer Offers Some Additional Compensation ... [4] Move Individual: Employer Encourages Use of the Health Insurance Marketplace." (The Bailey Group)  

14 Ways Individuals Can Avoid the Obamacare Tax
"You can probably take advantage of these off ramps all the way through 2016, at the very least. And one of them (#14) is so broad that it could capture just about any reason you can think of for not being able to pay the tax." (Forbes)  

If an Appeal is Filed and Nobody Knows It, Is it an Appeal?
"The Court found that the course of communications between the insurer and the participant caused the participant to have essentially the same protections in the processing of his claim as he would have had if he had, in fact, filed an appeal, and that the participant therefore suffered no prejudice from the fact that his claim was treated as though appealed. The Court then proceeded to decide the case on its merits." [Morgan v. Reliance Standard Life Insurance Company, No. 12-12151-NMG (D. Mass. Mar. 3, 2014)] (Stephen Rosenberg of The McCormack Firm, LLC)  

With Spotlight on Director Pay, Caution Against Homogeneity
"ISS ... recently introduced several new director-focused criteria to its proprietary QuickScore evaluation, including one which ranks director compensation on a relative basis ... [T]his focus on relative ranking seems to treat directors similar to a commodity, where one director can easily be interchanged with another. The approach ignores many important factors that determine individual director pay levels, including the director's level of responsibility. It also lacks any consideration for the size of the board or its aggregate cost to the company." (Steven Hall & Partners)  

Ed Slott Announces the Release of his 2014 Retirement Decisions Guide
Ed Slott

Mercer Wins First Place at the Eddy Awards for its ‘Uncover the Numbers’ Retirement Campaign
Mercer

Aetna Collaborates with HR Policy Association to Enhance Nation's First Private Exchange for Pre-, Post-65 Retirees
Aetna

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