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April 24, 2014          Get Retirement News  |  Advertise
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Plan Administrator
Nationwide Financial
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Genuine Parts Company
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Webcasts and Conferences

Health Care Reform Industry Update -- Recorded
May 5, 2014 WEBCAST
(Health Partners America)

What Keeps You Up At Night?
May 6, 2014 WEBCAST
(King & Spalding LLP)

Negotiating ERISA Service Provider Agreements: Practical Options and Avoiding Pitfalls
May 15, 2014 in NY
(WEB (Worldwide Employee Benefits Network), New York Chapter)

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

Federal SHOP Procedures and Other ACA Guidance
"CMS states that it intends to update the procedures set out in the slides with formal guidance before QHP certification begins in May. The slides set out a ten step process for new small group enrollment in the SHOP ... Employers may apply for coverage at any time during the calendar year (although they must meet participation requirements if they do not apply from November 15 to December 15), and may choose an effective date up to 2 months later, as long as it is in the same quarter." (Timothy Jost in Health Affairs Blog)  


[Advert.]

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[Guidance Overview]

FF-SHOP Eligibility and Enrollment Notices (PDF)
23 presentation slides. Includes list and description of FF-SHOP Generated Notices, their content and method of delivery. (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services)  

Small Businesses Find Benefits, Costs as They Navigate ACA
"In January, nearly half of small-business owners with at least five employees, or 45% of those polled, said they had to curb their hiring plans because of the health law, and almost a third -- 29% -- said they had been forced to make staff cuts[.]" (The Wall Street Journal; subscription may be required)  

San Francisco Bay Area Employers Must Provide Commuter Benefits Program by September 30, 2014
"Covered San Francisco Bay Area employers without an already-existing and compliant commuter benefits plan have until September 30, 2014, to select at least one of four commuter benefit options, notify employees of how to take advantage of the benefits, and register with the Bay Area Commuter Benefits Program (CBP).... The CBP applies to ... [a]ny public, private, or non-profit entity (person, corporation, partnership, business firm, government agency, special purpose agency, educational institution, health care facility, etc.) for which an average of 50 or more full-time employees per week perform work for monetary compensation within the geographic boundaries of the District.... The term excludes seasonal/temporary employees." (Littler)  

Group Benefits and the Defined Contribution Model (PDF)
"The top two reasons employers reported for considering making changes to their benefits model are to lower health care costs (59%) and to give employees more choice in the allocation of their benefit dollars (40%). 47% of employers report having already moved to this model or are currently implementing this type of program. 62% of those that are likely to move to an exchange and those that are currently considering participating in an exchange believe they will adopt this model in the next two years." (Prudential Group Insurance)  

New DOL FMLA Branch Chief: Expect Even More On-Site FMLA Investigations
"Calling 2014 a 'pivotal' year for FMLA enforcement, [DOL's FMLA Branch Chief Helen] Applewhaite focused [a recent] presentation on the DOL's renewed emphasis on conducting compliance investigations with an emphasis on-site FMLA visits to ensure compliance.... Ms. Applewhaite shared a few nuggets that employers should be aware of: On-site investigations are the new norm.... The DOL is focusing its attention on systemic FMLA issues.... DOL will give particular attention to those areas within your organization where leaves of absence tend to be more frequent.... Employee interviews will become standard practice in an on-site visit.... Given DOL's enforcement activity in this area, you need to be prepared for your inevitable FMLA investigation." (FMLA Insights)  

Sixth Circuit Affirms FTC Order of Divestiture, Prohibits Health System's Purchase of Competing Hospital
"The record made plain, the court concluded, that [managed care organizations] do not demand a single provider to present such a 'package deal,' and that therefore no market forces exist that bind all four categories of service together in one single cluster. The court's unequivocal acceptance of the FTC's analytical approach on this point is notable, and will surely be welcomed and relied upon by the antitrust authorities going forward. As such, this method of market definition should be borne in mind by hospitals, healthcare providers, and other parties contemplating similar transactions." [ProMedica Health System, Inc. v. Federal Trade Commission, No. 12-3583 (6th Cir. Apr. 22, 2014)] (Wilson Sonsini Goodrich & Rosati)  

Sixth Circuit Upholds FTC Hospital Merger Challenge
"[T]he Court observed that ProMedica failed to argue that the merger would enhance consumer welfare. ProMedica made no claim that the merger would allow for the creation of a robust population health management program, for increased efficiency and lower costs, or for development of localized tertiary or quaternary care in southwest Lucas County. Instead, ProMedica seemingly conceded that the merger would have no procompetitive benefits and the Sixth Circuit found this 'only diminishe[d] ProMedica's prospects' of evading antitrust liability." [ProMedica Health System, Inc. v. Federal Trade Commission, No. 12-3583 (6th Cir. Apr. 22, 2014)] (Mintz Levin)  

Insurance Cancellations in Context: Stability of Coverage in the Nongroup Market Prior to Health Reform (PDF)
"This article provides evidence on the stability of nongroup coverage using US census data for the period 2008-11, before ACA provisions took effect.... [T]his market was characterized by high turnover: Only 42 percent of people with nongroup coverage at the outset of the study period retained that coverage after twelve months.... 80 percent of people experiencing coverage changes acquired other insurance within a year, most commonly from an employer.... [T]urnover varied across groups, with stable coverage more common for whites and self-employed people than for other groups.... This suggests that the nongroup market was characterized by frequent disruptions in coverage before the ACA and that the effects of the recent cancellations are not necessarily out of the norm." (Health Affairs)  

Wellness Program Trends: A Closer Look at Health Coaching
"Experts believe that personal, one-to-one health coaching is an important part of a successful, results-oriented employee wellness program. Why? Because they help people cope with preventable health risks that cost the U.S. healthcare system hundreds of billions of dollars each year." (Healthcare Trends Institute)  

[Opinion]

Text of Comments to CMS on Exchange and Insurance Market Standards for 2015 and Beyond (PDF)
"According to the FAQ, risk corridor payments to plans would be reduced if risk corridor collections are insufficient to cover risk corridor payments. This changes the nature of the risk corridor program from one that shares risk between issuers and CMS to one that shares risk between competing issuers. In effect, issuers that overpriced would subsidize issuers that under priced.... If payments exceed charges for 2014 and payments are decreased to equal charges to achieve budget neutrality, then the risk corridor program will not fully achieve its goal of mitigating risk due to mispricing and may put some issuers at risk of solvency problems." (American Academy of Actuaries Risk Sharing Work Group)  

Benefits in General; Executive Compensation

Adding Employer Health Insurance Contributions to Social Security's Earnings and Tax Base
"[The authors] find that the increased present value of OASDI benefits from including ESI in the wage base in 2014 offsets about 22 percent of increased income and payroll taxes, 57 percent of increased payroll taxes, and 72 percent of increased OASDI taxes.... Over a lifetime perspective, all earnings groups experience net tax increases, but workers in the middle of the earnings distribution experience the largest net tax increases as a share of lifetime earnings. Higher benefits offset a larger share of tax increases for lower than for higher income groups." (Center for Retirement Research at Boston College)  

New Risk Management Paradigms for U.S. Insurers Have Broad Implications for Talent Management and Executive Pay
"For many years, the measures of organizational success within the insurance industry have placed greater emphasis on absolute returns and have not adequately focused on the risks undertaken or levels of capital required to generate returns. Given the long tail of some types of insured risks, there was an inherent disconnect between incentive plan cycles (in most cases, with payouts based on performance over one or three years) and a truer time period for measuring the success of executive decision-making and company health. At the executive levels, insurance companies are beginning to think at a new level about the metrics used for measuring performance, the goals that they establish in relation to those metrics and the most appropriate time frames for measuring performance." (Towers Watson)  

Coca-Cola Shareholders Approve Executive Equity Plan
"Shareholders ratified a non-binding say-on-pay vote by 90% the executive compensation package for Muhtar Kent, Coca-Cola's chairman and CEO, and other top executives. The equity plan ... was opposed by the $177.9 billion Florida State Board of Administration, Tallahassee; C$201.5 billion (US$182.6 billion) Canada Pension Plan Investment Board, Toronto; and C$140.8 billion Ontario Teachers' Pension Plan, Toronto. The $183.3 billion California State Teachers' Retirement System, West Sacramento, supported the equity plan." (Pensions & Investments)  

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