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Selection of Asset Managers: Required Due Diligence for Plan Sponsors
July 31, 2014 WEBCAST
(Momentum Events Group)

Prototype Plan Seminar
July 31, 2014 in NV
(McKay Hochman Co., Inc.)

Retirement Plan Insights Seminar
August 5, 2014 in MA
(McKay Hochman Co., Inc.)

COBRA: A Practical and Regulatory Update
August 12, 2014 WEBCAST
(Lorman Education Services)

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[Guidance Overview]

California Governor Signs Bill Giving Small Businesses Extra Time to Comply with ACA
"For many of the approximately 250,000 California employers in the small-group market, SB 1446 will offer additional time to secure ACA-compliant coverage and make needed adjustments to health plans to manage cost increases that may result from the new requirements. Beginning in 2015, the Small Business Health Options Program (SHOP), which is operated by the California insurance marketplace (Covered California) will be open to smaller employers and will offer a variety of health insurance products and tax credits. The transition relief offered by SB 1446 will enable many smaller employers an opportunity to take better advantage of the SHOP marketplace when they procure fully ACA-compliant insurance policies." (Ogletree Deakins)  

[Advert.]

2014 Employee Well-Being Bootcamp

Take a fresh look at the evolution of wellness, innovative initiatives, and building programs founded on reconciling business goals with employee health accountability. July 23-24, Boston.

[Guidance Overview]

Massachusetts Completes Repeal of Employer-Sponsored Health Plan Requirements (PDF)
"[E]ven with the repeal of the employer provisions, the requirement that residents of Massachusetts either have coverage that satisfies the minimum creditable coverage (MCC) standards or pay a penalty will continue.... The maximum individual penalty in 2014 is $1,104. Employees, retirees, and dependents enrolled in an employer-sponsored plan that does not meet the MCC requirements may be subject to the tax penalties." (Buck Consultants)  

Did a Court Just Allow FMLA Leave for an Employee to Care for Her Grandchild?
"[Suzan's former employer] argued that Suzan should not have been granted FMLA leave because she sought leave to care for her grandchild, a reason obviously not provided for under the FMLA. But the court didn't see that way. Suzan looked after the kids while Suzan's husband went to work, a 'caring for' duty that the court determined benefited Suzan as she was recuperating.... Generally speaking, the courts have frowned upon indirect care... Suzan's case is one that involves indirect care, so the expansive reading by the Seventh Circuit takes the FMLA to a land we really have not seen before." [Gienapp v. Harbor Crest, No.14-1053 (7th Cir. June 24, 2014)] (FMLA Insights)  

Fifth Circuit: Denial of Death Benefit for Intoxicated Operation of Boat Not Abuse of Discretion; Exclusion Term 'Vehicle' Not Ambiguous
"The insured's wife and mother argued that the Mississippi legal definition of 'vehicle,' which was limited to use 'upon a highway,' created an ambiguity that should be construed in their favor. They pointed out that Mississippi law also distinguished 'vehicle' from 'watercraft,' and that federal law recognized that a 'vessel' was not a 'vehicle.' The Fifth Circuit explained that Mississippi law did not apply to interpret 'vehicle' in the [ERISA-covered employer-sponsored Accidental Death & Dismemberment] policies.... Additionally, the plain meaning of 'vehicle' in the policies was unambiguous and broad enough to include the boat the insured was operating." [Green v. Life Insurance Co. of North America, No. 13-60049 (5th Cir. June 11, 2014)] (Wolters Kluwer Law & Business)  

Eleventh Report to Congress on the Implementation of the Administrative Simplification Provisions of HIPAA (PDF)
"This report summarizes for the Congress advances made in [1] electronic health information; [2] support of administrative processes in health care including standards to support health care reform; [3] the development of a roadmap for standards adoption and implementation; [4] convergence of clinical and administrative requirements; [5] aligning policies and programs to improve efficiency and effectiveness; and [7] measuring success as well as the vision for the future." (The National Committee on Vital and Health Statistics, U.S. Department of Health and Human Services [HHS])  

[Advert.]

Join Us at the ACO Summit: West! August 13-14, San Diego

This unique event has been researched and developed for executives working on all stages of ACO development -- specifically for Health Systems, Hospitals, IPAs, Physician Groups, and Health Insurance firms. Continuing Education Credits offered!

Health CO-OPs Stumble
"CO-OPs have blamed the weak enrollment figures on various obstacles during the first year, including: higher prices than some of the national payers, the administration's decision to allow people to renew noncompliant plans, and problematic health exchange interfaces. Disappointing enrollment figures are especially troubling given the $2 billion in federal loans supporting the CO-OPs." (HighRoads)  

The Maker of Jumbo Jets Tries a Makeover of ACOs
"Within the half year, a large employer and three hospital systems in the Seattle area are launching an unusual accountable care experiment that removes the insurance company middleman. The arrangement is also notable because it will use practically every tactic under way in managed care: health savings accounts, value-based benefits, narrow networks and medical homes. The experiment involving large aerospace manufacturer Boeing Corp. will be closely watched not only for the ACO portion, but also for its everything-but-the-kitchen sink approach to making employees healthier while slowing down the costs of doing so." (HealthLeaders InterStudy)  

Blue Cross Blue Shield Association: Value-Based Care Delivers Huge ROI
"The Blue Cross Blue Shield Association's plans are spending more than $65 million a year in value-based payment programs that have a high return on investment. In 2012 alone, the plans saved $500 million.... The three keys to its success include: changing payment incentives and reimbursements to reward providers when they offer value and quality care; partnering with clinicians to provide necessary support, data and tools so they can implement quality care; and engaging patients with wellness programs and transparency tools, plus educating them about how to be more healthful and manage chronic conditions." (FierceHealthPayer)  

Pockets of Group Membership Migrate to Public Exchanges
"More than 60 percent of adults who enrolled in exchange plans and Medicaid were uninsured at least just prior to gaining coverage ... but 18 percent of the new enrollees had employer-sponsored insurance and 9 percent had individual policies. For new exchange plan enrollees, just under 60 percent were previously uninsured, 21 percent were on group plans and 17 percent were on individual plans." (Healthcare Payer News)  

[Advert.]

BenefitsLink app for iPad, iPhone and iPod touch now available!

Stay up-to-date while you're on the go with the BenefitsLink App -- now available for iPad, iPhone 5, and iPod touch.

Text of GAO Report on Private Health Insurance: Early Effects of Medical Loss Ratio Requirements and Rebates on Insurers and Enrollees
"Three of the eight insurers stated that the MLR requirements were one among several factors that influenced their decisions about premium rates. Four of the eight insurers stated they had recently made changes to their payments to agents and brokers, and one reported the MLR requirements were a primary driver behind its business decision. All eight insurers GAO interviewed stated that the MLR requirements did not affect their decisions to stop offering health plans in certain markets and have had no effect or a very limited effect on their spending on quality improvement activities." (U.S. Government Accountability Office [GAO])  

[Opinion]

Exclusive Provider Organization Is an Irreparably Flawed Concept
"EPOs tend to use narrower networks to leverage more favorable contracts with those who do participate which further limits patients' access and coverage.... The only rationale for EPOs is for the insurer to negotiate lower prices. It is a terribly inefficient and disruptive way to do that." (Physicians for a National Health Program [PNHP])  

Ferenczy + Paul LLP Announces Changes
Ferenczy + Paul LLP

ERIC Applauds House and Senate Tax-Writing Committees for Not Including PBGC Premium Increase in Highway Bill
ERIC [ERISA Industry Committee]

Great-West Financial Appoints New Chief Financial Officer
Great-West Financial

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