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Navigating the "Bermuda Triangle" of FMLA, ADA, and Workers' Compensation
August 14, 2014 WEBCAST
(Clear Law Institute)

How Value-based Insurance Design Breaks Down Barriers to Care
August 14, 2014 WEBCAST
(Association of Health Care Journalists [AHCJ])

What the New Healthcare Law Means for Your Small Business
August 21, 2014 WEBCAST
(Small Business Majority)

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[Guidance Overview]

New Responsibility for Self-Funded Employers: Obtain a Health Plan Identifier (PDF)
"[HHS recently updated the Code Set rules, which] create uniform electronic standards for common health plan administrative processes. Requiring health care providers and other stakeholders to use the same data formats for common transactions simplifies certain administrative aspects of providing and paying for health care. Under the latest rules, self-funded employers need to apply for a Health Plan Identifier (HPID). Most employers will have to apply by November 5, 2014. This number will be used to ensure employers comply with certain Code Set rules requirements." (McGraw Wentworth)  

[Advert.]

WEB's mission is to further the development of benefits professionals

We are committed to helping define the role of the benefits professional in the 21st century, and as changing market forces reshape the profession, WEB will help its members meet the challenges ahead.

[Guidance Overview]

EEOC Issues Sweeping Enforcement Guidance on Pregnancy Discrimination
"On July 14, 2014, the [EEOC] issued a detailed Enforcement Guidance on pregnancy discrimination and related issues ... Exclusion of all infertility coverage for all employees is gender neutral and does not violate Title VII, but exclusions of treatments that pertain only to one gender might violate Title VII.... [An] employer's health insurance plan must cover prescription contraceptives on the same basis as prescription drugs, devices and services that are used to prevent the occurrence of medical conditions other than pregnancy (such as vaccinations, physical examinations, prescription drugs that prevent high blood pressure or lower cholesterol levels). A health insurance plan is facially discriminatory if it excludes prescription contraception but otherwise provides comprehensive coverage." (Schiff Hardin)  

Strategies Employers Are Using to Control Health Plan Costs (PDF)
"[E]mployers continue to embrace CDHPs and wellness as long-term cost control strategies.... New options that may become available to the middle market include: Accountable care organizations (ACOs),... Patient-centered medical homes... Reference-based pricing ... [An] employer may offer telemedicine with a low copay, or no copay at all....[S]ome employers are structuring cost-sharing to steer members to outpatient facilities, stand-alone imaging centers and other less costly treatment venues." (McGraw Wentworth)  

Five Reasons We Can't Predict the Future of Health Costs
"1) What's happening with the overall economy? ... [2] Why has technological change slowed? ... [3] Will payment reforms take hold more broadly and be successful? ... [4] What will happen to out-of-pocket costs over time? ... [5] Will narrow networks survive?" (Vox)  

CDHPs: As Enrollment Goes Up, a Time to Tune Up (PDF)
"The authors discuss the advantages for organizations that offer CDHPs, as well as outline key considerations for companies looking to update, optimize and align their CDHPs with the realities of health care reform. They also explain how CDHPs go hand in hand with wellness and health management strategies, both of which increase collaboration between employees and employers to control costs and give employees more personal responsibility for better outcomes." (Benefits Quarterly, published by the International Society of Certified Employee Benefit Specialists [ISCEBS])  

An Examination of Physician Visit Cost Sharing and Benefit Design for Silver-Level Plans
"Nationwide, copayments for [primary care physician (PCP)] visits range from $0 to $75 with a median of $35. Coinsurance ranges from 0 percent to 50 percent with a median of 25 percent. For specialist visits, copayments range from $10 to $150 with a median of $75. Coinsurance ranges from 8 percent to 100 percent with a median of 40 percent. Unlike most employer-sponsored insurance plans, many Exchange plans subject PCP and specialist visits to a deductible." (Robert Wood Johnson Foundation)  

The Future of Premium Tax Credits in Federally-Facilitated Exchanges: The Implications of Halbig and King (PDF)
"By striking at the core of the ACA, the Halbig decision, if it ultimately prevails, could have a dramatic impact on the success of ACA. However, the impact may depend on the details of an issue that is not really addressed by either the Halbig or King court -- what exactly is a Federal vs. a State Exchange or, more precisely, what does a State need to do to establish an Exchange?" (Alston & Bird, LLP)  

Young Adults and Health Insurance: Not Invincible, But Perhaps Convincible
"Among the young adults who didn't sign up for coverage, fewer than one in five said it was because they don't expect to need insurance. But two-thirds said they just couldn't afford it.... Those who did get insurance said the most important reasons were to pay medical bills, to secure peace of mind -- and to avoid paying the federal penalty.... [M]ore than half of all respondents (those who signed up and those who did not) remain unaware that the federal government can help them pay for insurance, or that they can stay on their parents' policies until age 26." (Deloitte Center for Health Solutions)  

Text of GAO Report to Congress: 'Healthcare.gov: Ineffective Planning and Oversight Practices Underscore the Need for Improved Contract Management' (PDF)
66 pages. "CMS incurred significant cost increases, schedule slips, and delayed system functionality for the FFM and data hub systems due primarily to changing requirements that were exacerbated by oversight gaps... Late in the development process, CMS identified major performance issues with the FFM contractor but took only limited steps to hold the contractor accountable... As of June 2014, costs on the contract had increased to over $175 million due to changes such as new requirements and other enhancements, while key FFM capabilities remained unavailable. CMS needs a mitigation plan to address these issues. Unless CMS improves contract management and adheres to a structured governance process, significant risks remain that upcoming open enrollment periods could encounter challenges." (U.S. Government Accountability Office [GAO])  

Poor Planning and Oversight Led to Healthcare.gov Flaws, GAO Finds
"Building 'a first-of-its-kind marketplace' was certain to be a complex undertaking, the investigators conclude ... But agency officials aggravated the situation by allowing too little time for the work; changing the directions [they] gave the main contractor ... and not scrutinizing the contractor's progress, the investigators found.... Overall, the GAO concludes, the efforts of federal health officials 'were plagued by undefined requirements, the absence [of] a required acquisition strategy, confusion in contract administration responsibilities, and ineffective use of oversight tools.'" (The Washington Post; subscription may be required)  

Court Endorses PTO Use Under California Labor Code for Exempt Employee Partial-Day Absences
"Employers often confuse the strict rules limiting the docking of exempt employees' salary with different rules relating to partial-day deductions under vacation or 'paid time off' (PTO) policies. A California appellate court has reaffirmed and clarified the vacation rule in Rhea v. General Atomics, No. D064517 (Cal. Ct. App. July 21, 2014)." (Ogletree Deakins)  

[Opinion]

The Potential Side Effects of Halbig
"First, it would nullify the so-called 'employer mandate' in states using the federal marketplace.... Second, it would make the individual insurance market unstable and potentially unworkable in federal marketplace states." (Henry J. Kaiser Family Foundation)  

How Executive Compensation Plans Relate to Shareholder Value
"At the outperforming companies: Stock options play a prominent role in long-term incentive (LTI) programs.... Target compensation is at the market median, but actual pay is consistently above the median.... Compensation designs evolve as companies grow and mature.... CEOs are a relative bargain." (CFO)  

BLS Employment Cost Index, June 2014 (PDF)
"Compensation costs for civilian workers increased 0.7 percent, seasonally adjusted, for the 3-month period ending June 2014, the U.S. Bureau of Labor Statistics reported ... Wages and salaries (which make up about 70 percent of compensation costs) increased 0.6 percent, and benefits (which make up the remaining 30 percent of compensation) increased 1.0 percent." (U.S. Bureau of Labor Statistics [BLS])  

Institutional Retirement Income Council Believes Fiduciary Concerns over Lifetime Income Solutions for Retirement Plans May Be Overstated
Institutional Retirement Income Council

Penbridge Advisors to Introduce U.S. Pension Industry’s First Defined Benefit Expense Benchmarks Report
Penbridge Advisors

Health and Human Services Awards $54.6 Million in Affordable Care Act Mental Health Services Funding
U.S. Department of Health & Human Services

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