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August 1, 2014          Get Retirement News  |  Advertise
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Webcasts and Conferences

It’s Not Too Late to Switch to a Better Document System
August 5, 2014 WEBCAST
(ASC Institute)

Defined Benefit Plan Terminations Phone Forum
August 14, 2014 WEBCAST
(IRS [Internal Revenue Service])

Advising Small Employers About Health Care Reform: Your Guide to Applicable Rules and Impacts
August 27, 2014 WEBCAST
(Thomson Reuters / EBIA)

Bundled Payment Success Stories: Case Study Results from Geisinger and BCBSNC
September 24, 2014 WEBCAST
(Atlantic Information Services, Inc)

View All Webcasts and Conferences


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

You Filed Your 2013 Health and Welfare Plan 5500s, But Did You Include Your M-1 Attachments?
"For calendar year large health plans (over 100 participants), July 31, 2014 was the normal deadline for filing the 2013 Form 5500.... [N]ot all software providers that generate Form 5500 were able to make programming changes in time to automatically produce this attachment to the 2013 Form 5500s. Accordingly, preparers and plan administrators using those vendors needed to generate the required attachment manually, scan it and attach it to their 5500 on the EFAST System as 'other attachments.'" (Stinson Leonard Street)  


[Advert.]

Private Exchanges: The Future of Commercial Health Insurance?

Sponsored by World Congress

This conference will answer important questions about the viability of private exchanges, the role of single-source vs. multi-carrier platforms, and the product, pricing and benefit strategies of top insurers. $200 discount with code BLINK2.



[Guidance Overview]

IRS Provides Guidance for Employee Income Tax Correction for Same-Sex Spousal Health Coverage After U.S. v. Windsor
"Information Letter 2014-0012 [issued on June 27, 2014] does not require employers to issue corrected Form W-2s or seek a refund of federal employment taxes. Accordingly, considerations of payroll department workload and employee relations can determine whether issuance of a corrected Form W-2 or the seeking of a refund is appropriate.... [The Information Letter] outlines two possible correction methods for an employee who has had the value of same-sex spousal health coverage reflected on a Form W-2." (Jackson Lewis)  

[Guidance Overview]

Group Health Plans May Have Short Orientation Plus 90-Day Wait
"The clock starts ticking on the employee's start date and all calendar days count, including weekends and holidays. Employers could be in compliance with the final regulation on orientation periods while still being in violation of the play-or-pay mandate." (Towers Watson)  

Checklist for Employers: Upcoming Health and Welfare Plan Requirements
"[This article provides] a checklist of upcoming health and welfare compliance initiatives which require action by employers, including preparation for upcoming fees and penalties under the [ACA], the filing of required forms and distribution of relevant notices. July 31 -- Deadline to pay PCORI fee for 2013 plan year ... September 22 -- Deadline to execute updated business associate agreements for the final HIPAA regulations (generally applicable to agreements in effect on January 25, 2013) ... September 30 - Deadline to provide Summary Annual Report (if no Form 5500 extension granted) ... [More.]" (McDermott Will & Emery)  

Health Insurer That Paid Another Insurer's Claims Is Not Entitled To Reimbursement
"Although an insurer that covered students' sports injuries was obligated to pay for their medical expenses where its policy and a health insurer's policies overlapped, it did not have to reimburse the health insurer for payments that had already been made on the students' claims, according to the Sixth Circuit ... This was because the claim was brought under ERISA Sec. 502(a)(3)(B), which only provides for equitable, not monetary relief, the court held. The terms of the two insurers' policies conflicted with regard to which company was responsible for making payments." [Central States, Southeast and Southwest Areas Health and Welfare Fund v. First Agency, Inc., No. 13-2077 (6th Cir. July 1, 2014)] (Wolters Kluwer Law & Business)  


[Advert.]

COBRA: A Practical and Regulatory Update

Sponsored by Lorman and BenefitsLink

August 12 live webinar. Legal land mines will be revealed, and special issues relating to consumer driven health benefit strategies will be discussed, along with other intermediate and advanced issues. BenefitsLink discount.



Health Care Subsidies Issue Rushed to Supreme Court
"Unless the Court were to return from its summer recess to take up the issue in a special session, the earliest that it would be likely to act on the dispute would be this fall, when it will return for a new Term. Such special sittings have occurred in the past when a truly important and urgent national controversy had reached the Justices. In any event, the Court is unlikely to take any action on the new petition at least until the federal government has filed an answering brief." (SCOTUSblog)  

Text of Petition for Writ of Certiorari to Fourth Circuit in Challenge to Subsidies for Purchase of Health Insurance Through Federally-Facilitated Exchanges (PDF)
43 pages. "This is a challenge to the most consequential regulation promulgated under the [ACA]. Two Courts of Appeals have squarely divided over its facial validity. The resulting uncertainty over this major plank of ACA implementation means that millions of people have no idea if they may rely on the IRS's promise to subsidize their health coverage, or if that money will be clawed back. Employers in 36 states have no idea if they will be penalized under the ACA's employer mandate, or are effectively exempt from it. Insurers have no idea if their customers will pay for health coverage in which they enrolled, or if large numbers will default. And the Treasury has no idea if billions of dollars being spent each month were authorized by Congress, or if these expenditures are illegal. Only this Court can definitively resolve the matter; it is imperative that the Court do so as soon as possible.... [T]he Fourth Circuit ... found the Act ambiguous by claiming that the provision directing HHS to establish Exchanges in states that failed to do so could be read as creating a legal fiction under which even Exchanges established by HHS are 'established by the State.' That reading is obviously wrong." [King v. Burwell, No. 14-1158 (4th Cir. July 22, 2014; cert. pet. filed July 31, 2014)] (Via Competitive Enterprise Institute)  

Text of Second Circuit Opinion: New York Anti-Reimbursement Statute Not Preempted by ERISA (PDF)
"The New York statute at issue in this appeal ... states that a personal injury settlement presumptively 'does not include any compensation for the cost of health care services' or other losses that 'are obligated to be paid or reimbursed by a benefit provider' (such as an insurer), and that benefit providers have no 'right of subrogation or reimbursement against any such settling party.' ... Because [the statute] is specifically directed toward insurers and substantially affects risk pooling between insurers and insureds, we conclude that it is saved from express preemption under ERISA Section 514 as a law that regulates insurance ... [Further, because] plaintiffs' claims do not satisfy either part of the [Aetna Health Inc. v. Davila (U.S. 2014)] test, we hold that they are not completely preempted by ERISA." [Wurtz v. The Rawlings Co., LLC, No. 13-1695-cv (2d Cir. July 31, 2014)] (U.S. Court of Appeals for the Second Circuit)  

Florida's Largest Health Insurer Is Raising Exchange Rates an Average of 17.6 Percent
"Florida Blue, the state's largest health insurer, is increasing premiums by an average of 17.6 percent for its [ACA] exchange plans next year ... The nonprofit Blue Cross and Blue Shield affiliate blames higher health costs as a result of attracting older adults this year who previously lacked coverage and are using more services than expected." (Kaiser Health News)  

Third Circuit: ERISA Doesn't Preempt N.J. Prevailing Wage Law
[T]he court found the state statute provided an employer with an 'independent legal duty' to follow that didn't require reference to either an employee benefits plan or a specific collective bargaining agreement.... [T]he employer only needed to examine the prevailing wage levels and compare them against the wages and benefits that it was paying to its employees to determine if it was in compliance with the law. As a result ... a claim under the state statute was not completely preempted by ERISA or the LMRA and thus was not properly removed to federal district court in the first place." [New Jersey Carpenters and Trust v. Tishman Construction Corp. of N. D., No. 13-3005 (3rd Cir. July 28, 2014)] (Bloomberg BNA)  

Medicare: Insolvency Postponed (PDF)
"Insolvency of the [Hospital Insurance (HI)] trust fund does not mean that the Medicare program will run out of money. After depletion, the HI trust fund would continue to receive tax income from which some benefits could be paid; however, funds would only be sufficient to pay for 85% of Part A expenses in 2030 and subsequently drop to 77% by 2088." (Congressional Research Service [CRS])  

Medicare Prescription Drug Premiums Projected to Remain Low
"[CMS has projected] that the average premium for a basic Medicare Part D prescription drug plan in 2015 will increase by about $1, to an estimated $32 per month, continuing its historically low growth rate.... For the last four years ... the average premium for a Medicare Part D basic plan has been $30 or $31.... [This] projection for the average premium for 2015 is based on bids submitted by drug and health plans for basic drug coverage for the 2015 benefit year[.]" (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

House Social Security Subcommittee Chair Introduces the 'Stop Disability Fraud Act of 2014'
"The [Act] is a result of some very high-profile cases involving massive disability fraud rings, and the fact that a record 11 million people are on disability and the program's trust fund will be exhausted in just two years. The bill includes much stiffer penalties for fraud and stricter criteria for being authorized to physically/mentally diagnose a claimant or represent a claimant in court[.]" (National Center for Policy Analysis [NCPA])  

Implementing the ACA: State Action on Quality Improvement in State-Based Marketplaces (PDF)
"This issue brief reviews actions taken by state-based marketplaces to improve health care quality in three areas: [1] using selective contracting to drive quality and delivery system reforms; [2] informing consumers about plan quality; and [3] collecting data to inform quality improvement." (The Commonwealth Fund)  

ACOs Make Inroads with Employers
"Large companies such as Intel and Boeing are taking advantage of [accountable care organizations (ACOs)] and smaller companies are also getting on board with the idea that more coordinated care delivery with proper incentives will, over time, lead to lower employer costs and improved care for employees. But some warn ACOs are still in their infancy and there is no reliable way for employers to gauge their effectiveness." (Employee Benefit News)  

[Opinion]

How Obamacare Fuels Health Care Market Consolidation
"The growth of monopoly power among health care providers bears much responsibility for driving up the cost of health care over recent years.... Instead of freeing these markets to allow the provision of care by the most efficient organizations, the [ACA] endorses these anti-competitive arrangements. It extends the premium paid for treatment in general hospitals, employs the purchasing power of the Medicare program to encourage the consolidation of medical practices, and reforms insurance law to eliminate many of the margins for competition between carriers. Institutions sheltered from competition tend to accumulate unnecessary costs over time. In the absence of pro-competitive reforms, higher spending under Obamacare is likely to only further inflate prices faced by those seeking affordable care." (The Heritage Foundation)  

[Opinion]

2014 Medicare Trustees Report: Dire Future for Seniors and Taxpayers
"The Medicare actuary estimates that, under the most realistic set of policy assumptions, Medicare has a long-term unfunded obligation ranging between $28 trillion and $35 trillion. This means that the federal government has promised tens of trillions of dollars' worth of Medicare benefits that it does not currently have the money to pay for over the next 75 years. While this issue is routinely overlooked, the sheer enormity of these obligations is America's greatest entitlement challenge. The current path is unsustainable[.]" (The Heritage Foundation)  

[Opinion]

Extraordinarily High Prices for Certain Drugs Are a Systemic Threat
"Medicare Part D has been heralded as a bipartisan success -- a social safety net program with high satisfaction and lower-than-projected costs. But the affordability of the program -- as well Medicaid and private insurance -- is now in jeopardy as the prices of new specialty drugs skyrocket." (America's Health Insurance Plans [AHIP])  

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