ESOP Retirement Plan Administrator
Alerus Retirement Solutions
in MN

Senior Implementation Project Manager
The Newport Group
in FL

Form 5500 Compliance Specialist
ERISA Pros, LLC
in GA

Post Your Job

View All Jobs

RSS Feed: All Jobs

[Guidance Overview]

Transferring Information Among the Exchanges, the IRS, and Taxpayers
"When these individuals file their tax returns in the spring of 2015 based on their actual 2014 income, the IRS will have to reconcile the advance premium tax credits they have received with the tax credits to which they were entitled given their actual 2014 income.... This will not be a simple calculation, as individuals will not only have to calculate the amount of the penalty, but will also have to determine whether coverage was 'affordable' ... or whether they had a short-term gap ... in coverage, and thus qualify for an exemption." (Timothy Jost for Health Affairs)  

[Advert.]

Public Insurance Exchanges: Life After the Launch

The impact of price on market share, the role of the 3Rs in stabilizing plan profits, narrow networks, and the emergence of both co-op and provider-owned plans. Speakers from both traditional health plans and new emerging competitors. $200 discount with code BLINK2.

OCR Expects Scrupulous Consistency in HIPAA Breach Response
"When investigating a breach of IT network security leading to leakage of protected health information, HHS looks for consistency in the covered entity's response -- with both HIPAA rules and the organization's own written procedures, according to a former official with HHS' Office for Civil Rights. OCR tends to 'expect a perfect assessment done the same way every time,' said David Holtzman ... OCR also wants to see policies and procedures that are 'almost a recitation of the notification process.'" (Thompson SmartHR Manager)  

HHS Final Regs Establish October 1, 2015 as the New ICD-10 Compliance Date
"[M]ost health plans were on track for the October 1, 2014 compliance date, and this delay will disrupt their implementation plans and result in additional costs. Now, covered entities (including health plans) will need to put ICD-10 implementation on hold to ensure that their systems can accommodate continued use of the ICD-9-CM codes until September 30, 2015, and then be prepared to switch to the ICD-10 codes, beginning on October 1, 2015." (Thomson Reuters / EBIA)  

How the ACA and Exchanges Are Driving a New 'Whole Workforce' Strategy
"One of the more prevalent and potentially game-changing perspectives is what [the authors] refer to as 'benefits for the whole workforce.' ... It's an incredible -- and incredibly complex -- challenge to address the needs of each type of employee. But new technology and connectivity options through private and public marketplaces are making it possible to not only meet the needs of a company's whole workforce, it's making it easy to thrive as a broker and as a consumer in this new world order." (The Institute for HealthCare Consumerism [IHCC])  

Court Awards Penalty for Failure to Provide COBRA Election Notices, But No Penalties for Covered Individual Who Was Not a Qualified Beneficiary
"Note that group health plans may cover individuals, such as this 'legal domiciled adult,' who are not qualified beneficiaries. But while these individuals (who could also include, for example, domestic partners, parents, siblings, or unrelated individuals) may be covered under the plan, they are not entitled to elect COBRA in connection with a qualifying event." [Honey v. Dignity Health, No. 2:12-cv-00416-MMD-GWF (D. Nev. June 16, 2014)] (Thomson Reuters / EBIA)  

[Advert.]

COBRA: A Practical and Regulatory Update

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.

ACA Preempts Arizona Law That Would Cancel Individual Health Insurance Mandate
"The provision of a 2010 voter-approved measure saying Arizonans don't have to buy health insurance is unenforceable because it conflicts with the [ACA], a federal appeals court [has] ruled ... A three-judge panel of the 9th U.S. Circuit Court of Appeals rejected claims ... that the state constitutional amendment provides protections for Arizonans from the federal directive. The judges also said language in the Arizona amendment prohibiting fines for those who refuse to buy the mandated coverage is similarly unenforceable." [Coons v. Lew, No. 13-15324 (9th Cir. Aug. 7, 2014)] (Capitol Media Services, via Yuma Sun)  

From Initial Rate Filings to Final Premiums: Peering Into the Black Box (PDF)
"Final premiums paid by consumers are the end results of a months-long process that begins with the development of rates for proposed 2015 insurance policies.... Filing requirements and rate review apply to policies offered in a given state, whether or not they are offered through exchanges ('marketplaces') established under ACA. Each state specifies the timeline by which these processes occur; therefore, any rates made publicly available at this time should be viewed with caution. Often early analysis of '2015 premiums' is based on information from form and rate filings." (Congressional Research Service [CRS])  

Washington's $10 Billion Search for Health Care's Next Big Ideas
"The [ACA] created the Center for Medicare and Medicaid Innovation to launch experiments in every state, changing the way doctors and hospitals are paid, building networks between caregivers and training them to intervene before chronic illness gets worse.... In several states the office is working to overhaul medicine for nearly all residents -- not just those with government Medicare and Medicaid coverage.... More than $2 billion has been doled out or committed since 2011. One of the biggest experiments is the center itself." (Kaiser Health News)  

Summary Cost Data for Federally-Facilitated Exchanges, 2014 (PDF)
"[HHS] established a data website that makes premium and cost-sharing data, for plans offered through federally-facilitated exchanges (FFEs), available to researchers and the general public. CRS developed a fact sheet for each of the 34 FFEs that offer private health plans to individuals and families. Each fact sheet provides summary data about the range of costs and options for plans in a specific state's marketplace." (Congressional Research Service [CRS])  

Arizona District Court Rules That Healthcare Providers Are Not ERISA Beneficiaries
"In a decision sharply at odds with a recent Illinois ruling, a federal district court in Arizona held that health care providers cannot be characterized as plan beneficiaries who can sue to compel payment of ERISA benefits. The court rejected the view that a direct payment for services is an ERISA benefit that give providers the right to sue under ERISA -- such a right only comes from an assignment of benefits from a plan participant, it held. Characterizing beneficiaries as more than just a covered spouse or dependent would undermine ERISA, the court decided[.]" [DB Healthcare v. Blue Cross Blue Shield of Arizona Inc., No. CV-13-01558 (D. Ariz. July 9, 2014)] (Thompson SmartHR Manager)  

Bundled Payment Contracts Under ACA Continue to Gain Influence
"Proponents of the bundled payment initiative are hopeful that this new approach to health care can lead not only to increased accountability for health care spending (and therefore greater cost-consciousness from providers), but also more transparency for health care consumers, whether employers, health insurers, or the patients themselves. Early market studies are showing a hearty enthusiasm from consumers, who are eager to better understand the costs of their care." (Sheppard Mullin)  

[Opinion]

The Total Evisceration of the Individual Mandate: 98.8% of Americans Won't Pay It
"We are up to 22 different ways a person can opt out of Obamacare. In fact, if you can't generate an exemption for yourself, you aren't even trying. If you can fog a mirror, you have a 99% chance of excusing yourself from the individual mandate. The Congressional Budget Office (CBO) now estimates that only 3.9 million Americans will pay that mandate in 2016. We have approximately 319 million people in our country. Hence, 1.2% of Americans will actually pay the fine." (Benefit Revolution)  

[Opinion]

Actuarial Value, Cost Sharing Limits, and Indexing Are at Odds with Lower Costs, Better Benefits, and Additional Consumer Protections
"Every year CMS updates a calculator that determines if an insurance plan meets the strict requirements of what Obama considers 'good' insurance.... Over time, plans that have a very low out-of-pocket will no longer be offered because good insurance doesn't equal 'Obamacare good' insurance. These tiers aren't designed to change, so as time goes on the health insurance plans people like, even the Obamacare compliant ones sold today, will no longer be available. Think about that for a moment: Obamacare increases your out-of-pocket maximums and calls that 'better' insurance." (InsureBlog)  

[Opinion]

Text of Comments by AFL-CIO to SEC on Dodd-Frank Pay Ratio Disclosure Requirements (PDF)
"The SEC should implement Dodd-Frank Section 953 as soon as practical.... Pay for performance data should supplement the summary compensation table ... 'Realized Pay' does not equal 'Executive Compensation Actually Paid'... Alternative pay formulas can dramatically understate executive compensation ... The SEC should require disclosure of quantifiable pay-for-performance metrics." (U.S. Securities and Exchange Commission [SEC])  

Contributions Invited for "What the Heck Was I Doing Back in 1974? - How the Birth of ERISA Affected Me"
Ferenczy Benefits Law Center LLP

Mercer Announces Senior Hires to Support Growing Client Needs in the Midwest
Mercer

SunGard Releases White Paper on How Managed Services Can Help Retirement Administrators Improve their Bottom Line
SunGard

View All Press Releases