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BenefitsLink Health & Welfare Plans Newsletter

August 24, 2011

Employee Benefits Jobs

Education Consultant
for AXA Equitable in CA, TX

Director of Client Operations @ fun, dynamic and growing company!
for The Online 401(k) in CA

Plan Document Specialist
for Lincoln Financial Group in IL, IN

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Webcasts and Conferences

Health Insurance Exchanges: What Employers Should Know Webinar Nationwide on August 30, 2011 presented by BNA, Inc.

HR Summit 2011 in Florida on October 17, 2011 presented by marcus evans

[Guidance Overview]
New Rules for Summaries of Health Benefits and Coverage (PDF)
"Comments on the proposed regulations, the template, and the uniform glossary are due by October 21, 2011." (Sutherland Asbill & Brennan LLP)

30th Annual ISCEBS Employee Benefits Symposium ? October 2011 [Advert.]

Sponsored by IFEBP (International Foundation of Employee Benefit Plans)

The Symposium is an unparalleled opportunity to learn from hundreds of industry colleagues, experts and leaders. Solution-oriented workshops, discussions, case studies and strategic sessions offer practical, timely takeaways. Register Now!


[Guidance Overview]
Guidance on Uniform Summary of Health Insurance Benefits and Coverage
"Sponsors of fully insured group health plans should check with their insurance carriers and prepare to begin distributing SBCs in accordance with the requirements described above starting March 23, 2012 (note that an immediate complete distribution of SBCs is not required). Also, because an insurance carrier generally satisfies its obligations by providing the form to the plan sponsor, sponsors should confirm with the carrier whether it is delivering the notice directly to participants." (Proskauer Rose LLP)
[Guidance Overview]
Medicare Part D Creditable Coverage Notice Issues
"The change in the annual election period means that employers must distribute notices of creditable (or noncreditable) coverage for Medicare Part D before October 15, 2011." (Dorsey & Whitney LLP)
[Guidance Overview]
Group Health Plan Internal and External Claim Review Requirements (PDF)
"The new Claims Review Rules added by the ACA incorporate by reference the claims review regulations set forth in ERISA . . . . Thus, if your group health plan is subject to ERISA, and your group health plan is not a grandfathered plan as defined by the ACA, you are responsible for complying with both ERISA's claims procedure rules and the new Claims Review Rules set forth in the ACA." (Alston & Bird LLP)
[Guidance Overview]
Settlement Approved in Years-Long Retiree Benefit Case
"Bargaining unit employees who retired under the Case Corporation Pension Plan for Hourly Paid Employees filed a lawsuit in December 2002 against El Paso Tennessee Pipeline Co. and Case arguing that when the firms required retirees to pay premiums to maintain their health care benefits they breached terms in collective bargaining agreements and violated [ERISA]." (PLANSPONSOR.COM)
[Guidance Overview]
Court Says COBRA Notice Claim Was Timely
"In reversing a lower court decision, the appellate court said it and other courts have applied a federal common-law rule under which a claim accrues when a plaintiff either knows or should know that he has sustained an injury." (PLANSPONSOR.COM)
[Guidance Overview]
HHS Issues Class Exemption for Stand-Alone HRAs
"The news report said stand-alone HRAs are relatively unusual, but have been used by employers to meet requirements set by a San Francisco law that requires employers to spend a minimum amount of money on health care coverage for employees in the city . . . ." (PLANSPONSOR.COM)
[Guidance Overview]
Proposed Regulations on Exchange and Premium Tax Credit Eligibility, SHOP Participation; Suggest Future Relief for Employers
"As we approach 2014, we can continue to expect plenty of guidance on Exchanges and premium tax credits. Employers and their advisors will especially look forward to the guidance that the IRS preamble suggests may be available later this year to stem mounting unease about how to provide minimum value sufficient to avoid the employer assessable payment, including the possible interplay with 'essential health benefits' alluded to in the preamble." (Thomson Reuters/EBIA)
[Guidance Overview]
Guidance Issued on Health Care Reform's Four-Page Summary Requirement
"This long-anticipated guidance answers some questions (for example, separate SBCs for each benefit option) and raises others (for example, the overlapping responsibilities of the insurer and plan administrator)—employers and their advisors will want to study all the details in the various pieces of the guidance." (Thomson Reuters/EBIA)
[Guidance Overview]
HHS's Preliminary Determinations Regarding State Compliance with External Review Standards
"Employers sponsoring insured group health plans may look to their insurers for compliance with the new external review requirements, and, as a result, the HHS determinations should create no compliance concerns for these employers directly." (Thomson Reuters/EBIA)

Campaign to Repeal the New, Annual Fee Assessed on Health Insurance Companies
"America's Health Insurance Plans, which lobbies for the insurance industry, says the provision will become a 'premium tax' that gets handed down to consumers." (The Washington Post; free registration required)

Key Recommendation for Medical Coverage Standards' Report May Miss September Deadline
"An 18-member IOM committee charged last year with developing recommendations for HHS recently signed off on their report, she said. The document is now being reviewed by a number of experts who will advise IOM before a final report can be sent to the department." (Thomson Reuters via Employee Benefit Adviser; free registration required)

[Opinion]
Postal Service Health Benefits Decision Could Have Wide Impact
"If the U.S. Postal Service is successful in its plan to withdraw from the Federal Employees Health Benefit Program (FEHBP), it would have ramifications for the entire federal workforce." (The Washington Post; free registration required)
[Opinion]
COBRA Premium Subsidies Should Be Reestablished
"[P]olicymakers should provide an additional extension of unemployment benefits when the current extension expires at the end of the year. They should then reestablish the COBRA premium subsidies that helped millions of people who lost their jobs during the recession maintain their health insurance coverage. These actions would shield many workers and their families from catastrophic health care costs and allow them to get the health care they need while they are between jobs." (The Commonwealth Fund)


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Jeanette Hull, News Editor
David Rhett Baker, J.D., Editor and Publisher
Lois Baker, J.D., President
Holly Horton, Business Manager

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