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BenefitsLink Health & Welfare Plans Newsletter

September 23, 2011

Employee Benefits Jobs

Actuary
for The Angell Pension Group, Inc. in ANY STATE

Sr. Consultant, Business Development
for Milliman in TX

Pension Specialist
for Multi-Employer Trust Fund in NY

Internal Wholesaler/Senior Internal Wholesaler - Retirement Plans
for Mutual of Omaha Insurance Company in ANY STATE, NE

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Webcasts and Conferences

Controlled Groups Nationwide on October 13, 2011 presented by McKay Hochman Co., Inc.

How Providers & Payors are Collaborating to Design a Value-Based System Nationwide on October 26, 2011 presented by MCOL

Multi-Employer Plans in Mergers & Acquisitions Nationwide on November 10, 2011 presented by ABA Joint Committee on Employee Benefits

[Official Guidance]
Text of IRS Notice 2011-78: Nonapplication of Section 6050W to Insurance Companies that Administer Certain Insurance Arrangements (PDF)
"[The IRS will] amend the existing regulations under section 6050W to expressly provide that an insurance company or an affiliate administering a self-insured arrangement on behalf of an employer or other entity on a cost-plus basis, or under an Administrative Services Only (ASO) plan or an Administrative Services Contract (ASC) plan, will not be treated as a third party settlement organization." (U.S. Internal Revenue Service via BenefitsLink.com)

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[Guidance Overview]
Court Rejects FMLA Claim that Supervisor Exacerbated Illness
"The issue of serious health conditions covered by the FMLA causes human resources professionals some confusion. But as the 7th Circuit's decision in Breneisen v. Motorola, Inc. makes clear, what or who caused the condition is not an issue under the FMLA." (SmartHR)
[Guidance Overview]
Court Finds no Discrimination Based on Health Insurance Use
"In addition, the court noted that Berry's son's diagnosis preceded his termination by a few months and given his history of disagreements, defendants could have fired him far closer to the son's diagnosis if their true intent was to firm Berry to avoid paying for medical care." (PLANSPONSOR.COM)
[Guidance Overview]
Disability Plan Clawback Ruling Reversed and Remanded
"A U.S. Court of Appeals has reversed and remanded a clawback request on grounds that the insurer's calculations were inaccurate." (PLANSPONSOR.COM)
[Guidance Overview]
ACA Adaptation: Benefits and Coverage Summaries (PDF)
"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)

CLASS Act's Future is in Doubt
"The health law's long-term care program, which has faced concerns about its fiscal sustainability, appears at risk following reports that the HHS office overseeing it faces a key staff reduction." (Kaiser Health News)

CLASS is Adjourned; Long-Term Care Federal Program on Hold
Administration officials have decided to postpone implementation of the CLASS voluntary long-term care program ('Community Living Assistance Services and Supports') created under the recent federal healthcare reform legislation. Concerns have been raised about its cost. (Associated Press via Forbes)

IRS Seeks Comments on When an Employee's Premium for Health Expense Coverage is 'Unaffordable'
"[A proposed] safe harbor would allow employers to measure affordability by using wages that the employer paid to an employee, instead of the employee's household income. To avoid trouble under this scenario, the employee portion of the self-only premium for the employer's lowest cost coverage (that offers minimum required benefits under government's rules) would have to not exceed 9.5 percent of the employee's W-2 wages." (SmartHR)

Study Shows Potential Savings from Enrolling Dual Eligible Beneficiaries in Managed Care Plans
"A new study . . . examines the health care quality and savings potential of health plans and other care coordination models for Medicare/Medicaid dual eligibles. The study documents the potential savings of specific strategies used by health plans and other coordinated care models." (America's Health Insurance Plans)

Health Insurance Coverage: Early Release of Estimates from National Health Interview Survey, January–March 2011 (PDF)
"From January through March 2011, 46.5 mil.lion persons of all ages (15.3%) were uninsured at the time of interview, 60.5 mil.lion (19.8%) had been uninsured for at least part of the year prior to interview, and 34.2 mil.lion (11.2%) had been uninsured for more than a year at the time of interview." (Centers for Disease Control and Prevention, National Center for Health Statistics)

Benefit Changes in Michigan
"After much debate, the Michigan Senate and House have agreed on a compromise bill (Senate Bill 7) that limits the amount that public employers may contribute towards health benefits of its employees. The compromise takes the two prevailing approaches of a hard dollar cap and an 80/20 contribution split and provides public employers with the option." (Kushner & Company)

Benefits in General; Executive Compensation

[Guidance Overview]
Guidance on the Tax Treatment of Employer-Provided Cell Phones and Similar Telecommunications Equipment
"Observation: Employers that reimburse the cost of an employee's personal cell phone that is also used for business purposes should ensure that the cell phone's service plan, or the portion of the service plan that is reimbursed, is reasonably related to the scope of the employer's business needs. This may require the employee to substantiate the type of coverage provided in the plan (domestic vs. international, flat-rate vs. set minutes)." (PricewaterhouseCoopers LLP)

Attorney Fee Awards under ERISA
"An ERISA litigant now must only achieve 'some degree of success on the merits of a case' to be eligible for fees. The Court did not, however, elaborate on the scope of the new standard, and left open questions regarding just how much success in an ERISA matter is enough to sustain a fee claim: (1) Is a court order remanding a case to a plan administrator for further review enough success? (2) How does the standard apply if the claimant loses on remand? (3) What if a case settles prior to a decision?" (GableGotwals Insurance Law Practice)

Best Hiring Practices at Employee-Owned Companies
Hiring practices are an important aspect of developing and maintaining an ownership culture at a company with an ESOP or another employee ownership plan. To optimize the effectiveness of the hiring process, it is important for employee-owned companies to understand how to recruit and retain candidates who have not only the core skills required but also the core values. This issue brief shows how successful employee-owned companies accomplish this. (National Center for Employee Ownership)



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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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