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BenefitsLink Health & Welfare Plans Newsletter

October 11, 2011

Employee Benefits Jobs

Senior Data Analyst (Healthcare / Pharmaceutical)
for 11199SEIU Benefit and Pension Funds in NY

Retirement Plan Consultant
for Bethesda, MD based financial services firm in MD

Director, Retirement Key Account Management (Southeast)
for Prudential in CT

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Webcasts and Conferences

401(k) Rekon Advisor Symposium- Costa Mesa in California on November 8, 2011 presented by 401(k) Rekon

Best Practices to Prevent 401(k) Litigation in California on October 20, 2011 presented by Western Pension & Benefits Conference - Orange County Chapter

Determination Letter Issues Regarding Employee Stock Ownership Plans Phone Forum Nationwide on October 28, 2011 presented by Internal Revenue Service (IRS)

[Guidance Overview]
Proposed Safe Harbor under ACA's Employer Responsibility Rule for Determining Household Income
"In Notice 2011–73, the Internal Revenue Service proposed and solicits comments on a safe harbor under which an employee's 'household income' is presumed to equal his or her W-2 wages solely for purposes of determining the amount of the employer penalty. This client advisory explains the impact of Notice 2011–73." (Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.)

2nd Annual Executive Forum on Creating a Culture of Health [Advert.]

Sponsored by World Congress

Employee Benefits professionals clearly recognize the benefits of health and wellness programs. Learn how to obtain the maximum value from these initiatives by shifting organizational norms and behaviors to a Culture of Health .


[Guidance Overview]
Can 'Open Multiple Employer Plans' Be Treated As Multiple Plans Under ERISA?
Derrin's back! In Q&A 300, attorney S. Derrin Watson posts and answers a new question in his popular column, Who's the Employer? Excerpt: "Open MEPs have a real problem. There is no relationship between the employers other than their participation in the plan, and the cosponsors have little or no control over plan operations, selection of fiduciaries, or other matters. Frankly, that's part of the appeal of open MEPs: leave the tough decisions to the experts and cast your fiduciary responsibilities aside. And the DOL is not above looking at the way a MEP is marketed to determine that it is not sponsored by a bona fide employer association." (S. Derrin Watson, Esq. on BenefitsLink.com)
[Guidance Overview]
Application of LTD Benefit Limitation Found Unreasonable; Potential Impact of Cigna v. Amara Noted
"Although the new analysis was not based on the SPD, we find it noteworthy that the court indicated that Amara's application may have impacted the earlier holding. Of course, while Amara noted that detrimental reliance must generally be shown in estoppel cases, it also suggested that there may be other available remedies that do not require detrimental reliance." (Thomson Reuters/EBIA)

Lawsuit Challenges Health Care Reform Employer Mandate
"Whereas other suits hinged mostly on a challenge to the law's 'individual mandate'—the requirement that most Americans obtain health insurance coverage—the Liberty University case also challenged similar requirements on employers to extend coverage to workers." (FOX News Network, LLC)

Essential Health Benefits: Affordability Is Key Criteria
"Recall that the ACA asks HHS to consider benefit packages offered by a 'typical employer' when designing the EHB. The IOM report narrows that approach by suggesting that packages of typical 'small' employers be the focus." (Wolters Kluwer Law & Business / CCH)

Lawyers Get Creative to Circumvent HIPAA's Lack of a 'Private Right'
"Patients may not have the right to sue covered entities for violations of HIPAA, but their attorneys are finding other laws, mostly at the state level, that allow patients to seek retribution after data breaches or other issues. And many of them have been successful." (Atlantic Information Services, Inc.; free registration required)

Don't Blame Doctors for High Health Care Costs
"The Kaiser Family Foundation released recently its latest estimate of what health insurance will cost in the future. By 2021, average family premiums are set to double, to more than $32,000. This year alone the premium is $15,073, up 9% from 2010." (USA TODAY)

Do Programs That Pay People to Lose Weight Really Work?
"The best programs are carefully calculated to exploit human nature: our love of a windfall, the risk of losing a small but significant financial stake, the camaraderie of a team effort, the heat of competition. All in the hope it may push us to do something difficult and unpleasant: shed pounds." (The Washington Post; free registration required)

Should Employers Require Employees To Have Flu Vaccinations?
"[The legal headaches from mandating the vaccination might be more painful than the aches and chills of the flu itself]. Forcing employees to get flu shots brings up issues with the U.S. Equal Employment Opportunity Commission, Title VII of the Civil Rights Act and the Americans with Disabilities Act Amendments Act . . . ." (Constangy, Brooks & Smith, LLP)

NCQA Releases Rankings of Health Plans by State
"National Committee for Quality Assurance rankings of health plans compare plans based on customer satisfaction, coverage of treatments for common conditions and provision of preventive services." (Mercer LLC)

Administration Wants To Work with Employers To Minimize Burdens under PPACA
"In describing several regulatory proposals which attempt to streamline the massive information swap between employers, exchanges, and the federal government, Yvette Fontenot, Deputy Director of the Office of Health Reform at HHS, noted that large multi-state employers simply 'may not have the capacity to deal with that many reporting requirements.'" (HR Policy Association)

New Health Care Developments Promote Patient/Consumer Involvement in Care (PDF)
"The federal government recently proposed two initiatives that have the potential to increase patient engagement and awareness of their own health care. First, [a Personal Health Record (PHR) Model Privacy Notice] will give patients/consumers an increased awareness of PHR vendors' privacy, security and data sharing practices. Second, [proposed rules] would allow patients direct access to laboratory test results." (Drinker Biddle & Reath LLP)

Bank of America Equalizes Health Costs for G.ay Employees
"Starting next year, the nation's largest bank will begin reimbursing its employees with same-s.ex partners for the extra taxes they pay for health insurance—something that their married heterosexual co-workers don't have to worry about because the federal government recognizes them as an economic unit." (The New York Times; free registration required)

Benefits in General; Executive Compensation

[Guidance Overview]
IRS Guidance Update on Per Diem Allowances and Optional Method for Computing Travel Expense Deductions
"The per diem rules can greatly simplify the process of substantiating business travel expense amounts. Note that if generous per diems exceed what will be deemed substantiated, employers must require substantiation, require return of the excess, or treat the excess as taxable wages." (Thomson Reuters/EBIA)

Institutional Shareholder Services Reports Pay and Governance Policy Survey Results
"[The new report] summarizes survey feedback on the proxy adviser's 2011 executive pay and governance policies. . . . Key US pay practices and board issues covered in this year's survey include pay for performance, say on pay, approval of equity plans, leadership structure and director elections." (Mercer LLC)

Milliman's Monthly Benefit News and Developments, October 2011 (PDF)
"The newsletter provides a summary of the previous month's legislative, regulatory, and judicial information on employee benefits and upcoming key dates." (Milliman, Inc.)



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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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