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BenefitsLink Health & Welfare Plans Newsletter

November 10, 2011

Employee Benefits Jobs

Pension Coordinator
for Directors Guild of America - Producer Pension and Health Plans in CA

Pension Representative
for Directors Guild of America - Producer Pension and Health Plans in CA

Assistant Manager, Pension Department
for Directors Guild of America - Producer Pension and Health Plans in CA

Compliance Administrator II
for Associated Pension Consultants in ANY STATE, CA

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Webcasts and Conferences

401(k) Rekon Advisor Symposium- Cincinnati in Ohio on December 8, 2011 presented by 401(k) Rekon

Are You Ready For the Revolution in Participant Communications? A webinar in New York on November 17, 2011 presented by Osler, Hoskin & Harcourt LLP

DB Plan Restatements Nationwide on November 29, 2011 presented by National Institute of Pension Administrators

Self Correction Program (SCP) and Closing Agreement Program (CAP) Phone Forum Nationwide on November 30, 2011 presented by Internal Revenue Service (IRS)

Conservative Group Calls on Justice Elena Kagan to Sit Out Health Care Cases
"Conservatives say [U.S. Supreme Court Justice Elena Kagan] should recuse herself from suits over the law's individual mandate because the administration began planning its defense while she was solicitor general." (The Hill)


American Health Care Congress and Exhibition [Advert.]

Sponsored by World Congress

Bringing together the health care community to discuss strategies aimed at more efficient and effective operation of our health system post-reform. December 5-6, 2011, Anaheim, CA.


Our Skyrocketing Health Care Costs, in One Chart
"The United States by far has the highest spending per capita, at $7,960 per person. None of the other ten, industrialized countries in the survey even come close . . . ." (Washington Post)

Health Plans Must Prepare for Consumer-Oriented Business Model
"Underwriting and risk management -- the traditional competencies of health plans -- won't be nearly as important as consumer-oriented product design, segmentation, and branding. Today, though, 'health plans have little expertise in those areas,' says Howard Lapsley, a partner at Oliver Wyman . . . ." (HealthLeaders Media)

Drug Shows Promise in Fighting Obesity
"Obesity has emerged as a global public-health problem. In the U.S. alone, about one-third of adults are considered obese. The condition is associated with cardiovascular disease, diabetes, cancer and other ailments." (Wall Street Journal)

Long-Term Care Costs: What's Next?
"What can those who were likely to benefit from the CLASS Act do now to pay for their current or anticipated long-term-care needs? How can the country deliver and finance long-term-care for its rapidly aging population? What role will providers play as Medicare and Medicaid payments are cut?" (MarketWatch)

Stern Advice: When to Skip Your Employer's Health Plan
"In general, if you're in a job that has a good health-care plan, it's usually a good idea to sign up. Employer-provided plans typically offer a high level of coverage, and they have to take you regardless of pre-existing conditions that could doom your attempts to buy private health insurance between now and 2014 (or thereafter, if the Supreme Court strikes out portions of the healthcare legislation.) But sometimes, buying your own coverage makes sense. Here are some considerations about when you may want to do that, and how to go about it." (Reuters)

Walmart Denies Plan to Build Major Health Care Platform
"Wal-Mart Stores Inc. erroneously portrayed its ambitions as a healthcare provider in a document sent to potential vendors recently, leading to the mistaken impression that the world's largest retailer wanted to become a national primary care provider." (Reuters)

Consumer Advocates Ramp Up Pressure on Health Insurers
"Consumers Union on Wednesday sent the White House a letter signed by more than 50 organizations demanding that the administration require simple, standardized health insurance forms starting next year, as called for in the [health care reform law]." (The Hill)

Five Key Lines in The Circuit Court Rulings on Reform
"The Supreme Court will convene on Thursday to decide whether to take up the case against reform. The universal expectation is that the high court will elect to grant certiorari, rather than avoid the lawsuits altogether. But which legal thinking will guide the justices' conclusion?" (California Healthline)

Judge Calls Pre-2014 Ruling on Health Insurance Mandate Premature
"Tuesday's 2-1 D.C. Circuit Court opinion could provide a roadmap for delaying a decision on the individual mandate until after 2014. Judge Brett M. Kavanaugh dissented from the majority opinion that upheld the mandate, writing that he thought it was premature for the courts to step in and decide the issue." (ABC News)

Supreme Court Health Care Reform Path Could Be Set Thursday
"All of the pending petitions ask the court to decide whether the mandate is constitutional. But they all ask the court to consider other questions, too, such as whether the law's Medicaid expansion and employer requirements are legal." (POLITICO.com)

Treasury Inspector General Report Says More Efforts Needed to Implement Tax Credits for Small Business Health Insurance Premiums
[A]s of mid-May 2011, just more than 228,000 taxpayers had claimed the Credit for a total amount of more than $278 mil.lion. The Congressional Budget Office had estimated that the Credit would cost $37 bil.lion over 10 years and that taxpayers would claim up to $2 bil.lion of Credit for Tax Year 2010. (Henry J. Kaiser Family Foundation)

ACA Would Cover 23 Mil.lion of The Uninsured Even If Individual Mandate Were Lifted
"If the individual mandate in the Patient Protection and Affordable Care Act (ACA) were lifted, premiums in the individual market likely would increase by 12.6%, with an estimated 7.8 mil.lion individuals losing coverage under the law, according to research from the Lewin Group." (Wolters Kluwer Law & Business / CCH)

Health Plan Assessed Double Damages for MSP Violation
"[The Sixth Circuit Court of Appeals has held that the Medicare Secondary Payer ('MSP') Act authorizes a medical provider to sue an employer health plan for double damages when the plan fails to comply with the MSP Act, thereby forcing the provider to accept the lower level of reimbursement available under Medicare." (Spencer Fane)

Evidence-based Medical Payment System Model Challenging to Implement
"A bundled health care payment model promoted by a group of employers, insurers and health care economics and policy experts is proving to be harder to implement in practice than had been envisioned in theory, according to researchers at RAND Corp." (Business Insurance)

New York Health Insurers Ordered to Refund $114.5M to Policyholders
"According to a department statement, most of the refunds — $44.7 mil.lion — are being made to large employers, defined as those that provide health care coverage to 51 or more plan members. Another $25 mil.lion is being refunded to small group plans, defined as those with 50 or fewer members." (Business Insurance)

Benefits in General; Executive Compensation

[Guidance Overview]
EBSA Issues Revised PT Exemption Procedures
"The updated procedures [clarify] the types of information and documentation generally required for a complete filing, by affording expanded opportunities for the electronic submission of information and comments relating to an exemption, and by providing plan participants and other interested persons with a more thorough understanding of the exemption under consideration." (Wolters Kluwer Law & Business / CCH)

2011 Survey of Top 250 Long-Term Incentive Grant Practices for Executives (PDF)
"For the first time in the history of this report, the use of long-term performance shares now is more prevalent than the use of stock options, while the prevalence of time-vesting restricted stock awards appears to have stabilized. Stock options continue to decrease in prevalence, but are not expected to go away, as they are by nature a performance-based long-term incentive vehicle and a common complement to full-value share awards." (Frederic W. Cook & Co., Inc.)

2011 Non-Employee Director Compensation Survey (PDF)
"Our findings confirm a general 'rule of thumb' in assessing director compensation programs: compensation levels vary primarily based on company size, while the structure of compensation is influenced by both company size and industry. As companies gain a better understanding of the increased responsibilities and perceived personal risk for directors, we anticipate that director compensation levels may increase at more rapid pace over the next several years." (Frederic W. Cook & Co., Inc.)



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David Rhett Baker, J.D., Editor and Publisher
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Holly Horton, Business Manager

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