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BenefitsLink Health & Welfare Plans Newsletter

December 13, 2011

Employee Benefits Jobs

401(k) Administrator
for TPA firm in San Diego, CA in CA

Employee Benefits Lawyer
for Lane Powell PC in OR

Sr Calc/Complex Spec
for Prudential in CT

Account Executive - Sales
for Liazon in CA, DC, DE, FL, MA, MD, NJ, NY, PA

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Webcasts and Conferences

Cafeteria Plan, Health FSA, and DCAP Mistakes: Finding, Fixing, and Preventing Nationwide on December 8, 2011 presented by Thomson Reuters / EBIA

[Guidance Overview]
FAQs Clarify Parity Requirements for Mental Health and Substance Use Disorder Benefits
"[DOL released a set of [FAQs] responding to questions raised regarding how the new parity requirements apply to nonquantitative treatment limitations, such as medical management standards, formulary designs, standards for provider admission to the network, and methods to determine reasonable and customary fees." (Deloitte via BenefitsLink.com)

Earn your CEBS (Certified Employee Benefit Specialist) Designation [Advert.]

Sponsored by IFEBP (International Foundation of Employee Benefit Plans)

CEBS is the most respected benefits designation in the industry. Co-sponsored by the International Foundation and the Wharton School, the program is an essential step for those who want to advance in the employee benefits industry. Learn More. .


[Guidance Overview]
Medical Loss Ratio Guidance Requires Insurers to Pay Employee Rebates to Policyholders for Employer-Sponsored Group Health Plans
"ERISA plan sponsors and advisors unfamiliar with the applicable ERISA fiduciary rules may wish to study them and consider what steps might be advisable in advance of the August 1, 2012 due date for the first rebates." (Thomson Reuters/EBIA)
[Guidance Overview]
DOL's Proposed New Rules Affecting Multiple Employer Welfare Arrangements
"Under the proposed rule, MEWAs that provide medical care benefits (but are not group health plans) are now required to register with the Secretary of Labor prior to operating in any state in the United States. The rule defines what constitutes 'operating' in a state; addresses how a MEWA may register . . .; describes what information must be included; and addresses the penalties for noncompliance (which include criminal penalties for intentional misrepresentation)." (Littler Mendelson P.C.)

MLR Rebate Program Likely Will Lead to Complicated Questions
"Some fiduciaries may decide to let the plan participants split the rebate money, but others may reinvest the rebate money in the plan . . . ." (LifeHealthPro)

Findings from the 2011 EBRI/MGA Consumer Engagement in Health Care Survey (PDF)
"The survey finds continued growth in consumer-driven health plans: In 2011, 7 percent of the population was enrolled in a CDHP, up from 5 percent in 2010." (Employee Benefit Research Institute)

USPS Hopes for Another Deferral on Mandatory Payment to Prefund Retirees' Health Benefits
"The Senate Homeland Security and Governmental Affairs Committee last month approved postal reform legislation that included language to restructure prefunded retirement health benefits, reducing the payment goal to 80 percent, and to require USPS to negotiate with its unions to develop a new employee health care plan." (National Journal Group, Inc.)

Texas Retirement System Changes Retirees' Health Plan to a Medicare Advantage Health-Insurance Plan
"With the change, the system's projected unfunded liability for retiree healthcare fell to $21.5 bil.lion as of September from a year earlier, according to a report to the fund's board Bloomberg reported." (PLANSPONSOR.COM)

Survey Report Highlights Several Concerns and Questions about Impact of Health Care Reform over Next Few Years (PDF)
"To better understand how employers are handling both current cost concerns and the development of a future health care strategy following the passage of [PPACA], Towers Watson conducted a survey of 368 midsize to large U.S. companies in July. The results confirm employers' commitment to health care . . . ." (Towers Watson)

Coverage of Bariatric Surgery Is Thin for Obese Kids
"As obesity among young people continues to rise, a growing number of clinicians and researchers say that weight-loss surgery may be their best chance to take off significant weight and either correct or avoid conditions like diabetes and heart disease, which often go hand-in-hand with obesity. But although health plans frequently cover bariatric surgery in adults, insurance coverage for the procedure in patients under age 18 is spotty." (The Henry J. Kaiser Family Foundation)

GAO Report: Federal Employees' Group Life Insurance: Retirement Benefit and Retained Asset Account Disclosures Could Be Improved
"GAO recommends that OPM (1) improve disclosures on important FEGLI features, (2) develop and implement a more structured process for reviewing the [Federal Employees' Group Life Insurance program] program and premium rates, and document review outcomes, and (3) improve disclosures on [retained asset account] protections and regulation." (U.S. Government Accountability Office)

Sprint Expands Wellness Efforts through Social Media
"Telecom giant Sprint estimates it saved approximately $1.1 mil.lion through a social media wellness challenge it launched last summer." (Employee Benefit News)

HHS Website: HIPAA Privacy & Security Audit Program
"The audit program serves as a new part of OCR's health information privacy and security compliance program. OCR will use the audit program to assess HIPAA compliance efforts by a range of covered entities[.]" (U.S. Department of Health & Human Services)

Dealing with Depression Difficult in Workplace
"'Stress and depression are very hot issues with employers,' said Christine Wilson, chief executive of the Mid-America Coalition on Health Care, which in 2000 began an initiative with a couple dozen large employers to understand and deal with depression." (The Kansas City Star)

Local Government Employee Health Insurance Programs, 2011, Survey Summary Results
The link can be found under downloads. (International City/County Management Association)

Legislation Barring Domestic Partner Benefits for Public Employees in Michigan Sent to Governor
"The measure was approved by the state House . . . mostly along party lines, with Republicans in support and Democrats opposed. It is aimed at ending programs that extend health care and other benefits to the unmarried partners of employees, usually in an effort to offer those benefits to same-s.ex couples." (Detroit Free Press)

[Opinion]
How Obamacare Targets Consumer-Directed Health Plans
"The MLR issue hinges on the requirement within Obamacare that forces insurers to spend no more than 20 percent of each insurance premium on non-health care costs in the small group and individual market, and 15 percent in the large-employer market. Shorthand: It's basically a hard cap for insurers' profits, which is odd, not just because such a thing is fundamentally un-American, but because insurers are not very profitable to begin with — averaging about 4 percent in profit." (The Heartland Institute)

Benefits in General; Executive Compensation

[Guidance Overview]
The ERISA Litigation Newsletter, December 2011
The newsletter includes the following: Third Circuit Finds 'Inequitable' The Enforceability of a Clear ERISA Welfare Plan Reimbursement Provision That Deprived a Participant of a Full Recovery; District Court Dismisses ERISA § 502(a)(2) Claim Based on Plaintiffs' Failure to Make Pre-Suit Demand; Application of ERISA Section 510 to Internal Workplace Complaints: A Review of Circuit Court Decisions; and, Rulings, Filings, and Settlements of Interest. (Proskauer Rose LLP)
[Guidance Overview]
New York's Same Se.x Marriage Law Has Broad Implications for Employee Benefit Plans
"Despite the broad application of DOMA, and perhaps to some extent because of it, states have begun to consider and in some cases enact laws that extend marriage rights to same se.x couples. By extension, these laws effectively require employers within those states to provide certain benefits to same se.x couples to the extent that these laws are not found to be preempted under ERISA or otherwise in conflict with federal law." (Porter Wright Morris & Arthur LLP)

Getting Executive Compensation Ready for 2012: Starting with ISS Guidelines (PDF)
"This Client Alert addresses some of the key implications for publicly traded U.S. companies, and is followed by our article titled 'Candor for Compensation Committees' which is reproduced from the latest edition of Board Member magazine because the article highlights actions that compensation committees should be taking this winter in order to be ready for the 2012 proxy season." (Paul Hastings LLP)

Companies Bolster Pay-for-Performance in Executive Comp Due to 'Say on Pay'
"Experts from consulting firm PricewaterhouseCoopers detail concrete preparations and advice for companies to reform their executive compensation practices in anticipation of what promises to be an even tougher shareholder vote in 2012." (Employee Benefit News)

2012 Resolutions for Employee Benefits and Executive Compensation
"This article identifies three key employee benefits and executive compensation items that employers should resolve to focus on in 2012: 1) Review compensation plans and practices for compliance with Section 162(m) of the IRC; 2) Plan for summaries of benefits and coverage for group health plans; and 3) Prepare to comply with DOL fee disclosure requirements." (Practical Law Company)

IRS Reminds Dual Citizens and Americans Living Abroad of FBAR, Other Filing Requirements
"In a fact sheet (FS-2011-13) released Friday, the IRS reminded U.S. citizens and dual citizens of the United States and foreign countries who live abroad about U.S. filing requirements, including Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts (FBAR)." (American Institute of Certified Public Accountants)

[Opinion]
The Commuting Tax Break Puzzle: Why Driving Is Rewarded Over Taking the Bus
"This backward state of affairs, where a solo driver in a Lexus trumps the hordes of people standing on the city bus and riding the suburban commuter train, is in part an accident of history." (The New York Times; free registration required)
[Opinion]
PayScale.com's Publication of 'Pay Ratios' Masks the Complexity of Dodd-Frank Requirement
"This week, PayScale.com, an online compensation database, produced its version of the ratio between CEO and median employee pay for the Fortune 50 companies, thereby perpetuating the misperception that it will be easy for companies to comply with the Dodd-Frank pay ratio mandate." (HR Policy Association)


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

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