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BenefitsLink Health & Welfare Plans Newsletter

February 5, 2013

Employee Benefits Jobs

Client Services Analyst
for SunGard Financial Systems in FL

Retirement Plan Specialist
for Retirement Plan Services, LLC in IA, MO

Benefits Compliance/Nondiscrimination Testing Analyst
for Insperity in TX

DC Administrative Specialist
for Benefit Equity Inc in CA

Client Service Representative
for Benetrends, Inc. in PA

Plan Administrator
for The Newport Group, Inc. in FL, TX, VA

Retirement Education Specialist
for The Newport Group, Inc. in NC

Document Support Specialist
for ftwilliam.com/Wolters Kluwer in ANY STATE

Customer Conversion Assistance Specialist
for ftwilliam.com/Wolter Kluwer in ANY STATE

ERISA Attorney/Analyst
for ftwilliam.com/Wolter Kluwer in ANY STATE

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Webcasts and Conferences

401(k) Advisor Symposium - Schaumburg in Illinois on February 26, 2013 presented by 401(k) Rekon

Understanding DB Language and Reports, Post-PPA Nationwide on April 17, 2013 presented by National Institute of Pension Administrators

Healthcare Reform - The Employer Pay or Play Rules! Webinar Nationwide on February 13, 2013 presented by Trucker Huss

HSAs, HRAs, and Consumer-Driven Health Care in Nevada on April 3, 2013 presented by Thomson Reuters / EBIA

ERISA Compliance for Health & Welfare Plans in Nevada on April 3, 2013 presented by Thomson Reuters / EBIA

HIPAA Privacy & Security in Nevada on April 4, 2013 presented by Thomson Reuters / EBIA

Cafeteria Plans in Nevada on April 2, 2013 presented by Thomson Reuters / EBIA

COBRA Compliance for Group Health Plans in Nevada on April 4, 2013 presented by Thomson Reuters / EBIA

Health Care Reform in Nevada on April 5, 2013 presented by Thomson Reuters / EBIA

2013 First Quarter Update Nationwide on February 21, 2013 presented by McKay Hochman Co., Inc.

2013 First Quarter Update Nationwide on February 20, 2013 presented by McKay Hochman Co., Inc.

Employee Plan Compliance Resolution Systems (EPCRS) 2013 Nationwide on February 12, 2013 presented by McKay Hochman Co., Inc.

View All Webcasts and Conferences


[Official Guidance]

Text of Final FMLA Regs Relating to Military Leave, Airline Pilots and Intermittent Leave
"This Final Rule amends certain regulations of the FMLA to implement amendments to the military leave provisions of the Act made by the National Defense Authorization Act for Fiscal Year 2010 ... to implement amendments to the hours of service requirements made by the Airline Flight Crew Technical Corrections Act ... and add new leave calculation regulations for flight crew employees, and to clarify existing regulatory provisions related to intermittent leave and make other clarifying changes." (U.S. Department of Labor, Wage and Hour Division)


[Advert.]

Upcoming Webcast: HIPAA Privacy and Security Regulations

Sponsored by IFEBP (International Foundation of Employee Benefit Plans)

Don't miss this update! New HIPAA regulations containing significant changes for employers, plan sponsors and business associates have been released. They contain a quick compliance date: September 23, 2013 for many items. Register Now for this February 19 webcast!


[Guidance Overview]

Proposed Contraceptive Compromise Rule Released
"[T]he Departments did not address potential ERISA issues that this structure could implicate. Remember, the whole construct is that the employer is not arranging for, paying for, or otherwise providing the coverage. So is this individual coverage or employer coverage (or neither)? Are Forms 5500 required if more than 100 individuals select the separate contraceptive coverage? Who would be responsible for the preparation of those forms and SPDs?" (Benefits Bryan Cave)

[Guidance Overview]

HHS Publishes Sample Provisions for HIPAA Business Associate Agreement
"In addition to updating existing contracts, covered entities should review all of their service provider relationships and determine if any additional business associate contracts are needed.... Business associates should identify any subcontractor relationships that may require business associate contracts. And since the sample provisions are very general in nature, both covered entities and business associates would be wise to confirm that the 'optional' provisions of their contracts accurately reflect both parties' understanding of applicable timelines and how compliance responsibilities have been allocated." (Thomson Reuters / EBIA)

[Guidance Overview]

Four Key Areas of the New HIPAA Privacy Regulations
"[These] four areas ... may have the greatest impact (in terms of privacy compliance) in the health care industry. [1] Potential Increase in Breach Notifications ... [2] Imposition of New Restrictions on Using PHI for Marketing Purposes ... [3] Potential Increase in Liability to Covered Entities for Acts of Business Associates ... [4] Direct Liability to Business Associates." (Epstein Becker & Green, P.C.)

[Guidance Overview]

HHS Regs Bring New HIPAA Breach Notification Standard
"Unfortunately, the new regulation does not define 'compromised.' For purposes of breach notification, the mere acquisition, use or disclosure of PHI alone does not necessarily mean that the PHI has been compromised. HHS noted that a contrary rule would overburden both covered entities and individual recipients with reports of 'inconsequential' breaches." (Holland & Hart)

For Insurance Exchanges, States Need 'Navigators' -- and Hiring Them Is a Huge Task
"While some people will find registering for health insurance as easy as booking a flight online, vast numbers who are confused by the myriad choices will need to sit down with someone who can walk them through the process. Enter the 'navigators,' an enormous new workforce of helpers required under the law. In large measure, the success of the law and its overriding aim of making sure that virtually all Americans have health insurance depends on these people. But the challenge of hiring and paying for a new class of workers is immense and is one of the most pressing issues as the Obama administration and state governments implement the law." (The Washington Post; free registration required)

We-Have-To-Pass-It-To-Find-Out-What's-In-It Fact of the Day
"Health insurers started sending out notices in January informing insurance brokers and agents that the companies will no longer guarantee that premium rate. From now on it's month to month. And that's not because they expect next month's premium to go down." (John Goodman's Health Policy Blog)

Employee Questions on ACA Exchanges Likely to Spike
"[A]bout 2% of uninsured people could purchase health insurance through a workplace plan, but simply chose not to do so. These same employees are likely to have questions about exchange eligibility come this fall, and turn to their HR department (and broker) for answers. For example, according to a ... survey compiled last fall, 78% of all uninsured were not aware that they may qualify for subsidies and will have coverage options in 2014." (Employee Benefit News)

Unwritten Risk of Relapse Exclusion is Unreasonable, First Circuit Says, Creating Split with Fourth Circuit
"[T]he court noted that [the disability insurance company] could have written into the plan an exclusion for the risk of relapse, but it had not. For the court, '[i]mporting into an ERISA plan an unwritten proviso categorically excluding risk of relapse as a basis for disability undercuts a plan administrator's higher-than-marketplace quality obligation to use its discretion to process claims solely in the interests of the participants and beneficiaries' of the plan.' ... [T]he First Circuit recognized that the Fourth Circuit had reached the opposite conclusion that a risk of relapse, even if significant, cannot ground a claim for LTD benefits absent an actual relapse." (Seyfarth Shaw LLP)

Employer Not Estopped from Denying Medical Leave, California Court Rules
"Ruling that an employer did not misrepresent by deed or silence that its employee's leave had been approved, the California Court of Appeal has affirmed a judgment in favor of an employer under the federal Family and Medical Leave Act and the California Family Rights Act, and has rejected the employee's claim that the employer was prevented from denying the leave and terminating the employee for failing to report for work when directed." [Olofsson v. Mission Linen Supply, No. A131471 (Cal. Ct. App., Dec. 13, 2012)] (Jackson Lewis LLP)

Two Wrongs Make a Right in Eighth Circuit's Denial of COBRA Penalties
"The Eighth Circuit considered whether it was appropriate for the bankruptcy court to have weighed the benefit of free medical care against the prejudice from failing to receive a COBRA notice. The plaintiff argued that it was improper for the court to have applied this type of 'hindsight' analysis. Two of the three judges sitting on the Eighth Circuit panel disagreed, holding that the 'free, ongoing coverage under the Plan despite the lack of a COBRA notice is plainly relevant to the degree of prejudice he suffered'." (Littler Mendelson LLC)

ML Strategies Health Care Reform Update, February 4, 2013
Update on developments in federal and state health care reform legislation and regulations, including summaries of recent announcements and regulatory activity by HHS, CCIIO, IRS and CMS. (Mintz Levin)

Health Care Spending In America, In Two Graphs
"Despite huge changes in medicine and medical technology, the share of health dollars that flows to each major category has changed little in the past 40 years. In other words, spending on each category -- drugs, hospitals, doctors, etc. -- has increased at about the same rate. What has changed dramatically is where the money comes from." (Kaiser Health News)

Online Tools to Help You Find and Price Small Business Health Care Insurance Options
"As small business owners, getting the right information from a credible resource is critical.... Here's a breakdown of some of the tools and features that you can find at Healthcare.gov. [1] Understand the Affordable Care Act as a Small Business Owner ... [2] Find Healthcare Insurance Options for Your Small Business ... [3] Assess and Compare Quality of Care." (U.S. Small Business Administration)

Family and Medical Leave Act in 2012: Final Report
"The vast majority of employers, 91 percent, report that complying with the FMLA has either no noticeable effect or a positive effect on business operations such as employee absenteeism, turnover and morale. Finally, 90 percent of workers return to their employer after FMLA leave, showing little risk to businesses that investment in a worker will be lost as a result of leave granted under the act." (Employee Benefits Security Administration)

[Opinion]

Deloitte Health Care Reform Memo, February 4, 2013
"Some believe that the problems of health care are too complex to be solved.... They're simple. At approximately $9,000 per capita, our health system is under-performing. No excuses. We spend more than any other country on the planet, but operate a system no one understands, and its costs are threatening our long-term economic survival. There's plenty of money in the system. That's not the problem." (Deloitte Center for Health Solutions)

[Opinion]

The Insured and the Unsure
"In 2014 the main provisions of Obamacare will come into force. The biggest uncertainty is whether the law will prompt employers, which currently provide most working Americans and their families with health insurance, to stop doing so. Surveys suggest most firms that currently provide their staff with insurance will not drop it straight away. But some will. And even for those that keep insurance, big changes are inevitable." (The Economist, reprinted in CFO)

[Opinion]

The HHS Contraceptives Mandate Isn't Fixed
"While the administration has expanded the definition of institutions that could qualify for a 'religious employer exemption,' the 'accommodation' is no different than the notice issued last year. The administration still intends to force health-insurance companies to provide the coverage." (Galen Institute)

[Opinion]

Whole Classes of Americans to Experience Obamacare Sticker Shock for Mandatory Healthcare They Can't Afford or Access (PDF)
"[HHS has] unveiled new Obamacare waivers to the individual coverage mandate, offering hardship exemptions to several classes of Americans that do not meet specific income thresholds. Among those groups are the family members of a spouse who has access to an affordable employer-sponsored individual policy and individuals who would be eligible for expanded Medicaid coverage in states that choose not to expand the Medicaid program. These exemptions create huge classes of still uninsured Americans, despite the Obamacare promise of ensuring that every American has health insurance that is affordable and accessible." (Citizens' Council for Health Freedom)

Benefits in General; Executive Compensation

[Guidance Overview]

SEC Approves Listing Rules Affecting Compensation Committees and Advisers
"Under the new listing requirements, ... members of the compensation committee must meet heightened independence tests akin to the heightened requirements for members of the audit committee. Additionally, the compensation committee must be vested with the authority to retain outside advisers and is required to evaluate the independence of such advisers prior to their engagement. The new listing rules do not, however, require that compensation advisers meet any specific independence test or mandate that companies retain compensation advisers in developing their executive compensation programs." (DLA Piper)

Cypen & Cypen Newsletter for January 31, 2013
Covers employee benefit developments with an emphasis on governmental plans. Topics in this issue include: Alaska Bucks Trend, Considers Traditional Pensions; Non-taxable Pension Amounts Under Section 72(D); Pew Report on Cities' Funding for Pensions; Michigan Governor Asks State Supreme Court To Rule on Right To Work; New York Comptroller Goes After Governor's Plan To Cut Pension Costs; California Bill Exempts Thousands of Public Employees From Pension Overhaul; Callan Table of Investment Returns. (Cypen & Cypen)

Press Releases

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David Rhett Baker, J.D., Editor and Publisher
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