Gross Strategic Marketing

Manager of Retirement Plan Processing
for Aspire Financial Services in FL

Pension Administrative Support
for TPA in Tampa, FL in FL

Benefits Administrator/Analyst
for General Atomics in CA

Account Manager II/III
for Lincoln Financial Group in ANY STATE, IN

Manager, RegulatorySupervision (Retirement Plan Compliance)
for Prudential in CT

Qualified Plan Administrator
for Trust Company of America in CO

On-Site Education Specialist
for Milliman in AR

Operations Daily Processing Supervisor
for Alliance Benefit Group of Houston, Inc. in TX

Processor for Defined Contribution Plans
for Alliance Benefit Group of Houston, Inc. in TX

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Overview of Types of Plans Nationwide on April 16, 2013 presented by McKay Hochman Co., Inc.

Qualified Plan Essentials Plus Series Nationwide on April 16, 2013 presented by McKay Hochman Co., Inc.

Roadmap to Compliant Wellness Programs Nationwide on April 30, 2013 presented by ABA Joint Committee on Employee Benefits

"401(k) Plan Workshop 2013: Tax Reform and the 401(k) Plan" - Appleton in Wisconsin on May 8, 2013 presented by SunGard Relius

"401(k) Plan Workshop 2013: Tax Reform and the 401(k) Plan" - Detroit in Michigan on May 8, 2013 presented by SunGard Relius

"401(k) Plan Workshop 2013: Tax Reform and the 401(k) Plan" - Bloomington in Illinois on May 10, 2013 presented by SunGard Relius

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[Guidance Overview]

CMS Releases 2014 Medicare Part D Benefit Parameters (PDF)
"Plan sponsors that want to remain qualified for the employer retiree drug subsidy will have to determine if their 2014 prescription drug coverage is at least actuarially equivalent to the 2014 standard Medicare Part D coverage. The actuarial equivalence testing will not reflect the new benefits provided in the coverage gap. Plan sponsors that provide coverage directly or indirectly through a Part D plan may want to evaluate the impact of the new parameters and provisions on their plans." (Buck Consultants)

[Advert.]

New In the Foundation Bookstore: Healthcare Reform Facts

Find answers to more than 300 frequently asked questions concerning the Patient Protection and Affordable Care Act (PPACA). Organized in a Q&A format, this reference book addresses implementation, compliance and tax implications for employers.

[Official Guidance]

CMS Announces Opportunity to Apply for Marketplace Navigator Grants
"The funding opportunity announcement is open to eligible self-employed individuals and private and public entities applying to serve as Navigators in states with a Federally-facilitated or State Partnership Marketplace. The new funding opportunity provides up to $54 million in total funding and applications are due by June 7, 2013." (Centers for Medicare & Medicaid Services)

Same-Gender Spouses Can Face Tax Barriers to Health Care Under Federal Law
"According to a [recent] report... an employee who buys health insurance for a domestic partner of the same or opposite sex pays $1,069 more a year in federal taxes, on average, than a worker in a heterosexual marriage would pay for the same coverage.... Companies are increasingly providing benefits to same-gender couples, even if they're not required to. Last year, 54 percent of employers with 10 or more workers offered same-gender health insurance benefits, up from 24 percent in 2008[.]" (Kaiser Health News)

Retiree Health Benefits: Facing Extinction?
"Employer-provided health insurance for retirees has been dwindling for decades now, but the trend is accelerating, experts say. Mounting costs have caused more employers to scale back or eliminate medical benefits for their former workers. What's more, the public-insurance marketplaces established under the [ACA] are expected to radically change the landscape for early retirees starting next January." (MarketWatch.com)

Colorado's Pitch for New Businesses: Our Healthy, Lean Workers Cost Less
"The cost of doing business may be lower in areas where there's a 'culture of health.' And that's put Colorado, which has the lowest adult obesity rate in the nation, on the map for companies looking to relocate or expand.... When [Kelly Brough, who runs the Denver Metro Chamber of Commerce] meets with businesses, she touts Colorado's low rates of common chronic diseases -- diabetes, heart disease, and cancer -- among the ones that cost companies a lot of money in health insurance claims." (Kaiser Health News)

[Advert.]

SouthWest Benefits Association 38th Annual Conference - May 8-10 - New Orleans

Staying up to date in the world of benefits has never been more critical. Changes in regulations, technology and the economy continue to influence benefits structures. Participation in the SWBA Conference is the most cost-effective way to stay informed.

Businesses Seek Out 'Culture of Health' Areas
[Note: This is an audio clip.] "Businesses looking to relocate are making the health of a state's population part of their decision-making process. One Fortune 500 CEO explains it can save millions in reduced health insurance claims and absenteeism. Colorado's economic development officials are already trying to improve the health and fitness of the next generation of workers in order to stay competitive." (National Public Radio)

Creating a New Competitive Health Insurance Marketplace
"States across the country have received grants to establish a Health Insurance Marketplace.... Each State's grant awards were made following a thorough examination of funding requested by the State, and an analysis of what would be a reasonable funding amount from the federal government: Forty-nine States and the District of Columbia received up to $1 million in planning grants. Four territories received similar grants on March 21, 2011." (Centers for Medicare & Medicaid Services)

Your Employees' Financial Problems Are Your Company's Problems
"[I]n a 2012 survey of HR managers, ... 83 percent believed that their employees' financial problems had an impact on their work.... [Here are five ways] to help ensure that your employees are thinking about your business and not their personal finances during the day ... Consider an EAP.... Be predictable with paychecks.... Change your reimbursement policy.... Consider telecommuting options... Cancel the party fund." (Inc.)

Does Access to Health Insurance Influence Work Effort Among Disability Cash Benefit Recipients?
"There is considerable policy concern about 'DI lock' -- that tying public health insurance coverage to cash disability benefit receipt contributes to the low exit rates due to work.... [I]ncreasing health insurance access does increase the likelihood of positive earnings among a subset of disability beneficiaries. [This study finds] evidence of SSI lock among beneficiaries with some Medicaid expenditures and find that both non-group health insurance regulation and generous Medicaid eligibility help alleviate the problem." (Center for Retirement Research at Boston College)

Urban Institute Criticizes Use of Stop-Loss Insurance by Small Employers
"To protect health reform in the event stop-loss insurer attitudes change, the [Urban] Institute touts state laws imposing on stop-loss insurers minimum attachment points of $60,000 to $100,000. Such attachment points may be easily handled by a large employer, but it would put self-funding out of the reach of employers with fewer than 200 employees, which the Institute says would be a good thing." (Thompson SmartHR Manager)

Fewer Health Plans Retain Grandfathered Status
"In 2012, 58 percent of U.S. employers that offered health care coverage had at least one plan that was grandfathered (or exempt from specific health care reform requirements such as fully covered preventative care). In contrast, an examination of 2013 plans reveals that, on average, less than 20 percent were grandfathered.... [F]indings suggest that many grandfathered plans are moving toward providing coverage levels required of nongrandfathered plans, and that 'fewer plans than expected will retain their grandfathered status'[.]" (Society for Human Resource Management)

Health Benefits for Retirees: 'Memoranda of Understanding' with Union May Cause Unexpected Vesting
"[T]he Court of Appeal ... made a number of points: ... Because the rights of public employees and the obligations of public employers with respect to things such as retiree health and pension benefits generally are interpreted by the same rules as private contracts, not only may local governments be bound by implied contracts, but they also will be bound by the express terms of their [Memoranda of Understanding (MOUs)]. The IBEW MOU could be interpreted to create a benefit obligation that not only extended to current or active employees, but to 'future retirees' as well." [International Brotherhood Of Electrical Workers, Local 1245 v. City Of Redding, 210 Cal. App. 4th 1114 (2012)] (Focus on Public Benefits)

$54M in Grants Will Help Enroll Uninsured in 33 States
"The size of the long-awaited grants offers a glimpse into the potential difficulties of carrying out the health law in the 33 states, including Texas and Florida, which are relying on the federal government to run all or part of their marketplaces. States setting up their own marketplaces are getting separate funding from the federal government. 'There's no way that's enough money to make a difference,' said John Poelman, a senior director of Leavitt Partners, a consultant working with many states to set up the marketplaces." (Kaiser Health News)

Consumer Groups Fear Patients Could Be Hit With Large Out-of-Pocket Costs
"Because of the complexity, [FAQ XII] gave insurers and employers another year to find ways to merge [combined out-of-pocket] caps. In theory, that means some plans next year may be able to double -- or even triple -- the $6,250 out-of-pocket cap, said the consumer groups. Plans with only one administrator overseeing all types of coverage are not exempted from the spending cap." (Kaiser Health News)

Going 'Off-Cycle' Extends Coverage, Making Some Unhappy
"Industry watchers say extending coverage for small-group plans into 2014 by resetting the clock on a plan's cycle to an off-cycle setting in order to avoid the effects of the health reform law next year is perfectly legal and an option the market should sustain. But critics say the idea of adjusting coverage dates to later in 2013 to extend current terms and conditions to late 2014 violates the intent of the [ACA]." (AISHealth.com)

CMS Administrator Sails Through Senate Confirmation Hearing
"CMS ... has been without a Senate-confirmed administrator since fall 2006. [Marilyn] Tavenner took over as acting administrator in December 2011 when her predecessor, Donald Berwick, stepped down.... The position has been left officially unfilled in part because of the political turmoil around Obamacare, but Tavenner appeared to enjoy bipartisan support at Tuesday's hearing and most expect that she'll be confirmed." (Governing)

2,271 State-Mandated Health Insurance Benefits
"'When CAHI started tracking mandates in 1992, there were about 850 mandates across all 50 states,' explained CAHI Research and Policy Director, Victoria Craig Bunce. 'Over the last twenty years the number of state mandated benefits has grown to 2,271. That's an increase of 167 percent! ... [M]andated benefits currently increase the cost of basic health coverage from slightly less than 10 percent to more than 50 percent, depending on the state, specific legislative language, and type of health insurance policy.'" (The Council for Affordable Health Insurance)

Scoring Health Care: Navigating Customer Experience Ratings
"The ratings culture in the U.S. has exploded in the last decade with consumers turning to reviews for dining, shopping, vacationing, and even home improvements. Now, as they spend more of their own money on health and wellness, consumers are beginning to search for rating systems to guide their decision making. A single trusted source of reviews and ratings has yet to emerge in the health industry, but these measures are prompting healthcare companies to focus on experience that goes beyond satisfaction." (PricewaterhouseCoopers)

U.S. Insurers See Promise in Pay-for-Performance Healthcare Approach
"Insurers and doctors are testing a way to pay for healthcare that has been more common in the corporate suite than the emergency room -- paying for better performance, betting it is the key to controlling runaway costs.... Large employers, which provide about half of Americans with healthcare plans, are adding these accountable care organizations and other coordinated care initiatives on top of other benefits that focus on prevention." (Reuters)

House Republicans Say New Bill Would Provide Working Families More Flexibility
"The Working Families Flexibility Act of 2013: [1] Allows employers to offer employees a choice between cash wages and comp time for overtime hours worked.... [2] Protects employees by requiring the employer and the employee to complete a written agreement to use comp time ... [3] Retains all existing employee protections in current law, including the 40 hour work week and how overtime compensation is accrued.... [4] Allows employees to accrue up to 160 hours of comp time each year." (U.S. Rep. John Kline, Subcommittee on Heath, Employment, Labor and Pensions, Committee on Education & the Workforce, U.S. Senate)

[Opinion]

A Temporary Insurance Program Foretells Exploding Obamacare Costs
"[The] temporary Pre-Existing Condition Insurance Plan is running out of money, and the Obama administration has closed enrollment to any new applicants ... And the costs are significant: The average cost per enrollee in 2012 was $32,108 a year. But the costs varied widely by state, from a low of $4,276 per enrollee to a high of $171,909. Some patients have annual claims as high as $225,000 per person.... The problems with this program are predictors of the costs that are likely to come when the full law takes effect on January 1, 2014." (Galen Institute)

[Opinion]

The Latest Obamacare Tactic in Massachusetts: Boiling the Frog Slowly
"In what has become a predictable PPACA strategy, the Obama administration kicks the rate spikes down the road three years and mandated that Massachusetts healthcare companies spread those costs out in their increases in 2014, 2015, and 2016. The approach is a textbook non-solution: start with a cold pan of water and slowly turn up the heat, the frog will never know what hit him." (William Gallagher Associates)

[Opinion]

How About a 'Do Over' for the HHS Contraceptive Coverage Mandate?
"According to figures from the Guttmacher Institute for 2010, 90 percent of U.S. employer-based health plans already cover a 'full range of prescription contraceptives,' an amount that has tripled in a decade. Add to that the fact that the U.S. currently spends $2.37 billion a year domestically for 'family planning,' and that, according to HHS's Kathleen Sebelius, 'contraceptive services are available at sites such as community health centers, public clinics, and hospitals with income-based support,' and you have to ask: what exactly was the problem the mandate was supposed to address?" (American Center for Law and Justice)

[Opinion]

Comments to Agencies on Delayed Enforcement of ACA Out-of-Pocket Limits (PDF)
"The policy stated in the FAQ would allow plans with two or more administrators to maintain separate and independent limits, based on their current practice, for one year starting in 2014 under certain conditions.... Clearly, the technology and systems capability already exist to coordinate information about a patient's expenditures among multiple administrators.... The most disturbing aspect of the policy imbedded in the FAQ is that it places the burden of the problem entirely on the patient." (AARP, AFSCME, Consumers Union and 7 other groups)

[Opinion]

Comments to NAIC on Defining 'Actuarial Value' Under the ACA (PDF)
"'Actuarial value' measures the relative generosity of benefits covered by a health insurance plan. Under the ACA, a health insurance plan's actuarial value indicates the average share of medical spending that is paid by the plan, as opposed to being paid out of pocket by the consumer.... Catastrophic plans are not required to meet actuarial value targets, except that they must have actuarial values below those of the bronze tier (60 percent)." (American Academy of Actuaries)

[Opinion]

Comments to HHS on MLR Reporting Aspects of Proposed Contraceptive Mandate Rules (PDF)
"[I]n situations in which ['zero premium contraceptive-only'] policies are issued to individuals whose underlying comprehensive medical coverage is provided via a self-funded group health plan ..., the issuer (or an affiliate) would be eligible to receive adjustments to any federally facilitated exchange (FFE) user fees it might owe ... All else being equal, a lower level of FFE user fees would lead to higher reported premiums for MLR purposes, a lower reported MLR value, and a potentially higher level of customer rebates." (Medical Loss Ratio Regulation Work Group, American Academy of Actuaries)

[Opinion]

For-Profit Medicine: The Great Health Care Sinkhole
"Equipped with shovels on the edge of the great sinkhole, health care executives contend that they are filling up the hole. In reality they are digging it deeper to everyone's peril. In the world of for-profit medicine, doctors also need to be held accountable, particularly among sub-specialties, as the gap between the pay of primary-care physicians and specialists continues to grow." (Physicians for a National Health Program)

[Opinion]

Obama Administration Intervenes to Give $71.5 Billion to Overpaid, For-Profit Medicare Advantage Plans
"Medicare's costs will jump by $7.43 billion next year -- the equivalent of $149 for each of the nearly 50 million beneficiaries in the program ... Enrollment in [Medicare Advantage] plans, currently at 13.1 million beneficiaries, was expected to dip sharply over the next few years in the wake of a reduction in government overpayments to the plans under the [ACA], but the researchers said enrollment may not decrease, due to this windfall and last year's 'quality bonus' payments: hence the variation in the estimated cost." (Physicians for a National Health Program)

Liberate Employers from Benefits Burden
"Given that employer-linked benefits are not optimal for anyone, it seems like a good time to take a look at alternatives.... [One proposal] involves establishing third-party Benefit Administrators -- trusted intermediaries with expertise in designing, delivering, and managing health and retirement benefits. These administrators could be banks, insurance companies, investment companies, or new entities created specifically for this purpose. These entities would compete among themselves for employers' business and also for individuals who want to buy their benefits directly." (MarketWatch)

Public Still Unwilling to Cut Entitlement Benefits to Reduce Deficit
"[T]he public continues to say it is more important to keep Social Security and Medicare benefits as they are than to take steps to reduce the budget deficit. There has been little change in these opinions over the past two years. A [recent] survey found that 55% of Americans put the priority on keeping Social Security and Medicare benefits as they are over reducing the deficit. These majorities run across all age groups. In comparison, about a third (34%) say taking steps to reduce the deficit is more important." (Pew Research Center)

A Legal Service Plan Meets the Needs of PepsiCo?s Diverse Workforce Hyatt Legal Plans, a MetLife company

Benefits Expert Jody Hunter Joins Pacific Resources from Koch Business Solutions Pacific Resources

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