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BenefitsLink Health & Welfare Plans Newsletter

August 2, 2013

Employee Benefits Jobs

Retirement Plan Administrator
for PenSys, Inc. in CA

Regulatory Services Analyst
for OneAmerica Financial Partners, Inc. in IN

Benefits Specialist
for Cedars-Sinai Medical Center in CA

Attorney
for Unite Here Health in IL

Distribution & Loan Specialist
for Scholz, Klein & Friends Enlightened Retirement Group, Inc. in TX

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Webcasts and Conferences

Prohibited Transactions
September 19, 2013 in PA
(ASPPA Benefits Council of Greater Philadelphia)

Fusion Forum 2013
August 21, 2013 in WA
(Pension Plan Specialists)

Getting It Right - Know Your Fiduciary Responsibilities - Part Two - Webcast
August 8, 2013 WEBCAST
(Employee Benefits Security Administration (EBSA), U.S. Department of Labor)

ERISA Enforcement and Compliance: A 2013 Perspective -- Webcast
August 27, 2013 WEBCAST
(Bass, Berry & Sims)

Health Insurance Marketplaces: Different Strokes for Different States
August 9, 2013 in DC
(Alliance for Health Reform)

View All Webcasts and Conferences


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Hand-picked links to the web's best news articles,
official guidance, jobs, webcasts and more.
[Official Guidance]

2013 County Data for Use by Health Plans and Insurance Issuers in Providing Culturally and Linguistically Appropriate Services (PDF)
"The regulations implementing section 2719 require these plans and issuers to make certain accommodations for notices sent to an address in a county meeting a threshold percentage of people who are literate only in the same non-English language. This threshold percentage is set at 10 percent or more of the population residing in the claimant's county ... The list below includes all counties which meet or exceed the 10 percent threshold for the 2007-2011 ACS data and is applicable for 2013." (Center for Consumer Information & Insurance Oversight, Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)

[Official Guidance]

Instructions for Optional Calculation of Threshold for Applying Culturally and Linguistically Appropriate Standards under ACA by Health Plans and Insurance Issuers (PDF)
This unnumbered Technical Guidance document is dated July 24, 2013. Excerpt: "Public Health Service (PHS) Act section 2719 [and its amended Interim Final Rules require] ... group health plans and health insurance issuers to provide relevant notices in a culturally and linguistically appropriate manner ... when a certain threshold is met. The threshold percentage ... is that at least 10 percent of the population in the claimant's county speak a particular non-English language and speak English less than 'very well' ... Below are step-by-step instructions to make the calculations ... to facilitate plans and issuers making these calculations on their own, if they so choose, consistent with the requirements of the amended IFR. Plans and issuers ... can rely on the chart in the amended IFR as a safe harbor. HHS will update this table on an annual basis[.]" (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)

[Guidance Overview]

Implementing Health Reform: Verifying Income, Combating Discrimination, and More
"[A]t a hearing of the House Ways and Means Committee on August 1, 2013, Gary Cohen, Director of the HHS Center for Consumer Information and Insurance Oversight, stated that ... guidance would be issued shortly that would require physical verification of income for premium tax credit applications if income could not be verified through available electronic data sources." (Timothy Jost in Health Affairs)

[Guidance Overview]

Cafeteria Plans, the ACA, and Compliance with Massachusetts Requirements
"Employers that have failed to adopt a cafeteria plan that conforms to the requirements of both the Code and Massachusetts law are subject to a free-rider surcharge.... While Massachusetts has taken some additional steps to accommodate the [ACA] ... the free-rider surcharge and the cafeteria plan requirement have not been repealed or otherwise amended. Thus the federal and state laws are on a collision course. In a recent letter to employers, the Connector has addressed this conundrum." (Mintz Levin)

[Guidance Overview]

Employer-Sponsored Wellness Programs: What Financial Incentives Are Legal?
"Employers now have guidance on how to ensure that a wellness program is compliant with, and not in violation of, the HIPAA and ACA nondiscrimination requirements for group health plans. The application of nondiscrimination requirements in other federal and state laws remains less clear. Given the legal uncertainties, we recommend adhering to the following when considering implementing a wellness program: (i) refrain from making a health risk assessment or any other aspect of the program mandatory in order to qualify for health coverage; (ii) avoid any questions (written or otherwise) regarding family health history, in order to avoid violating GINA; and (iii) weigh the costs and benefits of various financial incentives considering, among other things, the income and employment tax implications." (Jones Day)

The Skinny on Workplace Wellness Programs
The infographic on the linked page presents findings from a national survey on workplace wellness programs, including typical components, incentives for participation and levels of employee engagement. (RAND Corporation)

Administration Announces One-Stop-Shop on the Health Care Law for Businesses Big and Small
" Business.USA.gov/healthcare [is] a one-stop-shop where employers of all sizes can go for information on the [ACA]. The new site includes a web-based tool that allows employers to get tailored information on how the health law may affect them based on their business' size, location, and plans for offering health benefits to their workers next year. From tax credits for small businesses to help make coverage affordable, to measures to help slow the growth of health care costs, there are a variety of ways that the Affordable Care Act can help businesses expand health care coverage and compete." (The White House Blog)

Groups Go Door-to-Door to Encourage Enrollment in Obamacare
"For the law to succeed, groups such as Enroll America, whose officials include several veterans of Obama campaigns, will need to cajole millions of Americans, including many healthy ones, to enter the insurance market. It could be a tough sell. Confusion about the law is rampant. The online insurance sites, which open for enrollment Oct. 1, could be tricky. Some people who rarely need medical care might view even low-cost health plans as too pricey. And while advocates say that knocking on doors is one way to overcome these challenges, skeptics point out that such canvassing, which is modeled on successful political campaigns, is untested for a complex national program such as the [ACA]." (The Washington Post; subscription may be required)

Obamacare: What It Will Cost In Washington State
"For some people, individual insurance plans offered through Washington's new online exchange marketplace may cost more than those available now, but they will cover much more, state Insurance Commissioner Mike Kreidler said ... And although people in some counties will have limited choices, as they do now, in most counties the 31 new plans available from four companies will offer a wide range of premiums and cost-sharing options.... The insurance office ... pared premiums overall by 1.8 percent, compared with what the companies originally requested, for a total savings of more than $10 million." (Kaiser Health News)

Federal Government Launches New Healthcare Reform Website for Employers
"The federal government has launched a new website for employers that addresses some common employer healthcare reform questions. The healthcare portion of the website allows an employer to select the location of its headquarters, the number of employees it has, and whether or not it will offer insurance to its employees in 2015. Based on these answers, a list of frequently asked questions pertaining to employers of that size are generated.... While this information is helpful for employers who have not already started preparing to meet the requirements of PPACA, employers should undertake a deeper dive and analyze exactly how PPACA will impact an employer of their size, location, and employee demographic." (Hill, Chesson & Woody)

In 2014, Congress Gets Obamacare -- Here's How They'll Pay for It
"Starting in 2014, members of Congress and their staffs will have to get their health insurance through Obamacare's insurance marketplaces. But according to a regulation that the Obama administration's Office of Personnel Management plans to announce on Friday and release next week, the federal government can continue to contribute toward the cost of their health plans." (Ezra Klein in The Washington Post; subscription may be required)

Proceed with Caution When Changing Service Providers in Self-Funded Trust Plans
"These [checklist recommendations] are intended to assist plan sponsors and consultants in identifying what to look out for when projecting time and financial commitments for these types of changes. It is optimal to allow at least four to six months to prepare for these changes; however, a three-month turnaround is not impossible if the transition plan is prepared in advance and closely adhered to, with all parties committed to the priority of the transition." (Healthcare Town Hall)

Health Insurance Rates for California's Small Businesses Unveiled
"Rates in most of the state's populous counties are expected to be significantly below premiums now charged by insurers for similar plans. Average premiums for a 40-year-old employee are slated to fall 17% in southern Los Angeles County and 13% in the northern part. Rates for younger and older workers are expected to drop proportionally, Covered California said." (Los Angeles Times)

Univision Obamacare Deal Could Put WellPoint, Blues Ahead of Competitors
"WellPoint and other Blues insurers in six states including Florida have signed deals with Univision for undisclosed sums to be the exclusive health insurance sponsor of the network's Peabody-award winning health initiative, 'Salud Es Vida,' which means Health Is Life. The deals include a special plan-sponsored Univision website that will be able to connect Latinos with coverage on the online markets, or exchanges, that will serve individuals beginning in October. But it's a path that could take a detour around some competitors who are offering plans: because of a little-known rule proposed by the administration in June, customers will be able to buy their subsidized Obamacare insurance directly from the insurer." (Kaiser Health News)

Voluntary Benefits and Services Survey: A Fresh Look at Enriching Core Benefit Plans
"Employers are turning to voluntary benefits and services to personalize their benefit offerings and support their employee rewards strategy. Voluntary benefits and services offerings today tend to be geared toward baby boomers, who are a large segment of today's workforce. However, as baby boomers begin to retire in increasing numbers across the next decade, expect to see voluntary benefits and services redesigned for younger generations, who are generally attracted to customized benefit packages." (Towers Watson)

North Carolina Marketplace Will Have Three Insurers and Up to 60 Plans
"Three insurance carriers will be offering plans in the Marketplace, and in some counties, that number is reduced to one. Despite the small number of carriers participating, as many as 60 plans may be offered. Details of the plans, like premium costs, are still under wraps. North Carolina insurance officials have approved the health plans that will be available through the Marketplace, and the plans now await approval from the U.S. Department of Health and Human Services[.]" (Hill, Chesson & Woody)

CMS Chief Challenges Claim That Obamacare Hurts Workers
"At a stormy House of Representatives committee hearing, Marilyn Tavenner, who heads the Medicare and Medicaid programs, said she has found only anecdotal evidence of employers reducing work hours or benefits because of worries about President Barack Obama's landmark reforms, which take effect on January 1.... Tavenner's characterization of the business impact as isolated angered Republicans at a House Energy and Commerce Committee hearing, who accused Tavenner of being out of touch with concerns among businesses." (Reuters)

Expanding Options for Employers in Next-Generation Private Exchanges (PDF)
"[G]iven continuing cost escalation and the looming 2018 excise tax (which will impact over 60% of employers in 2018, according to our surveys and projections), these organizations need to consider more cost-effective ways to deliver those benefits. One avenue is through the public and private health exchanges, which can potentially offer an efficient and targeted way to deliver health benefits to various segments of the workforce, particularly vis-a-vis traditional, self-managed employer programs." (Towers Watson)

Health Costs Are Still Tame, Insurer Results Show
"Every insurer reported moderate cost increases. Some lowered already low projections.... WellPoint projected a huge increase -- 750,000 -- in members whose claims will be paid directly by their employers by the end of 2014. (WellPoint makes money processing the claims.) WellPoint implied it's taking the business from rivals. But other carriers also reported increases in self-insured employers.... Aetna's [CEO Mark] Bertolini suggested he's not prepared to accept Maryland's final premium rates for Obamacare exchange plans as really final.' (Kaiser Health News)

Five Things to Know About Obamacare Premiums: A Guide for Perplexed Individuals and Small Employers
"Comparing apples to apples is virtually impossible.... Look for which premiums state regulators are using for their comparisons.... You are not average.... Subsidies will offset costs for many people.... Last, but certainly not least -- premium changes are unlikely to affect you at all." (Kaiser Health News)

Statement on ACA Implementation by IRS Principal Deputy Commissioner, to the House Ways and Means Committee
"The taxpayer data supplied by the IRS will be transmitted over secure, encrypted channels to the HHS Federal Data Services Hub, which was developed to facilitate these data transfers. This data hub will not be storing taxpayer information, but merely routing that information to authorized users. At no time is the tax data to be displayed to anyone outside of the Marketplace itself." (Internal Revenue Service)

The Private Health Exchange Wars
"Are private exchanges actually beneficial to companies, beyond providing what seems to be a decent employee benefit? Or they more like a mirage, simply a repository of health-benefits plans with financial implications that, at the end of the day, aren't so different from what employers have been used to all along in the health-benefits arena?" (CFO)

39 Republican Senators Call on White House for Details on Obamacare Implementation at 21 Federal Agencies
"A group of 39 Republican Senators today called on the White House to provide details on efforts by at least 21 federal agencies to help implement the new health care law -- specifically, 'agencies with no responsibilities' to implement or promote under that law.... The senators' letter includes three spreadsheets, which, the senators write, 'may have been sent to all government agencies, [and] appear to specifically require agencies to provide information and undertake activities in support of the health care law regardless of their statutory missions and responsibilities.'" (Committee on Health, Education, Labor and Pensions, U.S. Senate)

[Opinion]

Floor Statement of Ways and Means Committee Chairman Regarding H.R. 2009, the 'Keep the IRS Off Your Health Care Act'
"Even the agency's own watchdog says the IRS cannot handle the job. Less than two weeks ago, the independent Treasury Inspector General stated they are not confident about the IRS's ability to protect confidential taxpayer information or to prevent fraud. Well, neither am I -- and by every indication, neither are the American people." (Rep. Dave Camp, Committee on Ways and Means, U.S. House of Representatives)

[Opinion]

Is Congress Too Good for Obamacare?
"Congress and their staff will lose the health insurance they like -- breaking a big promise from Obama -- unless Congress passes another law to preserve its own current coverage. That's something they have so far been unwilling to do for their constituents, millions of whom are also facing the prospect of losing their current coverage." (The Heritage Foundation)

Benefits in General; Executive Compensation

Two Federal Courts Recognize Same-Sex Spousal Rights for Residents of States Not Permitting Same-Sex Marriage
"These cases may reflect a growing trend of courts and other bodies to recognize -- at least for some purposes -- same-sex marriages validly celebrated elsewhere even if the couple's current state of residence does not recognize such marriages. Notably, the [Ohio] case provided such recognition where the state of residence provides no recognition of the relationship, and the [Pennsylvania] case did so where the state of residence merely recognizes the relationship as a civil union, which is spousal equivalent under state law but is not technically a 'spousal' relationship." (McDermott Will & Emery)

ISS Launches 2014 Policy Survey
"In contrast to last year's policy survey, which hinted at changes in how ISS would evaluate say on pay by re-examining its peer group methodology and alternative definitions for measuring pay, it's noteworthy that this year's survey includes no questions directly related to say on pay. Instead the focus this year is on criteria under which ISS evaluates directors and equity compensation plans. Here are the details ..." (Towers Watson)

Congratulations, You've Mastered Shareholder Say on Pay -- Now Get Ready for Shareholder Proposals on Executive Comp
"The most common shareholder proposals in 2013 have been requests for (i) adoption of a stock retention policy, or (ii) pro-rata vesting of equity awards, rather than acceleration, upon a change in control. Compensation clawback proposals were common among financial institutions. (Shareholder proposals for a mandatory say on pay vote virtually disappeared.) Not one of these proposals succeeded, and quite a few were withdrawn. The proposals with the highest 'For' voting percentage were around 45%." (Winston & Strawn LLP)

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