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BenefitsLink Health & Welfare Plans Newsletter

October 10, 2013

Employee Benefits Jobs

Client Service Representative
Associated Pension Consultants
in CA

ERISA Compliance Administrator
City National Bank
in CA

Accounting Specialist
Northwestern Benefit Corporation of Georgia
in GA

Account Mgr I - SRS
The Standard
in OH

Retirement Program Client Executive
RCM&D
in DC, MD

Enrolled Actuary
Matthews Benefit Group, Inc.
in FL

Regional Vice President, Sales
Transamerica Retirement Solutions
in CO

Team Leader II - Defined Contribution and Deferred Compensation Plans
Raytheon
in MA

Relationship Manager III - ESOP
Wilmington Trust
in DE, NJ, PA

Plan Consultant
T. Rowe Price
in MD

Plan Document Analyst
T. Rowe Price
in MD

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Webcasts and Conferences

Best Practices for Conducting an Advisor Request for Proposal (RFP)
October 17, 2013 WEBCAST
(University Conference Services)

An Economic Update: Growth or Chaos?
October 22, 2013 in CA
(Western Pension & Benefits Council - San Diego Chapter)

WiPN Fall Networking Event
October 27, 2013 in MD
(Women in Pensions Network)

Inside the 2014 Star Ratings for MA and Part D: Trends and Their Implications
October 29, 2013 WEBCAST
(Atlantic Information Services, Inc)

The Post-DOMA Impact on Employee Benefits
October 30, 2013 WEBCAST
(Worldwide Employee Benefits Network (WEB))

ERISA Workshop 2013 - St. Louis
November 8, 2013 in MI
(SunGard Relius)

ERISA Workshop 2013 - Atlanta
November 8, 2013 in GA
(SunGard Relius)

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.
[Guidance Overview]

CMS Releases Draft Operating Manual for the Federally Facilitated Marketplace
"The manual begins with an overview of the various kinds of exchanges and the roles and functions of the exchange. It then proceeds in the next section to provide information on the initial and annual open enrollment periods and effective dates.... The guidance describes in detail how enrollments will be handled technically once the marketplace website is fully operational. The federal exchange and insurers will exchange files on a daily basis." (Timothy Jost in Health Affairs Blog)


[Advert.]

HIPAA Compliance Deadline Fast Approaching: September 23

Sponsored by International Foundation of Employee Benefit Plans (IFEBP)

HIPAA Privacy for Health Plans After HITECH is a comprehensive manual to help plan sponsors remain compliant. The helpful guide is updated to reflect the 2013 regulations and includes a CD with model policies, procedures, notices and more. Order Now!



[Guidance Overview]

New Guidance Requires Immediate Action by Sponsors of Health Reimbursement Arrangements
"For plans operating on a calendar-year basis, plan sponsors need to take the following steps immediately: Revise plan documents, reimbursement policies and procedures, and HRA claims forms to reflect the new rules. Establish procedures under which an participant provides documentation of other group health plan coverage, if the HRA reimburses expenses for individuals covered outside of the plan sponsor's group health plan.... If the plan permits participant to spend down accrued balances after termination of employment, provide an opt-out procedure so that participant can decline HRA coverage and apply for premium assistance tax credits if they purchase Marketplace coverage." (Segal)

[Guidance Overview]

Jersey City Passes Paid Sick Leave Ordinance
"The ordinance covers all employees who work within Jersey City.... [E]mployees of Jersey City-based businesses who are not themselves based in Jersey City are covered by the ordinance if they work at least 80 hours per year within city limits. Jersey City businesses with 10 or more employees (whether the employees are located within Jersey City or not) will be required to provide paid sick leave, while those with fewer than 10 employees need only provide unpaid leave." (Morgan Lewis)

New Wrinkle: Deadline to Avoid Health Law Fines Will Fall Around Valentine's Day, Not March 31
"You'll have to get coverage by Valentine's Day or thereabouts to avoid penalties for being uninsured, the Obama administration confirmed Wednesday. That's about six weeks earlier than a March 31 deadline often cited previously. The explanation: health insurance coverage typically starts on the first day of a given month, and it takes up to 15 days to process applications. You still have to be covered by March 31 to avoid the new penalties for remaining uninsured. But to successfully accomplish that you have to send in your application by the middle of February." (The Washington Post; subscription may be required)

15 Indiana School Districts, Attorney General Sue to Block Obamacare Penalties
"In an aggressive challenge to President Barack Obama's health-care law, 15 Indiana school districts -- backed by the state's attorney general -- say they shouldn't have to pay expensive penalties if they fail to provide health benefits to employees who work a minimum of 30 hours a week. The state and school districts filed a lawsuit ... against the Internal Revenue Service and other federal agencies.... At least one other state, Oklahoma, also has challenged the IRS rule. So has a group of private employers in Washington, D.C." (Indy Star)


[Advert.]

23rd Annual National Health Benefits Conference & Expo

Sponsored by HBCE- Health Benefits Conference & Expo

Jan.28-29 in Florida. Sessions: IBM, L.L. Bean, Southern Co, City of Houston, Quad/Graphics (Onsite Clinic since 1990), Univ of Iowa and Ala, Sarasota and Anoka Co, Eastman Chemical, Chesapeake Energy, Palm Beach Co Schools, Crowley Corp, etc. Best value.



Why Less Choice is More in Health Insurance Exchanges
"[C]onsumers don't necessarily prefer more inclusive hospital networks.... [S]mall network with a high-quality system was far more coveted than other networks with a broader array of choices.... [C]onsumers care more about having a high-quality hospital system than having their own primary care physician (PCP) in their chosen network.... [T]he upper-tier brand of hospitals and health systems widely believed to be required in any network -- well-known facilities, academic medical centers, and/or flagship institutions -- are not always 'must-have' to consumers." (Harvard Business Review; free registration required)

White House Was Warned in Advance That the Exchanges Were Not Ready
"Major insurers, state health-care officials and Democratic allies repeatedly warned the Obama administration in recent months that the new federal health-insurance exchange had significant problems ... Despite those warnings and intense criticism from Republicans, the White House proceeded with an Oct. 1 launch.... Administration officials continued Tuesday to decline to say how many people have gone through all the steps to pick a health plan through the Web site. They said they would give a monthly tally, probably starting in mid-November." (The Washington Post; subscription may be required)

Health Care Exchange Rollout Gets Poor Reviews
"Among those who've actually tested out the system, three-quarters of those polled said they've experienced problems trying to sign up. Only about 1 in 10 succeeded in buying health insurance. Overall, the poll found, 40 percent of Americans said the launch of the insurance markets hasn't gone well, 20 percent said it's gone somewhat well and 30 percent didn't know what to say." (The Washington Post; subscription may be required)

State-Run Exchanges Fare Better in Enrollment's Early Days
"At Kynect (Kentucky's exchange), a few quick questions about age, family, household income and tobacco use lead to a menu that lets consumers sort plans by premium, deductibles, out-of-pocket maximums, and metal tiers, and allows for searches by hospitals and providers.... In its first five days, Kynect screened 142,242 people for eligibility. In its first week, Kynect had 22,000 applications started and nearly 15,000 completed. More than 200 small businesses are also in the application process." (HealthLeaders InterStudy)

Early Results From Connecticut Show Health Reform Is Helping Young Adults Get Coverage
"Almost one-third of those who applied for coverage through Access Health CT, Connecticut's state-run marketplace, in the first five days are under 35, according to Kevin Counihan, the exchange's CEO.... This is an early report, but it's a promising indicator of health reform's potential to reduce the rate of uninsurance among young adults -- and address this group's need for greater coverage options." (Center on Budget and Policy Priorities)

Hawaiians Still Unable to Shop on State Exchange
"Ten days after the Hawaii Health Connector was supposed to allow consumers and small employers to shop and enroll for coverage, officials are using paper applications and referring people to insurers' websites to check prices. About 100,000 people are uninsured in Hawaii. It is the only one of the 14 state-run marketplaces, also called exchanges, that has no major functions online. Oregon's marketplace does not yet allow online enrollment, but consumers can shop for health plans on its website." (Kaiser Health News)

Medical-Device Tax Repeal Gains New Life
"White House officials said the administration would be willing to review the tax in a broader discussion of the ACA, provided Republicans found a credible way to replace the $30 billion in funding the tax was projected to raise over the next decade.... The industry's top lobbying group and five companies with the most sales exposure to the tax are on track to spend more on lobbying this year than in each of the previous three years ... The industry's push faces big obstacles, including administration concerns that ending the device tax would prompt similar demands by other health-care industries that would help pay for the health law." (The Wall Street Journal; subscription may be required)

Evaluating Employer Insurance Coverages to Defend Against Claimed Violations of the ACA
"Employers who fail to provide the requisite disclosures under the ACA may find themselves in litigation for failure to comply with these mandates.... In short, employers should expect to experience an increase in their exposure to new causes of action under the ACA.... Whether these professional lines insurance policies will protect an employer against actions brought under the ACA is an issue that employers should be focused on now." (Wilson Elser)

As Healthcare Costs Rise, Employers Stress the Need for Employee Wellness
"Michael Cox, vice president of human resources at Duncan Aviation, told the Omaha World-Herald that his company's emphasis on wellness -- which includes on-site clinics at the company's two locations and financial incentives offered to healthy employees -- has helped to solidify their low healthcare costs. 'I think it's a cumulative effect,' Cox told the news outlet. 'It's not something in one year or two years or five years where you see huge dividends. It's more of a long-term strategy. It's part of the culture. People think about it.'" (ConnectYourCare)

The Global Wellness Tourism Economy (PDF)
"Wellness tourism represents about 6% (524.4 million) of all domestic and international trips.... Wellness tourism is projected to grow by more than 9% per year through 2017, nearly 50% faster than overall global tourism.... As the conventional medical industry increasingly turns toward preventive, alternative, and traditional approaches in order to deliver more effective care and improve costs ... the lines between medical tourism and wellness tourism will in some instances blur." (Global Spa & Wellness Summit)

Inequality Is at the Core of High Health Care Spending
"To estimate the impact of income inequality on health care spending, it was applied to the spending level in each of the [Organization of Economic Cooperation and Development (OECD)] countries ... So doing erased the difference between the price-adjusted level expected from GDP and the actual expenditures in the U.S. Thus, while the U.S. spends more than twice as much on health care than the mean of other OECD countries, its greater GDP and higher prices explain most of it, and income inequality offers an explanation for the rest." (Health Affairs Blog)

The ACA's New Tools and Resources to Improve Health and Care for Low-Income Families Across the Country
"This issue brief reviews provisions of the [ACA] that have the potential to benefit low- and modest-income individuals, including those that expand health insurance coverage; strengthen primary care and improve care coordination; bolster the capacity of providers serving low-income communities; move toward greater accountability for the quality and cost of care; and invest in public health." (The Commonwealth Fund)

Benefits in General; Executive Compensation

[Guidance Overview]

SEC Proposes Pay Ratio Disclosures
"Despite receiving and considering over 22,000 comment letters prior to releasing the Proposed Rules for public comments, the SEC embedded within the Proposed Rules 60 particular requests for comments, more than 55 of which are directed at specific and, in most cases, controversial elements of the proposals.... [T]he Proposed Rules are expected to have the greatest impact on large multinational companies due to, among other things, the number of employees, variations in international payment practices, payment disparities among employees in different countries and the range of laws governing the collection and reporting of employment data[.]" (Pillsbury Winthrop Shaw Pittman LLP)

[Guidance Overview]

Supreme Court Same-Sex Marriage Decisions Create New Rules for Employee Benefit Plans
"The effect of the Supreme Court's decisions and the agency guidance will depend on what benefits the employer is currently providing to same-sex spouses or domestic partners, and whether the employer wishes to avoid providing more benefits than are legally required. Each of the possible situations is discussed [in detail]." (Calhoun Law Group)

U.S. Public Companies Concerned About Proposed CEO Pay Ratio Rule
"U.S. public companies are more concerned about the cost and effort likely to be involved in complying with the [SEC's] proposed CEO pay ratio disclosure rule than they are about how shareholders might react ... [O]nly one in 10 employers believes the CEO pay ratio disclosure will provide important information for investors and companies." (Towers Watson)

Cloud of Litigation Rains on a Plan
"The Ninth Circuit instructed the district court to consider whether the plan 'paid up only under the cloud of litigation.' If that were the case, the Ninth Circuit said, the participant likely achieved 'some degree of success' on the merits of her actions and would therefore be eligible for an award of attorneys' fees.... Plans may [now] face a Hobson's choice -- implement the change unilaterally, and risk the plaintiff seeking catalyst theory attorneys' fees; or, implement the change as part of a negotiated settlement with the plaintiff, and risk the plaintiff exacting some monetary payment in return for waiving the catalyst theory attorneys' fees claim." [Bryant v. Cigna Healthcare of Cal., Inc., No. 11-57249 (9th Cir. Sept. 30, 2013)] (Seyfarth Shaw LLP)

[Opinion]

Text of Comments by 14 Business Organizations to SEC Requesting Extension of Comment Period on Proposed Pay Ratio Rules (PDF)
"[A 60-day] extension [of the comment period] is necessary if stakeholders and interested parties are to even begin to have a chance to provide the diverse, detailed, and complex information sought in the overlapping requests for comments contained in this Proposed Rule. On the one hand, the rule requests comments within 60 days on dozens of narrow, sensitive, and highly-technical company-specific issues.... On the other hand, the proposal seeks comments on numerous broad, complex macro-economic issues.... The Proposed Rule goes on to solicit separate comments to [OMB] on the data collections and burden analyses associated with nine separate forms and schedules. The request for comments concerning these documents is subject to the admonition that 'comments are best assured of having their full effect if the OMB receives them within 30 days of publication.'" (U.S. Chamber of Commerce, Society for Human Resource Management, and 12 other employer organizations)

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