April 2013
From the editors of CCH's BENE and BAN products, here are hot topics from recent Employee Benefits Management Directions newsletters as well as recent explanatory updates in Employee Benefits Management. Also included are recent explanatory updates to the Benefits Answers Now product.
If you have any comments/suggestions concerning the information provided or the format used, we'd like to hear from you. Please contact Tulay.Turan@wolterskluwer.com.
Hot Topics in Employee Benefits Management:
HHS finalizes rules on premium stabilization programs, exchange user fees, SHOP and medical loss ratio under health care reform, Employee Benefits Management Directions, Issue No. 535, March 12, 2013 — The Department of Health and Human Services (HHS) has issued a final rule that provides further detail and parameters related to: the risk adjustment, reinsurance, and risk corridors programs (known as the premium stabilization programs); cost-sharing reductions; user fees for a federally-facilitated health insurance exchange; advance payments of the premium tax credit; a federally facilitated Small Business Health Option Program (SHOP); and the medical loss ratio (MLR) program.
EBSA's latest set of FAQs about ACA address coverage of preventive services, Employee Benefits Management Directions, Issue No. 535, March 12, 2013 — EBSA issued another set of Frequently Asked Questions (FAQ) about implementation of the Affordable Care Act (ACA) on February 20, 2013. Among other issues, these FAQs address the coverage of preventive services.
Dental benefits are popular, expert says, Employee Benefits Management Directions, Issue No. 536, March 26, 2013 — After providing health care and retirement programs, employers often look to dental coverage as a valuable employee benefit. For an overview of dental benefits plans and what employers might do after the Patient Protection and Affordable Care Act takes effect, Wolters Kluwer spoke to Bruce Elliott, manager of compensation and benefits at the Society for Human Resource Management (SHRM).
House panel considers tax impact of health reform law, Employee Benefits Management Directions, Issue No. 536, March 26, 2013 — A House tax panel heard testimony from expert witnesses on March 5 about the impact of tax increases included in the Patient Protection and Affordable Care Act. The hearing allowed House Ways and Means Oversight Subcommittee Chairman Charles W. Boustany, Jr., R-La., to restate his arguments that the 2010 health care law is stunting economic growth, harming job creation, and failing to rein in health care costs.
What's New in Employee Benefits Management:
ACA's whistleblower protections — The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) has published an interim final rule that governs whistleblower complaints filed under Sec. 1558 of the Patient Protection and Affordable Care Act. For details, see ¶10,050.
Insurance reforms — The Department of Health and Human Services has issued a final rule that implements provisions of the Patient Protection and Affordable Care Act (ACA) designed to protect consumers from insurance company abuses. For more information, see ¶10,140 and ¶10,420.
State disability laws — The discussion on state disability laws has been updated at ¶30,100.
Reinsurance fee — Section 1341 of the Patient Protection and Affordable Care Act imposes a reinsurance fee on insurers and self-insured group health plans. The Department of Health and Human Services recently finalized rules regarding the fee. The rules are discussed at ¶10,505.
2014 Medicare Part D amounts — In the 2014 advance notice and call letter, the CMS announced the Medicare Part D deductible for 2014. For the amount, see ¶10,360.
Proposed rules on SHOP — The Department of Health and Human Services has issued a proposed rule that would implement provisions of the Patient Protection and Affordable Care Act regarding health insurance exchanges and the Small Business Health Option Program (SHOP). The rule is discussed at ¶12,130.
What's New in Benefits Answers Now (BAN):
Department of Labor issues final rule expanding FMLA protections for families of eligible veterans, airline personnel. The Department of Labor has issued a final rule implementing expansion of FMLA provisions for families of certain veterans and for airline personnel. The rule also includes clarifying changes concerning the calculation of intermittent or reduced schedule FMLA leave, reorganization of certain sections to enhance clarity, the removal of the forms from the regulations, and technical corrections to current regulations. For more information about the final rule, see ¶30,980 and ¶31,275.
ACA regulations on MEWAs issued by EBSA. The EBSA has published final rules, in accordance with the Patient Protection and Affordable Care Act (ACA) on reporting requirements for multiple employer welfare arrangements (MEWAs) and entities claiming exception (ECEs), along with details on its enforcement authority to crack down on fraudulent health plans. See the discussion at ¶23,320 for more information about the reporting requirements for MEWAs under the ACA.
EBSA’s latest set of FAQs about ACA address coverage of preventive services. EBSA has issued another set of frequently asked questions (FAQ) about implementation of the Patient Protection and Affordable Care Act (ACA). Among other issues, these FAQs address the coverage of preventive services. The ACA requires non-grandfathered group health plans and health insurance coverage offered in the individual or group market to provide certain preventive services without cost sharing. An overview of the preventive care requirements under the ACA can be found at ¶20,051.
HHS final regulations help determine minimum value and provide standards for essential health benefits. The Department of Health and Human Services (HHS) has issued final regulations that outline health insurance issuer standards for essential health benefits (EHBs) as applicable to non-grandfathered health insurance coverage in the individual or small group markets. In addition, the final rule provides guidance on the calculation of minimum value (MV) for employer-sponsored group health plans. To find out more about the new rule, see ¶20,052.
What's New in Spencer’s Benefits Reports:
PCORI fee. The health reform law created the Patient-Centered Outcomes Research Institute (PCORI). To help fund the PCORI, a fee is imposed on self-insured health plans. This report describes the fee and how self-insured plans will calculate the fee owed (Report 564.-1).
HIPAA privacy rules. This report provides general guidance to employers, including the insured and self-funded health care plans that employers sponsor, for complying with the HIPAA privacy rule (Report 502.-15).
Genetic information. The Genetic Information Nondiscrimination Act (GINA) prohibits health insurance and employment discrimination on the basis of genetic information. This report reviews the GINA provisions that concern employers (Report 402.3.-1).
ERISA disclosures. All individual account retirement plans that permit the participants to direct the investment of the assets in their accounts must now provide certain information about their investment options. This requirement includes all plans that are already complying with the ERISA Sec. 404(c) disclosures (Report 605.1.-21).
401k salary deferrals. Employers with 401(k) plans are responsible for depositing salary deferrals to the plan’s trust on the earliest date that the deferrals can reasonably be segregated from the employer’s general assets. The IRS has provided tips on how employers may correct a failure to timely deposit 401(k) salary deferrals (Report 229.-23).
New Pension/Benefits Titles Added:
Employee Benefit Plan Review (April 2013 issue)
401(k) Advisor (April 2013 issue)
Journal of Pension Benefits (Spring 2013)
Pension Benefits (April 2013)
Plan Termination Answer Book, Fifth Edition