Innovative Benefit Planning Blog

Posting of Employee Rights Notice Extended; Now Required on Jan. 31

Posted On: October 10, 2011 | Categorized as: Company News, Health Care Reform

The National Labor Relations Board (NLRB) has postponed the implementation date for its new notice-posting rule by more than two months in order to allow for enhanced education and outreach to employers, particularly those who operate small and midsize businesses.  The new effective date of the rule is Jan. 31, 2012.  No other changes in the rule, or in the form or content of the notice, will be made. Most private-sector employers will be required to post the 11-inch-by-17-inch notice, which is available at no cost from the NLRB through its website, either by downloading and printing or ordering a print by mail. For further information about jurisdiction and posting requirements, please see frequently asked questions at the nlrb.gov website, which will be updated frequently as new questions arise. 


CMS Proposes Updates to Medicare Advantage and Part D Coverage

Posted On: October 6, 2011 | Categorized as: Company News, Health Care Reform

The Centers for Medicare and Medicaid (CMS) has issued 298 pages of proposed revisions to the Medicare Advantage program and prescription drug benefit program (Part D) that would implement new benefits under the Patient Protection and Affordable Care Act (PPACA) and increase patient protections.  The proposals would codify provisions providing new benefits including the 50 percent discount on covered brand name drugs in the Part D coverage gap known as the "donut hole" as well as new tools to fight fraud and abuse in Medicare and improve patient protections. Once final, the proposed rule will be effective for calendar year 2013 operations.  CMS will accept comments from all stakeholders through the close of business 60 days following the publication of the proposed rule in the Federal Register (scheduled for Oct. 11, 2011).  The full text can be found at http://www.ofr.gov/OFRUpload/OFRData/2011-25844_PI.pdf.


Jobs Bill Would Cap Employer Exclusion and HRA/HSA Deductions

Posted On: October 6, 2011 | Categorized as: Company News, Health Care Reform

The release of President Barack Obama's deficit reduction plan comes just a week after the President submitted to Congress the actual text of his proposed jobs legislation.  The bill, S.1549 , would change the tax treatment of employer-sponsored health insurance.  Section 401 of the bill limits the value of all itemized deductions for married couples filing jointly with adjusted gross income of at least $250,000 and single taxpayers with adjusted gross income of at least $200,000 to 28 percent.  This would include the cost of employer-sponsored health coverage and deductions for health savings accounts (HSAs and HRAs).  The amount that is reported by the employer for the employee is not excludable by the taxpayer.


U.S. Plan Would Boost Access to Lab Results

Posted On: September 30, 2011 | Categorized as: Company News, Health Care Reform

The Obama administration proposed a new rule that would allow patients to have direct access to electronic medical records, including lab results without waiting to hear them from a doctor. At present, patients can only obtain lab results if their physicians provide authorization, or if they reside in a few states which allow such access. The rules proposed by the Department of Health and Human Services are part of a broader effort to give patients greater access to medical data electronically so they can become more engaged in their care. They would replace a confusing patchwork of state laws and privacy statutes and affect more than 6 billion lab tests a year.


CMS Issues Changes to Claims Submissions for Early Retiree Reinsurance Program

Posted On: September 29, 2011 | Categorized as: Company News, Health Care Reform

The Centers for Medicare and Medicaid Services (CMS) has announced several changes to improve and streamline the process of submitting claims data for Early Retirement Reinsurance Program (ERRP) reimbursement requests. On Monday, Oct. 3, 2011, CMS will begin providing specific, claim line-level feedback to sponsors who submit claim lists through a new, fully automated review system.  Given this expedited feedback, all claim lists submitted on or after October 3 must be error-free (it must pass the automated review) in order for the plan sponsor to be able to submit a reimbursement request, and then be approved for payment.  If a claim list is determined to be invalid as a result of the automated review and cancelled from the system, the sponsor may resubmit a corrected claim list.  Similarly, before the automated processing system becomes effective in October 2011, claim lists and reimbursement requests that have errors will be cancelled from…


Innovative Congratulates Jim Edwards!

Posted On: September 26, 2011 | Categorized as: Company News

Innovative would like to congratulate UBA partner firm president, Jim Edwards of Mountain West Benefits in Helena, Montana, for having been chosen by Employee Benefit Adviser magazine as 2011 Health Plan Adviser of the Year.  Mountain West Benefits proudly represented UBA firms with this honor and demonstrated the forward-thinking cost containment strategies for which UBA firms have become known.  Congratulations to Jim and the entire Mountain West Benefits team! READ THE ARTICLE


Innovative Speaks in Dallas!

Posted On: September 26, 2011 | Categorized as: Company News, Health Care Reform, Retirement Plans

At the Fall 2011 United Benefit Advisors (UBA) Meeting in Dallas, Innovative’s own Mark Sulpizio and Terriann Procida spoke to over 300 members from across the country.  Recognized as experts in the retirement plan industry, they discussed the added scrutiny and fiduciary responsibility for retirement plan sponsors, in light of the new 408(b)2 and 404(a) regulations that take effect April of 2012.   To shed light on these new regulations, Mark and Terriann shared with their UBA colleagues the specifics behind our Fiduciary marketing campaign, “Are Employees Getting Their Fair Share”, which is currently underway.  Great job Mark and Terriann!


Proposed Regulations to Make Health Insurance Shopping Easier for Consumers

Posted On: September 15, 2011 | Categorized as: Company News

As part of the Patient Protection and Affordable Care Act (PPACA) the Department of Labor and the Department of Health and Human Services has proposed some new regulations centered around clarifying health plan benefits and coverage for consumers.  Many consumers feel overwhelmed when trying to decide which plan to take because the information is somewhat sophisticated.  In an effort to simplify the information, a “uniform summary of coverage” represented by: 1) a Summary of Benefits and Coverage form, as well as;  2) a glossary of universal health insurance terms, has been proposed.   These two documents will provide consumers with clear-cut information that is easily used for comparison purposes, thus allowing them to better understand and evaluate their health insurance options. The Summary of Benefits and Coverage will be available to the consumer within seven days of their request, while shopping for coverage, or during the open enrollment period at each…


Tibble v. Edison International, A Lesson in Revenue Sharing

Posted On: September 15, 2011 | Categorized as: Company News, Retirement Plans

When you sponsor a retirement plan you, or someone you appoint, are responsible for making many important decisions associated with the plan such as investment options and service providers.  Informed decision making is reliant upon understanding and evaluating the costs associated with the plan.  One of the costs inherent in most plans is revenue sharing which, generally speaking, refers to payments made by investment providers to other service providers.  Investment providers include mutual fund companies and insurance companies while other service providers are record keepers and third-party administrators.   In some instances these payments are expenses for services that the investment provider would otherwise have to provide itself, such as administrative services.  While there is nothing innately unlawful about revenue sharing, the Department of Labor has proposed a regulation that will require providers to disclose any indirect compensation, such as revenue sharing, made to service providers. In the of case Tibble…


EBSA FAQ Clarifies End of COBRA ARRA Subsidy

Posted On: September 6, 2011 | Categorized as: Company News

The Department of Labor's Employee Benefits Security Administration (EBSA) updated its web page to clarify the end of the COBRA ARRA subsidy. FAQ Q1 states that some individuals are eligible to receive the COBRA premium reduction subsidy beyond Aug. 31, 2011.  Individuals who qualified on or before May 31, 2010 may continue to pay reduced premiums for up to 15 months, as long as they are not eligible for another group health plan or Medicare even if their COBRA coverage did not start until a later date due to the terms of a severance arrangement, or the use of banked hours or other similar provision that delayed the start of their COBRA coverage. 


CBO Predicts Delay In Start Of CLASS Program

Posted On: September 6, 2011 | Categorized as: Company News

The Congressional Budget Office (CBO) anticipates a one-year delay in implementation of the Community Living Assistance Services and Supports (CLASS) Act included in last year's health reform bill.  In its latest periodic update to Congress on the federal budget, the CBO notes that based on the pace of implementation of the CLASS program so far, the program will start collecting premiums in fiscal year (FY) 2013, not FY 2012, as previously estimated. The CLASS program has been under close scrutiny since the health reform law was enacted; the budget plan approved by the House of Representatives earlier this year included a provision to repeal it.


Health Law’s Premium Rate-Review Provision

Posted On: September 6, 2011 | Categorized as: Company News

Under a health reform law provision that goes into effect Sept. 1, states and the federal government will scrutinize health insurance company's proposals for rate increases on individual and small-employer plans.  Insurers will be required to submit a seven-page document, justifying the increase to the Department of Health and Human Services (HHS) Also, information on any insurers that propose premium increases exceeding 10 percent will be posted on the HHS website.  It remains to be seen, however, whether bad publicity will deter insurers from implementing the proposed rates, as the reform law does not give HHS the authority to block the increases.


Consumer Driven Health Plan Growth Slows; Costs Surpass HMOs

Posted On: August 29, 2011 | Categorized as: Company News

Cinnaminson, NJ,  August 29, 2011 -Consumer Driven Health Plans (CDHPs) in the U.S. experienced continued growth this year – albeit at a slower rate than in 2009 and 2010 – according to preliminary results released by United Benefit Advisors (UBA) from its 2011 UBA Health Plan Survey, the nation’s largest health plan benchmarking survey, with 16,421 plans from 10,744, employers. “CDHPs grew at a rate of 13.9 percent this past year (about two-thirds of the 2010 rate) to 22.9 percent of plans offered and cover more employees (17.3 percent) than Health Maintenance Organization (HMO) plans (11.9 percent),” according to Terriann Procida, Principal, Innovative Benefit Planning, a UBA member located in Cinnaminson, New Jersey. “The Northeast region of the country had the largest concentration of CDHPs (31.3 percent), followed by the Southeast region (27.4 percent). The average cost increase for all CDHPs at 8.0 percent was slightly lower than that of…


New Rule Requires Non-Union Employers To Notify Employees Of Their Right To Unionize

Posted On: August 29, 2011 | Categorized as: Company News

The National Labor Relations Board (NLRB) has just issued a final rule obligating the vast majority of private sector employers to notify employees of their rights under the National Labor Relations Act (NLRA).  The purpose of the notice is to inform employees of their rights to organize, form, join or assist a union; to bargain collectively with their employer; and to discuss their wages, benefits, and other terms and conditions of employment with their co-workers or a union.  The new rule covers not only union workplaces, but also non-union workplaces. The rule will pose new challenges for non-union employers and make it harder for all employers to defend themselves against allegations of unfair labor practices.  For example, an employer’s failure to properly comply with the rule will toll the six-month statute of limitations period for filing a charge against the employer for unfair labor practices.  An employer’s knowing violation of…


New Exchange Subsidy, Medicaid Expansion and Premium Tax Credit Regulations Released

Posted On: August 16, 2011 | Categorized as: Company News

The Obama administration put out three proposed rules (comprising 409 pages) on Friday that will be critical to the establishment of health insurance exchanges.  Two of the rules came from the Department of Health and Human Services (HHS): The first rule (139 pages) outlines exchange eligibility and employer standards.  It can be found  HERE.  The second rule (203 pages) addresses the Medicaid eligibility increase and the proposed enrollment system.  It can be found  HERE. The IRS also released a proposed rule (67 pages) that provides guidance on premium subsidies for coverage obtained through exchanges.  It can be found HERE. Comments on all three rules will be accepted until Oct. 26.


Federal Appeals Court Rules Against PPACA’s Individual Mandate

Posted On: August 16, 2011 | Categorized as: Company News

Since the enactment in 2010 of the Affordable Care Act’s requirement that all Americans must carry health insurance or face a tax penalty there has been controversy over the constitutionality of the mandate.  When the White House passed the law the administration argued that the legislative branch has the ability to regulate interstate commerce, including the health care industry, according to the Constitution.  Last Friday a divided three-judge panel of the federal appeals court of Atlanta ruled that Congress overstepped its authority when they passed this mandate. There are constitutional issues raised by compelling individuals to purchase health insurance from private companies.  Proponents have argued that it is similar to the requirement for auto insurance.  There are differences, however, in that only those who wish to drive must have auto insurance.  You can avoid having to purchase auto insurance by choosing not to drive.  There is no way to avoid…


Affordable Care Act Ensures Women Receive Preventive Services at No Additional Cost

Posted On: August 3, 2011 | Categorized as: Company News

Historic new guidelines that will ensure women receive preventive health services at no additional cost were announced today by the U.S. Department of Health and Human Services (HHS). Developed by the independent Institute of Medicine, the new guidelines require new health insurance plans to cover women’s preventive services such as well-woman visits, breastfeeding support, domestic violence screening, and contraception without charging a co-payment, co-insurance or a deductible. “The Affordable Care Act helps stop health problems before they start,” said HHS Secretary Kathleen Sebelius.  “These historic guidelines are based on science and existing literature and will help ensure women get the preventive health benefits they need.”  Before health reform, too many Americans didn’t get the preventive health care they need to stay healthy, avoid or delay the onset of disease, lead productive lives, and reduce health care costs.  Often because of cost, Americans used preventive services at about half the recommended…


EBSA Extends 408(b)(2) to April 2012

Posted On: July 22, 2011 | Categorized as: Company News

The Employee Benefits Security Administration, an arm of the U.S. Department of Labor, has extended the effective date for the interim final fiduciary-level fee disclosure rule, 408(b)(2), from July 16, 2011 to April 1, 2012. Initially proposed in the summer of 2010, the Department ruled to enhance the required fee disclosures from certain pension plan service providers to plan fiduciaries.  Now known as Regulation 408 (b)(2) under ERISA, this disclosure is considered to be part of a “reasonable” contract or arrangement for services. The Department received many requests for an extension of the effective date based on the need for updating systems and procedures in order to more accurately collect and disclose information.  A January 1, 2012 extension was agreed upon.  In addition, the Department agreed to align the 408(b)(2) regulation with participant-level disclosure regulation believing that the additional time would assist plan fiduciaries and administrators in gathering the information…


$10 Million In Funding Available For Workplace Health Programs

Posted On: July 7, 2011 | Categorized as: Company News

In addition to the President’s Childhood Obesity Task Force, the First Lady’s Let’s Move initiative, and the National Prevention Council, which was formed to design and implement a National Prevention and Health Promotion Strategy, the government has now embarked upon another area of wellness, this time aimed at supporting workplace health promotion programs.  The United States Department of Health and Human Services announced the availability of $10 million from the Affordable Care Act’s Prevention and Public Health fund to establish and evaluate comprehensive workplace health promotion programs across the nation to improve the health of American workers and their families. This funding will enable the development of programs promoting healthy living to be available to companies of all sizes.  Work environments that promote a healthier lifestyle by:   1) encouraging physical activity through the availability of flex-time;  2) offering healthier food choices in worksite cafeterias and vending machines and;   3) discouraging…


Voucher Provision Repealed

Posted On: April 21, 2011 | Categorized as: Company News

After much negotiation and the threat of a government shutdown the budget was passed last week.  This is good news for employers as members of Congress agreed to have the Voucher Provision taken out of the Patient Protection and Affordable Care Act (PPACA) in an effort to reduce the budget.  This provision was originally instituted last spring as part of health care reform.  Although it won’t affect the budget until 2014, this repeal removes the large burden that would otherwise have been felt by employers. Under the provision, an employer offering health coverage for employees would have been required to provide free choice vouchers to each employee meeting two criterion.  First, the employee’s premium contribution must be between 8.0% and 9.8% of the employee’s household income, assuming such employee’s household income is less than 400% of FPL; and second the employee is enrolled in the Exchange.The voucher amount would have…


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