Practical HR Tips, News & Advice. Updated Daily.
The summary of benefits and coverage (SBC), while still a work in process, will improve plan participants’ ability to comparison-shop for coverage. That fills a currently unmet need, federal regulators told a recent conference. They were responding to concerns that the SBC — mandated by the health reform law — is redundant, confusing or even […]
Concerns about the implementation of participant fee disclosure rules did not just rest within the retirement plan community – the Department of Labor (DOL) itself raised red flags about how the rules would interact with a formatting requirement under Securities and Exchange Commission (SEC) rules. But we recently got word from DOL that the SEC […]
Have you asked your doctor or dentist to see his fee schedule? When I did so once, a dentist refused, saying in effect: “my prices are higher, but that’s what you need to get my quality advantage.” What’s a consumer to do? A similar relation exists between large employers and institutional providers (hospitals.) The lack […]
Retirement plan investors will save between $5 billion and $13 billion annually, thanks to new exceptions to DOL’s prohibited transaction rules, DOL estimates. The DOL’s Employee Benefits Security Administration (EBSA) opened the door to allowing fiduciaries to offer investment advice in a final rule published to become effective Dec. 27, 2011. DOL estimates this new rule […]
Administering qualified transportation fringe benefits (QTFBs) will be more complicated in 2012. Congress has allowed the parity between mass transit and parking thresholds — which gave transit and vanpool users the same tax advantage as drivers — to expire. Starting Jan. 1, 2012, the excludible amount for those who purchase bus, rail and other mass […]
A plan participant cannot pick definitions from various state or federal statutes and impose them on an employer-sponsored health plan where the plan left terms undefined, if the plan applies a common and ordinary meaning to those terms when asked to justify a claims denial. Applying this rule, a Michigan appeals court affirmed a lower […]
I’ve read how, due to the cost of administering long-term care (LTC) insurance, some private-sector vendors are either revisiting that benefit or jacking up premiums — partly because not enough people are signing up to sufficiently spread the risk, and costs, around. Well, the federal health reform law included a lofty goal of establishing a […]
It’s like the Hollywood movie Groundhog Day all over again. The Self Insurance Institute of America (SIIA) wakes up and has to face the same “anti-self-funding” arguments about adverse selection, insolvency and inferior benefits that it refuted last year … the year before … and the year before that. Again in damage-control mode, this time the […]
It’s important to disclose information through ERISA-required documents properly: it can be a plan administrator’s last line of defense if participants allege that they suffered losses because they didn’t know their rights or important plan terms. That obligation has grown in response to the financial scandals of the last decade (Enron, WorldCom, mortgage-leveraged bonds, etc.). […]
It has now been almost a year since health care reform was first enacted. The first year involved many compliance challenges, not the least of which was keeping up with the many pieces of guidance issued by DOL, IRS and HHS. Plans had to expand coverage (more dependents, fewer dollar limits, no more questions about […]