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08/30/10: Model Notices on PPACA Grievance and Appeal Rules
08/26/10: Notice Published in Federal Register on Lifetime Income Options for Retirement Plans
The Agencies published in the Federal Register a request for information (RFI) regarding whether, and, if so, how, by regulation or otherwise, it would be appropriate for them to enhance the retirement security of participants in employer-sponsored retirement plans and in individual retirement arrangements (IRAs) by facilitating access to, and use of, lifetime income or other arrangements designed to provide a lifetime stream of income after retirement.
08/24/10: The Occupational Training Center of Camden County
We recently partnered with the Occupational Training Center in Berlin NJ to help us put together some of our promotional items. We have had great feedback and success on the work they have done for us. The OTC is a great partner to hiring high paid temporary services or running extra labor shifts. The OTC workforce is ready to be scheduled to handle your small or large volume production needs and to meet your deadlines. The nonprofit organization is dedicated to providing a realistic work experience to individuals with disabilities who are not currently seeking a competitive job. The program offers a variety of manufacturing, assembly and packaging jobs assignments to the participants to experience.
We recommend the OTC if you have labeling, shrink-wrapping, inspection, and sorting projects that require assistance, contact them at 856-768-0845; they offer pick up and delivery services too.
To learn more about the OTC please take a look at their website, www.arccamden.org
07/28/10: Preventive Care Regulation Released
On Wednesday, the Departments of Health and Human Services, Labor and Treasury released an interim final regulation outlining the details of the preventive care coverage requirement for health plans established by the Patient Protection and Affordable Care Act (PPACA).
PPACA requires that all plans provide first-dollar coverage of specific preventive care services recommended by the United States Preventive Services Task Force beginning on the first day of the first plan year following September 23, 2010. The requirements apply to all individual and group health plans, including self-funded plans, but grandfathered plans are exempt as long as they retain their grandfathered status. The complete list of preventive care services that are required to be covered can be found here.
07/27/10: PA Mini-Cobra Extended
On July 9th, Governor Rendell signed House Bill 1251 that included a change to Pennsylvania Mini-COBRA to allow for coverage beyond 9 months if a covered individual is also receiving a federal premium subsidy. This means that individuals who are eligible for the premium subsidy under the American Recovery and Reinvestment Act (ARRA) would be eligible for up to 15 months of continuation coverage (for assistance eligible individuals only). This will likely result in the necessity to send notices to affected individuals and reinstate their mini-COBRA coverage. To date, details on who is eligible to be reinstated have not been released. Model notices and guidance are expected.
To read the Governor’s Office press release, go to PA Governor’s Office News Room and view the release titled “Governor Rendell Signs Legislation, July 9.”
To read the text of the amended law: House Bill 1251
07/27/10: 5500 Efast Filing
As you may already be aware, new regulations were recently passed requiring all sponsors of qualified plans to file their Form 5500 and accompanying schedules electronically beginning January 1, 2010. Hard copies will no longer be accepted, rather will need to be submitted via the Department of Labor’s EFAST2 electronic on-line filing system. We will still be preparing your filing as in previous years.
To comply with these regulations and to update and streamline the ERISA filing process, the DOL has created a new, web-based electronic filing system known as EFAST2. The EFAST2 system provides all of the basic functionality required to fulfill annual reporting requirements from the website www.efast.dol.gov.
For the sake of accuracy, security, and timeliness, you must complete the registration process in a single session. Incomplete registration forms will not be saved in the EFAST2 database. If you end the session prior to completing the registration form, you will need to start the process over from the beginning. Below are the six steps to complete EFAST2 registration:
- Read and accept the privacy statement
- Provide contact information and select user type(s)
- Select challenge question and answer
- Verify registration information
- Receive a credentials email notification
- Retrieve and activate credentials
To register with EFAST2, you will need to log onto the EFAST2 web site, located at http://www.efast.dol.gov. On the navigation panel on the left side of the Welcome screen, you will click on the “Register” link. Complete instructions for obtaining your credentials are attached.
07/27/10: New Break Time Requirement for Nursing Mothers
The United States Department of Labor’s Wage and Hour Division recently released a Fact Sheet providing guidance on the new break time requirement for nursing mothers. This new requirement took effect when Section 7 of the Fair Labor Standards Act (”FLSA”) was amended by the Patient Protection and Affordable Care Act on March 23, 2010. The Fact Sheet explains that employers with 50 or more employees must provide “reasonable break time for an employee to express breast milk for her nursing child for 1 year after the child’s birth each time such employee has need to express the milk.” In addition, employers must supply a functional space, aside from a bathroom, for mothers to express breast milk. If an employer does not have a dedicated space, it must create a temporary or converted space that is shielded from view and free from intrusion from co-workers and the public. Although the new law only applies to employees who are nonexempt from the FLSA’s overtime provisions, employers should be aware that they may be required to provide such breaks to exempt workers under state or local laws. Generally, employers are not required to compensate nursing mothers for such breaks under the FLSA. However, if an employer already provides compensated breaks, an employee who uses her break time to express milk must be compensated in the same manner as other employees on break.
07/26/10: Interim Final Rule on Internal Claims and Appeals and External Review Processes Released
New Regulations Give Patients Right To Appeal Health Plan Decisions; New Grants Program Strengthens State and Territory Consumer Assistance Programs
The Obama Administration is announcing both new regulations to empower consumers to appeal decisions made by their health plans or insurance companies and the availability of resources that will be used to help give consumers more control of their health care decisions. These provisions of the Affordable Care Act will help support and protect consumers and help end some of the worst insurance company abuses.
For more detailed information visit these links:
Regulation: http://www.dol.gov/federalregister/HtmlDisplay.aspx?DocId=24056&AgencyId=8&DocumentType=2
Fact Sheet: http://www.dol.gov/ebsa/newsroom/fsaffordablecareact.html
Related Press Release: http://www.dol.gov/ebsa/newsroom/2010/ebsa072210.html
NAIC Uniform External Review Model Act: http://www.dol.gov/ebsa/pdf/externalreviewmodelact.pdf
07/23/10: Regulations Issued on Lifetime and Annual Limits
Close on the heels of their regulations concerning grandfathered plans, the Departments of Labor, Health and Human Services (HHS), and Treasury have now released interim final regulations relating to preexisting condition exclusions, lifetime and annual limits, rescissions, and other patient protections under the Affordable Care Act (the “Act”).
Lifetime Limits
Under the Act, a group health plan may not establish any lifetime limit on the dollar amount of “essential health benefits” provided to any individual. This requirement is effective for plan years beginning on or after September 23, 2010. It applies to both grandfathered and non-grandfathered plans, although not to health FSAs or health savings accounts.
According to the Act, essential health benefits include, at a minimum, items and services in the following categories: ambulatory patient services; emergency services; hospitalization, maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care. Interestingly, the regulations provide no further guidance on the definition of “essential health benefits” — except to say that, until HHS issues such guidance, the regulatory agencies will take into account good-faith efforts to comply with the “guidelines” set forth in the Act.
A group health plan may still impose lifetime limits on non-essential health benefits. Thus, the key will be to determine which benefits are “essential.” For example, would treatment for autism be considered a “mental health service”? If so, it would be an essential health benefit.
This notice may be included with other enrollment materials, and notice to an employee will satisfy the notice requirement for the employee’s dependents, as well. Model language for this notice has just been issued by the Department of Labor and is available on the EBSA website.
07/23/10: IBP sponsors 401(k) Educational Luncheon
Mark Sulpizio, a founding partner at IBP, was the presenter at a qualified plan educational luncheon held at Union Trust Steakhouse in Philadelphia on Thursday, July 22 2010. At the luncheon, Mark reviewed the recently released 408(b)(2) “interim final regulations” from the Department of Labor and how the new rules will affect the fiduciary responsibilities of plan sponsors. Mark provided valuable insight on what plan sponsors needed to do in preparation for the July 16, 2011 effective date of the regulations. The event was well attended and received tremendous interest due to timeliness of the topics discussed. If you would like to learn more about the added fiduciary responsibilities employers face because of the new regulations please feel free to call our office. To view a fact sheet from the Department of Labor please click here.