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Benefits: Cost Containment, Audits and Legal Risk

May 9-10, 2012
This event has ended. Click Enter Event to view the archive.
Benefits or employee benefits, in the broadest definition includes all benefits and services, other than wages for time worked, that are provided to employees in whole or in part by their employers. This program will keep you up-to-date on healthcare legislation & compliance (including COBRA, ERISA, HIPAA), FMLA, Medical Benefits, Outsourcing Benefits, Retirement Benefits, Voluntary Benefits and Work-Life Programs (including EAPs).

The IHR is the only institute that focuses on niche areas within Human Resources. A specialty certification increases your market value, adds value to your work experience, furthers your knowledge, and recognizes you as an industry leader and/or expert in the field.

Do you want that competitive edge in your professional space? Do you want to assert your knowledge of current HR topics, trends within your domain? Why not set yourself apart from your peers and get certified with and the Institutes for Human Resources (IHR).

Conference Webcast Schedule
Diana Vallee, Content Curator - Benefits & Payroll(

Welcome to the Institute for Human Resources Benefits: Cost Containment, Audits and Legal Risks. Thank you to everyone for your participation and support. The Institute is committed to furthering the deploying and adoption of best practices across the Benefit vertical. The Institute provides an opportunity to bring together industry thought leaders in a year-long community that promotes best practices among vendors and HR Professionals with a series of research, webcasts, presentations, virtual events, awards and market research. The next two days mark the fifth virtual event for this great community. We have a very exciting event planned for you with many informative sessions covering the hot topics and trends in this exciting space.

This introduction to the event will give you an overview of the Institute for Human Resources certification program as it specifically relates to Benefits Cost Containment, Audits and Legal Risks. You will be introduced to the Advisory Board, learn about the opportunity to become certified within the IHR and see who is speaking and their topics. You will be given guidance on how to chat online with colleagues and access the virtual exhibit hall. You will have the opportunity to ask questions as it relates to the overall program, prior to its commencement. You can access all of the archived sessions where we launched this Institute in May, 2011 with 16 sessions followed by additonal events in August, November and February, 2012. The Institute will be offering in total over 80 hours of content over the 12 month period. There will be two more virtual events in 2012, August 7 & 8 and November 7 & 8. There will also be 2 webcasts per month with additional content and best practices. This virtual event introduction is not eligible for an HRCI credit.

Alfred V Norton III, Registered Representative(Charter Oak Insurance and Financial Services Co.)

The American College and MassMutual commissioned the study, Employer Perspectives on Disability Benefits, in order to better understand what employers are offering in disability coverage and to identify potential shortfalls and gaps in these offerings. The study was conducted by the Boston Research Group, a leading strategic market research and consulting firm specializing in the financial services industry. Benefit managers, or those most familiar with their company’s group long term disability plan, were interviewed by telephone. From a list of the 3,000 largest companies, 316 interviews were completed. Key findings overview highlights the responses of the companies interviewed for this study.

Overview of findings will be presented including the Base Disability Plan, Potential Coverage Gaps, the ability to purchase Buy-Up coverage within Group Plans and finally the purchase of Supplemental Individual Coverage.

Topical highlights include the following:
Base Disability Plan-the typical benefit amount of a group disability plan is less than the employee’s salary – 60 percent on average. In most cases, the benefit is taxable – further reducing the amount an employee would receive.
Potential Coverage Gaps- variable compensation (such as bonuses) in most cases are not covered.
Buy-Up Disability Coverage-For employees of most companies, the somewhat limited base plan is the only option. However, a few companies offer “buy-up” coverage, paid for by the employee, usually with after-tax dollars.
Supplemental Individual Disability Coverage- Supplemental individual coverage offers the opportunity to customize a long-term disability solution for an individual to help meet his or her unique needs.

Generally speaking, benefits managers regard their group long-term disability plan as an important part of their company’s benefit package. However, they feel that employees don’t necessarily feel as strongly. Insurance is an intangible product that can’t be seen, felt or tasted. Experienced benefits managers are more likely to have observed real-life cases of disability claims and understand the difference insurance can make to an individual and his or her family.
What makes a good group long-term disability plan? It depends on many things, such as a company’s size or its culture. Disability coverage offers a combination of many options to help protect an employee’s ability to earn an income. Plan decisions are best considered carefully and re-evaluated frequently.

Nathan Carlson, President(24HourFlex)

This presentation will review the basics of Cafeteria plans; explain the change of status rules and nondiscrimination tests that each Cafeteria Plan must annually pass; show how Cafeteria Plans can integrate with HSAs; explain the various definitions of a "dependent" and how these definitions apply differently to health plans, Cafeteria plans, and HSAs; and explain how COBRA applies to Medical Flexible Spending Accounts.

Cafeteria plans provide tremendous tax savings to employers and employees. These amazing plans are the only employee benefit plan whereby the employer can actually make money through their FICA tax savings! However, in exchange for the marvelous tax benefits these plans provide, Congress requires that these plans comply with many specific rules.

While describing the basic structure and requirements of Cafeteria plans, this presentation takes you much deeper into the subject. We will examine how these plans can integrate with an HSA. We will study how and when COBRA applies to the Cafeteria Medical Flexible Spending Account.

Last, we will review the various "dependent" definitions. There are actually four different definitions that apply separately to health plans, HSAs, and dependent care plans. In other words, an "eligible dependent" on your company's health plan may not be an "eligible dependent" in an HSA.

It can be confusing. Join me, Nathan Carlson, President and owner of and a professional with over 25 years of experience as I explain these important rules in understandable terms. Although this is the first time that I have presented on, I conduct about 30 continuing education seminars each year to the HR and brokerage community.

Jeremy Lurey, CEO & Chief Architect(Plus Delta Consulting, LLC)

Many of today’s employees are accustomed to employer provided rich benefit packages with high employer contributions. They are also more benefit savvy as more vendor benefit communication is being directed at the individual versus the employer.

In a time where the average employee has come to expect growing benefits packages and high employer contributions, how do organizations that can no longer afford to maintain this trend make changes without causing discontent among the employee population?

There is no lack of discussion surrounding what more HR executives must do to please both the executive team and the employee population. The Human Resource Department realizes that it must get used to the trend of doing more with fewer resources but how can it continue to do this efficiently and cost effectively? To whom can you turn for proper guidance and to help you accomplish these tasks? In this informative webcast, we will address these questions as well as the questions below.

Please join me, Nadine Dwan, Employee Benefits Advisor at Beneflex Insurance Services as I address the following:

1) How much of employees' perceived value of benefits is due to employee benefit communication and service level versus actual wealth of available benefits?

2) What are proper benchmarks to justify changes to employee benefit offerings and contribution levels?

3) How to communicate these benchmarks to employees?

4) How to communicate to employees the true cost of providing benefits?

5) How to increase employees' perceived value of the benefits you offer?

6) Who should be involved in benefit cost saving strategies and communication of changes to your employees?

Diana Vallee, Content Curator - Benefits & Payroll(

Long Term Care is one of the biggest issues facing our country. Over 90% of baby boomers have made no plans for the expense of long term care, even though they are turning 65 at the rate of around 10,000 per day. This presentation will discuss the impact that’s likely to have on employees and their families, their employers and governments. Employees that are caregivers cost businesses due to absenteeism, presenteeism, lost productivity and higher than average health care requirements. Government budgets are affected due to the fact that when people deplete their assets to pay for long term care expenses they are forced to rely on welfare.

The presentation will discuss the probability of needing care, the cost of that care, and how to plan for the cost. Long Term Care insurance will be discussed as one possible option in planning for long term care. We will look at gaps in health care insurance, and how Long Term Care insurance can fill those gaps, even for younger employees. We will examine what MediCare and Medicaid will pay for and what they won’t pay for.

Most previous attempts to offer long term care insurance at the workplace have used Group LTC products and have not been successful. This presentation will introduce Multi-Life products and discuss the advantages of this product. It will also show how to ensure a successful rollout, not only among the older employees, but also with younger employees, spouses and even extended family members. Unless the spouses and other family members are covered, you haven’t truly protected your business from the impact of a long term care event.

We will look at how a long term care insurance policy works; how to design a policy, what it covers, when it begins paying benefits, and how much it costs.

We will discuss the different ways that Long Term Care insurance can be offered at the workplace. This includes an executive carve-out for only the top executives, a totally voluntary plan, a combination of a base plan or a full plan for top executives plus a voluntary offering to the rank and file, a base plan for all or some employees or a contribution toward plans for all or some employees. We will discuss the advantages of offering a plan through the worksite, including the preferential tax treatment that LTC premiums are given by the IRS.

Even if your company has previously rolled out a long term care benefit in the past, you may want to attend, as it may be in your company’s interest to roll out a new Multi-Life offering, especially if the first rollout had a poor participation rate. This would give your employees who didn’t take advantage of it the first time around a new window for Simplified Underwriting. If your company purchased a base plan for employees, and very few of them bought up to a meaningful level of benefits with inflation protection, you will benefit from attending this presentation. You may discover a way to better utilize those corporate dollars.

Scott Warner, Senior Underwriter, Accident & Health(Chartis Insurance /AIG)

You have a benefits program. Your employees have smartphones. Now what? Attend this presentation to learn how mobile technology will change insurance and employee benefits forever. On demand Real-Time and finally the potential for a fully integrated health records systems encompassing Government health plans and private health insurance. This presentation will cover, among other things;
What will change in the delivery of my benefit program?
How will mobile devices enhance personal health?
Will this brave new world help eliminate fraud in benefits?
How will my pension plan use mobile technology
Beyond the Smartphone (Hint you will likely wear it)
This presentation will review emerging standards in mHealth, and how benefit programs can use this to lower employer costs. Stretched thin – organizations and human resources will learn about this new platform for program management, and how to lower administration overhead by using and effectively deploying not just Apps to smartphones but components of a fully integrated health system, major medical to sundry and consumer medical devices, this presentation will review why this new technology may be the most important weapon in the fit against obesity in the western world.
Moving to a voluntary set of coverages will never be the same as the ease of communication and engagement allowed by the Smartphone and future devices places actionable control of their plans in the hands of employees and their families.
Apps everywhere but will Apps be the true future of mobile and will they deliver what employers and plan sponsor need with respect to pensions and benefits?

Richard Hudson, Principal Consulting Actuary(Cheiron Inc)

The Adjustable Pension Plan (APP) is designed to mitigate the various risks that have caused many pension plans to shutdown over the past decades. Americans need a secure way to provide lifetime income during retirement and the current defined contribution plans will not provide a safe level income stream throughout the retirement years. This plan creates a partnership with the employers and employees by sharing the investment risk of the pension plan and moving towards a lower risk investment pool.
The basic plan design provides a flat dollar or career average pay formula for the participants. This benefit is developed after determining what level of contributions are available to fund the plan. This information is used to determine the cost of the plan and develop the ultimate benefit level that can be sustained by the employer’s contribution level. The costs are developed using very conservative assumptions to provide more certainty that the benefits promised can be delivered. This benefit is referred to as the Floor Benefit and will provide a minimum level of benefit to the participants. The Adjustable Benefit will be tied to overall investment performance of the fund. The participant gets the greater of the Floor Benefit or Adjustable Benefit.
The APP considers the following risks that are inherent in typical defined benefit plans today:
• Investment Risk
• Maturity Risk
• Mortality Risk
• Inflation Risk

The studies we have performed show the Adjustable Pension Plan is a sustainable model for providing secure retirement income for life and has a high probability of delivering a benefit higher than the promised floor benefit. It provides a risk sharing element to create a partnership between the interested parties and considers the risks that have hurt many retirement plans during the past decades.

James Holland, Assistant Compliance Officer (MillenniuM Investment & Retirement Advisors, LLC)

On July 1st, 2012 72 million Americans are going to find out their 401k/403b is not free. Service Providers are going to be sending information to Plan Sponsors who in turn will have to decipher this information to send out to each participant in their plan. What is required in these disclosures? How must they be sent out? Is our plan ERISA Compliant? Where do I go to get information on how to better understand the information my Service Providers send me? What happens if the provider is late in sending the information? Are there sources out there to help me? In what format must these disclosures be made? What information must be in the disclosure? All of these questions and more will be addressed during the webinar so Plan Sponsors & HR can be proactive and get out in front of the new disclosure rules. Fee disclosure is one of the biggest changes we have seen in the ERISA space and the responsibility and liability is enormous. Every HR & Finance professional who at any point in time during the year has their finger prints on the 401k/403b must attend this program. The Retirement Plan is set up solely for the benefit of the participants and their beneficiaries; this is clearly stated in ERISA. ERISA also clearly states that if you are a Responsible Plan Fiduciary (RPF) and you are not an expert in ERISA, you are required to hire an independent, un-conflicted qualified expert to help you. There are going to be plan participants lined up outside HR demanding answers to why they are just learning about these expenses now. How long have I been paying these? Who gets these fees? What did I get in return for these fees? Is this the best plan possible? Are there less expensive options out there? How did you decide to choose these vendors? Who actually makes that decision? What is my recourse if I am not satisfied with the answers I am getting? Fee disclosure is going to be a very complicated issue, no one Human Resource professional needs to answer alone. Join us for this webinar and come find out who is available to help guide you through this very detailed and complicated process.

Michael DelTergo, Principal, Law Office of Michael J. DelTergo(Law Office of Michael DelTergo)

The growing trend toward employers providing domestic partner benefits to their employees shows no sign of abating. As more employers consider adopting LGBT-friendly benefit policies, they confront questions regarding eligibility, verification issues, plan amendments, tax compliance, civil rights issues, compliance with ever-changing state and municipal law, and even new requirements for companies seeking certain government contracts. Companies that have adopted domestic partner policies will have to deal with eligibility, compliance, and tax reporting issues that they did not have before. Moreover, the domestic partnership landscape has been changing constantly as more municipalities add domestic partner registries and impose new requirements on contractors, and as more states recognize gay marriage. This session covers:

• How various states and municipalities recognize domestic partnerships;
• Federal law treatment of domestic partner benefits;
• State law treatment of domestic partner benefits;
• Tax and reporting requirements;
• Policy creation and communication;
• Special situations affecting government contractors;
• Verification and audit issues; and
• Civil rights issues.

Even in companies that have adopted policies to provide coverage for domestic partners, some plans contain terms that limit eligibility in order to control costs, limit benefits to DPs that have the attributes of traditional marriage, or to comply with government mandates. Consequently, a plan’s eligibility criteria may exclude the partners of some LGBT employees and/or the dependents of an employee’s partner. When that happens, there exists the potential for disputes between the LGBT community and the employer, resulting in negative publicity, pressure from government actors and special interest groups, and threats of legal action. This session will include case studies that discuss how such disputes may arise, who the various third-party actors are, legal considerations, and how potential PR disasters can be managed.

Dorann Cafaro, Senior Vice President(Fiduciary Benchmarks)

This presentation will discuss what benchmarking is and the importance of benchmarking qualified plans. Who needs to benchmark and why? It will detail how to benchmark a 401(k) plan. Are there any consequences to fiduciaries if they do not meet ERISA rules? We will discuss benchmarking ties to value and services. What is driving a benchmarking focus? What has changed in fee disclosure legislation, litigation and regulation?

How do go about benchmarking? We will look at the requirements of data collection and the building of the correct comparison group. We will discuss the different providers and how their fees are paid. How does each service provider compare to his or her benchmark? We shall discuss the unique factors in fee disclosure for investment options. We will walkthrough how to build a benchmark report reviewing what you need to look for to make sure you have a statistically viable, defendable documentation of fee disclosure. Then we look at an actual benchmark report uncovering all the nuances that are important for documenting reasonableness as required by 408(b)(2). How do you benchmark for value and services rendered? You will learn how to uncover hidden fees. You will learn how to review investment options’ fees looking for how they are paid, to whom and whether the payment structure is in the best interests of the participant. We will discuss investment disclosure issues that may change how your plan handles fee payments in light of participant fee disclosure under 404(a)(5). Finally we will consider why benchmarking a plan is an insurance policy for potential litigation.

Jennifer Benz, Chief Strategist and Founder(Benz Communications)

Many employers communicate to their workers about health care benefits during open-enrollment season. Such an initiative is appropriate at a time when employees need information to make health care coverage decisions. But, this effort should be only a small part of an employers’ benefit communication street. Communication needs to be two-way, and it needs to be year-round. In this program, Jennifer Benz will discuss best practices in benefits communication, including how to leverage social media and your corporate website for benefits communication.

Jennifer will ask, how do the best companies make their benefits a success? How can you use what they already know to make your company’s benefits successful as well? In this fast-paced presentation, she will lead the audience through the case studies that are making headlines: rolling out the newest results-based wellness incentives, driving health care consumerism, launching dynamic benefits websites and mobile tools and making the most of health care reform.

She’ll share stories from the leading Fortune 500 companies, from their benefits strategy to plan design to communications. She’ll show the audience how they can turn their biggest challenges into their biggest success.

Attendees will gain strategic insights and practical, usable tips on a variety of benefits topics including: Wellness plan design and incentives, best practice benefits communication, including the latest social media and mobile strategies, promoting health care consumerism, retirement savings and financial wellness. Attendees will also learn why having a website on the Internet is a requirement and how to effectively leverage social media to engage people year-round.

Dale Vlasek, Attorney(McDonald Hopkins LLC)
Colin Fitzpatrick Smith, retirement plan designer(The Retirement Company, LLC)

With the DOL (Department of Labor) having hired nine hundred agents whose sole purpose is to audit qualified retirement plans, proactive preparation is key.

So, our efforts in this session will be directed towards preparing, in advance, for the likely possibility of a visit (soon) from the DOL.

We will describe in detail what will trigger an appearance by the auditors, from a complaint raised by a plan participant to failure to promptly direct deferrals from their compensation towards the plan to the lack of an Investment Policy Statement (IPS).

We will also touch on the topic regarding the importance of having an Investment Committee, having regular Investment Committee meetings and having the Plan follow the directions provided by the Investment Committee consistently.

We will expand on the definition of what are ‘reasonable’ fees charged to the Plan by its providers….from investments to recordkeeping and from accountancy to attorneys.

We will address the requirements for disclosure to Plan Sponsors by July 1 and the subsequent reporting regulations for plan participants on October 1.

And we will provide you with a checklist of what must be done and reported to whom.

We will be offering suggestion-solutions from both a legal perspective utilizing the more than quarter century of experience by Dale Vlasek of McDonald Hopkins and the quarter century of experience from Colin Fitzpatrick Smith of The Retirement Company, LLC. from an investment-fiduciary perspective.

We will provide you with access to the types of questions that may be posed to you by the Department of Labor when they arrive and the adverse consequences to everyone involved in your plan….from you to plan trustees and to your fellow plan participants.

And we will be able to answer any questions or address any concerns you might have during and after the webinar.

Sherrie Boutwell, Partner(Boutwell Fay LLP)

Plan sponsors and fiduciaries have been hit by a barrage of class action and other lawsuits from retirement plan participants. A federal district court has just issued its decision following a trial in the case of Tussey v. ABB, Inc. holding the employer, each member of the plan committee individually and Fidelity Investments liable for a variety of ERISA violations with respect to revenue sharing, plan fees, plan investment selections, and float payments resulting in a nearly $40 million dollar verdict against the collective defendants. In addition, the Employee Benefits Security Administration of the United States Department of Labor has recently issued new 401(k) fee disclosure regulations that become effective in July of 2012 which can be expected to increase participant attention to (and possibly concerns regarding) their 401(k) plans. Fortunately, there are steps that can be taken to help protect you, your company (and, if you are a service provider, your clients) from 401(k) plan benefit claims and litigation. This webinar will feature a case study approach based on the decision in Tussey and others to help you formulate strategies to avoid and protect against lawsuits in your 401(k) plan and wil include the following:

· Lessons from the Federal Court’s ruling in Tussey v. ABB, Inc.

· Update on current ERISA and 401(k) litigation cases and enforcement actions

· Effect of recent non-ERISA class action cases on ERISA cases

· Fiduciary risk management strategies

· Fiduciary insurance overview

· Best practices for responding to participant claims and inquiries

· Best practices for handling Department of Labor investigations

Christine A. Williams, Of Counsel(Perkins Coie Llp)

Dependent eligibility audits are commonly used by employer-sponsored health plans to verify that employees have enrolled only eligible dependents. Identifying ineligible dependents and removing them from coverage, either retroactively or prospectively, can reduce health plan costs and provide evidence of good plan management. In addition, employers that perform services for governmental agencies are often subject to expense audits that include review of health plan costs. If the employer cannot provide proof of dependent eligibility to the government auditors, the employer may find itself with a reduction in its reimbursement or subject to penalties for inaccurate claims.

There are no hard and fast rules for dependent eligibility audits, and employers and insurers can design an eligibility audit program in many ways—for example, audits can be done on a regular schedule or randomly; employees may or may not be given an amnesty period to remove ineligible dependents voluntarily; ineligible dependents can be removed from coverage prospectively as of a date set by the health plan or retroactively to the date of enrollment. But the health care reform law placed new limits on retroactive cancellation of coverage, which the law refers to as "rescission," and employers need to understand the new rescission rules in order to avoid triggering penalties. The new rules apply to grandfathered and non-grandfathered health plans, insured and self-funded plans, and impose notice and external review requirements. In addition, plans should review and many will need to revise their eligibility language to state eligibility rules as clearly as possible and to advise employees that enrolling ineligible dependents is prohibited and constitutes fraud or misrepresentation of material facts.

This program will address common dependent eligibility audit design issues and provide detail on the new health care reform limitations on retroactive cancellation of coverage.

Erin O'Connor, Practice Leader(Cammack Larhette Consulting)

This session will provide an overview of why and how value based insurance design (VBID) can help employers lower healthcare costs while at the same time maximizing care for their employees. As employers face increased pressure to control health costs, they're turning to VBID as a viable and effective option for cost-savings. VBID attempts to align patient costs with the value of the health services provided. It uses both incentives to reduce the barriers to high-value services and disincentives to discourage low-value services. The reduction of barriers leads to increases in patient compliance and decreases in costs. Both private and public employers are embracing VBID to save money and provide better care for their employees. In addition, VBID was included in the 2010 healthcare reform law and the U.S. Department of Health & Human Services featured it in their National Quality Strategy.

Attendees will also learn about two models of collaborative care used to achieve high-quality and high-value healthcare: Patient Centered Medical Homes (PCMH) and Accountable Care Organizations (ACOs). PCMH is a team-based approach to healthcare delivery in which accessible, comprehensive, longitudinal care leads to maximized health outcomes. A team of health professionals, led by a personal physician, takes responsibility for providing all of a patient's healthcare needs, including arranging care with outside specialists and providers. An ACO is a payment and delivery model that ties provider reimbursement with both quality metrics and cost reductions. The ACO, often a group of healthcare providers, is accountable to the patient and to the third-party payer.

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