Wednesday, June 30, 2010

Early Retiree Reinsurance Program Applications Begin Now

Applications for reimbursements from the Early Retiree Reinsurance Program (EERP) may be submitted now, the U.S. Department of Health and Human Services’ Office of Consumer Information and Insurance Oversight (OCIIO) has announced. The OCIIO on June 29 published the official ERRP program application, the address for submitting the application, official ERRP application instructions, and application “dos and don’ts.”

Links to these documents and to other pertinent information are available at this Web page . Plans are encouraged to check this Web page periodically for HHS announcements on upcoming program-related training events.

Applications to the program must be signed and submitted in hard copy to HHS ERRP Application Center, 4700 Corridor Place, Suite D, Beltsville, MD 20705

The Patient Protection and Affordable Care Act, P.L. 111-148, established a temporary reinsurance program to reimburse part of the claims costs for participating employment based plans that provide health insurance coverage for early retirees ages 55 through 64, and their eligible spouses, surviving spouses, and dependents. The EERP will reimburse for 80% of a plan's individual claims that are between $15,000 and $90,000, indexed for inflation. The program is effective June 1, 2010, and ends on the earlier of Jan. 1, 2014, or when the $5 billion appropriated for the program is exhausted Program participants will be able to submit claims for medical care going back to June 1, 2010, HHS added. This program has been the subject of many of our blogs recently, including here and here.

More than half of employers that currently offer retiree medical plans to early retirees plan to apply for the EERP, the International Foundation of Employee Benefit Plans reported recently from its survey of 1,021 employers

Monday, June 28, 2010

Government Funds Prevention And Wellness Initiatives

On June 18, Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced the availability of $250 million to support prevention and wellness activities, as well as to develop the nation’s public health infrastructure. The Patient Protection and Affordable Care Act allocated $500 million in fiscal year 2010 for the Prevention and Public Health fund, and this $250 million is a part of that fund.

Chronic diseases, such as heart disease, cancer, stroke, and diabetes, are responsible for seven out of ten deaths each year among Americans, and account for 75% of the nation’s health spending, the HHS noted. According to the HHS, the $250 million investment in prevention and public health will be allocated, as follows:

Community and clinical prevention: $126 million will support federal, state and community prevention initiatives; the integration of primary care services into publicly funded community-based behavioral health settings; obesity prevention and fitness; and tobacco cessation.

Public health infrastructure: $70 million will support state, local, and tribal public health infrastructure and build state and local capacity to prevent, detect, and respond to infectious disease outbreaks.

Research and tracking: $31 million will support data collection and analysis; to strengthen the Centers for Disease Control and Prevention’s Community Guide by supporting the Task Force on Community Preventive Services; and to improve transparency and public involvement in the Clinical Preventive Services Task Force.

Public health training: $23 million to expand CDC’s public health work force programs and public health training centers.

This is just the beginning...

Friday, June 25, 2010

More regs issued on ACA market reforms

Have you finished digesting the new rules on coverage of adult children and on grandfathered plans under the Affordable Care Act? That's good, because more interim final guidance regarding ACA's market reforms has been issued this week.

The regulations provide detailed guidance on four separate health insurance provisions in the Patient Protection and Affordable Care Act (ACA; P.L. 111-148): (1) prohibition of preexisting condition exclusions (Public Health Service Act Sec. 2704); (2) No lifetime or annual limits (PHSA Sec. 2711); (3) Prohibition on rescissions (PHSA Sec. 2712); and (4) Patient protections (PHSA Sec. 2791A).

The interim final rules are effective August 27, 2010 and are applicable to plan years beginning on or after September 23, 2010.

Preexisting condition exclusions. The regs define such exclusions as a limitation or exclusion of benefits (including a denial of coverage) based on the fact that the condition was present before the effective date of coverage (or if coverage is denied, the date of the denial), whether or not any medical advice, diagnosis, care, or treatment was recommended or received before that day. A preexisting condition exclusion includes any limitation or exclusion based on a pre-enrollment questionnaire or physical examination given to the individual, or review of medical records relating to the pre-enrollment period.

Annual and lifetime benefit limits. ACA's ban on annual/lifetime limits applies in 2014. Until then, under the new regs, a group health plan may establish an annual limit on the dollar amount of benefits that are essential health benefits, but must provide a minimum limit. For plan years beginning on or after September 23, 2010, the limit is $750,000; for plan years beginning on or after September 23, 2011, the limit is $1,250,000; and for plan years beginning on or after September 23, 2012 (but before January 1, 2014), the limit is $2,000,000.

Rescissions. The ACA prohibits coverage rescissions, defined in the interim final rules as a cancellation or discontinuance of coverage that has a retroactive effect. For example, a cancellation that treats a policy as void from the time of the individual’s or group’s enrollment is a rescission. A cancellation of coverage is not a rescission if the cancellation has only a prospective effect.

Patient protections. The ACA also requires that plans allow enrollees to select, when the plan requires it, any primary care provider that participates in the plan’s network.

For a comprehensive analysis of the Affordable Care Act, and additional information on health reforms and otehr developments in employee benefits, just click here.

Wednesday, June 23, 2010

Report: $2 billion in COBRA subsidy benefits paid in 2009

Washington spent just over $2 billion dollars in 2009 to offer subsidized COBRA coverage to an estimated two million households in the U.S., according to figures released recently by the Treasury Department. The 2009 stimulus law required the Treasury Department to provide Congress with an interim report detailing utilization and expenditures associated with the subsidy.

The report, which for the most part uses data collected from Form 941, emphasizes that because many health benefit plans cover spouses and dependents, subsidized coverage for two million households translates into coverage for substantially more than two million individuals.

Over 300,000 claims for subsidy refunds were filed by employer tax reporting units through early 2010, totaling just over $2 billion dollars in credits for premium assistance. In addition, the Labor Department has received over 20,000 requests for expedited review of employer decisions regarding the subsidy. Over 13,000 of these reviews resulted in the employer’s determination being overturned.

Monday, June 21, 2010

Nine percent spike in employer health costs expected in 2011

We're all familiar with the argument that in the long run health care reform is supposed to be reining in the cost of health care in the U.S. However, few predicted we'd see those savings in the short run, and sure enough, U.S. employers can expect medical costs to increase by nine percent in 2011, according to the annual "Behind the Numbers: Medical Cost Trends 2011"  survey published by the PricewaterhouseCoopers LLP Health Research Institute (registration required to download report).

The good news, if you want to call it that, is that this increase is slightly lower (0.5 percent) than the jump reported by last year's survey.

The report includes findings of the PwC Health and Well-Being Touchstone Survey of more than 700 employers from 30 industries, as well as interviews with health plan actuaries and other executives whose companies provide health insurance for 47 million American workers and their families.

What design changes can we expect in 2011? Expect increased cost-sharing, for one thing. For the first time, PwC reports, the majority of the American workforce is expected to have a health insurance deductible of $400 or more, as more employers return to "indemnity style" cost-sharing by raising out-of-pocket limits, replacing co-pays with co-insurance and adding high-deductible health plans. Improving wellness programs is also high on the list of changes planned for 2011.

Will the Affordable Care Act lower health care costs in the long run? There's much debate to be found on that point--for starters, go here, here, and here.

Friday, June 18, 2010

Pending Senate bill would plug "premium hole" in health care reform law

Many Americans are unaware that, under the Pension Protection and Affordable Care Act (PPACA), nothing prevents insurers from drastically raising premium rates on insurance policies. They are also unaware that a bill was introduced in the Senate in March by Sen. Dianne Feinstein (D-Calif.) to address that issue. The bill, S. 3078, gives the National Association of Insurance Commissioners (NAIC) the authority to define what would constitute an unreasonable insurance rate increase. NAIC would also provide a report on each state’s authority to review rates and take corrective action in each insurance market, and methodologies used in such reviews and rating requests received by each state.

While groups such as the American Cancer Society Cancer Action Network (ACS CAN) applaud the attempt to control unreasonable premium increases, some, such as Consumer Watchdog, are concerned that, in its current form, the bill would give too much power to the insurance industry, since the NAIC is industry funded. Consumer Watchdog recommends amendments to clarify that it is the HHS, not the insurance industry, that has the sole authority to make decisions.

Others feel that the bill already goes too far.

Kentucky state lawmaker Robert Damron, (D-Frankfort) president of the National Conference of Insurance Legislators, has sent a letter to Sen. Christopher Dodd, (D-Conn.), questioning “the need to allocate oversight of insurance regulation to yet another federal system.” In the letter, Damron adds that, “State health insurance regulation has been fashioned to respond to each state’s unique health landscape and has been honed over years of experience.”

S. 3078 has been referred to the Committee on Health, Education, Labor, and Pensions.

For a comprehensive analysis of the Patient Protection and Affordable Care Act, and additional information on health reform and other developments in employee benefits, just click here.

Wednesday, June 16, 2010

Could the PPACA be unconstitutional?

While various provisions of the Pension Protection and Affordable Care Act (PPACA) are becoming effective, attempts are underway to repeal or nullify them. In at least 39 states, lawmakers have filed legislation designed to outlaw the PPACA provision that anyone who does not obtain health insurance by a specified date must pay a penalty. It is doubtful that any such state law could override federal law, so it would seem that these measures are simply political posturing.

However, the American Legislative Exchange Council’s (ALEC’s) Freedom of Choice in Health Care Act, modeled on Arizona Proposition 101, has already passed the legislatures of Idaho, Arizona, and Virginia. It is designed to make unconstitutional any attempt to require the purchase of health insurance—or any attempt to forbid anyone from purchasing health care services not in line with the federal PPACA’s requirements.

On March 23, 2010, Virginia became one of a number of states that have now filed suit challenging the constitutionality of the PPACA’s requirement that individuals obtain or maintain health insurance or pay a penalty (Commonwealth of Virginia, Ex Rel. Kenneth T. Cuccinelli, II v. Sebelius, No. 3:2010cv00188). In the lawsuit, Virginia claims that the requirements violate the Commerce Clause.

HHS Secretary Kathleen Sebelius has filed a response, arguing that Virginia does not have standing to sue since the state of Virginia itself has not sustained injury from the law, and, since that particular PPACA provision does not take effect until 2014 anyway, the suit is not timely.

An amicus brief was filed by the American Center for Law and Justice (ACLJ), on behalf of various members of Congress in support of the suit, arguing that, not only would the Commerce Clause be violated, but forcing Americans to purchase health insurance is unprecedented. Physician Hospitals of America has also filed a motion for leave to file an amicus brief.

Argument on the Adminstration’s motion to dismiss is set for 10:00 a.m., July 1, at the U.S. District Court for the Eastern District of Virginia.

For a comprehensive analysis of the Patient Protection and Affordable Care Act, and additional information on health reform and other developments in employee benefits, just click here.

Monday, June 14, 2010

Gov't agencies tout advantages of new "grandfather" rule

According to a Q&A sheet on HealthReform.Gov, a website managed by the Department of Health and Human Services (HHS), a new interim final rule issued by the HHS, Labor Department, and IRS that implements the grandfather provisions of the Patient Protection and Affordable Care Act (PPACA) creates a win-win situation for both employers and employees.

Health plans that were in existence on March 23, 2010 can be “grandfathered” and exempt from some of the PPACA’s provisions on individual and group market reforms, unless they significantly cut or reduce benefits, raise co-insurance charges, co-payment charges or deductibles, lower employer contributions to premiums by more than 5%, or add or tighten an annual dollar limit on what an insurer pays for covered services. Cost adjustments are allowed to keep pace with inflation, and such premium changes will not be used to determine whether or not a plan is grandfathered. A new grant program has recently been announced by the Obama administration that is designed to strengthen states’ abilities to spot unreasonable premium increases and take appropriate action.

If a plan loses its grandfathered status, individuals in that plan will receive certain benefits such as coverage of recommended prevention services with no cost sharing and guaranteed access to OB-GYNs and pediatricians.

The rule is designed to let employees keep their current coverage while giving them new benefit protections. It will require employers and insurers to inform employees and insureds with regard to whether or not their plan is grandfathered. The rule will not, according to the website, drive up health insurance costs, cause employers plans to eventually lose their grandfathered status, make it difficult for health plans to respond to rising health care costs and other changes, drive up employers’ coverage costs, or create more red tape for employers. The Q&A emphasizes that grandfathered health plans will be able to make routine changes, including cost adjustments and the addition of new benefits, to their policies.

Special benefits are provided for people who work in smaller firms. Such firms change insurers more often due to annual fluctuations in premiums. Small businesses may, starting in 2010, qualify for a tax credit to offset up to 35% of their premium contributions, and in 2014, up to 50% of their premiums.

It is estimated that health plans for well over half of American workers and their families will remain grandfathered through 2013, with change coming more swiftly on the individual market, since up to two-thirds of individual policyholders switch coverage in a given year.

The HHS, Labor Department, and the IRS are apparently using the new grandfather rule to strike a balance between letting health plans make routine changes and preventing those plans from making such extreme changes that the plans are no longer recognizable. All three agencies have the authority to enforce the grandfather rule, and are claiming that it should ease the transition that the health care and health insurance industries must make to comply with the PPACA.

Friday, June 11, 2010

Early Retiree Health Claims Reinsurance Program Funds Limited

Employers that sponsor health care benefits for early retirees and who plan to benefit from health reform’s new early retiree reinsurance program (ERRP) better hurry to file their claims: the funds allocated for the program likely will be exhausted within the next two years, well before the 2014 termination date for the program, according to a study released on June 7 by the Employee Benefit Research Institute (EBRI).

The Patient Protection and Affordable Care Act establishes a temporary reinsurance program to reimburse part of the claims costs for participating employment based plans that provide health insurance coverage for early retirees ages 55 through 64, and their eligible spouses, surviving spouses, and dependents. The ERRP will reimburse for 80% of a plan’s individual claims that are between $15,000 and $90,000, indexed for inflation. The program is effective June 1, 2010, and ends on the earlier of Jan. 1, 2014, or when the $5 billion appropriated for the program is exhausted.

Using data to calculate how many early retirees there are and how much they tend to spend on health care services, Paul Fronstin, director of the EBRI Health Research and Education Program and author of the study, concluded that available funds will be exhausted well before the program is set to expire. If the subsidy were drawn down for all eligible early retirees and their dependents, $2.5 billion of the available $5 billion would be exhausted in the first year of the program. The $5 billion would last no more than two years and would not be available in 2012 or 2013, Mr. Fronstin reported. This assumes that all employers eligible to apply do so and is contingent on other assumptions outlined in the study.

Before the Department of Health and Human Services issued interim final regulations (on May 5 of this year) implementing the EERP, a Hewitt survey found that three-fourths of large employers that offered early retiree medical benefits planned to apply for the ERRP reimbursement. According to Hewitt estimates, the average federal reimbursement will amount to between $2,000 and $3,000 per pre-65 retiree per year, or approximately 25% to 35% of total health care costs.

The EBRI survey report is at http://www.ebri.org.

Wednesday, June 9, 2010

COBRA Subsidy Boosts Take Up Rate, Survey Finds

The COBRA subsidy certainly has boosted the number of workers who lost their jobs in the past year and continued their former employer’s health coverage, recent surveys have shown. One-third of terminated employees chose the 65% COBRA subsidy in 2009, according to preliminary results of the 2010 COBRA Health Care Continuation of Coverage Survey being conducted by Spencer’s Benefits Reports.

The 65% subsidy in COBRA premiums is available for up to 15 months for certain "assistance eligible individuals," as originally provided by the American Recovery and Reinvestment Act of 2009.

In past Spencer surveys, as the eligibility rate rose, the COBRA election rate often dropped, as happened in 2008, just before the COBRA subsidy took effect. In preliminary figures for 2009, however, both the eligibility and election rates were high. The 33% COBRA election rate by terminated employees is significantly above the 20% average in previous Spencer COBRA surveys. In addition, 18% of employees covered by health care became eligible for COBRA in 2009, well above the 11% average in previous surveys.

These results mirror results of a recent Treasury Department survey of COBRA elections in New Jersey which suggested that one-fourth to one-third of eligible unemployed workers enrolled in subsidized COBRA for continuing health insurance.

Congress has extended the COBRA subsidy several times, and in March the Senate agreed to another extension. The House of Representatives, however, recently stripped out the COBRA extension when it passed H.R. 4213, the American Jobs and Closing Tax Loopholes Bill, and a further extension is unlikely right now.

Spencer’s Benefits Reports has been collecting and analyzing COBRA survey information since 1990. This year’s survey requests information concerning the costs, administrative procedures, and problems associated with COBRA and the COBRA subsidy initiated in 2009.

The COBRA Health Care Continuation of Coverage Survey is an important source of information for benefit plan administrators nationwide and is regularly quoted in national and government publications. It is the longest-running national COBRA survey.

Employers and plan administrators who complete the survey will receive a free copy of the results. In addition, survey participants who include a name and email address will be entered in a drawing to win one of three $100 American Express gift certificates.

To take part in Spencer’s Benefits Reports 2010 COBRA Health Care Continuation of Coverage Survey survey, visit http://www.zoomerang.com/Survey/?p=WEB22A6JEFSRSH.

For the past 65 years, Spencer’s has been a major information resource on employee benefit federal laws and regulations and trends for employee benefits professionals.

Monday, June 7, 2010

Simple Cafeteria Plans Boon For Small Employers

The new health reform law adds a new provision of particular interest to small employers: simple cafeteria plans, established under Sec. 9022 of the Pension Protection and Affordable Care Act.

In years beginning after Dec. 31, 2010, certain small employers’ cafeteria plans can qualify as simple cafeteria plans and thus avoid the nondiscrimination requirements of a classic cafeteria plan under IRC Sec. 125(b).

Through the establishment of a simple cafeteria plan, without worrying about running afoul of the nondiscrimination requirements of a classic cafeteria plan, employers can retain potentially discriminatory benefits for highly compensated and key employees (subject to some restrictions relating to contributions, as discussed below) while allowing other employees to enjoy the benefits of a cafeteria plan.

An employer eligible to establish a simple cafeteria plan is any employer that, during either of the two preceding years, employed an average of 100 or fewer employees on business days.

If an employer has 100 or fewer employees for any year and establishes a simple cafeteria plan for that year, then it can be treated as meeting the requirement for any subsequent year even if the employer employs more than 100 employees in the subsequent year. However, this exception does not apply if the employer employs an average of 200 or more employees during the subsequent year.

This provision allows small but growing employers to continue to offer simple cafeteria plan benefits to employees without the concern of having to meet the discrimination requirements of a classic cafeteria plan. Without this exception, the establishment of simple cafeteria plans could create a disincentive to increased hiring.

Contribution Requirements

Under the contribution requirements, a simple cafeteria plan must make a contribution to provide qualified benefits on behalf of each qualified employee, in an amount equal to:
• a uniform percentage (not less than 2%) of the employee’s compensation for the year, or
• an amount not less than the lesser of:
(a) 6% of the employee’s compensation for the plan year, or
(b) twice the amount of the salary reduction contributions of each qualified employee.

If the employer bases the satisfaction of the contribution requirements on the second option, it will not be in compliance if the rate of contributions to any salary reduction contribution of a highly compensated or key employee is greater than to the rate of contribution for any other employee.

For purposes of the contribution requirements, a salary reduction contribution is any amount contributed to the plan at the election of the employee and not includable in the employee’s gross income under the Sec. 125 cafeteria plan provisions. The terms “highly compensated employee” and “key employee” retain their definitions under the classic cafeteria plan provisions. A “qualified employee” is any employee who is not a highly compensated or key employee.

Eligibility, Participation Requirements

A simple cafeteria plan also must satisfy minimum eligibility and participation requirements. The requirements are met if all employees who had at least 1,000 hours of service for the preceding plan year are eligible to participate, and if all employees have the same electon rights under the plan.

An employer may elect to exclude from the plan employees who have not attained the age of 21 before the close of the plan year, who have less than one year of service with the employer as of any day during the plan year, who are covered under a collective bargaining agreement if there is evidence that the benefits covered under the plan were the subject of good faith bargaining between employee representatives and the employer, or are nonresident aliens working outside the United States whose income did not come from a U.S. source.

The provision applies to years beginning after December 31, 2010.

For a comprehensive analysis of the Patient Protection and Affordable Care Act, and additional information on health reform and other developments in employee benefits, just click here.

Friday, June 4, 2010

Behind the scenes: Implementing health reform keeps federal agency staffers busy

Throughout the whole health reform process, many people commented on how massive the legislation was. In the end, the law text weighed in at nearly 3,000 pages. If you thought that the new law is huge, just think about the efforts needed to implement the new law.

The Washington Post has taken a look at the efforts of the staffers at the Department of Health and Human Services and other federal agencies who are working to issue regulations clarifying the meaning of the health reform legislation. As the Washington Post says: the “health-care overhaul may have slipped from the headlines since President Obama signed the bill into law in March. But the gargantuan chore of putting the statute’s more than 2,000 pages of provisions into practice is keeping Washington's policymakers and bureaucrats busier than ever.”

The White House is quite involved in this implementation effort, which reflects not only the importance of the law on President Obama’s presidency but also “reflects the degree to which the law leaves fundamental decisions to the administration's discretion,” the Post points out.

The bottom line: "How these regulations get written can have a real impact on how much health-care reform we actually end up getting--and a lot of them need to get written within weeks," says Mark B. McClellan, a former administrator of the Centers for Medicare and Medicaid Services now with the Brookings Institution.

For a comprehensive analysis of the Patient Protection and Affordable Care Act, and additional information on health reform and other developments in employee benefits, just click here.

Wednesday, June 2, 2010

Cadillac plan tax to hit most employers by 2018

By the time it officially takes effect in 2018, the excise tax on so-called “Cadillac plans” will affect more than 60 percent of large employers’ active health plans, according to a Towers Watson analysis. Based on data from the firm's 2010 Health Care Cost Survey, the study also found that, by taking certain actions, employers can contain their costs and significantly delay hitting the excise tax cost ceiling for a number of years.

"The original concept of the excise tax was to penalize employers with excessively rich health benefit plans," says Randall Abbott, a senior consultant for Towers Watson. "Assuming even reasonable annual plan cost increases to project 2018 costs, many of today's average plans will easily exceed the cost ceiling primarily directed at today's 'gold-plated' plans."

"There is some good news: Employers have a long runway to plan for 2018, so there is time to approach the issue strategically and thoughtfully. But reform and the excise tax may have unintended consequences," Abbott suggests. "As employers strive to preserve the affordability of core health coverage, there will be difficult decisions to change or eliminate ancillary benefits like dental coverage and health flexible spending accounts, which are included in the excise tax definition." Excise tax rules will also be needed to clarify certain confusing aspects of the law, according to Towers Watson.

For a comprehensive analysis of the Patient Protection and Affordable Care Act, and additional information on health reform and other developments in employee benefits, just click here.

Tuesday, June 1, 2010

Most companies offering pre-65 retiree medical benefits to apply for ERRP payments

Companies that offer pre-65 retiree medical benefits say that they intend to apply for the Early Retiree Reinsurance Program (ERRP) under the Patient Protection and Affordable Care Act (PPACA) to offset a portion of health care claims costs for retirees ages 55 to 64 and their families, according to a survey from Hewitt Associates.

Conducted in May, Hewitt's survey found that 76 percent of 245 large employers that offer medical benefits (to more than 1.3 million retirees) plan to seek reimbursement under the ERRP. Under regulatory guidance issued in early May by the Department of Health and Human Services (HHS), the ERRP provision goes into effect today (June 1, 2010).

ERRP program details. Under the ERRP program, companies can receive an 80 percent reimbursement on claims incurred by early retirees and dependents between $15,000 and $90,000 over the course of a year. Eligible claims under the program include those involving medical, prescription drug and behavioral health. The program will last until January 1, 2014, or until the funds set aside for the program are exhausted.

According to Hewitt estimates, the average federal reimbursement will represent between $2,000 and $3,000 per early retiree per year, or approximately 25 percent to 35 percent of total health care costs. As an example, for a company that covers 1,000 pre-65 retirees, participation in the ERRP could result in $2 million to $3 million in reinsurance proceeds per year, Hewitt says.

As healthcare costs continue to increase, the number of companies eliminating pre-age 65 retiree health benefits has grown, according to Milind Desai, co-leader of Hewitt's Retiree Health Care Task Force. "The early retiree reinsurance program encourages employers to continue offering coverage to pre-65 retirees and their families by providing some temporary relief from expensive pre-65 retiree medical claims. But because so many companies plan to apply for the ERRP, employers will need to act quickly to secure a share of the proceeds, since the federal funds earmarked for this program are limited," Desai says.

Use of ERRP reimbursements. While the health reform law requires that employers use the ERRP reimbursements to reduce the cost of the plan, Hewitt found that most surveyed employers have not yet decided on a specific approach. (Note that Hewitt's survey was conducted just the HHS regulatory guidance was issued). At that time, Hewitt found, two-thirds (66 percent) of companies that intend to apply for the reimbursement said they were not sure about how they plan to use the proceeds and were waiting for this guidance before making a decision. Sixteen percent said they are considering using the reimbursement to reduce premiums—including both employer and retiree share, and another five percent said they are considering reducing the retiree share of premiums only.

"While the interim final rule on the ERRP was released in early May, most employers are still looking for more details about how these funds can and cannot be used," suggests John Grosso, co-leader of Hewitt's Retiree Health Care Task Force. "We expect additional guidance by the end of June, and we believe companies will then make final decisions on how to best allocate these reimbursements to offset the cost of the plan. Employers will be required to describe how the proceeds will be used to support the plan in their ERRP application," he says.

For more information. For a comprehensive analysis of the Patient Protection and Affordable Care Act, and additional information on health reform and other developments in employee benefits, just click here.