Employee Benefits Headlines

Gathered from the web by the editors at BenefitsLink.com.
New Perk Gives Federal Employees a Break on the Cost of Education
"Federal workers who live outside of Maryland can receive a 25 percent discount on all undergraduate and most graduate programs offered at the University of Maryland University College.... Federal workers' spouses and their legal dependents also are eligible for the reduced rates. The tuition break applies to in-person and online classes." (Government Executive)

Obamacare Triggers Jump in U.S. Consumers' Health-Care Spending
"Consumer spending climbed by $20.4 billion at an annualized rate adjusted for inflation in February, and $13 billion of the increase came from outlays on health services spurred by the [ACA].... While it's been rising fairly steadily since 2000, the share of consumer budgets dedicated to medical care climbed to a record 17.1 percent in February from 16.9 percent in December. Since the end of the recession in June 2009 through September, the proportion ranged from 16.4 percent to 16.7 percent." (Bloomberg)

Health Care Spending's Recent Surge Stirs Unease
"A surge of insurance enrollment related to rising employment and President Obama's health care law has likely meant a surge of spending on health care, leaving policy experts wondering whether the government and private businesses can control spending as the economy gets stronger and millions more Americans gain coverage.... A report from IMS, a health care data and analytics firm, found use of the health care system increasing broadly in 2013. Americans made more visits to doctors' offices, were hospitalized more often and purchased more prescription medication." (The New York Times; subscription may be required)

Social Security to Resume Benefits Statement Mailings
"Starting this September, the Social Security Administration (SSA) will resume mailings at five-year intervals to workers who have not signed up to view their statements online, an agency spokesman told Reuters. The statements will be sent to workers at ages 25, 30, 35, 40, 45, 50, 55 and 60, he said, adding the agency would continue to promote use of the online statements." (Reuters)

Illinois Pension Law Had Costly Typo
"Universities were already worried about large-scale departures of employees who would lose benefits under the change to Illinois' public pensions if they didn't leave by June 30. The language in the bill signed into law last December was intended to ease that concern by limiting how much public university employees who didn't retire would lose. But it made the effective date June 30, 2013, rather than 2014 -- taking away a full year of benefits." (Houston Chronicle)

Why Asset Class Diversification Is Important (PDF)
"ic studies have shown that more than 90% of the variations in a portfolio's return can be attributed to the asset allocation decision.... [A table] illustrates that the major asset classes ... have experienced negative returns in approximately 25% -- 40% of the 120 calendar quarters covering the last 30 years. However, the table also shows that the historical probability of multiple asset classes experiencing negative returns at the same time is signifi cantly lower." (Manning & Napier)

Helpful Tips to Prepare for a Retirement Plan Financial Audit (PDF)
"What is the 80-120 Rule? ... Under what conditions can small plans waive the requirement for a plan audit ... What are the filing requirements for 403(b) and other non-ERISA retirement plans? ... When are limited-scope audits worthwhile ... Is your auditor helping you become IRS audit-ready?" (Belfint, Lyons & Shuman, via Legg Mason)

Unpaid Employer Contributions as Plan Assets: Expansion Of Liability Under ERISA
"In a distinct trend, federal courts have found that, depending on the text of the underlying plan documents, unpaid employer contributions due under a CBA may be viewed as plan assets, such that the representatives of an employer who exercise fiduciary control over those plan assets can be held individually liable for the unpaid amounts (together with interest and penalties) under ERISA. These cases will no doubt help plan trustees and administrators collect monies owed to the plan. They also should serve as cautionary warnings to contributing employers to ensure that they fully understand the obligations that they are undertaking when they agree to contribute to ERISA funds pursuant to CBAs." (Proskauer Rose LLP)

Can the SEC Fix Target-Date Funds?
"The Investment Advisory Committee (IAC), a group of regulators, consumer advocates, academics and others who advise the SEC on matters of concern to consumers, earlier this month recommended a number of changes to the proposed TDF regulations. And that has caused the SEC to go back to the drawing board." (MarketWatch)

Treasury Department Starting Unit That Includes Oversight of Public Pension Funds
"The Treasury Department is creating an Office of State and Local Finance to coordinate the department's efforts to oversee developments in state and local financial markets, including public pension fund liabilities. Kent Hiteshew was named the office's first director ... Mr. Hiteshew is currently managing director at J.P. Morgan Chase, responsible for public finance in the Northeast U.S. as well as the bank's housing finance group." (Pensions & Investments)

[Guidance Overview] 408(b)(2) Guide and More
"The first [DOL concern] is that some covered service providers are not giving fiduciaries information that specifically applies to their plan.... The Department's view is that the disclosures should include only the services and compensation for the plan receiving the disclosures. The second concern is that service providers are using overly-broad ranges to make disclosures.... [We] anticipate that the DOL will begin their first wave of 408(b)(2) investigations in the second half of this year." (FredReish.com)

Employers, Start Your Reporting! (Or at Least Start Preparing)
"[E]mployers need to start looking at the reporting process now. First, since the obligations under [Internal Revenue Code sections] 6055 and 6056 are somewhat duplicative, employers should first figure out whether they have to file both. Second, collecting this information is going to take a lot of coordination between the HR, payroll and benefits departments. Now is a good time to see what information is available and how responsive information will be collected and aggregated for final reporting." (Fox Rothschild LLP)

The Cash Balance Capital Preservation Guarantee Quantitative Analysis
"For a generic 60/40 portfolio, employers have experienced one material floor risk in the past 63 years -- 1974, which cost 0.2% of total payroll for our 5% of pay plan. For more aggressive portfolios the cost can be somewhat higher -- the 'worst case' cost historically was 1.5% of total payroll in 2008 for a 100% stock portfolio. For more conservative (40/60 or less) portfolios, employers have not seen a material floor risk in any year since 1950. Interestingly, the 'least risky' portfolio is 20/80, not 100% bonds, which speaks to the benefit of asset diversification." (October Three Consulting)

IRS Safe Harbor for Accepting Rollover Contributions: on the Interplay Between Rev. Rul. 2014-9 and Form 5310
"The Form 5310 Application for Determination for Terminating Plan instructions, updated in December 2013, added an odd and time-consuming new requirement, 'Submit proof that any rollovers or asset transfers received [during the year of plan termination and five prior plan years] were from a qualified plan or IRA (for example, DL [determination letter] and timely interim amendments).' ... [E]ven if the administrator were attempting to rely on the safe harbor with respect to an invalid rollover, which is not what is happening when the employer requests a determination letter, the administrator would not have that type of documentation." (Porter Wright Morris & Arthur LLP)

[Guidance Overview] DOL Proposes Qualified Plan Fee Disclosure Guide
"Pending the finalization of this proposed rule, an employer should consider doing the following to assess the adequacy of the fee disclosures provided by the plan's covered service providers: [1] review the disclosures already provided to determine if the 'basic framework' information has been provided; [2] request a specific analysis of the fees and how they are calculated, and a glossary of terms and examples to assist in the review of the analysis; and [3] review any recordkeeping agreement or investment adviser's agreement to determine how fees contractually are required to be disclosed." (Wolff & Samson)

The Next Stage in Executive Compensation's Evolution
"Among the most impactful drivers of change over the past decade have been so-called best practices, regulators and proxy advisors. On the plus side, these forces supported a number of improvements in pay design and governance. However, on the downside, they've helped to create a compliance-driven and 'play it safe' environment.... [We] hear an undue focus on narrow pay issues and standardized rules, that third-party opinions have supplanted empirical research and that pay programs have become increasingly similar across organizations. The notions of customization ... and differentiation ... have received short shrift." (Towers Watson)

District Court Rejection of Challenges to Verizon Annuity Purchase Supports Derisking Strategy (PDF)
"[T]he court simply reiterated its prior ruling that Verizon was not acting as fiduciary when it amended the plan to direct the annuity purchase because 'the disputed decisions involve Verizon's role as settlor, not Plan fiduciary' ... [T]he court rejected the claim that Verizon's decision to purchase annuities from a single provider, Prudential, the day after it amended the plan to provide for it, was a fiduciary breach.... [T]he court stated, 'at bottom, plaintiffs are disagreeing with the rights of a settlor under ERISA, and such a disagreement must be addressed to Congress through requests for legislative changes to ERISA, not through litigation that complains of the decisions that ERISA empowers a plan sponsor as settlor to make.'" [Lee v. Verizon Communications, No. 3:12-CV-4834-D (N.D. Tex. Apr. 11, 2014)] (Groom Law Group)

IRS Defers Effective Date of Bobrow Decision to 2015 Distributions
"The IRS will not apply the new one rollover per 12-month rule to any rollover that involves a distribution occurring before Jan. 1, 2015.... [T]he IRS indicated it had received comments about 'the administrative challenges' presented by the Bobrow interpretation of section 408(d)(3)(B). The announcement affords trustees and custodians time to alter their internal processing of IRA rollovers." (McGladrey LLP)

[Guidance Overview] IRS Issues Final Regs on Employer Shared Responsibility Requirements (PDF)
"It will be important to determine whether workers characterized as independent contractors who are not offered medical coverage may, in fact, be common-law employees. In the final regulations, the IRS declined to provide relief from the assessments for previously misclassified employees.... The concept of 'seasonal workers' is used only for purposes of determining applicable large employer status and should not be confused with 'seasonal employees,' which describes certain employees who may not have to be treated as full-time even though they are expected to average at least 30 hours of service a week at their start date." (Buck Consultants)

[Guidance Overview] FATCA Compliance Updates (PDF)
"The long-awaited final Form W8-BEN-E is designed to assist U.S. withholding agents in collecting the information needed to properly classify foreign payees for FATCA compliance purposes. The final form contains over 20 new FATCA entity classifications and certifications, but the portion addressing retirement plan exemptions mirrors the draft form. The IRS has not yet issued instructions to accompany the final form." (Buck Consultants)

[Guidance Overview] Final ACA Shared Responsibility Regulations Issued
"Some key changes in the final regulations include: [1] Delay the shared responsibility mandate for employers with 50-99 employees; [2] Extend certain transition rules; [3] Temporarily liberalize the requirement to offer coverage from 95% to 70% of employees; [and] [4] Provide a definition of seasonal employee as well as other types of employees." (ErisaDiagnostics)

Four Years Into a Commercial ACO for CalPERS: Substantial Savings and Lessons Learned
"In 2007, Blue Shield of California, along with provider and employer partner organizations, began exploring development of one of the first ACO-like programs in the country to serve Commercial patients. It launched in 2010 ... Of particular note has been overall cost of health care savings reported at gross savings of more than $105 million, with net savings of $95 million to CalPERS members, since 2010. [In this article] the partners illuminate the ACO's future directions and offer lessons for other organizations considering development of an ACO delivery system for the Commercial market." (Glenn Melnick and Lois Green in Health Affairs Blog)

Both Sides in Tussey vs. ABB Case File Requests to Appeal Court Ruling
"In its appeal of the $13.4 million judgment vs. ABB, the company said the appeals court took a 'myopic focus on a single component of the (total) fee,' arguing that it should have taken into account the aggregate fee for its plans. 'In other words, the net return is what matters to the investor,' said the appeal ... In appealing the reversal of the Fidelity float income decision, the plaintiffs said the appeals court panel majority 'disregarded ... settled law' in its ruling that float income wasn't a plan asset.... The ABB attorneys' objection to the mapping ruling centered on its claim that plaintiffs' waited too long to file a complaint[.]" (Pensions & Investments)

Millennials Eschew Retirement Plans for Online Brokerage Accounts
"74% of affluent millennials -- those with more than $100,000 in investable assets -- have assets in online brokerage accounts, while only 67% have assets in a defined contribution plan. This cohort is alone among working age segments to be more likely to invest assets in online brokerage accounts than retirement plans ... For example, only 30% of millennial investor assets are allocated to employer-sponsored retirement plans, in contrast to Generation X, the next age cohort, which has allocated 48% of their assets to such plans." (Financial Planning)

Update on the Basic Health Program
"Currently, only a few states have shown an interest in implementing a Basic Health Program. Some states have studied the option, and seven states -- California, Massachusetts, Minnesota, New York, Oregon, Rhode Island, and Washington -- and the District of Columbia are part of a discussion group sponsored by CMS on topics related to the Basic Health Program, including funding, eligibility, and enrollment. In the final rule, CMS estimated that a total of three states would create a Basic Health Program over the next five years." (Health Affairs Blog)

[Opinion] Text of Letter from American Academy of Actuaries to Congressional Leaders on Pension Funding Provisions of Recent Legislative Proposals (PDF)
"MAP-21 was designed to provide short-term funding requirement relief to plan sponsors in light of economic conditions and included a schedule on which its impact would be reduced. Recent proposals ... would defer this phase-out, and by doing so, [lower] the ongoing funding requirements. Extending these temporary provisions accelerates tax revenue while deferring the pension cost to future generations, distorts the pension measurements, and undermines the benefit security of plan participants while increasing the risk exposure to the PBGC." (American Academy of Actuaries)

White House Fact Sheet: Affordable Care Act by the Numbers
"The Affordable Care Act is working.... 8 million people signed up for private insurance in the Health Insurance Marketplace ... 3 million young adults gained coverage ... 3 million more people were enrolled in Medicaid and CHIP ... 5 million people are enrolled in plans that meet ACA standards outside the Marketplace ... Health care costs are growing at the slowest level on record ... Medicare spending growth is down." (The White House)

[Opinion] Hundreds of Thousands of Participants Could Lose Benefits If Closed DB Plan Testing Issue Is Not Fixed (PDF)
"A nondiscrimination testing rule contained in U.S. Treasury Department regulations will effectively compel many defined benefit plans across the country to completely freeze all benefits in the next few years... The American Benefits Council has for several years been proposing a very simple solution. If the grandfathered group is a nondiscriminatory group when the plan is first closed (or at a later date), then the plan is permitted to be tested with the employer's defined contribution plan on a benefits basis.... We urge Congress to move forward with that legislative proposal to prevent hundreds of thousands of participants from losing benefits." (American Benefits Council)

Making the Case Against Allowing Health Insurers to Raise Premiums
"In Colorado ... rate review saved consumers as much as $32 million in one year. And in Oregon ... rate review cut at least $69 million from 2014 premiums. In the next few months, health insurance companies will be notifying state health insurance commissioners of their planned health insurance premium rates (known as 'rate review filings') for 2015. Because these rate review filings will peak in May and June, advocates and consumers should start preparing now by learning how the rate review process works in their states." (Families USA)

Executive Compensation Clawbacks: 2013 Proxy Disclosure Study (PDF)
18 pages. Excerpt: "This study presents [an] analysis of 2009 through 2012 year-end proxy disclosures for 100 large public companies relative to their compensation recoupment or 'clawback' policies.... Of the companies in [this] study, 92% have policies to recoup compensation if there's a restatement of financial results.... 27% require repayment in the event of a restatement without personal accountability.... Another prevalent reason for recoupment of incentives was misconduct (84%), which includes breaking a company's code of conduct or ethics policies, being convicted of a criminal offense, or other transgressions[.]" (PricewaterhouseCoopers)

President Obama's 2015 Budget Proposes Changes to Employer Benefits
"The budget calls for new limits for tax-preferred retirement plans, caps on tax preferences for health and retirement benefits, and higher PBGC premiums. While the full proposal is unlikely to gain legislative traction, revenue-raising provisions could be attached to other legislative proposals. The budget would establish automatic payroll deduction IRAs -- a long-standing proposal from the administration and some lawmakers." (Towers Watson)

Retirement Security Tops List of Employee Concerns
"Older DC plan-only participants are more likely to expect most of their retirement income to come from Social Security. Almost seven in 10 workers were happy with their health plans in 2007, but satisfaction rates dropped to 59% in 2013. Sixty-two percent would give up some pay for a guaranteed retirement benefit, and more than half would sacrifice pay for a more generous benefit." (Towers Watson)

[Official Guidance] Text of Social Security Notice of Discontinuation of the Letter Forwarding Service
"In recent years, the internet offers a rapid expansion of locator resources via free social media Web sites and for pay locator services. The public now has widespread access to the Internet and the ability to locate individuals without relying on our letter forwarding services. Based on the availability of the alternative locator resources and the effects it would be as a cost saving measure, we are discontinuing the letter forwarding service. This decision is in line with the Internal Revenue Service, which successfully eliminated part of its letter forwarding workload as of August 31, 2012." (Social Security Administration)

Can an Employer Force an Employee Onto FMLA Leave When the Employee Wants to Continue to Work?
"[W]hen you have a reasonable belief that your employee cannot perform the essential functions of the job (including when you are faced with mental health issues ...), you can keep the employee off work until you have that confirmation.... [E]ven if an employer wrongfully forces an employee to take FMLA leave ... the employee cannot successfully raise an FMLA interference claim unless the employee seeks FMLA leave at a later date and the leave is not available because the employee was wrongfully forced to use FMLA leave in the past." (FMLA Insights)

Labor-Force Participation Rates of the Population Ages 55 and Older, 2013
"The labor-force participation rate for those ages 55 and older rose throughout the 1990s and into the 2000s, when it began to level off but with a small increase following the 2007-2008 economic downturn.... [A]mong those ages 65 or older, the rate increased for both males and females over that period. This upward trend in labor-force participation by older workers is likely related to workers' current need for continued access to employment-based health insurance and for more years of earnings to accumulate savings in defined contribution (401(k)-type) plans and/or to pay down debt." (Employee Benefit Research Institute [EBRI])

Characteristics of the Population with Consumer Driven and High Deductible Health Plans, 2005-2013
"The population of adults within consumer-driven (CDHPs), high-deductible (HDHP) and traditional health plans was split about 50-50 between men and women in 2013. The CDHP population was more likely than traditional-plan enrollees to be in households with $150,000 or more in income in every year except 2006, 2009 and 2010. They were also more likely to be in households with $100,000-$149,999 in income in most years. CDHP enrollees were roughly twice as likely as individuals with traditional coverage to have college or post-graduate educations in nearly all years of the survey." (Employee Benefit Research Institute [EBRI])

State Marketplace Design and Policies
"In an effort to ensure independence in governance and policy setting, avoid conflicts of interest, and ensure long-term viability, 11 states created a quasi-governmental agency to operate their marketplaces. Governing boards composed of experts and key stakeholders oversee the new agencies; the majority of states prohibit insurers and/or brokers from serving on the board.... [S]everal require that issuers offer a standardized plan design to enable consumers to more easily compare plans based on price and provider networks.... States used a variety of interactive web features to provide a customer-friendly application and shopping experience, including allowing consumers to browse plans before creating an online account or submitting an application." (Center on Budget and Policy Priorities)

Text of CBO Cost Estimate for PBGC Proposals in the President's 2015 Budget (PDF)
"The President's Budget proposes to give PBGC the authority to set premium rates in both the single employer and multi-employer programs, but does not specify how to allocate the premium increase across the two programs. For this estimate, CBO assumed that 75 percent of the increase would be for the single employer program and 25 percent for the multi-employer program. CBO projects that the multi-employer revolving fund will be exhausted in 2021." (Congressional Budget Office)

[Opinion] Text of Letter from American Academy of Actuaries to Congressional Leaders on on Risks of Using Pension Provisions as Revenue Offsets (PDF)
"In evaluating the current [PBGC] premium level and structure, as well as possible changes thereto, primary consideration should be given to the risks inherent in the pension system and the effects on all stakeholders. These issues are not being appropriately considered when premium-increase proposals are added to unrelated legislation as a 'pay-for' to enable other priorities. Further premium increases will increase the cost of plan sponsorship and could accelerate the rate of plan closures, plan terminations, and other sponsor efforts to transfer risks to participants, which include offering lump sum distributions to current retirees." (American Academy of Actuaries)

Is a DB Plan Right for Your Organization?
"The decision to move away from DB plans raises two key questions: [1] Are those organizations that have abandoned their DB plans missing out on significant workforce planning opportunities? [2] If an organization that sponsors a DB plan lowers its financial risks through, for example, liability-driven investing, would it gain the workforce management advantages of a DB plan and the costs and risks similar to a DC plan? ... This paper outlines how various employees would fare based on participation in a DB plus DC versus a DC-only plan. It also provides information to address whether the workforce planning advantages of DB plans justify the cost and risk of plan sponsorship." (Towers Watson)

Why Plan Participants Change Their Planned Retirement Date (PDF)
"Workers who report a change in their expected retirement age in 2014 most often cite the poor economy (25 percent)... Other reasons cited included the inability to afford retirement (18 percent), a change in their employment situation (17 percent) and health care costs (12 percent)[.]" (Employee Benefit Research Institute [EBRI])

New Data Signal Smaller Jump in Health Care Costs for 2015
"Statisticians working with insurers to project next year's insurance premium rates say they expect to see an average increase of about 7%, well below the feared double-digit increases making recent headlines.... [As] insurers dig through the new health exchange enrollees to figure out their ages and health conditions to determine next year's premiums, [Dave Axene, a fellow with the Society of Actuaries] expects an overall increase of 6% to 8.5%.... Before the [ACA], premiums rose an average of 7-10% a year." (USA TODAY)

Obamacare and the Early Retiree: Health Law Offers Relief
"The system was designed to make health-care costs comprehensive and affordable at all income levels. Right or wrong, by ignoring assets as a criteria, the system can also provide benefits for those who are relatively affluent. Whether or not the early retiree is eligible for subsidies or prefers to shop outside the exchanges, advisors now have better tools for predicting future health-care costs than in the past." (Morningstar Advisor)

The Risks of Derisking DB Plans
"Assets that left the plan early in 2012 and 2013 missed out on the double-digit return potential of those years. When participants are offered a lump sum election opportunity, those in poor health are more likely to accept the offer ... Thus, the plan may be subject to more unfavorable mortality experience ... [A] lump sum transaction is likely to decrease a plan's funded status ... and will have to maintain a certain funding level in order to avoid lump sum restrictions. The lower funded status will generally result in higher plan sponsor contribution costs. It may also result in a higher PBGC variable-rate premium." (Milliman, via Actuarial Digest)

Paid Family Leave: Can a State-by-State Approach Work?
"After lobbying state by state for years, some supporters of paid family leave say it's time for a federal solution. A proposal in Congress ... would export the models used in California, New Jersey and Rhode Island nationwide. Those are the only three states with their own paid leave laws." (The Pew Charitable Trusts)

PBGC Announces 'My PAA' is Ready for 2014 Premium Filings
"My PAA has been updated to reflect recent changes to the premium regulation (first effective for 2014 plan years) as described in the 2014 premium filing instructions. Comprehensive filings for plan years beginning in 2014 may now be electronically submitted via My PAA. Information about how to e-file via My PAA (e.g., Demos and FAQs) is on the Online Premium Filing with My PAA page ... A reminder[:] the new rules have no impact on premium filings for plan years beginning in 2013 (e.g., small calendar plans whose 2013 premium filing is due April 30th, 2014)." (Pension Benefit Guaranty Corporation [PBGC])

The Flexibility Bias
"What the flexibility bias literature shows us is that using work/life policies for other kinds of reasons -- such as for a personal health-related reason or even using it to do things like training for a marathon, are not stigmatized in the same way as taking leave for family care-related responsibilities." (Human Resource Executive Online)

Average Retiree Health Costs Could Overtake Social Security Benefits
"Retirement health care costs will increase from 69% of Social Security benefits for a couple retiring next year to 98% of Social Security benefits for a healthy couple retiring 10 years from now ... For couples retiring two decades from now, the gap will be even more dramatic. They would need 127% of average Social Security benefits to cover their health care costs in retirement." (InvestmentNews)

Helping Plan Participants to Choose Between Annuities and Lump Sums
"If his main retirement goal is to be happy, have him take the pension or a similar lifetime annuity. A 2012 report ... found that among retirees of similar wealth and health, those with annuitized incomes were happier than those without annuities. Any financial adviser worth her credentials would argue that this happiness is likely to be short-lived, though.... There's another angle. Pensions don't generate commissions or asset management fees; rollovers do. So how do you help clients make informed decisions and manage the inherent conflict of interest?" (Reuters)

Best Practices for Investment Menus in 401(k)/403(b) Plans
"[1] Offering 12 to 15 core fund options, which do not include managed fund choices; [2] A set of professionally managed investment options ... with the most common offering being target date funds; ... [3] At least 4 conservative fund choices ... Although the average number of investment options offered in 401(k) plans has risen to 15 ... the average number of investment funds used by participants has remained consistent over time at 3." (Lawton Retirement Plan Consultants)

Report and Recommendations for Price Transparency in Health Care
24 pages. Excerpt: "Transparency tools for insured patients should include some essential elements of price information, including: [1] The total estimated price of the service; [2] A clear indication of whether a particular provider is in the health plan's network and information on where the patient can try to locate a network provider; [3] A clear statement of the patient's estimated out-of-pocket payment responsibility; [and] [4] Other relevant information related to the provider or the specific service sought (e.g., clinical outcomes, patient safety, or patient satisfaction scores)." (Healthcare Financial Management Association [HFMA])

California Makes It Harder for Insurers to Deny Autism Treatment
"In tightening its rules on covering behavioral intervention for children with autism, California is tackling a problem encountered by numerous states seeking to improve access to therapies for children with autism ... The new rules make it clear that insurers must cover behavioral interventions for children with autism at the same level that they cover visits to a medical doctor[.]" (Reuters)

Unions Want to Use $100M in Federal Housing Relief Money to Plug Detroit Pension Hole
"Under the plan being discussed, Detroit Emergency Manager Kevyn Orr would get access to $100 million earmarked for Michigan from a fund the U.S. Treasury Department established in 2010 to provide relief in the wake of the housing crisis. Michigan would send the federal money to Detroit for blight reduction, as has been done in the past. Mr. Orr then could take other funding already earmarked for blight elimination and use that in a plan to help make up a $3.5 billion shortfall in the retirement system for city workers[.]" (The Wall Street Journal; subscription may be required)

Knowing Your Account Value Isn't Enough
"The rule of thumb in the retirement industry is that, assuming you remain well invested, you can withdraw about 4%-5% of your initial savings each year and have a good chance that the money will last for the rest of your life.... But only 27% of our survey participants got that right ... More than one-fourth said they didn't know, and about half guessed too high.... More than one-third of our respondents said you could withdraw 10% or more." (Alliance Bernstein)

Provider Sponsored Health Plans: Five Necessities for Launching a Successful Plan
"[H]ospitals are discovering [that] serving as both provider and insurer often gives them the best chance to lower the cost of care, prevent unnecessary hospitalizations through patient tracking, unearth new market share potentials, and truly create a healthier community. What's more, they know that if done properly such a strategy will allow them to capture and retain dollars that otherwise would end up in the pockets of the insurance companies with whom they have historically contracted and often battled." (Advance Healthcare Network)

[Guidance Overview] It's Time to Gear Up for Employer Reporting Under the ACA (PDF)
"Employers should determine which reporting requirements apply to them and their plans. While much of the information required by section 6055 and 6056 is duplicative, there are differences and employers should familiarize themselves with the requirements so they know what information they must provide and, if necessary, implement steps to start collecting that information now." (Wilkins Finston Law Group)

New York City Earned Sick Time Act Expanded Before Taking Effect on April 1
"Under the revised Act, employers must provide written notice to all existing employees by May 1, 2014 in addition to the original Act's requirement that employers provide written notice to new employees hired on and after April 1, 2014....[A] model notice ... is available in English, Spanish, Italian, and Russian ... The amendments expand the Act's coverage to more employers by reducing the threshold number of employees from 15 to five.... [A]ll covered New York City employees must start accruing sick leave on April 1, 2014 (at an accrual rate of at least one hour of sick leave for every 30 hours worked)." (Morgan Lewis)

[Guidance Overview] Same-Sex Marriage Developments: Recent Guidance from CMS and HHS (PDF)
"This FAQ addresses a requirement for issuers of health insurance, not employer group health plans or employers. Employers are free to control the terms and conditions of the group health plan. The FAQ reiterates that [the ACA's guaranteed availability requirement] does not direct the definition of spouse and the terms of eligibility for group health plans. If a group health plan chooses to offer coverage to same-sex spouses, this FAQ clarifies that an issuer may not decline to cover that same-sex spouse on the same terms and conditions as opposite-sex spouses." (Buck Consultants)

Early Estimates Indicate Rapid Increase in Health Insurance Coverage Under the ACA
"[N]either the Marketplace enrollment figures nor the CMS Medicaid report provide an accurate picture of how many uninsured people have gained coverage since open enrollment began, because both sets of enrollment figures may include newly insured people as well as those who had other sources of coverage before 2014. [The authors] use the March 2014 Health Reform Monitoring Survey (HRMS) to examine changes in health insurance coverage in early March 2014 relative to coverage over the prior year, including more disaggregated information on coverage changes and additional details on the statistical precision of the estimates." (Urban Institute)

Analysis of Enrollment, Premiums and MLR by Product (Individual, Small Group and Large Group) and by State for Every Health Plan
199 pages. Excerpt: "[The] industry still lost 2.0 million risk lives in 2012, as commercial risk enrollment fell from 80.5 million to 78.5 million, a drop of 2.5%. The drop reflects the significant attraction many employers have for non-risk products....[S]ince 2002, risk enrollment at the publicly traded plans has fallen by over 14 million lives on an organic basis ... [L]osing 2 million risk lives hurts revenue by $8 billion, while the enrollment decline hurts potential commercial risk earnings by an estimated $400 million ... Despite losing 2 million lives, commercial risk premiums still increased in 2012, albeit by only 0.2%, to $317 billion." (CitiResearch)

Bay Area Approves Mandatory Commuter Benefits Pilot Program
"By September 30, 2014, employers with 50 or more full-time employees in the San Francisco Bay Area will be required to offer commuter benefits to their employees.... Employers will need to select one of the following benefit options to offer to covered employees: [1] Pre-Tax Benefit.... [2] Employer-Provided Subsidy.... [3] Employer-Provided Transit.... [4] Alternative Commuter Benefit Program." (Mazursky Constantine, LLC)


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