Health & Welfare Plans Newsletter

November 25, 2014

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Employee Benefits Jobs


Webcasts and Conferences

Ethical Considerations for Employee Benefits and Executive Compensation Attorneys
December 3, 2014 in NY
(Worldwide Employee Benefits Network [WEB] - New York Chapter)

Affordable Care Act Measurement Periods: 11th Hour Review
December 5, 2014 WEBCAST
(Littler Mendelson)

Increase Employee Understanding and Engagement in Health Benefits Choices
December 16, 2014 WEBCAST
(Tango Health)

View All Webcasts and Conferences



[Official Guidance]

Text of CMS Draft 2016 Actuarial Value Calculator Methodology (PDF)
"The AV Calculator represents an empirical estimate of the AV calculated in a manner that provides a close approximation to the actual average spending by a wide range of consumers in a standard population. This draft document is meant to detail the specific methodologies used in the AV calculation. The revised version of this draft document incorporates updates to account for the draft 2016 AV Calculator." [Also available: 2016 AV Calculator (Excel spreadsheet)] (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  


[Advert.]

WEB's mission is to further the development of benefits professionals

Sponsored by WEB - Worldwide Employee Benefits Network

We are committed to helping define the role of the benefits professional in the 21st century, and as changing market forces reshape the profession, WEB will help its members meet the challenges ahead.



[Guidance Overview]

Minimum Essential Coverage, Other Health Care Reform Guidance Issued
"[T]he final regulations provide that, for purposes of determining the affordability of coverage, the required contribution is reduced by any contributions made by an employer under a Sec. 125 cafeteria plan that [1] may not be taken as a taxable benefit; [2] may be used to pay for minimum essential coverage; and [3] may be used only to pay for medical care as defined in Sec. 213 ... The final regulations clarify that, in general, HRA contributions count toward affordability of health care coverage, and not minimum value, if an employee may use the HRA contributions to pay premiums for the primary plan only or to pay cost-sharing or benefits not covered by the primary plan in addition to premiums." (Journal of Accountancy)  

[Guidance Overview]

Proposed Approach to Changes in Measurement Methods (PDF)
"The proposed approach explained in this [article] could also be used in mergers and acquisitions involving employers using different measurement methods. Until further guidance is issued (or at least until the end of 2016), employers may use the proposed approach to determine the status of employees as full time or not full-time following a corporate transaction" (Buck Consultants at Xerox)  

[Guidance Overview]

How to Transition an Employee to Your Standard Ongoing 12-Month Measurement Period After the Initial ACA Measurement Period
"Once a new variable hour, seasonal employee or part-time employee has been employed for an entire standard measurement period, the employee must be tested for full-time status, beginning with that standard measurement period, at the same time and under the same conditions as other ongoing employees.... [Here] is a simple visual sample of what your standard measurement periods might look like if you had a 1/1 renewal and selected 12-months. The vast majority of employers are electing to use 12-months to gain the longest period over which to average hours and to avoid having to repeat the ongoing calculation more than once a year." (Benefit Revolution)  

[Guidance Overview]

Feds Say It Again: Don't Pay or Reimburse Employees' Individual Insurance Premiums (PDF)
"[T]he agencies stressed that employers who pay or reimburse premiums for individual health insurance coverage will violate health reform law requirements, even if the amounts are treated as taxable compensation. The agencies then explained that an employer violates various laws by paying individuals with high claims to waive coverage under the employer's health plan. Finally, the agencies explained that schemes for reimbursing individual health insurance premiums are group health plans that must comply with health reform law mandates even if the employer has no involvement in choosing the health coverage." (Lockton)  


[Advert.]

The Corporate Benefits Summit brings together top HR/Benefits professionals

Sponsored by marcusevans

This Summit will focus on the current challenges facing the benefits and compensation industry. Topics include: Private Exchange Transition, Employer Mandate Final Regulations, Employee Engagement, The Global Health Issue, and Strategic Benefit Plan.



[Guidance Overview]

Flowchart of Employer Responsibility Under the ACA
"The Affordable Care Act does not require businesses to provide health benefits to their workers, but larger employers face penalties if they don't make affordable coverage available. The Obama Administration announced 'transition relief' under which the penalties will go into effect in 2015 for employers with 100 or more employees and in 2016 for employers with 50 or more workers. This simple flowchart illustrates how those employer responsibilities work." (Henry J. Kaiser Family Foundation)  

[Guidance Overview]

New IRS Revenue Ruling Clarifies Taxation of Transit Benefits Provided via Electronic Media
"Drawing [the] bright-line distinction [between TID- and MCC-debit cards], while understandable in 2006, ultimately proved to back the IRS into a corner.... [T]echnological developments rendered obsolete the rationale for categorically distinguishing the tax treatment of the two cards.... IRS regulations allows employers to provide employees with vouchers or similar items before the employee has in fact incurred the transit costs. The IRS highlighted this requirement in the new ruling." (Bloomberg BNA)  

[Guidance Overview]

New IRS Guidance for Transportation-Related Benefits Restricts Use of Cash Reimbursements
"[IRS Rev. Rul. 2014-32] addresses several examples involving payment methods for certain employer-provided transportation benefits, and whether the benefits must be included in employees' gross income.... IRS takes the position that the rule permitting employers to use cash reimbursements if the only available voucher (or similar item) is a terminal-restricted debit card is 'no longer warranted'." (Practical Law Company)  

[Guidance Overview]

Massachusetts Attorney General Advises on Domestic Violence Leave Act
"[T]he Advisory clarifies that the Act only applies to employers with 50 or more employees in Massachusetts.... The Advisory clarifies that there is no mandatory form of notice and lists several possible methods.... It remains unclear whether an employer is required to provide intermittent leave. The Act establishes that an employee may take up to 15 days of leave in any 12-month period. However, it is unclear whether the 12-month period is a rolling 12 months, or a fixed 12-month period." (Proskauer's Law and the Workplace)  

[Guidance Overview]

California Guarantees Paid Sick Leave to Employees
"An employer must provide an employee with written notice that sets forth the amount of paid sick leave available for use, either on the employee's itemized wage statement or in a separate writing provided on the designated pay date with the employee's payment of wages.... [If] an employee separates from an employer and is rehired within one year, previously accrued and unused paid sick days must be reinstated, and the employee is permitted to use those reinstated days upon rehire." (Ballard Spahr LLP)  

[Guidance Overview]

City of Oakland Joins Two Other California Cities in Mandating Paid Sick Leave
"Under the new measure, which goes into effect March 2, 2015, employers are required to provide up to 72 hours of paid sick leave rather than the minimum 24 hours provided by state law. The new ordinance also allows employees to carry over more unused paid sick leave than permitted under state law. Further, unlike the state's law, Oakland's measure permits employees to designate certain non-family members for whom they can use their paid sick leave. Similar to state law, the new ordinance does not require an employer to pay an employee for unused leave at the time of the employee's separation from employment.... A comparison table showing some key differences in each jurisdiction's paid sick leave laws is [provided]." (Ford & Harrison LLP)  

Preparing for HIPAA Compliance Audits
"The next phase of OCR HIPAA audits is expected to begin in 2015.... [It] is expected that OCR will conduct limited scope offsite or 'desk' audits of both covered entities and business associates in 2015. The return of comprehensive onsite audits appears likely ... Once a covered entity is selected for an OCR HIPAA audit, it can expect to receive a data request that will include a request to identify all of its business associates. OCR has stated that it will only give audited entities two weeks to respond to the data request. It is therefore critical that covered entities prepare for HIPAA audits before they are selected for an audit." (Privacy & Security Law Blog, from Davis Wright Tremaine LLP)  

Managing Health Care Costs During Retirement: What Pre-Retirees Can Do Now
"Pre-retirees should investigate long-term care insurance and HSAs as ways to hedge against health-care cost inflation and longevity risk in retirement, says Fidelity's John Sweeney." (Morningstar Advisor)  

Obama Officials Seek to Clarify Abortion Coverage Rules
"The [proposed regulations issued Nov. 21] specify ways in which insurers can assess and collect separate payments for abortion coverage, which must total at least $1 per month. But anti-abortion groups are complaining that the guidance in the new rules does little to address the bigger problem: It is still extremely difficult for the average consumer to tell which plans include elective abortion coverage and which do not." (Kaiser Health News)  

SHOP Marketplace Premiums Flat in 2015
"Businesses seeking coverage on the SHOP Marketplace in 2015 will find that, on average across the 32 States where the Federal government operated the SHOP Marketplace in both 2014 and 2015, the premium for the lowest-cost bronze, silver, and gold policies has remained steady or declined slightly relative to 2014. The premium for the median policy within each metal tier also saw very slow growth on average, rising just 2.1 percent for bronze plans, 0.7 percent for silver plans, and 1.6 percent for gold plans. On average across the States where the Federal government is operating the SHOP Marketplace in 2015, businesses can choose from 25 different plans." (The White House Blog)  

Lower Subsidies Could Lead to Exchange Sticker Shock for Enrollees
"The news that some exchange carriers will offer lower premiums in 2015 was a surprise in many markets. But the biggest surprise could await exchange customers who stick with their existing exchange plan without shopping around. An unintended consequence of lower premiums is lower subsidies, which raises the percentage of premium that enrollees pay for their plan." (HealthLeaders InterStudy)  

Press Releases

PSCA Updates ERISA Fiduciary Training
PSCA [Plan Sponsor Council of America]

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