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BenefitsLink Health & Welfare Plans Newsletter
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Health Care Reform: What Should Plan Sponsors Be Doing Now?
"Make sure all current requirements of Health Care Reform have been implemented; Prepare to implement additional plan changes and provide additional participant notices; Prepare for new reporting requirements; Prepare for new taxes and penalties; Strategize for 2014[.]"
(Miller Johnson)
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New! Plan Document Software Module [Advert.]
Wolters Kluwer Law & Business - ftwilliam.com has implemented lots of feedback and our own innovative ideas into a newly designed plan document software module. Join our webinar on July 10th for a sneak peek at our enhancements and what’s coming.
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Employers Wary of Health Reform Costs
"White Castle System Inc. began offering health coverage when Calvin Coolidge was president. That 88-year history didn't make last week's U.S. Supreme Court ruling any more palatable to the seller of hamburger sliders.... 'Just because something is constitutional to us doesn't necessarily make it a good idea,' [said a company vice president]. 'There are so many different rules and regulations that still need to be finalized. It's really difficult to predict what costs are actually going to be.' Preserving the health law may boost employers' bills, in the form of higher premiums or penalties if plans don't meet standards, said executives at retailers, restaurant chains and small businesses, where insur.ance is less common than at large firms. Companies may have to respond by curbing hiring or charging more for products[.]"
(Treasury & Risk)
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Will IRS Be Able to Enforce Health Law Tax on People Who Don't Buy Insur.ance?
"[M]any questions still remain about how and whether the Internal Revenue Service will be able to enforce the [ACA]. A top concern is that when the statutory tax penalty for individuals not carrying health insur.ance ... goes into effect in 2015, IRS may have few options for collecting the penalties because Congress restricted the agency's collection authority. Unlike most other types of tax debts, IRS cannot file a tax lien against individuals who do not comply with the health insur.ance mandate and can only collect the money by withholding it from tax refunds or Social Security checks."
(Bloomberg BNA)
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'Come and Get Me'—The Likely Failure of Obamacare Despite the Health Insur.ance Mandate
"Even before [the Supreme Court's decision], there were those who feared that many Americans would pay the tax rather than purchase health insur.ance. The Obama Administration itself estimated that four mil.lion Americans will choose to pay the tax instead of acquiring health care coverage. Chief Justice Roberts' opinion invites Americans to do just this. Because Congress precluded the IRS from using many of its standard enforcement techniques to collect this tax, many Americans will simply decline to pay the tax—without anything happening to them."
(Prof. Edward Zelinsky, OUPblog)
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10 Polemics from the Supreme Court Decision
"One may be loath to read all 193 pages of Thursday's U.S. Supreme Court decision declaring the constitutionality of the Patient Protection and Affordable Care Act, including dissents and footnotes. But some of it is quite instructive, even entertaining, and in some places, downright sarcastic. The Justices wrote with some passion, and used several catch phrases to signify major themes in their legal wrangling."
(HealthLeaders Media)
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Florida Says No to Two Health Care Law Provisions
"Florida will not implement two provisions of the U.S. healthcare law involving an expansion of Medicaid for the poor and creation of a private insur.ance exchange, Governor Rick Scott said on Sunday. Two other states with Republican governors, Wisconsin and Louisiana, opted out of the two provisions last week in the wake of the Supreme Court decision upholding the Patient Protection and Affordable Care Act."
(Chicago Tribune)
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HHS Posts Audit Protocol for HIPAA Privacy, Security and Breach Notification Requirements
"Covered entities and business associates may find the audit protocol useful in doing a self-assessment of their compliance with the privacy, security, and breach notification rules. Reviewing the audit protocol can help covered entities and business associates identify the documentation that OCR would expect to see during an audit. It is unclear how the items included in the protocol might be affected by anticipated final regulations under the HITECH Act."
(Thomson Reuters / EBIA)
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Ninth Circuit Cases Limit Health Plan Subrogation/Reimbursement Rights
"In unrelated cases addressing an ERISA plan's ability to obtain reimbursement from a participant who receives payments from a third party, the Ninth Circuit ruled that (a) equitable principles may limit the reimbursement amount, despite contrary plan language; and (b) a plan provision that does not identify a particular fund from which reimbursement will be made is not enforceable as equitable relief.... The Supreme Court [has announced] that it will consider US Airways v. McCutchen, [a Third Circuit case], in its next term." [CGI Technologies and Solutions Inc. v. Rose, 2012 WL 2334230 (9th Cir. 2012); Bilyeu v. Morgan Stanley Long Term Disability Plan, 2012 WL 2333629 (9th Cir. 2012).]
(Thomson Reuters / EBIA)
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Attention Shifts to Lower Courts on Challenges to Mandated Contraception Coverage, Medicare Cost Advisory Board
"When the Supreme Court upheld the central tenet of President Obama's health care law, it meant that several lower court fights on other aspects of the sweeping legislation can move forward. Those cases, including high-profile lawsuits by Catholic organizations challenging the law's contraception coverage rules, would, obviously, have been affected if the court had found the individual mandate unconstitutional or struck down the law in its entirety. But with the law intact, the lawsuits—many of them held in abeyance pending the high court's decision—will proceed."
(National Public Radio)
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Enhanced Rights for Purchasers of Individual Health Policies Might Prompt Employers to Drop Health Plans
"The Supreme Court's endorsement of the federal healthcare law this week could spur more employers across the nation to relinquish their long-standing role as chief healthcare buyer for their workers. This shift has already begun among some big employers shedding their role in providing retiree health benefits, and experts say the court's decision ... could eventually lead companies to pursue a similar approach with current workers. With the Affordable Care Act still on track to offer numerous new benefits, such as guaran.teed coverage for all adults starting in 2014, some companies may want to stop providing health coverage and instead give workers money to buy their own."
(Los Angeles Times)
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High Court Health Care Ruling Might Mean Layoffs or Work Reductions
"How employers respond to the law's pay-or-play penalties might reduce employment opportunities in low-wage industries.... The lack of final regulations on major provisions of the [ACA], including ones implementing employer penalties ... means that many employers do not yet see clearly how they might restructure their employee benefits or, in some industries, restructure their workforces in response to the new law and regulations. The employer penalty rules ... and separate nondiscrimination rules for fully insured plans could make it difficult for companies to restructure, especially in industries such as retail, food service, and hospitality, 'unless employers are willing to limit large portions of their workforces to less than 30 hours per week[.]'"
(Bloomberg BNA)
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Employers Coming to Fork in Road in 2014: Provide a Satisfactory Health Plan or Pay Annual Taxes
"[B]y far the most significant component of the legislation for employers is the so-called 'play or pay' provision. Effective January 1, 2014, two types of nondeductible penalties can be imposed on certain employers with at least 50 full-time equivalent employees. Covered employers who do not offer certain specified minimum levels of health coverage, and that have at least one employee who receives health premium assistance subsidy from the federal government, will have to pay an annual tax of $2,000 per each full-time employee."
(Nixon Peabody LLP)
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Multiple Employer Plans and the Affordable Care Act
"Now that the U.S. Supreme Court has found most of the Affordable Care Act constitutional, it creates an interesting dilemma for the Dept of Labor. One of the key provisions of the Affordable Care Act establishes multiple employer plans which employers can utilize to provide health care benefits to their employees."
(The Pension Protection Act Blog)
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Health Care Advisory: Supreme Court Decision on the Affordable Care Act (PDF)
"Parsing the opinions issued (just short of 200 pages) also is somewhat of a challenge. Although four opinions were issued, only selected portions of the Chief Justice's opinion were written 'for the Court' (meaning that four other justices expressly joined his opinion in those sections). For the majority of issues decided, determining a 'holding' requires reading all of the decisions and, for each proposition, determining which propositions are agreed to by shifting alliances of five or more justices.... [This advisory provides] highlights of the Supreme Court's decision and an initial analysis of the major holdings.... the opinion's likely impact on state Medicaid programs and state health insur.ance exchanges, as well as other key stakeholders.... [and] the likely political impact of the Court's decision."
(Alston + Bird LLP)
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[Opinion]
We Can Achieve Universal Coverage Without Mandates
"When Barack Obama was a candidate for president, he endorsed universal health insur.ance, but opposed forcing individuals to buy their own insur.ance. As President, he signed into law a bill that violates both of these promises.... Now that the Supreme Court has declared the mandate constitutional, what's next? ... Here is [the author's] suggestion; Return to the two original ideas Obama said he was for: universal coverage and no mandate."
(John Goodman's Health Policy Blog)
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Benefits in General; Executive Compensation
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Proposed Tightening of Section 83 'Substantial Risk of Forfeiture' Rule Could Mean Changes for Other Deferred Comp Rules (PDF)
"The definition of 'substantial risk of forfeiture' for purposes of the deferred compensation rules in Code Section 409A, although broader than the definition under Section 83, also provides, in part, that compensation is subject to a substantial risk of forfeiture if the right to the deferred amount is conditioned on either the performance (but not the refraining from performance) of substantial future services (i.e., a length-of-service requirement) or the occurrence of a condition related to the purpose of the compensation (e.g., a performance requirement) and the possibility of forfeiture is substantial.... Although its position is unknown at this point, the IRS ultimately may expand the regulations for Sections 409A and 457(f) to mirror the positions in the proposed Section 83 regulations."
(Buck Consultants)
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IRS Proposes Regs to Allow Local Lodging Deduction
"Whether local lodging expenses paid or incurred in carrying on a taxpayer's trade or business as an employee are deductible depends on the facts and circumstances, one of which is whether the expense is incurred to satisfy a bona fide requirement imposed by the employer. Prop. Regs. Sec. 1.162-31(b) contains a safe harbor (and numerous examples illustrating the safe harbor) allowing a deduction for expenses for local lodging to attend business meetings and conferences[.]"
(Journal of Accountancy)
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