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Looking Ahead: The Pay or Play Mandate for Large Employers
"The same aggregation rules that apply to qualified retirement plans (namely, Section 414 of the Internal Revenue Code) apply to the 'pay or play' mandate. So, in determining FTEs, you need to include: 1. any other company that is part of the same controlled group or affiliated service group.... 2. certain workers who are 'leased employees'.... In certain situations, you may also need to include employees of predecessor employers."
(McKenna Long & Aldridge LLP)
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CCIIO Issues Guidance on Contraception Coverage Safe Harbor
"For the purposes of this exemption, a religious employer is one that: (1) has the inculcation of religious values as its purpose; (2) primarily employs persons who share its religious tenets; (3) primarily serves persons who share its religious tenets; and (4) is a non-profit organization. Other non-exempt religious-affiliated employers that provide health coverage to their employees, however, were given an additional year to comply with the requirement that their plans include contraception coverage. The new CCIIO guidance issued on August 15, 2012 describes in greater detail this temporary enforcement safe harbor."
(Littler Mendelson LLC)
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ACO Plans, Reference-Based Pricing Gain Employer Interest
"As large employers put the finishing touches on their health plan designs for 2013, many of them will continue to shift more costs onto employees, while others are considering defined-contribution plans to ensure more predictable health spending. However, looking ahead, many employers are considering other changes, such as switching over to products based on accountable care organizations (ACOs) and relying more on reference-based pricing as ways to both minimize cost increases and improve health outcomes for their employees[.]"
(AISHealth.com; free registration required)
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Health Care Enrollment Time Tries Workers
"The majority of American workers—56%—estimate that they waste up to $750 each year because of costly mistakes they have made with their health insur.ance benefits, according to ... a July survey of more than 2,000 consumers ... That could represent four months of the grocery budget for a single person."
(USA TODAY)
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2012 Survey of U.S. Employers About the U.S. Health Care System, ACA, and Plans for Employee Health Benefits
"U.S. employers are concerned about continued rising health care costs; however, they are unaware of solutions that could improve the safety and quality of care, and simultaneously reduce cost. While employer-sponsored health benefits are not likely to disappear, changes that shift financial risk to employees are certain.... Survey results also reveal: Employers believe that the U.S. health care system underperforms....Thirty percent think the ACA is 'a good start,' 59 percent 'a step in the wrong direction.' ... To manage health care costs, increased cost-sharing with employees is considered the optimal strategy."
(Deloitte)
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Plaintiffs' Claims Under ERISA Section 510 and 502(a)(1)(B) Survive Motion To Dismiss
"Proof of a Section 510 violation is not easy. To state a claim under Section 510, plaintiff must show that her employer had 'specific intent' to violate ERISA. Denial of ERISA benefits 'alone is not probative of intent.' ... On the alleged facts, the [Eighth Circuit] concludes that the plaintiff established a plausible case under Section 510. Plaintiff alleged that defendant terminated her under the false pretense of 'misconduct' in order to interfere with her right to the Plan's benefits. These allegations 'are sufficient to show a plausible claim and to thus unlock the doors of discovery.'"
(Health Plan Law blog by Attorney Roy F. Harmon III)
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Proskauer ERISA Litigation Newsletter, August 2012
"[The lead article analyzes] whether an employer's failure to satisfy ACA's new coverage requirements may lead to 'planwide'—hence potential classwide—litigation within ERISA's remedial framework, and offer[s] some thoughts on potential defenses and strategies to minimize exposure to such lawsuits."
(Proskauer Rose LLP)
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Changes to Massachusetts Fair Share Contribution Test
"Under the new legislation, the Fair Share Contribution rules will only apply to employers that employ the equivalent of 21 or more full time employees. Also, when calculating whether 25% or 75% of its full time employees participate in the employer's plan, the employer may disregard any employee who has qualifying health insur.ance coverage from a spouse, parent, veteran's plan, Medicare or a 'plan or plans due to disability or retirement.' This second rule will ease the requirements for employers that have employees who chose to be covered under another plan."
(HighRoads)
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[Opinion]
The Way Out of the Wilderness
"In 1932, the Committee on the Cost of Medical Care identified rising medical costs as a threat to the financial security of millions of Americans. In a series of studies that created the field of health services research, the Committee recommended several strategies for cost containment that reads like a blueprint for today's cost containment efforts: prevention, price controls, capitation, elimination of unnecessary care, and integration. If it sounds like a precis of [the author's] previous two blogs—cut prices and cut quantities—it should. We have known for a long time that those are the only ways to cut spending. And yet here we are, 80 years later, facing a spending crisis that threatens to take down the entire economy."
(The Health Care Blog)
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Benefits in General; Executive Compensation
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[Guidance Overview]
IRS Issues Section 162(m) Guidance Regarding Deductibility of Dividends and Dividend Equivalents in Equity Awards
"In Rev. Rul. 2012-19 ... the IRS held that such dividends and dividend equivalents would qualify as performance-based compensation, provided that each of them separately satisfy Code Section 162(m)'s performance-based compensation requirements. In contrast, if dividends and dividend equivalents were paid to employees at the same time as dividends on common stock were paid to shareholders, regardless of whether the underlying awards were vested, the dividends and dividend equivalents would not be performance-based compensation. This conclusion is consistent with what most practitioners already believed, but it was still welcomed news to see the IRS confirm this conclusion."
(Porter Wright Morris & Arthur LLP)
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2011 Risks and Process of Retirement Survey Report: Working in Retirement (PDF)
"Financial concerns play a critical role in the decision to work during retirement. Respondents indicated they opted to work in retirement in order to: Earn supplemental income (74 percent of retirees and 87 percent of pre-retirees); Preserve or build up assets (59 percent of retirees and 80 percent of pre-retirees); Keep employee benefits (33 percent of retirees and 61 percent of pre-retirees)."
(Society of Actuaries)
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Among Many Aging Americans, Surprising Optimism
"Were the respondents in this survey being wonderfully upbeat? Or, less wonderfully, unrealistic? Though people did express some concerns when the questions got more specific, particularly those with lower incomes, on the whole these aging Americans envisioned buoyant futures."
(The New York Times)
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Longevity: Make It For Better, Not Worse
"Older Americans are paying attention to the steady stream of research findings and stories about impressive gains in longevity. In particular, we have a pretty accurate view of the increases achieved in average life spans ... There also are encouraging signs that this recognition is leading to changes in financial planning and preparation for a longer retirement. In particular, greater attention is being paid to the age at which people begin to collect Social Security."
(U.S. News & World Report)
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U.S. Department of Labor's ERISA Advisory Council to Hold Public Meeting Aug. 28-30
"The purpose of the meeting is for advisory council members to hear testimony from invited witnesses and to receive an update from Deputy Assistant Secretary of Labor for Employee Benefits Security Michael L. Davis. The council is studying the following issues: managing disability risks in an environment of individual responsibility; current challenges and best practices concerning beneficiary designations in retirement and life insur.ance plans; and examining income replacement during retirement years in a defined contribution plan system."
(U.S. Department of Labor)
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Press Releases
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