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Sixth Circuit Rules Employer Entitled To Make 'Reasonable Modifications' to Retiree Health Care Benefits Despite 'Vesting'
"The Sixth Circuit majority concluded that whatever else vesting in the health care context means, it does not mean that beneficiaries receive a bundle of services fixed once and for all.... Unlike pension obligations, health care benefits cannot readily be monetized at retirement, explained the court. Thus, vesting in the context of health care benefits provides an evolving, not a fixed, benefit." [Reese v. CNH America, LLC (Nos. 11-1359, 11-1857 and 11-1969, Sept. 13, 2012)]
(Wolters Kluwer Law & Business)
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Risk Adjustment Programs Associated with Health Reform (PDF)
"This [Update] is just a brief summary of some of the changes to the health insurance market in 2014. These changes will create uncertainty as carriers attempt to develop rates for a market with new rules and a likely influx of new members."
(McGraw Wentworth)
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Small Businesses in D.C. Push Back on Rule Requiring Use of District of Columbia's Health Insurance Exchange
"The D.C. Health Benefit Exchange Authority ... voted ... to accept a recommendation that all health-insurance plans sold in the city for 50 members or fewer must be purchased through the exchange.... [A] coalition of more than 150 small businesses and associations said the exchange mandate betrayed 'President Obama's repeated assurances that, "If you like your health plan . . . you will be able to keep your health care plan. Period."' The businesses called the exchange 'an undefined, untested, more expensive entity" that would offer "standardized, cookie-cutter coverage.'"
(The Washington Post; free registration required)
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As Group Health Insurance Premiums Creep Up, Retirees Face More Responsibilities
"Aon Hewitt's 2012 survey of almost 450 private and public plan sponsors representing 5.8 million retirees found that 60% of those employers have reviewed or are reviewing their retiree health care strategies. Of those planning changes, 63% percent are currently implementing or are considering moving towards an individual market strategy."
(Financial Planning)
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Health Care Reform: What Plan Sponsors Must Do Before 2012 Year-End (PDF)
"[S]ix actions that covered employers and plan sponsors must take this year: (1) Determine ... what employer-sponsored health benefits that you offer that may be subject to some or all of the requirements under the Act. (2) Provide a ... Summary of Benefits and Coverage (SBC) to plan participants ... (3) Collect the information needed to report the value of 2012 health coverage on the Forms W-2 due on January 31, 2013. (4) Ensure that your Form W-2 reporting system has changed to include the value of 2012 health coverage. (5) Ensure that your tax withholding system has changed to collect additional Medicare tax for high wage earners starting January 1, 2013. (6) Ensure that [FSA] salary reduction contributions are limited to $2,500 for plan years beginning on or after January 1, 2013."
(Hanson Bridgett LLP)
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2013 Segal Health Plan Cost Trend Survey (PDF)
"Almost all medical plan types are forecast to experience trend increases under 10 percent. The exception is fee-for-service/indemnity plans. All managed care cost trends are expected to be in the single digits."
(The Segal Group, Inc.)
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Americans Still Confident About Health Care, But Concerned About Cost
"While 56 percent of Americans indicated that they are extremely or very confident about their ability to get the treatments they need today, only 31 percent are confident about their ability to get needed treatments during the next ten years, and just 23 percent are confident about this once they are eligible for Medicare."
(Wolters Kluwer Law & Business)
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What Obamacare Means for Small Employers in 2013
"[A recent] study examined where small business owners get their personal coverage, as opposed to earlier studies that focus on where their employees get coverage. It found that small business owners are in similar straits as their employees: One-quarter are uninsured and half rely on a family member for coverage or buy private health insurance, if they can afford and qualify for it. Only 19 percent get insurance through their companies."
(Bloomberg BusinessWeek)
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An Overview of Comparative Effectiveness Fees
"In general, the fee on self-insured plans applies to plan sponsors of an 'applicable self-insured plan.' ... The term does not, however, include a plan that provides benefits substantially all of which are excepted benefits as described in Code Section 9832(c) (e.g., a health FSA that meet certain requirements), or an employee assistance program (EAP), disease management program, or wellness program if the program does not provide significant benefits in the nature of medical care or treatment."
(Groom Law Group)
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Voluntary Benefits Can Be Part of a Winning Game Plan in a Post-Health Care World (PDF)
"Four out of 10 employers are going on the offensive against costs by adding new voluntary benefits within the next two years, signaling a significant interest in expanding their benefits offerings to employees.... As employers seek to engage their workers and make their voluntary offerings more successful, they are demanding tools that will make these products not only more accessible, but more understandable."
(Guardian Life)
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Benefits in General; Executive Compensation
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2012 Year-End Action Possibly Needed for 409A Plans Providing for Payments Contingent Upon Release
"Under IRS-approved correction procedures, employers may amend noncompliant arrangements to provide either: that the payment will be made only on the last day of the specified period for executing and not revoking a release (e.g., payment will be made on the 60th day following the employee's separation from service regardless of when the terminated employee delivers the executed release to the employer); or that if the specified payment period (e.g., within 60 days after the employee's separation from service) straddles two tax years of the employee, the payment must be made in the later of those tax years."
(Sidley Austin LLP)
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409A Transition Relief Expires at Year-End; Employers Should Review Their Nonqualified Deferred Compensation Plans
"The IRS has provided general corrective guidance for certain 409A compliance issues. The guidance included transition relief involving release-based payments, but that relief expires on December 31, 2012. Consequently, employers should review and, if necessary, revise before the end of this year their 409A plans and arrangements that provide release-based payments. Failure to do so may constitute a 409A violation with adverse tax consequences to the employee."
(Ballard Spahr)
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Proposed IRS Regs Permit Deduction of Certain Local Lodging Expenses as Employee Business Expenses
"The proposed regulations also provide a safe harbor, under which an employee can deduct local lodging expenses if: (i) the lodging is necessary for the individual to participate fully or to be available for a bona fide business meeting, conference, training activity, or other function, (ii) the period during which such local lodging is provided does not exceed five calendar days and does not recur more than once per calendar quarter, (iii) the employer requires the employee to remain at the activity or function overnight and (iv) the lodging is not lavish or extravagant and does not provide a significant element of personal pleasure, recreation or benefit."
(Bloomberg BNA)
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Seventh Circuit Holds Internal Grievances About Employer Fiduciary Duty Breaches Are Actionable Under ERISA Sec. 510
"Concluding that the language of Section 510 of ERISA was 'ambiguous' and 'a mess of unpunctuated conjunctions and prepositions,' the Seventh Circuit concluded that, 'an employee's grievance is within Section 510's scope whether or not the employer solicited information.' The court did, however, reiterate the high threshold to prevail on a Section 510 claim: 'It does not mean that Section 510 covers trivial bellyaches—the statute requires the retaliation to be "because" of a protected activity.... What's more, the grievance must be a plausible one, though not necessarily one on which the employee is correct.'"
(Drinker Biddle)
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Higher Medicare Taxes Coming for High-Income Wage Earners in 2013
"Under the [ACA], workers earning more than $200,000 a year ($250,000 for joint filers) must pay higher Medicare hospital insurance (HI) taxes beginning in 2013. The new tax is 2.35% (an increase of 0.9%) of applicable wages above those thresholds, so a worker earning $300,000 a year will pay HI taxes of 1.45% on $200,000 plus 2.35% on $100,000. There is no change to the employer's share of the HI tax."
(Towers Watson)
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Press Releases
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David Rhett Baker, J.D., Editor and Publisher
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