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BenefitsLink Health & Welfare Plans Newsletter

July 3, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Sr. Communications Consultant
for Lincoln Financial in ANY STATE

401k/Defined Contribution Administrator
for Long Island Employee Benefits Group in NY

Defined Benefit - Client Service Manager
for Milliman in TX

Defined Benefit - Client Service Analyst
for Milliman in TX

Retirement Services Consultant
for CUNA Mutual Group in WI

IRT Relationship Manager 3
for Wells Fargo in VA

Vice President, Strategic Relationships
for Prudential in CA

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Webcasts and Conferences

ERISA 3(38) Investment Management Agreement -- Webinar
July 11, 2013 WEBCAST

Think Like Your CFO: Bringing Healthcare Design into the C-Suite -- Free Webinar
July 18, 2013 WEBCAST
(Corporate Research Group)

APP and VFCP Compliance Online Workshops -- Free
July 25, 2013 WEBCAST
(Employee Benefits Security Administration (EBSA), U.S. Department of Labor)

Apprenticeship Plans and Fiduciary Responsibilities -- Archived Webcast
July 16, 2013 WEBCAST
(Employee Benefits Security Administration (EBSA), U.S. Department of Labor)

Fixing the Broken Plan: Tools to Get the Plan Back on Track -- Webcast
August 28, 2013 WEBCAST
(American Society of Pension Professionals & Actuaries (ASPPA))

DOMA and Prop 8 Implications for Employers -- Webinar
July 9, 2013 WEBCAST
(Faegre Baker Daniels LLP)

Supreme Court Round-Up
July 16, 2013 WEBCAST
(ABA Joint Committee on Employee Benefits)

Health Care Reform What Now?
August 10, 2013 in CA
(ABA Joint Committee on Employee Benefits)

What Impact Will Delaying the Employer Mandate Have? -- Webcast
July 11, 2013 WEBCAST
(Health Partners America )

View All Webcasts and Conferences


[Official Guidance]

Text of CMS Question and Answer Regarding the Medical Loss Ratio Reporting and Rebate Requirements (PDF)
"Issuers may exclude ACA assessments or fees from MLR calculations for a reporting year only if such assessments or fees were incurred in that reporting year. Issuers may not exclude ACA assessments or fees they expect to incur in future MLR reporting years." [CCIIO Technical Guidance (CCIIO 2013-0003)] (Center for Consumer Information & Insurance Oversight, Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)


A Practical Approach to Developing a Wellness Program

Sponsored by Lorman and BenefitsLink

Learn to use a six step model process for designing your program, look at a practical example of a program, find out how to locate resources for your program, and how to keep it fresh and effective. Registration discount for BenefitsLink readers.

Background on U.S. Supreme Court DOMA Decision and Implications for Health and Welfare Plans (PDF)
60 presentation slides. Topics include: State of spousal recognition rules; Brief background on DOMA; Overview of the Court's holding in Windsor; Potential implications for H&W plan sponsors and administrators; Open issues. (American Benefits Council)

[Guidance Overview]

Relief From Employer Mandate Penalties Until 2015 Leaves Many Unanswered Questions
"Will the IRS still require employers to take reasonable steps toward complying in 2014 to avoid penalties, or will employers get a free one-year pass? If employers are not required to offer qualifying coverage, will it cause employees to flood the exchanges? Will this transition relief further extend, through 2015 (or later), the previous transition relief granted: For employers contributing to multiemployer plans? From the dependent coverage requirement? For employers with off-calendar year plan years? For employers to treat full-time, temporary employees as variable hour employees if it cannot be determined that they will be employed at least 30 hours per week over the initial measurement period?" (Seyfarth Shaw LLP)

[Guidance Overview]

Final Rules Include TPA Role for Providing Certain Contraceptive Coverage
"The regulations finalize an approach under which TPAs become the ERISA plan administrator, and claims administrator, for providing contraceptive coverage payments to an eligible organization's self-insured plan.... If it agrees to provide payments for contraceptive services, the TPA will either do so on its own or arrange for an insurer to do so, and must provide individuals notice of the availability of separate payments for contraceptive services. In carrying out these obligations, the TPA must satisfy ERISA's requirements regarding claims procedures, providing required ERISA disclosures and ERISA's requirements for group health plans." (Practical Law Company)

One-Year Employer Mandate Delay Could Impose High Penalty on Other Aspects of ACA
"One has to hope ... that the Administration has thought through the ramifications of this delay for the other provisions of the ACA.... If employers have no obligation to report coverage, how will the exchanges or the IRS verify claims that coverage is unaffordable or inadequate? ... Will the lack of an employer mandate mean that many more individuals will become eligible for premium tax credits, either because their employers drop or do not expand coverage, or fail to respond to requests to verify coverage? ... The CBO has projected most recently that the employer penalty would yield $10 billion in 2015, presumably from employers who fail to provide coverage in 2014. Can we afford to lose this revenue?" (Timothy Jost in Health Affairs)


Innovative Drivers of Value-Based Purchasing of Healthcase Benefits

Sponsored by World Congress

A meeting that gets rid of the fluff and elevates and directs the conversation to non-traditional and innovative areas of value-based purchasing, so you can master modern day benefit design. July 25-26, Chicago.

Delay in Major Health Law Provision Raises Doubts at Critical Stage of Rollout
"Tuesday's announcement could mean a drop in revenue for the Treasury. The CBO estimated about $10 billion in employer penalties would be collected in 2015, some of that presumably from employers who chose not to offer coverage in 2014. The CBO also estimated that the health law would have little or no effect on job-based coverage the first year.... [O]ther analysts said the delay could cause more workers to lose their health care coverage." (Kaiser Health News)

Administration Delays Mandate for Firms of 50+ Employees But Other Rules Coming on Schedule for Smaller Employers
"The administration did not delay the many new requirements facing employers who choose to offer health insurance in the small group market -- employers with less than 50 workers. They are faced with the essential health benefit requirements as well as the rating reforms -- a small group with lots of young people will see their rates increase significantly because of the new 3:1 age compression rules, for example." (Health Care Policy and Marketplace Review)

Key Health Care Mandate Delayed
"Even so, the mandate remains under constitutional challenge in a lower court, and the issue could return to the Supreme Court.... Liberty University ... has argued that the employer mandate was beyond Congress's powers under the Commerce Clause, and that it violated Liberty's religious beliefs, protected by the First Amendment. After the Supreme Court ruled on the other parts of the law, the Justices simply denied review of Liberty University's petition ... [but] in November, the Justices granted the university's rehearing petition, and sent the case back to the Fourth Circuit Court to give the challenger a further opportunity to make its case." (SCOTUSblog)

Administration Announces Plan to Postpone Employer Mandate Assessments Until 2015
"Employers negotiating collective bargaining agreements that will expire during or after 2015 should pay particular attention to further details regarding this development, especially if they are evaluating proposals to participate in multiemployer health plans. At best, today's announcement only postpones important questions about employer mandate compliance in the context of collectively-bargained plan participation." (Ogletree Deakins)

Health Law Penalties for Big Employers to Be Delayed
"'They realized they were not ready, and we were not ready,' said Neil Trautwein, vice president at the National Retail Federation ... 'At the very least, this will give retailers and chain restaurants a chance to breathe.' The decision follows media reports that companies had already cut back on some workers' hours to avoid exposure to penalties under the new health-care law." (The Wall Street Journal; subscription may be required)

UnitedHealthcare to Stop Selling Individual Plans in California
"The announcement comes two weeks after Aetna Inc. said it also plans to exit California's individual insurance market. Both insurers avoided participating in the state exchange that is being established as part of the Affordable Care Act. State Insurance Commissioner Dave Jones says the departure of UnitedHealthcare and Aetna is bad news for consumers." (Fox News)

U.S. House Panel: Vermont Exchange Violates ACA
"At issue is a Vermont state law that says starting next year, individuals and businesses with up to 50 employees have to get their health insurance through the state exchange, called Vermont Health Connect, which is to be open for enrollment by Oct. 1. The House Oversight and Government Reform Committee wrote on Friday to Mark Larson, commissioner of the Department of Vermont Health Access, to say it appeared that requiring enrollment in the exchange violated the [ACA]." (InsuranceNewsNet.com)

Obamacare Provisions Set to Hit Small Business Hard
"[A] third ACA-related bill [is] being debated in the Commonwealth [of Massachusetts] that would force Governor Deval Patrick and his administration to file a federal waiver to avoid the adverse effects of rating and rule changes to the Massachusetts merged market (1-50 employees). The move could lead to some turmoil for the Obama Administration as the ACA seems to be forcing significant changes to a state law that they claimed acted as a model in Washington." (William Gallagher Associates)

HHS Continues Preparations for New Health Insurance Marketplace by Awarding Grants to Promote Kids Enrollment
"According to HHS, the grants will build on the Secretary's Connecting Kids to Coverage Challenge to find and enroll all eligible children and support outreach strategies that have been shown to be successful." (Solutions Law Press)


Comments by U.S. Chamber of Commerce to IRS on Proposed Regs for Minimum Value and Health Insurance Premium Tax Credit (PDF)
"First and foremost, we dispute the proposal that minimum value must be assessed based on the coverage of any specific benefits, much less be tied indirectly to the Essential Health Benefits. Second, we disagree with the proposal to disregard financial incentives (other than those relating to tobacco use) available to employees who participate in nondiscriminatory wellness programs that would reduce premiums -- thereby impacting affordability -- and reduce cost-sharing -- thereby impacting minimum value. Finally, we believe that it is inappropriate to adjust the value of employer contributions to health savings accounts and health reimbursement arrangements to reflect expected spending." (U.S. Chamber of Commerce's Health Care Solutions Council)


Obamacare's Employer Mandate Shouldn't Be Delayed -- It Should Be Repealed
"Delaying Obamacare's employer mandate is the right thing to do. Frankly, eliminating it -- or at least utterly overhauling it -- is probably the right thing to do. But the administration executing a regulatory end-run around Congress is not the right way to do it.... The irony is that the worker-based employer mandate got passed in part because employers preferred it to a payroll-based mandate ... Part of the reason is that the mandate, as written, affects relatively few employers." (Ezra Klein in The Washington Post)


Text of ERIC Comments to IRS on Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit (PDF)
"ERIC recommends that the IRS adopt the following revisions to the proposed regulations: All wellness incentives should be taken into account for affordability purposes, not just those related to tobacco use.... A safe harbor should be available for plans that have copayments.... [T]he IRS should provide statutory justification for the assertion in the preamble that employers may not cover employees in an employer-sponsored health plan unless the employee may opt out of coverage. The proposed regulations' treatment of retiree coverage should be maintained in the final regulations." (The ERISA Industry Committee)

Benefits in General; Executive Compensation

[Official Guidance]

Reminder: IRS to be Closed July 5 Due to Budget and Sequester; Filing and Payment Deadlines Unchanged
"[A]ll IRS operations will again be closed on July 5. This means that all IRS offices, including all toll-free hotlines, the Taxpayer Advocate Service and the agency's nearly 400 taxpayer assistance centers nationwide, will be closed.... Because none of the furlough days are considered federal holidays, the shutdown will have no impact on any tax-filing or tax-payment deadlines. The IRS will be unable to accept or acknowledge receipt of electronically-filed returns on any day the agency is shut down." (Internal Revenue Service)

Dealing with Overturn of DOMA: Immediate Steps
"[The authors] recommend the following steps: ... Determine if you have any employees or plan participants who are residents of the Same-Sex Marriage States.... This affects death benefits under qualified plans and certain rights under welfare plans, such as COBRA continuation coverage, HIPAA special enrollment rights and FMLA.... [If] income and employment taxes are being imputed on the value of health benefits provided to a same-sex spouse, such withholding should stop.... Determine whether you will wait to have employees come forward to inform you that they have a valid same-sex marriage or proactively send a communication to employees in the Same-Sex Marriage States to inform them of the effect of Windsor on their taxes and plan benefits.... Determine your company's position on offering equivalent spousal benefits to same-sex spouses." (Benefits Bryan Cave)


Why 'Say on Pay' Failed and Why That's a Good Thing
"From its very beginning, the 'say on pay' movement was an attempt to reduce executive pay. Instead, since becoming a requirement for all public companies in 2011, 'say on pay' has led to the routine endorsement of C-suite compensation. In fact, it may even be encouraging rising pay for top executives who can now point to direct shareholder approval of their pay packages." (CNBC)

Press Releases

PBGC to Assume Responsibility for Pension Benefits at Butzel Long
Pension Benefit Guaranty Corporation (PBGC)

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