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November 25, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Employee Benefits Account Manager
Corporate Synergies Group, LLC
in MD

Retirement Benefits Specialist
New York City Economic Development Corporation (NYCEDC)
in NY

Pensions Field Service Manager
Nationwide Financial
in AZ, IL, TX

DC Plan Administrator
The Retirement Plan Company, LLC

Account Manager
MullinTBG, A Prudential Financial company
in CA

ERISA Counsel
USI Consulting Group
in CT

401(k) Administrator
Nicholas Pension Consultants
in CA

DC Plan Administrator
MGKS, Inc.
in AZ

DB/DC Combo Plan Administrator
MGKS, Inc.
in AZ

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Webcasts and Conferences

Developing Effective and Efficient Solutions for Your Retirement Plan Clients’ Greatest Challenges
December 10, 2013 WEBCAST
(Transamerica Retirement Solutions)

Voluntary Insurance Products in the Workplace: Compliance Issues and Changing Legal Requirements
December 12, 2013 WEBCAST
(Thomson Reuters / EBIA)

Advanced Pension Conference - Orlando 2014
February 5, 2014 in FL
(SunGard Relius)

Professional ESOP Forum
February 25, 2014 in LA
(ESOP Association)

Banks with ESOPs Seminar
February 26, 2014 in LA
(ESOP Association)

33rd Annual Conference
March 12, 2014 in DC
(Employers Council on Flexible Compensation (ECFC))

View All Webcasts and Conferences

  LinkedIn   Twitter   Facebook Hand-picked links to the web's best news articles,
official guidance, jobs, webcasts and more.
[Guidance Overview]

Agencies Issue Final Regs for Compliance with the Mental Health Parity and Addiction Equity Act
"What's New in the Final Rules? Sub-Classifications Allowed for Outpatient Benefits and Multiple Provider Network Tiers ... Exception to Nonquantitative Treatment Limitations Requirements Removed ... Parity Requirements Apply to Intermediate Levels of Care ... Disclosure Requirements Clarified ... Cost Exemption Procedures Clarified[.]" (Trucker Huss)  


10th Annual American Health Care Congress - Dec. 2-3 - Anaheim, CA

Sponsored by World Congress

Senior health care executives from hospitals, health systems, health plans, and medical groups gather to address meaningful change in our system - policy, business strategy, and care delivery transformation.

[Guidance Overview]

Employer Guidance Issued on Post-Windsor FICA Claims
"Affected benefits include group health plans, cafeteria plans, and health reimbursement arrangements, along with qualified tuition reduction programs, arrangements providing or reimbursing meals and lodging for the convenience of the employer, and dependent care assistance programs (relating to the care of a disabled spouse).... Notice 2013-61 provides a separate special administrative procedure for employers to make adjustments or claims for refund or credit of overpayments of FICA taxes paid with respect to same-sex spouse benefits for any year before 2013." (Mintz Levin)  

[Guidance Overview]

Paying Exchange Premiums for Individual Health Policies: Not with Pre-Tax Dollars
"[S]mall employers who participate in the SHOP Exchange can reimburse employees with pre-tax dollars, and pre-tax dollars can still be used for other benefits, like vision or dental. And even SHOP Exchange reimbursement programs are still subject to the Section 125 cafeteria plan rules. [But] the idea that an employer outside of the SHOP can pay for coverage on the exchange with pre-tax (non-compensation) dollars is pretty much destroyed. Plus, large employers reimbursing employees for premiums for other coverage does not constitute offering a health plan for purposes of avoiding the excise tax penalties." (Fox Rothschild LLP)  

[Guidance Overview]

New Carryover Option for Health Flexible Spending Accounts: A Change in the 'Use It or Lose It Rule'
"[T]he only exception to forfeiture upon employment termination is if the employee elects COBRA under the FSA. And even in that case, for most Health FSAs, COBRA is generally only available (under a special durational rule) for the remainder of the plan year in which the termination of employment occurs. Since the carryovers apply to the next plan year, from a practical standpoint, this means that the only Health FSA participants that can take advantage of the $500 carryover rule are those employed on the last day of the plan year." (Saul Ewing LLP)  

[Guidance Overview]

Massachusetts State and Local Mandates After ACA
"[F]or 2014 employers with operations in Massachusetts will no longer need to worry about compliance with the Massachusetts mandatory health coverage requirements, including the cafeteria plan requirements.... If you are an employer who has already adopted a separate cafeteria plan or broadened eligibility in your employer group health plan in order to comply with the Massachusetts requirements as to your part-time employees (or other employees for whom you must provide separate coverage), you now have the option to terminate this coverage for 2014." (McKenna Long & Aldridge LLP)  

Claims Administrator Not Liable Under ERISA For Alleged Failure to Follow ACA's Enhanced Benefit Claim Procedures
"A federal court in New York appears to have issued the first published decision addressing alleged violations of the enhanced benefit claim procedures arising out of the [ACA].... The court ... appeared to suggest that, if brought against a proper defendant, a participant could bring a claim under ERISA Section 502(a)(1)(B) to conform a plan's benefit claim procedures with ACA's requirements. This aspect of the court's decision is in tension with Amara v. Cigna, where the Supreme Court stated that Section 502(a)(1)(B) is limited to enforcing benefit plan terms as written, and that claims for additional relief based on alleged violations of ERISA's disclosure provisions must satisfy the causation and harm conditions for equitable relief under Section 502(a)(3)." (Proskauer's ERISA Practice Center)  

Companies Prepare to Pass More Health Costs to Workers
"Many employers are betting that the [ACA]'s requirement that all Americans have health insurance starting in 2014 will bring more people into their plans who have previously opted out. That, along with other rising expenses, is prompting companies to raise workers' premium contributions, steer them toward high-deductible plans and charge them more to cover family members." (The Wall Street Journal; subscription may be required)  

Supreme Court Declines Request by Special Needs Trust to Review ERISA Plan's Right to Reimbursement
"The U.S. Supreme Court has denied a petition by a special needs trust asking whether funds paid into the trust by 'bona fide purchasers' on behalf of insured tortfeasors for the benefit of a health plan beneficiary pursuant to a settlement extinguished the health plan's right to recover in equitable subrogation under ERISA.... The Fifth Circuit [had ruled] that: [1] ACS was allowed to recover from the Special Needs Trust the costs that the plan bore on Griffin's behalf; [2] the Trust was a proper ERISA defendant; [3] the Trust received funds directly traceable to Griffin's tort recovery; and [4] the plan held a pre-existing equitable lien by agreement on the proceeds of the recovery after the plan paid Griffin's medical bills." (Wolters Kluwer Law & Business)  

Administration Tests Fixes That Would Allow Insurers, Brokers to Enroll More Consumers
"Allowing insurers and online brokers to directly enroll customers in subsidized coverage could be key to signing up the millions of people the government had projected would gain coverage this year -- particularly if the glitch-ridden federal site continues to have problems. But so far, some of those same technical difficulties have prevented most insurers and brokers from being able to do that." (Kaiser Health News)  

Federal Delays and State Exchange Enrollment
"HHS announced that the deadline for enrolling in a qualified health plan through an exchange to ensure eligibility beginning January 1, 2014, had been delayed from December 15 to December 23, 2013, thus presenting a nice Christmas gift to Americans who need health insurance and have been stranded at Healthcare.gov, while at the same time [ruining] the holidays for employees of insurance companies. The delay was announced through an 'HHS Intergovernmental and External Affairs Notification,' and has apparently not yet appeared on the web.... A second announcement was made even less formally -- at a White House press conference. Jay Carney, White House Press Secretary, announced ... that the open enrollment period for 2015 would be delayed.... The one month delay will give insurers an extra month to file their rates for 2015. Instead of those rates being due at the end of April, they will now apparently be due at the end of May." (Health Affairs Blog)  

Congressional Research Service Report on ACA Annual Fee on Health Insurers (PDF)
[Dated Sept. 13, 2013; released online on November 24, 2013.] Excerpt: "Some insurance issuers have informed shareholders and state insurance regulators that they intend to pass on the cost of the fee to businesses and enrollees in the form of higher premiums.... It is difficult to estimate the precise impact of the fee on the insurance industry, government programs, and consumers for several reasons, including a lack of public data on net premiums written. In addition, insurers' ability to pass on the fee will vary depending on competition in local markets, and their individual financial strategies." (Congressional Research Service)  

New California Numbers Show Disproportionate Enrollment by Those Over 55
"Although persons age 55 through 64 constitute about 18% of the California population aged 18 through 64, they constitute double that, 36%, of persons in that same age segment who have enrolled for a plan. Similarly, although persons age 45 through 64 constitute about 41% of the California population, they constitute 59% of those who have enrolled thus far." (The Health Care Blog)  

CBO Analysis of Options for Reducing the Deficit Includes Health Policy Proposals (PDF)
316 pages; excerpt from "Options Related to Health": "Most of the 16 options in this chapter would either decrease federal spending on health programs or increase revenues (or equivalently, reduce tax expenditures) as a result of changes in tax provisions related to health care.... [F]ive options address broad approaches to changing federal health care policy, all of which would offer lawmakers a variety of alternative ways to alter current law.... [1] Impose caps on federal spending for Medicaid, [2] Convert Medicare to a premium support system, [3] Change the cost-sharing rules for Medicare and restrict medigap insurance, [4] Bundle Medicare's payments to health care providers, and [5] Reduce tax preferences for employment-based health insurance." (Congressional Budget Office)  

Flood of Negative News Drives Introduction of More ACA Amendments
"Oregon announced its exchange will not be working before the end of the open enrollment period on March 31, 2014, and encouraged people to fill out paper applications.... Senator Mark Begich (D-AK) introduced a bill (S. 1729) that would add 'copper' plans to the public exchanges that would have an actuarial value of 50 percent, reduced premiums, and higher out-of-pocket costs.... Senator Jeanne Shaheen (D-NH) introduced a bill (S. 1693) to extend the public exchange enrollment period from March 31, 2014 to at least May 31.... [T]he number of Americans identified as eligible for Medicaid during the period of Oct. 1 through Nov. 2 totaled more than 3.7 times as many as enrolled in individual health plans through the public exchanges." (HR Policy Association)  

Annual Statistical Report on the Social Security Disability Insurance Program, 2012
"Disability benefits were paid to just over 10.1 million people. Awards to disabled workers (960,206) accounted for over 90 percent of awards to all disabled beneficiaries (1,063,045).... Workers accounted for the largest share of disabled beneficiaries (87.5 percent). Average age was 53. Men represented under 53 percent. Mental disorders was the diagnosis for about a third." (U.S. Social Security Administration Office of Retirement and Disability Policy)  


Still Stuck: An Update on the Obamacare Cancelations 'Fix'
"Often lost in coverage of the President's 'fix' is the intent to allow renewal for people covered through small group coverage, not just the individual market. Approximately 17 million people are insured in the small group (fewer than 50 people insured) market, and many ... are receiving cancellations affecting not just their own families but that of their employees as well. State insurance commissioners and insurance companies must add this segment into the equation when calculating potential disruption of exchange pools and short turnaround times for pricing and renewals." (The Heritage Foundation)  


Lessons from the Cancellation Crisis
"About 450,000 of the 900,000 cancelled California policyholders will see rate hikes, according to the analysis released by Covered California. That's 50% of all cancelled Californians who will be paying more. Most strikingly, half of those cancelled policyholders are getting policies that are little different from the ones cancelled, deemed by Covered California 'comparable policies.' In other words, half of cancelled California policyholders are paying more, in some cases a lot more, for policies that are worth no more under the [ACA]." (Consumer Watchdog)  

Benefits in General; Executive Compensation

Will Fiduciary Liability Insurance Cover Severance Agreement Payments If the Company Can't Make Them?
"[The insurer] contends that even if [the employee]'s severance agreement was a 'Sponsored Plan' under the policy, there wasn't a 'Wrongful Act' -- again, an accident or negligence -- on [the firm]'s part: [when it decided to liquidate,] the firm simply chose not to continue making payments it had agreed to make.... Much will depend on the exact policy language here, and how it addresses severance agreements -- if it does at all. Even outside of the insurance field, whether a severance agreement is a 'plan' under ERISA is often in dispute.... [T]he Supreme Court tried to provide some clarity [in one case] by holding that a one-time severance payment after a plant closure was not a plan under ERISA because it didn't have an ongoing administrative component -- but it's not at all clear if that's the only test for a covered plan." (Zuckerman Spaeder LLP)  

New York Cracks Down on Executive Compensation for Not-for-Profits
"In this article, [the authors] discuss the relevant authorities, and focus on regulations issued by the [New York] Department of Health for not-for-profits in the health industry. [They] then suggest a series of 'best practices' for not-for-profit corporations -- both in the health industry and other sectors -- as they make compensation determinations for their executives." (Mintz Levin)  

No Surprises in Final ISS Voting Policies for 2014
"ISS conducted back-testing and found that less than 7% of U.S. companies would show significant differences in [relative-degree-of-alignment (RDA)] test results as a result of the change.... If the RDA test raises a concern, ISS will continue to shift to a more detailed qualitative review of company pay programs. In another change, made in a little-noticed footnote, the universe of U.S. companies for which ISS will include realizable pay comparisons to granted pay will be expanded to the S&P 1500 companies from the S&P 500 beginning with February 1, 2014 meetings." (Towers Watson)  

ISS and Equilar/Glass Lewis Now Accepting Updated Peer Group Submissions (PDF)
"Institutional Shareholder Services (ISS) and Equilar / Glass Lewis have announced that they are now accepting updated self-selected peer group submissions from Russell 3000 companies.... Submitted self-selected peers may be considered by ISS and Equilar /Glass Lewis when developed peer groups used for next year's executive pay evaluations." [Article includes a summary of each group's announcement including links to access online submission forms.] (Frederic W. Cook & Co., Inc.)  

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