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November 26, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Account Manager
National Retirement Services, Inc.
in CA

Product Specialist II -- Employer Sponsored Retirement Plans
Edward Jones
in MO

Retirement Plan Services Manager
Beltz Ianni & Associates, LLC
in NY

Retirement Plan Consultant and Coordinator
CDM Retirement Consultants, Inc.
in MD

Sr. Consultant, Retirement Benefits
The University of Maryland Medical Center
in MD

Employee Benefits Attorney
Schwabe, Williamson & Wyatt
in OR, WA

Paralegal 3
Wells Fargo
in ND

Transition Manager
AUL: OneAmerica
in IN

Counsel 3
Wells Fargo
in MN, NC

Plan Manager - Trust
AUL: OneAmerica
in IN

Plan Services Consultant II
AUL: OneAmerica
in IN

Regulatory Services Analyst
AUL: OneAmerica
in IN

Client Service Manager
The Newport Group
in NC

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Webcasts and Conferences

Annual HR Forum
June 3, 2013 in PA
(Corporate Synergies)

Next Generation of LDI Strategies
December 12, 2013 WEBCAST

Annual HR Forum
May 7, 2014 in DC
(Corporate Synergies)

Annual HR Forum
May 14, 2014 in NY
(Corporate Synergies)

Annual HR Forum
June 3, 2014 in PA
(Corporate Synergies)

View All Webcasts and Conferences

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

Text of HHS Notice of Benefit and Payment Parameters for 2015, Also Decreasing 2014 Attachment Point
"This proposed rule sets forth payment parameters and oversight provisions related to the risk adjustment, reinsurance, and risk corridors programs; cost-sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges. It also proposes additional standards with respect to composite rating, privacy and security of personally identifiable information, the annual open enrollment period for 2015, the actuarial value calculator, the annual limitation in cost sharing for stand-alone dental plans, the meaningful difference standard for qualified health plans offered through a Federally-facilitated Exchange, patient safety standards for issuers of qualified health plans, and the Small Business Health Options Program.... We also propose to decrease the attachment point for 2014 from $60,000 to $45,000." (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  


23rd Annual National Health Benefits Conference & Expo

Sponsored by HBCE- Health Benefits Conference & Expo

The Biggest Challenge Remains: Addressing the Most Intractable Cost Problem Facing Employers, Employees & Governments at All Levels - January 28-29, 2014 - Clearwater Beach, FL. High quality, moderate cost - Register now for best rates!

[Official Guidance]

Proposed Actuarial Value Calculator for 2015 (XLS)
"The Actuarial Value Calculator (AV Calculator) is designed to give an estimate of network liability for a given plan design. This version of the AV Calculator uses data from a large national commercial database to build continuance tables by metal tier." [Also included are the Proposed AV Calculator methodology and a Draft User Guide.] (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

[Guidance Overview]

HHS Announcement of Release of Notice of Benefit and Payment Parameters for 2015
"In 2014, HHS will also implement the premium stabilization programs, which are intended to promote price stability for health insurance in the individual and small group markets.... Key policies in today's proposed rule include: Promoting Stable Individual Market Premiums ... Alleviating the Burden of Reinsurance Contributions ... Adjusting for the Transitional Plan Policy ... Amendments to Open Enrollment Period for 2015 ... New Blueprint Timelines ... Protecting Individuals from Excessive Out-of-Pocket Expenses ... Annual Limitation on Cost Sharing for Stand-alone Dental Plans (SADPs) ... Small Group Participation in Risk Adjustment and Risk Corridors ... Simplifying Composite Rating ... Protecting Personally Identifiable Information (PII) ... Protecting Enrollees in QHPs ... Protecting Federal Funds ... Fully Implementing Employee Choice in the Federally-facilitated SHOPs (FF-SHOPs)." (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

[Guidance Overview]

IRS Permits Health FSA Carryovers (PDF)
"Employers should consider carefully whether the rollover makes sense for their organization. It will add administrative complexity. It may only add a limited value depending on current forfeiture activity. Employers need to consider if they may increase participation in a health FSA by limiting the impact of the 'use it or lose it' rule." (McGraw Wentworth)  

[Guidance Overview]

ACA Does Not Preempt San Francisco's Health Care Mandate
"San Francisco's Health Care Security Ordinance (SFHCSO) continues to require medium and large-sized employers to spend a minimum amount of money on health care for their employees who work in San Francisco.... San Francisco has issued an FAQ acknowledging that the use of stand-alone HRAs may violate ACA and promising future guidance on the interplay between ACA and SFHCSO.... If you are subject to the SFHSCO, you must report your health care expenditures to San Francisco on an annual basis on the SFHCSO Mandatory Annual Reporting Form. This form continues to be due by April 30th following the end of each calendar year." (McKenna Long & Aldridge LLP)  

Supreme Court to Rule on Contraceptive Coverage Mandate
"[T]he Supreme Court on Tuesday agreed to hear challenges to the requirement that employers must provide health insurance for their workers that includes birth control and related medical services. The Court said it would decide constitutional issues, as well as claims under the Religious Freedom Restoration Act.... The Court did not expedite the briefing schedules for the new cases, so presumably they will be heard in March." [Grant of Petition for Certiorari in Sebelius v. Hobby Lobby and in Conestoga Wood Specialties v. Sebelius] (SCOTUSblog)  

HHS Plan Adjusts 2014 Risk Payments for Health Insurers
"The U.S. government has issued a proposal that would likely increase risk payments in 2014 to health insurers offering plans on the Obamacare exchanges after the companies complained a recent policy change allowing people to keep their insurance policies had changed the financial equation. The rule ... lowered the threshold at which risk payments kick in for the sickest health plan members. The government proposed paying insurers 80 percent of claims greater than $45,000 in 2014. Previously the lower limit was $60,000." (Reuters)  

Health Plan Funding Options: An Employer's Decision Guide
"Employers pay the vast majority of health plan expenses for their employees, averaging 82% of the cost of single coverage and 71% of the cost of family coverage in 2013.... This paper focuses primarily on funding employer health plans and reviews the many intricacies involved in selecting the appropriate funding method, as well as the advantages and disadvantages of different funding methods." (Manning & Napier)  

Constitutional Law Scholars Discuss Religious Rights, the First Amendment and Obamacare
"Professor Michael W. McConnell is the Richard and Frances Mallery Professor and director of the Constitutional Law Center at Stanford Law School, as well as a Senior Fellow at the Hoover Institution.... David H. Gans is the Director of the Human Rights, Civil Rights, and Citizenship Program at the Constitutional Accountability Center. He is the co-author of an amicus brief filed in the Sebelius v. Hobby Lobby Stores, Inc. case.... Their discussion covers topics such as the Founding Fathers' intentions about corporate rights, religion, and the First Amendment; the ability of corporations to exercise certain types of religious rights; and rights of corporations to refuse to pay for health insurance programs they find morally objectionable." [Article includes link to podcast.] (Constitution Daily)  

Analysis Projects Potential for Increased Subsidized Exchange Enrollment
"[As] of Nov. 2, only 30 percent of exchange applicants are eligible for federal subsidies to reduce their monthly insurance premiums and out-of-pocket costs for medical care. This percentage is far below the 84 percent of enrollees who are ultimately expected to qualify for financial assistance. Furthermore, state-based exchanges (SBEs) are tracking behind states with federally-run exchanges. Based on the latest data, only 23 percent of eligible applicants in SBEs were determined subsidy-eligible in SBEs compared with 34 percent in federally-run exchanges." [Also see detailed report of enrollment numbers by state.] (Avalere Health)  

Deloitte Health Care Current, November 26, 2013
Topics include: ACA 2015 open enrollment may be delayed by 1 month; CCIIO issues guidance to insurers on the extension of non-compliant individual and small group health plans; AHIP pushes for changes in ACA premium stabilization programs; Pharmaceutical sales projected to increase at the lowest growth rate in four years; Seniors in Medicare Advantage required to verify mail-order prescriptions before delivery; and States divided on Administration's policy to give insurers a year to make individual health plans ACA compliant. (Deloitte Center for Health Solutions)  

Is Obamacare Turning the Corner?
"The worry, at this point, is that the site is working in ways that are visible but broken in ways that are harder to see. The Obama administration won't answer direct questions on the percentage of '834s' -- the forms insurers need to sign people up for the correct policies at the correct prices -- that are coming through with errors. Robert Laszewski, a health-industry consultant with deep contacts among the insurers, told the National Journal the problem is getting better, but that his clients are still seeing a five percent error rate. That's still too high." (Ezra Klein and Evan Soltas in The Washington Post; subscription may be required)  

Catholic Dioceses of Pittsburgh, Erie Win Injunction in Challenge to ACA Contraceptive Accommodations
"The right of church-related organizations to keep a clear conscience trumps the federal government's desire to improve access to contraceptives, a federal judge ruled Thursday ... The [federal district court] judge wrote in his 65-page opinion that he was ruling on whether 'the Government will be permitted to sever the Catholic Church into two parts (i.e., worship and faith, and "good works") -- in other words, whether the Government will be successful in restricting the Right to the Free Exercise of Religion as set forth in the First Amendment to a Right to Worship only.'" [The Most Rev. David Zubick et al. v. Kathleen Sebelius, No. 2:13-cv-01459; and The Most Rev. Lawrence Persico et al. v. Kathleen Sebelius, No. 2:13-cv-00303 (W.D. Pa. Nov. 21, 2013)] (Pittsburgh Post-Gazette)  

ACA Premium Stabilization Programs: How Reinsurance, Risk Corridors, and Risk Adjustment Protect Consumers (PDF)
"The reinsurance program will help health plans meet the needs of high-cost enrollees while making individual market premiums more affordable for consumers. [HHS] estimates that the reinsurance program will reduce premiums in the individual market in 2014 by 10-15 percent compared to what they would have been absent this program.... By spreading risk across all health plans in a state, risk adjustment promotes market stability as it protects consumers with complex medical conditions." (America's Health Insurance Plans [AHIP])  

'Narrow Networks' Trigger Push-Back from State Officials
"In Maine, state regulators prohibited Anthem BlueCross BlueShield from switching some customers to a network sold through the [ACA]'s marketplace that excluded six of the state's hospitals. In Washington State, the insurance commissioner initially banned several health plans from the online exchange for what he called inadequate caregiver networks. Some of the plans have broadened networks; the dispute continues with others. In New Hampshire Anthem's 2014 marketplace plans exclude more than a third of the state's hospitals. Lawmakers have written legislation that would force insurers to expand choice.... Now Mississippi, too, is talking about an any-willing-provider law, which typically requires insurers to take any hospital, clinic or doctor under terms accepted by other participants." (Kaiser Health News)  

Incorrect Statements During Claims Process Do Not Render ERISA Inapplicable
"During the claim process your claims administrator mistakenly tells the claimant that the ERISA-governed plan is NOT governed by ERISA. Uh oh. Do you lose ERISA as the governing law over the policy and claim? NO.... If the plan was originally governed by ERISA, 'employee statements or writings opining on legal determinations that are not binding admissions of an insurer ...do not determine the interpretation of an insurance contact.'" [Hill v. Lincoln National Life Insurance, No. C -13-00276 EDL (N. D. Cal. Oct. 30, 2013)] (Lane Powell PC)  

Most Older Adults Have Not Begun to Prepare for Health Care Costs During Retirement
"Adults age 60-64 (40%) are just slightly more likely than those age 50-59 (35%) to have money set aside although these differences are not statistically significant.... Two-thirds of respondents have thought about the costs at least somewhat but only 52% are confident they can afford the costs." (AARP)  

What Employers Need to Know About Portland, Oregon's Paid Sick Leave
"Unlike other paid sick leave laws utilized by other cities, the number of leave hours that an employer is required to provide under the Portland ordinance does not fluctuate depending on the size of the employer.... Unlike other paid sick leave ordinances enacted by other jurisdictions, Portland's ordinance does not explicitly carve out employees governed by a CBA from coverage.... [T]he ordinance provides that employers must allow employees to carry over up to 40 hours of unused Sick Time to the following year.... [T]he ordinance does not require employers to compensate employees for unused paid Sick Time upon the termination of employment." (Fisher & Phillips LLP)  

'Eating Turkey Made Me Fall Asleep and I Missed My Shift': How Employers Can Deal with the Most Outrageous Excuses for FMLA Leave
"[As] we approach the holidays and winter months, keep in mind [these] tricks for warding off employee FMLA leave abuse: [1] Is the Employee Requesting Leave That May Be Covered by FMLA? ... [2] Require that Employees complete a written leave request form for all absences ... [3] Enforce usual and customary call-in procedures ... [4] Prepare a list of probative questions you ask of all employees when they call in to report an absence ... [5] Use medical certification and recertification to your advantage ... [6] Conduct a comprehensive audit of your FMLA policy, procedures and use of leave." (FMLA Insights)  


Text of Letter from U.S. Chamber of Commerce to Reps. Cassidy and Roe in Support of H.R. 3462, the 'Self-Insurance Protection Act' (PDF)
"[HHS] has shown interest in the possibility of regulating stop-loss insurance which raises concerns that future regulations may make the administration of self-insured plans more burdensome and expensive for employers who choose this option. In addition to making self-insurance coverage less appealing, including stop-loss insurance in the definition of health insurance coverage could effectively force many self-insured entities using stop-loss insurance to discontinue their plans. In light of this tumultuous and highly transitional time for our country's private sector health insurance system, it is critical to ensure that businesses continue to have a variety of accessible options to offer their workers quality health care coverage." [Similar letter sent to Senators Alexander, Risch, Rubio, and McConnell] (U.S. Chamber of Commerce)  


Text of Letter from U.S. Chamber of Commerce to Representative Jack Kingston in Support of H.R. 3419, the 'Small Business Fairness in Obamacare Act' (PDF)
"The PPACA created a complicated and confusing definition that requires a new mathematical calculation to determine if a business is an 'applicable large employer,' while the Small Business Act already provides a more workable definition that the business community is accustomed to and that appropriately varies based on industry.... Protecting the nation's most at-risk small businesses and returning to the widely-accepted definition of a full-time employee would remove the barriers that are forcing many employers to reduce employee hours, restructure their workforce, and limit overall business growth." (U.S. Chamber of Commerce)  


Trying To Make Sense of the Covered California Numbers
"California has 5.3 million uninsured eligible to buy in the exchange with half estimated to be subsidy eligible. California is cancelling another 1.1 million people of which Covered California has estimated 510,000 qualify for a subsidy they can only get if they go to Covered California. At least 80% need to act by December 23 to avoid losing their coverage. The state is spending $250 million in federal money to get people signed up -- dramatically more than any other state. The Covered California goal is to sign-up 500,000 to 700,000 subsidy eligible people by March 31. Why should we be so impressed with Covered California because they have signed-up 80,000 people so far?" (Robert Laszewski in The Health Care Blog)  

Benefits in General; Executive Compensation

[Guidance Overview]

New Pension and Other Postretirement Accounting for Insurance Companies (PDF)
"The National Association of Insurance Commissioners (NAIC) has changed employers' accounting for pensions and other postretirement benefits.... For employers filing under US GAAP as well as SAP, the new guidance may simplify the process of determining employee benefit obligations and net periodic plan cost ... However, the requirement to recognize the unfunded benefit obligation, including obligations for nonvested plan participants, may prove onerous for many employers, especially employers who provide other postretirement benefits, since obligations for employees who are not yet eligible to retire are generally considered to be nonvested." (PricewaterhouseCoopers)  

U.S. Senate Bill Would Penalize Employers for Innocent Independent Contractor Misclassifications
"Ignoring the risks of independent contractor misclassification may become more costly for employers under a bill introduced this month by U.S. Senator Bob Casey (D-PA).... The bill is part of a targeted initiative by the current administration to eliminate worker misclassification. According to the bill's sponsor, in addition to being 'payroll fraud,' worker misclassification evades tax laws and deprives workers of benefits and legal protections." (Faegre Baker Daniels LLP)  

2013 Plan Sponsor Year End 'To Do' List: Executive Compensation
"Last Chance to Correct Certain Section 409A Document Failures Discovered in 2013 ... Consider Shareholder Reapproval of Section 162(m) Performance Compensation Plans Approved in 2009 ... Review Whether Your Equity-Based Compensation Plan Has Sufficient Shares Remaining for 2014 Grants ... Consider Adding Separate Annual Limits on Director Equity Awards ... Code Section 6039 Information Statements Due by January 31, 2014 ... Review Grant Procedures for Upcoming Equity-Based Grants." (Snell & Wilmer L.L.P.)  

More Pitfalls for Current-Year Bonus Deductions Arising in IRS Audits
"While its status as 'guidance' is not clear (for example, the memo was issued by an IRS Field Counsel Office rather than the National Office), this new IRS advice highlights how a company's discretion to reduce bonus payments -- whether outright or as part of certifying and approving performance results -- can result in the all events test not being met, and therefore delay the tax year when bonus amounts are deductible." (Groom Law Group)  

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