Senior Account Manager
Gallagher Benefit Services, Inc.
in IL

Senior Legal Counsel, ERISA Title I
T. Rowe Price
in MD

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Compensation under Qualified Plans
February 20, 2014 WEBCAST
(ASC Institute)

2014 NIPA Annual Forum & Expo (2014NAFE)
April 27, 2014 in NV
(National Institute of Pension Administrators)

IRI Retirement Plan Summit
July 2, 2014 in DC
(Insured Retirement Institute (IRI))

Retirement Plans Legislative Update
March 27, 3014 WEBCAST
(TRI-AD)

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[Guidance Overview]

CMS Proposes Major Changes to Medicare Parts C and D
"If adopted as drafted, these rules will significantly impact how Medicare Advantage (MA) organizations and Part D Prescription Drug Plan (PDP) sponsors operate and interact with their contractors, beneficiaries, and the government. The proposed rules will also impact the operations of all health care entities involved in providing drug products under Parts C and D, including pharmacy benefit managers (PBMs), pharmacies, physicians, and pharmaceutical manufacturers. Impacted parties and entities will want to carefully review the text of the proposed rules, along with CMS's justification for the rules, and consider submitting comments by the deadline." (Mintz Levin)  

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[Guidance Overview]

CMS Proposed Rule Reflects Increased Sophistication in Administration of Medicare Advantage and Part D Programs
"Addressing issues ranging from participation in Part D Plan pharmacy networks to compliance training for so-called first-tier, downstream and related entities, the Proposed Rule covers numerous topics with varying degrees of importance for MA Organizations, Part D Plan Sponsors, pharmacy benefit managers, and other health care and administrative service providers participating in the Programs. This summary of the Proposed Rule addresses several issues of interest for both MA Organization and Part D Plan Sponsors (collectively, Plan Sponsors), as well as for entities with which Plan Sponsors contract." (McDermott Will & Emery)  

Employers Sponsoring MEWA Plans Should Beware of ACA Non-Compliance Risks
"What happens if your employer-sponsored group health plan renews on or after January 1, 2014, but the plan that is being renewed is not compliant with healthcare reform? This situation can arise if the employer is purchasing a plan from a MEWA (multiple employer welfare arrangement) and the MEWA is a non-calendar year plan that renews after the employer renews its group health plan. The employer renewing earlier in 2014 than the MEWA will be purchasing a health plan from the MEWA's 2013-2014 plans, which are likely not compliant with certain provisions of the ACA. The employer would then have that non-compliant plan in place for its entire 2014-2015 plan year[.]" (Hill, Chesson & Woody)  

Employers Still Feeling the Weight of ACA Communication Requirements
"[W]hile many employers measure the success of their efforts by year-over-year cost reduction, compliance teams appear to be getting larger and organizations continue to have a vague picture of the aggregate costs of writing, producing and distributing compliance documents." (HighRoads)  

Explaining Health Care Reform: Risk Adjustment, Reinsurance, and Risk Corridors
"The ACA's risk adjustment, reinsurance, and risk corridors programs are intended to protect against the negative effects of adverse selection and risk selection, and also work to stabilize premiums, particularly during the initial years of ACA implementation. Each program varies by the types of plans that participate, the level of government responsible for oversight, the criteria for charges and payments, the sources of funds, and the duration of the program." (Kaiser Family Foundation)  

Risk Adjustments in Obamacare
"[T]hese programs are all aimed at protecting individual insurance companies from the consequences of ObamaCare enrollment and rating restrictions. None of them ensure the solvency of the market as a whole. Indeed, they do just the opposite -- they encourage the sickest people to enroll by subsidizing them while discouraging the healthiest people to enroll by overcharging them. So, while individual companies may be exempt from the 'death spiral,' the program as a whole is not." (John Goodman's Health Policy Blog)  

625,000 Enrolled in California Health Exchange
"Covered California officials today said more than half a million Californians signed up for exchange coverage that started Jan. 1 and about three-fourths of them have paid their premiums and are officially receiving coverage through the exchange. About 85% of the new enrollees are eligible for subsidies, according to Peter Lee, executive director of Covered California." (Kitsap Sun)  

Target to Drop Health Plan for Part-Timers as Obamacare Steps In
"About 10 percent of Target's part-time employees, defined as those working fewer than 30 hours a week, use the company's health plans now ... Target said it would pay $500 to part-timers losing coverage and a consulting firm will help workers sign up for new Obamacare plans." (Bloomberg BusinessWeek)  

Can Private Health Care Exchanges Improve the U.S. Health Care System? (PDF)
"Private health exchanges will be a permanent and significant avenue for health care benefits delivery because they are dynamic, powerful and necessary for employers aiming to achieve lower, predictable health care costs. The emergence of efficient and effective health exchanges, combined with a responsibility to provide affordable health coverage, presents an opportunity for employers to take advantage of new options available to help manage costs and improve the health of their population in a way that leads to a workforce that is healthy, present and productivity." (Aon Hewitt, via Benefits Quarterly)  

Most Employees Happy with Private Exchange Choices, Some Want More
"In a survey of 207 employees from 54 small, mid-size and large companies ... over 70 percent said they were satisfied with both the online shopping experience and the variety of health benefit plans they could choose from, compared to their previous experiences having to enroll in a group policy selected by their employer.... [Ten] percent of the employees surveyed said they had too many choices. But most of the employees preferred having lots of options, and about one-third said there 'can never be too many options,' while 17 percent said they thought there weren't enough." (Healthcare Payer News)  

ERISA Plaintiffs' Attorneys Find Small Victories Can Be Winning Lottery Tickets
"Plan sponsors should consider adopting the following practices to avoid or limit potential exposure for plaintiffs' fees and costs: [1] If voluntarily reversing a benefit denial, obtain a release of attorneys' fees in exchange for agreeing to grant the benefit. [2] Emphasize that fees are unwarranted or should be reduced substantially to reflect any unsuccessful claims.... [3] Vigorously defend against allegations of bad faith ... [4] When amending plan language, state the reasons for the change, so that a participant can't argue that the plan was amended as a result of a lawsuit." (Seyfarth Shaw LLP)  

To What Extent Can an ERISA Fiduciary Rely on Legal Advice?
"Though the D.C. Circuit panel sought to clarify 'when' ERISA permits plan fiduciaries to act in reliance on the advice of counsel, it did not provide particularly clear guidance on this issue. Rather, citing the common law of trusts, the court noted that a fiduciary may rely on the advice of counsel when 'reasonably justified under the circumstances.' The court reasoned that the 'propriety' of that reliance must be judged 'based on the circumstances at the time of the challenged decision,' and 'whether a prudent trustee in those particular circumstances would have acted in reliance on counsel's advice.'" [Clark v. Feder Semo and Bard, P.C., No. 12-7092 (D.C. Cir. Jan. 7, 2014)] (Alston & Bird, LLP)  

Supreme Court Overturns 4th and 11th Circuit Rule Governing Finality of Judgment
"When a United States District Court judge enters judgment in a case, but postpones for a later date determination of a party's motion for attorneys' fees, when is the Court's decision 'final' ... particularly when counting the 30 days by which to appeal under the Federal Rules of Appellate Procedure? Until last week, the answer in the Fourth and Eleventh Circuit was: 'It depends.' ... [T]he U.S. Supreme Court resolved the split, unanimously holding that a District Court's decision on the merits was 'final' and started the clock running for the appeal deadline, even if an attorneys' fees award had not yet been determined, regardless of whether attorneys' fees were sought pursuant to statute or by contract." [Ray Haluch Gravel Co. v. Central Pension Fund of Int'l Union of Operating Engineers and Participating Employers, No. 12-992, 2014 WL 127952 (S. Ct. Jan. 15, 2014)] (Womble Carlyle)  

Annual ISO and Employee Stock Purchase Plan Information and Reporting Requirements
"Participant information statements may either be delivered or mailed to the participant's last known address or, if the participant has given his or her consent to receive the statement electronically, provided in electronic format. The consent to receive the statement electronically must be made in a way that demonstrates that the participant can access the statement in the electronic format in which the statement will be provided." (Orrick)  

2014 Executive Pay Challenges in Europe: Coming Soon to Boardrooms in the U.S.?
"Given the recent trend of European practices increasingly finding their way to the U.S., companies in the United States should be aware of ... [1] The bifurcation of say-on-pay votes in the U.K. into votes on pay policy (binding) and implementation (nonbinding), and the likely impact on pay practices; [2] The increased prevalence of longer-term vesting and performance periods on both short- and long-term incentives; and [3] The diminishing role of relative TSR plans, particularly in the U.K." (Towers Watson)  

Wilkins Finston Law Group LLP is Pleased to Welcome Misty A. Leon to the Firm
Wilkins Finston Law Group LLP

Chairman Camp Announces Hearing on the Impact of the Employer Mandate’s Definition of Full-time Employee on Jobs and Opportunities
U.S. House Ways and Means Committee

UAW Retiree Medical Benefits Trust Finalizes Transactions Providing $4.35 billion in Funding for Retiree Health Care
UAW Retiree Medical Benefits Trust

Willis Launches Global Human Capital & Benefits Practice Led by Willis International CEO
Willis

$10M Settlement Reached with People Care and DOL: Agreement Includes More Than $9M to Employee Stock Ownership Plan
Employee Benefits Security Administration (EBSA), U.S. Department of Labor

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