Benefits Analyst 3
Northrop Grumman Corporation
in CA, VA

Actuarial Analyst
Benetech, Inc.
in CA

Manager of Technical Plan Services
EPIC Advisors, Inc
in NY

Financial Analyst
The Newport Group
in FL, TX

Internal Sales Consultant
The Newport Group
in NC

ERISA Consultant
The Newport Group
in FL

Manager III (Benefits Manager)
Stanislaus County Chief Executive Office
in CA

Account Manager
ASPire Financial Services LLC
in FL

Health Practice Leader
The Segal Group
in DC

Non-Qualified Plan Consultant
The Newport Group
in FL

Plan Document Specialist
America's 401(k), Inc.
in TX

Regional Pension Wholesaler
Nationwide Insurance
in CA

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Mental Health Parity Final Rules: Design and Administration for Employer Health Plans
January 23, 2014 WEBCAST
(Thomson Reuters / EBIA)

Affordable Care Act 101 Webinar
February 6, 2014 WEBCAST
(U.S. Small Business Administration (SBA))

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[Guidance Overview]

IRS Fills in Details About the Shared Responsibility Requirement
"Where an individual is not eligible for employer-sponsored coverage, the issue under the individual responsibility requirement becomes whether the lowest-cost bronze plan that would cover all members of the individual's family who are not exempt from the MEC requirement and that is available through the individual's exchange can be purchased for 8 percent or less of the individual's MAGI after allowable premium tax credits are applied. The proposed rule preface notes that the IRS has not yet determined how individual market wellness demonstration programs will affect this calculus, since these demonstration programs have not yet been established." (Timothy Jost in Health Affairs Blog)  

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Minimum Essential Coverage and Shared Responsibility Penalty Rules Provide Transitional Relief for Individuals
"Proposed regulations issued by the IRS on [January 24] answer a number of questions regarding the Sec. 5000A 'individual mandate' under 2010's health care reform legislation, including the definition of those government programs that do not provide minimum essential health care coverage. They also provide a hardship exemption for individuals who obtained coverage through an exchange for 2014 during the open enrollment period. Such individuals may claim an exemption for the period before their coverage is effective without obtaining an exemption certificate." (Journal of Accountancy)  

District Court Upholds Validity of IRS Rule Authorizing Premium Tax Credits to Individuals Who Enroll in Health Care Coverage through Federally-Facilitated Exchanges
"If Halbig is eventually reviewed by the Supreme Court, for example, and if the Supreme Court disagrees with the district court's position and finds that the IRS exceeded its authority in implementing the IRS Rule, employers operating in the thirty-four states in which the Federally-facilitated Exchanges have been established will be exempt from the play-or-pay penalties under the ACA that are assessed when full-time employees are not offered affordable coverage and receive a Premium Tax Credit on the Federally-facilitated Exchange. For now, at least according to the district court's decision, this is not the case. But that court likely will not have the final word on this very important ACA issue." [Halbig v. Sebelius, No. 13-062 (D.D.C. Jan. 15, 2014)] (Proskauer's ERISA Practice Center)  

Partial Win for Little Sisters in Challenge to Contraceptive Mandate
"The Justices' order does require the Little Sisters to tell the government, in writing, that they are non-profit groups 'that hold themselves out as religious and have religious objections to providing coverage for contraceptive services.' That was a procedural wrinkle that the Court itself invented, outside the rules laid down by the government. If the Little Sisters do make that substitute kind of notification, then the government, under the order, is barred from enforcing the mandate against them. At no point in the case as it moves forward, the order stressed, are the Little Sisters required to file Form 700 with the government, or to send copies of it to the separate entity that operates their employee health benefit plan." (SCOTUSblog)  

Monetary Incentives Encourage Corporate Wellness Participation
"One common focus of incentives is employee participation in a health risk assessment.... [One study] found that health risk questionnaires coupled with follow-up interventions -- such as support activities or health promotion programs -- raised the likelihood that the programs would be beneficial. Convincing employees to provide information for the assessment can be challenging, so the incentive is needed." (U.S. Chamber of Commerce)  

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IRS Issues 2013 Versions of Publications 502 (Medical and Dental Expenses) and 503 (Child and Dependent Care Expenses)
"[R]eferring to Publication 502 in connection with these tax-favored benefits must be done with caution, because Publication 502 addresses only the expenses that are deductible -- it doesn't describe the different rules for reimbursing expenses under health FSAs, HSAs, or HRAs. Likewise, Publication 503 is written primarily to help taxpayers determine whether expenses qualify for the [dependent care tax credit]; while similar requirements must be met for expenses to be reimbursable under a [dependent care assistance plan], caution is advised when consulting the publication for this purpose." (Thomson Reuters / EBIA)  

Humana Sued Over Consumer Troubles Cancelling Policy
"The lawsuit alleges that Humana policy holders in 22 states were unable to cancel their policies prior to 2014 and continued to be billed for premiums or have the payments deducted from their bank accounts. The suit is being brought as a class action on behalf of Doyle and other consumers who may have had similar experiences, although Doyle is the only consumer identified as experiencing a cancellation ordeal." (Healthcare Payer News)  

California Employer Health Benefits Survey: Workers Feel the Pinch (PDF)
"The proportion of California employers offering coverage has declined significantly over the last decade, from 69% in 2000 to 61% in 2013. Coverage is offered to employees at a higher rate at larger firms, firms with higher wages, and firms with some union workers. Since 2002, premiums in California rose by 185%, more than five times the state's overall inflation rate. Average monthly premiums for single coverage in California were $572 in 2013, compared to $490 nationally. For family coverage, monthly premiums were $1,442 in California and $1,363 nationally." (California HealthCare Foundation)  

Projections Show HSA Limits to Rise in 2015
"Recent projections are showing HSA contribution limits, minimum deductibles and maximum out of pocket limits will all increase in 2015.... The prescribed data period for calculating the inflation adjustments runs through March. The U.S. Treasury Department is required to publish the inflation-adjusted amounts for the upcoming year for HSAs by June 1 each year." (Healthcare Trends Institute)  

HSAs Drive Greater Employee Health Engagement
"Employees and members of their families who are enrolled need to understand why it is important for them to take a more active role in managing their health and their health care spending. This usually requires communication focused on their role as a health care consumer. Once they understand their role, they also need access to resources that help them make informed health care decisions." (Idaho Business Review)  

What Health Insurance Coverage Changes Are the Uninsured Anticipating for 2014?
"Almost one in five (17.6 percent) of all nonelderly adults were uninsured on the eve of reform. Overall, 39.3 percent of these adults expected to gain health insurance coverage in 2014. Younger, nonwhite or Hispanic, and healthier adults were more likely to expect to gain coverage ... Nearly a third (31.0 percent) of the adult Medicaid target population thought they would be eligible for Medicaid in 2014." (Urban Institute)  

[Opinion]

Why You Should Care About How HHS Calculates 'Actuarial Value'
"If [HHS] overestimates actuarial value, which it appears that it has done, the bloated insurance plans required by ObamaCare can be offered with higher deductibles, copayments, and other out-of-pocket costs than would otherwise be the case. All else equal, higher deductibles and out-of-pocket costs also enable lower premiums.... When the actuarial value calculations were carried out, the amount of cost sharing that ObamaCare allowed depended upon the government's estimate of the overall plan costs for plans that have not yet taken effect. In a methodology report, HHS explained how it estimated plan costs for its standard population. With one exception, the choices made would likely overstate the cost of essential benefits coverage." (John Goodman's Health Policy Blog)  

[Opinion]

PCORI Needs to Step Up Research on Comparing the Effectiveness of Health Care
"[Comparative effectiveness research (CER)] evaluates the effectiveness of two or more prevention, diagnosis, or treatment options ... [and] has the potential to lower health care costs over the long term while maintaining or improving the quality of care ... The [ACA] created a new independent nonprofit, the Patient-Centered Outcomes Research Institute, or PCORI, to fund and disseminate CER.... [F]our years into its 10-year existence, the institute has dedicated less than 40 percent of its research funding to CER. Moreover, PCORI has not initiated a single CER study of medical devices, launched only a few CER studies of drugs, and produced only a handful of analyses that synthesize existing CER studies." (Center for American Progress)  

[Opinion]

Towards a Solution for Medical Price Transparency
"According to a recent report published by the Altarum Institute, less than one third of patients asked about the price of a treatment before receiving it, and few believe that they can 'shop around' different providers.... Perhaps a solution in the healthcare arena would be to institute binding arbitration in cases where providers refuse to agree on prices before providing service. And perhaps the binding arbitration could be based on the fee the patient offered to pay upfront, but declined by the provider in favor of bureaucratic claims processing." (John Goodman's Health Policy Blog)  

[Guidance Overview]

Handout for January 29 IRS Phone Forum: Ethical Standards for Employee Benefits Practitioners -- What to Ask and Say to Clients and What to Tell the IRS (PDF)
67 presentation slides. Includes detailed examination of Circular 230, hypothetical situations, discussion of specific issues, and citations to relevant authority. (Internal Revenue Service)  

[Guidance Overview]

ISS 'Burn Rate' Caps: 2009-2014
"As part of its analysis of equity compensation plan proposals, Institutional Shareholder Services analyzes a company's 'burn rate' compared to maximum amounts established by ISS for Russell 3000 and non-Russell 300 Global Industry Classification Standard groups [GICS].... If a company's ISS burn rate exceeds GICS group ISS burn rate cap, ISS will recommend AGAINST the company's equity compensation plan proposal. [A company that exceeds] their allowable burn rate cap can avoid a negative vote recommendation from ISS by publicly committing ... to maintain its burn rate over the next three fiscal years of equal to or less than its GICS group ISS burn rate cap[.]" (EdwardHauder.com)  

District Court Rules that Church Hospitals Cannot Establish Non-ERISA Church Plans
"[T]he risk has increased substantially that separately incorporated 501(c)(3) entities that are not actual churches (such as hospitals, schools, colleges, universities, nursing homes, thrift shops or other charities) cannot establish and maintain their own church plans (though they may be able to participate in denominational church plans). The decision's reasoning would not be limited to defined benefit pension plans -- it would apply to any pension or welfare plan. Because few plans that are church plans will have complied with ERISA and the Code in every respect, the potential taxes, interest and penalties resulting from a finding of non-compliance for any given church-related charitable organization could be staggering." (Groom Law Group)  

Should Companies Bifurcate Their Requests for Shareholder Approval of Stock Incentive Plans?
"The question comes up every year around this time (during the drafting of proxy statements) with respect to shareholder approval of stock incentive plans: Should we bifurcate our request to shareholders for the approval of: [1] The performance measures available for Section 162(m) purposes (which generally require re-approval every 5 years), [2] The addition of shares to the authorized share pool, and/or [3] Other amendments of the plan? ... Last week, the SEC Staff has weighed in with new Compliance and Disclosure Interpretations (C&DIs) on the issue[.]" (Winston & Strawn LLP)  

Conrad Siegel Investment Advisors Reaches $1 Billion in Assets Under Management
Conrad Siegel Investment Advisors, Inc.

ConnectYourCare’s HSA On Demand with Healthcare Payment Card Named Winner in Eighth Annual Paybefore Awards
ConnectYourCare

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