Client Service Representative
Associated Pension Consultants
in CA

Benefits Paralegal/Retirement Plan Specialist
Robinson & Cole LLP
in CT

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Earned Income: Computing Compensation for the Self-Employed
February 18, 2014 WEBCAST
(SunGard Relius)

Aggregation Aggravation: Who's the Employer?
February 19, 2014 WEBCAST
(SunGard Relius)

2014 IRA Online Institute
February 24, 2014 WEBCAST
(Ascensus)

Taking Money Out of Plans: The Legal and Practical Implications of Loans and Distributions
March 12, 2014 WEBCAST
(American Society of Pension Professionals & Actuaries (ASPPA))

COBRA Compliance for Group Health Plans
March 28, 2014 in WA
(Thomson Reuters / EBIA)

HIPAA Privacy & Security
March 28, 2014 in WA
(Thomson Reuters / EBIA)

Innovations in Workplace and Community Wellness: Navigating the New Terrain
April 7, 2014 in DC
(U.S. Chamber of Commerce)

Health Care Reform Essentials: Helping Hawaii's Employers Stay Steady Amidst the Chaos of the Rollout
April 30, 2014 in HI
(Lorman Education Services)

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[Official Guidance]

Text of CMS Submission to OMB and Request for Public Comment on Information Collection for Health Plan Certification, Financial Management, and Exchange Operations
"The purpose of this collection is to ensure that Qualified Health Plans must meet certain minimum certification standards, such as those pertaining to essential community providers, essential health benefits, and actuarial value. In order to meet those standards, the Exchange is responsible for collecting data and validating that QHPs meet these minimum requirement In addition to data collection for the certification of QHPs, the reinsurance and risk adjustment programs outlined by the [ACA] ... have general information reporting requirements that apply to issuers, group health plans, third party administrators, and plan offerings outside of the Exchanges. Subsequent regulations for these programs ... provide further reporting requirements. Based on experience with the first year of data collection, we propose revisions to data elements being collected and the burden estimates for years two and three." (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

[Advert.]

4th Annual Leadership Summit on Ancillary Products and Voluntary Benefits

This unique Summit convenes health plans, non-medical insurance carriers and brokers to discuss leveraging ancillary and voluntary products to increase their competitive edge and to meet the needs of a consumer driven market. March 11-12, Orlando. BLINK3 for discount.

[Official Guidance]

Text of CMS Bulletins on Enrollment and Termination Policies and Processes for FFM and SPM Issuers (PDF)
14 pages. Excerpt: "This set of guidance covers a variety of topics related to consumers or issuers being able to make changes to information or plan selections based on changes in life circumstances or as the result of being granted a special enrollment period. New functionality in the [Federally-facilitated Marketplaces (FFM)] will allow consumers to make certain changes to their application. The attached guidance represents a series of bulletins and FAQs related to consumer changes where new functionality is available. Interim processes are outlined for situations where functionality is not yet available, such as special enrollment periods." (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

[Guidance Overview]

Determining Full-Time Employee Status Under the ACA: Time to Get Going
"Although the IRS has yet to finalize the regulations for determining full-time employees, employers who wish to take advantage of the measurement periods in the proposed regulations will need to have developed systems and processes for tracking hours well in advance of January 1, 2015. This results from a look-back period being used to lock in a current employee's full-time or part-time status for the applicable stability period." (Mazursky Constantine LLC)  

[Guidance Overview]

New Guidance Covers Expatriate and Fixed Indemnity Plans, Mental Health Coverage
"The new guidance clarifies that an expatriate health plan is an insured group health plan in which enrollment is limited to a primary insured (and his or her dependents) for whom there is a good faith expectation that the primary insured will reside outside his or her home country or outside of the United States for at least six months of a 12-month period.... HHS is ... considering regulations that will treat fixed indemnity coverage in the individual market as exempt from Health Care Reform mandates if it meets [certain] requirements ... Large group health plans are not required to cover mental health and substance abuse services -- but if they do, they must also comply with the mental health parity regulations for plan years that begin on or after July 1, 2014." (Warner Norcross & Judd LLP)  

Private Health Exchanges: Today, Tomorrow and Employer Impact
"There are four reasons employers would make the move to a private exchange, and the first and most prominent reason is to cap costs and take variability out of the budget process. Making a move to an exchange: Shifts from a defined benefits to a defined contribution model ... Avoids excise tax on high-cost coverage (Cadillac tax), which starts in 2018.... Simplifies benefits distribution and administration ... Provides potentially more benefit choices for employees[.]" (HighRoads)  

[Advert.]

ERISA Audits: What We All Knew but Forgot - June 5 Webinar

Understand potential audit triggers and hot button areas, the scope of audits, what to expect in such audits, and best practices to avoid audit complications. Special BenefitsLink discount.

An Obamacare Case Study for Employers
"Target may have considered the following in its decision-making process: The exclusion of employees who work less than 30 hours per week does not result in any ObamaCare excise taxes.... The exclusion of employees who work less than 30 hours per week may have freed up funds to allow Target to offer coverage to full-time employees that is both 'affordable' and provides 'minimum value' if it previously did not.... Since part-time employees are no longer eligible for employer-provided coverage, they may be able to use the generous federal tax subsidies to purchase health insurance through a state exchange." (Blank Rome LLP)  

House Committee Approves 40-Hour Definition of Full-Time Employee Under ACA
"The bill was approved by a 23-14 party-line vote and is now cleared for action on the House floor. House approval is expected. Similar legislation is pending in the Senate. The Forty Hours Is Full Time Act (S.1188) was introduced by Senators Susan Collins [R-ME] and Joe Donnelly [D-IN]. In addition, the budget resolution approved by the Senate in March 2013 included a provision aimed at 'restoring a reasonable definition of a full-time employee.' However, the Senate outlook is unclear." (Towers Watson)  

What Happens in Vegas ... May Be Protected FMLA Leave
"[T]he court recognized that its decision creates a split with the First and Ninth Circuit Courts of Appeal on the definition of 'caring for' a family member.... [T]he court acknowledged, but dismissed, the Chicago Park District's concern that the court's expansive reading of the term 'caring for' will open the door to increased FMLA requests and create a greater potential for FMLA abuse." [Ballard v. Chicago Park District, No. 13-1445 (7th Cir. Jan. 28, 2014)] (Ogletree Deakins)  

Aetna Expects to Lose Money on ACA Marketplaces
"The insurer said in the first quarter of this year it expected to lose about 90,000 members from its self-insured account rolls to private exchanges, but that it should gain around 130,000 private-exchange enrollees. Of those, around two-thirds will be in fully insured plans, which are four or five times more profitable because the insurer is taking on the risk, rather than simply administering the coverage as it does for self-insured employers." (The Wall Street Journal; subscription may be required)  

Proposed Bipartisan Bill Would Reward Medicare Doctors for Quality
"After negotiating for months over how to overhaul Medicare's troubled payment system for physicians, the bipartisan leadership of three Senate and House committees has reached a deal on the policy.... [D]octors would receive an 0.5 percent bump for each of the next five years as Medicare transitions to a payment system designed to reward physicians based on the quality of care provided, rather than the quantity, as the current payment formula does." (Kaiser Health News)  

Sixth Circuit: Failing to Disclose Disability Claim in Bankruptcy Not Fatal to Disability Claim Lawsuit
"What happens when a long term disability claimant declares bankruptcy, and fails to list the long term disability claim in the bankruptcy estate? Is he judicially estopped from bringing the lawsuit alleging wrongful denial of disability benefits? Probably not." [Javery v Lucent Technologies, Inc. Long Term Disability Plan, No. 12-3834 (6th Cir. Feb. 3, 2014)] (Lane Powell PC)  

Repealing and Replacing the Sustainable Growth Rate: a Fact Sheet
"Since 2003, Congress has spent nearly $150 billion in short term patches to avoid unsustainable cuts imposed by the flawed SGR. The most recent patch will expire on March 31st. Building on bipartisan legislation unanimously reported out of the House Energy & Commerce and Ways & Means Committees, and reported out of the Senate Finance Committee, the unified legislation from the three committees repeals the SGR and transitions Medicare away from a volume-based system towards one based on value." (House Committee on Energy and Commerce)  

Patients Need Training on New Health Insurance
"New Medicaid patients in Oregon failed to use their benefits effectively because they did not understand how to use insurance or health care ... People assumed if they used their insurance for something minor, like a physical, someone who needed care more might not get a turn.... Patients who knew they only had emergency dental care assumed that extended to all health care, so they went to the emergency room and not a regular doctor's office. Medicaid beneficiaries did not understand that preventive screenings could save the system money in the long term, or simply didn't know they should get an annual exam. People were afraid of how much they would be required to pay if they saw a doctor." (USA TODAY)  

The Payment Reform Landscape
"Fed up with the status quo, large employers, other purchasers, and health plans have been on a steady march to change how we pay for health care, moving away from paying for care based on volume to paying for value.... In releasing the first-ever National Scorecard on Payment Reform last March, Catalyst for Payment Reform (CPR) started to measure this progress in the private sector, including the prevalence of specific payment methods. The Scorecard revealed what many of us already know -- the vast majority of payment (89 percent) is still tied up in fee-for-service and other methods that are agnostic about the quality of care." (Health Affairs Blog)  

Obamacare 'Bailout' for One Insurer Will Cost Up to $450 Million in 2014
"Humana announced that it expects to tap the three risk adjustment mechanisms in ObamaCare for between $250 and $450 million in 2014. This amounts to about 25 percent of the insurer's expected exchange revenue. This money is needed to offset losses that the insurer will take as a result of slower enrollment in its ObamaCare plans, and a skewed risk pool that weighs more heavily toward older and less healthy members than it originally budgeted. More than half of the money will come from the $25 billion reinsurance pool that ObamaCare provides (collected through a tax on employer-sponsored health plans). The other half will come mostly from the risk corridors." (Forbes)  

[Opinion]

A Missing Argument in Favor of Upholding the ACA's Mandatory Contraceptive Coverage
"Oddly, the Justice Department has relegated to a footnote what may be the strongest single argument against allowing the two companies to deny their workers contraceptive coverage that they would otherwise be entitled to under the health care law. That would be the Constitution's establishment clause enforcing the separation of church and state and barring government from favoring one religion over another or nonbelievers. But that is exactly what would happen if the restoration act were to be read as a congressional order requiring federal courts to grant private for-profit employers an exemption that would effectively allow them to impose their beliefs on employees to deny them a valuable government benefit." (The New York Times; subscription may be required)  

[Opinion]

CBO Confirms Warnings on Obamacare and the Minimum Wage
"[T]he minimum cost of hiring a full-time worker will rise to $10.30 per hour nationwide when the mandate takes effect next year. This figure includes the minimum wage, payroll taxes, and the Obamacare penalty. From the employers' perspective, the President has already instituted a $10 minimum wage for full-time workers. They will respond by reducing hiring and cutting hours." (The Heritage Foundation)  

Outlook for HR and Employee Benefits Legislative and Regulatory Activity in 2014 (PDF)
11 pages. Excerpt: "Few measures are likely to pass both chambers in 2014 ... However, even with the possible obstacles, Congress is expected to consider a number of issues related to HR and government operations in the months ahead. A brief overview of some of the major issues is provided[.]" (Aon Hewitt)  

Second Circuit Reinforces Broad Scope of ERISA Preemption
"[O]ne of the more significant aspects of the opinion is its focus on the fact that preemption is invoked by any state regulations that dictate plan terms, reporting or benefits in a manner that places the plan at risk of having to comply with multiple conflicting state requirements, as well as ERISA's own requirements. This is a broad holding that reinforces this widely applied, but often contested, rule of ERISA preemption, and extends beyond the narrow, specific confines of the specific state reporting requirements at issue in [this case]." [Liberty Mut. Ins. Co. v. Donegan, No.12-4881-cv (2nd Cir. Feb. 4, 2014)] (Stephen Rosenberg of The McCormack Firm, LLC)  

ISS Implements New Compensation and Governance Factors in QuickScore 2.0
"ISS will now assess director compensation levels on a relative basis. ISS will measure the average director pay (based on the director compensation table as disclosed in the proxy) as a multiple of the median pay of the ISS-selected peers. ISS did not disclose the level of multiple that will be considered harmful to QuickScore 2.0 ratings.... ISS will now consider whether the company's most recent Say-on-Pay received shareholder support below the index industry level, compared to results of 4-digit GICS groups, and the S&P 500, S&P 400, S&P 600, Russell 3000 -- excluding S&P 1500 indices." (Steven Hall & Partners)  

Share Utilization at Fortune 500 Companies: Full-Value Awards on the Rise
"While overhang levels continued to fall in the most recent period studied, both run rate and the fair value of long-term incentive (LTI) awards remained exactly the same as the previous year. Meanwhile, the ongoing shift in the equity mix from appreciation awards (e.g., stock options) to full-value awards (e.g., restricted shares/units and performance-based shares) makes it clear that companies favor full-value awards more than ever." (Towers Watson)  

Newport Helps Employees Make Better Choices for Retirement
Newport Group, The

Ascensus Creates New Organizational Structure To Support Rapid Growth
Ascensus

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