Employee Benefits Compliance Attorney
Gallagher Benefit Services, Inc.
in TX

Employee Benefits Associate Attorney
Smith, Gambrell & Russell, LLP
in FL

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JPMorgan Chase
in CA, CO, IL, KS, NY, TX

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Focused Topics Web Series - Nondiscrimination Testing with Related Employers, Topic 2 of 12
March 31, 2014 WEBCAST
(SunGard Relius)

The Future of Wellness
April 2, 2014 in TN
(Crichton Group)

Legislative Updates
April 22, 2014 in TX
(ASPPA Benefits Council of Dallas/Fort Worth)

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[Guidance Overview]

Structuring Contracts with Staffing Agencies to Comply with Play or Pay Regulations
"In the preamble to the final regulations, the IRS seems to draw a distinction between 'temporary staffing firms' and 'staffing firms'.... where workers are obtained for short periods of time (for example, to meet temporary increases in production, or to cover for employees who are on short-term leaves of absence), the IRS seems comfortable with the idea that the workers are the common law employees of the temporary staffing firm, leaving the temporary staffing firm responsible for offering coverage and liable for paying penalties if coverage is not offered." (Warner Norcross & Judd LLP)  

[Advert.]

WEB's mission is to further the development of benefits professionals

We are committed to helping define the role of the benefits professional in the 21st century, and as changing market forces reshape the profession, WEB will help its members meet the challenges ahead.

[Guidance Overview]

Expanded NYC Sick Leave Law to Cover All Employers Regardless of Size
"With the amendments, New York City employers with five or more employees must provide at least five days of paid sick leave to employees. Employers with less than five employees must provide five days of unpaid sick leave to employees. Before the amendments, the law only required employers with 15 or more employees to provide paid leave. The law is set to go into effect on April 1, 2014. The amendments also expanded the definition of family member." (Clifton Budd & DeMaria, LLP)  

[Guidance Overview]

New Whistleblower Rules Impact Health Plan Sponsors
"No employer wants to have to defend its employment actions in an investigation, hearing, or court case. Having to prove that its actions were not based on retaliation by 'clear and convincing evidence' greatly adds to this burden. These whistleblower rules highlight why it is important for employers to clearly and appropriately document their reasons for taking employment actions. Careful compliance with PPACA, although helpful, will not shield an employer from these concerns -- even if an employee is wrong about the alleged PPACA violation or the employee accepted a subsidy based on incorrect information, he can still allege retaliation." (Winston & Strawn LLP)  

Employer Barriers to Adoption of Private Exchange Model
"[A recent survey] revealed that 45% of employers have implemented or plan to consider utilizing a private exchange for full-time active employees before 2018.... [O]ver 80% of employers consider the following to be barriers to adopting a private exchange-based healthcare benefits model: [1] Immaturity of the private exchange marketplace... [2] Stability or track record of exchange administrators... [3] Limited information about private exchanges... [4] Employee readiness... [5] Stability of cost over time." (Healthcare Trends Institute)  

Employers See Negligible Increase in Workers Participating in Job-Based Coverage
"[A]verage enrollment grew from 69.1 percent of workers last year to 69.3 percent. Meanwhile, the average percent of employees eligible for coverage grew from 84.9 in 2013 to 85.2 this year.... 10 percent of firms surveyed said they reduced the number of hours their employees worked or plan to do so in 2015, to avoid the 30-hour rule, while 14 percent said they made some other kind of change. 12 percent of firms -- up from about 9 percent -- said they instituted a surcharge for covering spouses who were eligible for insurance through their own jobs, with very large employers more likely to do so than those with fewer than 500 workers." (Kaiser Health News)  

[Advert.]

11th Annual World Health Care Congress - April 7-9 - National Harbor, MD

World-class faculty share innovative ideas, strategic initiatives, and best practices for shaping the future of health care delivery, affordability, and quality. BLINK3 for discount.

Health Mandate Won't Be Delayed, Sebelius Says
"Testifying before the House Ways and Means Committee, [HHS Secretary Kathleen] Sebelius said categorically that the administration would not delay the 'individual mandate' ... In addition, she said that officials would not extend the six-month open enrollment period, scheduled to end on March 31.... Ms. Sebelius said she did not know how many of the 4.2 million people selecting health plans had paid the premiums required to complete their enrollment. She said the data would be available when the government finished building a 'fully automated financial system' for the exchanges." (The New York Times; subscription may be required)  

The Future of Healthcare Benefits: Employers' Opportunity for Strategic Change in the New Healthcare World (PDF)
"The value proposition for private exchanges is likely to improve over time.... The private exchanges may enable more aggressive delivery-based strategies over time.... Key issues in 2014 are the employer 'pay or play' penalties and related reporting.... There is a big correlation between happy employees and business outcomes.... Much of the corporate interest in private exchanges is coming from leadership and finance, not HR." (PricewaterhouseCoopers)  

How Many Are Eligible for Account-Based Health Plans? (PDF)
"11.8 million adults ages 21-64 (9.7 percent of the U.S. population) were enrolled in a plan with an HRA or HSA. An additional 9.3 million reported that they were in an HSA-eligible plan but had not opened such an account. Thus, overall, about 21 million adults ages 21-64 with private insurance, representing 17.3 percent of that market, were either in a CDHP or an HSA-eligible plan but had not opened the account." (Employee Benefit Research Institute [EBRI])  

Health Reform 2014 Survey Results: Are We There Yet? (PDF)
37 presentation slides. Topics include: [1] Only minimal increase in employer health plan enrollment in 2014; [2] Employer response to the delay in the effective date (from 2013 to 2014) for penalties associated with the shared responsibility requirements; [3] Adjustments to workforce strategy to manage growth in the number of employees eligible for coverage in 2015; [4] Changes to health plan contribution strategy to manage growth in the number of employees electing dependent coverage. (Mercer, via Kaiser Health News)  

[Advert.]

Why Is This Guy Still on My Health Plan?

This March 27 webinar will discuss how to formally investigate whether the right individuals are participating in your plan, and how to address a participant or beneficiary who should not have been initially enrolled. Special BenefitsLink discount.

Health Care Reform: Full Steam Ahead (PDF)
10 pages. Topics in this 'Eighth Annual Study of Employee Benefits: Today & Beyond' include: [1] Employers have taken more action this year regarding benefits as a result of the increased impact of health care reform. [2] Employees anticipate positive and negative health care reform outcomes. [3] Despite their somewhat neutral view of exchanges, few employees would welcome migrating to one. [4] Brokers believe that TPAs and enrollment companies will benefit mutually from the rise in private exchanges. (Prudential)  

Obamacare CO-OPs Win Market Share, Defy Forecasts
"Obamacare opponents predicted early on that insurance co-ops created by the law would fail, and that much of the $2.1 billion they were loaned to get started would be lost. Instead, the 23 co-ops that now exist nationally have enrolled about 300,000 people in health plans by combining low premiums with a certain homespun appeal, according to company executives." (Bloomberg)  

So How Many Have Paid ACA Premiums?
"A White House official said the administration can't provide the more precise enrollment total because the data it receives from insurers are incomplete -- they come only from plans that are covering people who are getting federal subsidies to buy insurance. Those paying full price for their coverage are not included, the official said.... Insurance industry sources reject that assessment, noting that insurers are actually providing several streams of data -- not just from subsidized plans -- that give an accurate snapshot." (Politico)  

House Leaders Request Enrollment Numbers from Every Obamacare Insurance Provider
"House Energy and Commerce Committee leaders today sent letters to every insurance provider participating in the Federally-Facilitated Marketplace requesting specific enrollment data, including the number of individuals who have paid their first month's premium and those who are identified as previously uninsured. The letters seek data to create a more comprehensive picture of the health care law's enrollment as the White House has failed to provide a complete assessment." (Committee on Energy and Commerce, U.S. House of Representatives)  

CBO: Proposed Five-Year Individual Mandate Delay Would Mean 13 Million More Uninsured, Higher Premiums
"Consistent with earlier CBO and outside analyses of the effects of repealing the mandate entirely, the new CBO figures show that the bill ... would undermine health reform's implementation and produce serious harm. Without the individual mandate, many fewer uninsured people would enroll in job-based coverage, Medicaid and the Children's Health Insurance Program (CHIP), subsidized private coverage through health reform's new marketplaces, and other sources of health coverage." (Center on Budget and Policy Priorities)  

[Opinion]

Evolution of the HSA Toward Promoting Wellness
"HDHPs continue the trend of shifting financial decision-making from providers and insurers to patients and caregivers.... Does it make sense to constantly pay thousands of dollars every year to treat chronic medical conditions? Maybe investing funds in proactive, lower-cost alternatives that promote health and wellness should be the thought process for the future." (Altarum Institute)  

[Opinion]

Is the ACA Here to Stay?
"Among the many reasons that state leaders believe the ACA will remain in place are two key points: [1] Many states have already begun implementing the law and providing coverage, meaning a full repeal of the law would be complicated at best, if not impossible. [2] The law seems to be gaining traction and enrollments are on the rise. Nearly 3.3 million people have signed up through Feb. 1 for health care coverage under the law. The White House also reported that during the month of January alone, one million people across the country signed up for private insurance under the law." (William Gallagher Associates)  

Second Circuit: All Relevant Factors Must Be Considered in Awarding Attorney's Fees; Absence of Bad Faith Alone Is Not Sufficient
"[I]f a court chooses to consider factors other than a plaintiff's 'success on the merits' in assessing a request for attorneys' fees, Chambless still provides the relevant framework in this Circuit, and courts must deploy that useful framework in a manner consistent with our case law. A court cannot selectively consider some factors while ignoring others.... [The District Court] originally denied attorneys' fees on the sole basis that Liberty had not acted in bad faith. But we have explained that 'a party need not prove that the offending party acted in bad faith' in order to be entitled to attorneys' fees.... The District Court did not consider culpability, which we have found in circumstances analogous to those at issue here.... The District Court also did not address the 'relative merits' ... By inadequately addressing these two important factors and, instead, treating the absence of bad faith as the most salient factor, the District Court committed an error of law[.]" [Donachie v. Liberty Life Assurance Company of Boston, No. 12-2996-lv (2d Cir. Mar. 11, 2014)] (U.S. Court of Appeals for the Second Circuit)  

Fidelity Bonds and Fiduciary Liability Insurance: Do You Need Both?
"A fidelity bond is fixed at the beginning of each year for each plan official covered by the bond, and guards the applicable plan against losses due to fraud or dishonesty -- for example, theft -- by any covered plan official. Fiduciary insurance, on the other hand, is designed to insure the plan against losses caused by breaches of fiduciary responsibilities and, simultaneously, protect the covered fiduciary or fiduciaries from any personal liability resulting from such breaches." (Benefits Bryan Cave)  

Defendants See Success with Statute of Limitations Defenses After Heimeshoff Decision
"Defendants have recently received three favorable decisions involving contractual and statutory limitations defenses. In each case, a federal court held that claims for benefits under ERISA plans were time-barred.... In combination, the three cases, together with the authorities on which they rely, provide some increased hope to plan administrators and sponsors that, with proper administration, they can limit the risks of defending claims based on dated events." (Proskauer's ERISA Practice Center)  

The Other CEO Pay Ratio and Its Influence on Succession Planning
"In the wake of the [SEC's] proposed rules requiring disclosure of the ratio of CEO pay to that of the median employee, some observers have expressed interest in a different ratio: the one between the CEO's pay and that of the second highest-paid employee.... The theory is that a good succession plan means paying the likely successor more closely to the CEO to discourage the heir apparent from leaving for greener pastures. However, a recent study on the pay differences between the two highest-paid executives calls this logic into question." (Towers Watson)  

Shareholder Engagement: A Key Component of Improved Say-on-Pay Outcomes in 2014
"The fourth season of mandatory say on pay ... is under way and ... the vast majority of companies continue to receive good marks from shareholders regarding their pay programs. Based on the first 131 Russell 3000 companies to hold their 2014 meetings, average support for say-on-pay resolutions is 94% so far this year, up from 90% in 2013. While 2% of companies failed their say-on-pay votes last year, only one Russell 3000 company has failed this year as of March 10[.]" (Towers Watson)  

US Secretary of Labor Thomas E. Perez Announces New Appointments, Leadership for 2014 ERISA Advisory Council
Employee Benefits Security Administration (EBSA), U.S. Department of Labor

DALBAR Gives Securian Retirement's Quarterly Statements for Employees Its Highest Designation
Securian Retirement Services

Fidelity Enhances Mobile Experience With Workplace NetBenefits App for iPad
Fidelity Investments

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