Pension Plan Administrator - DB/DC
Primark Benefits
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NRECA
in VA

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Cammack Retirement Group
in NY

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Lincoln Financial Group
in ANY STATE

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Producing TPA
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Best Practices for 3(16), 3(21) and 3(38) Fiduciaries
March 18, 2014 WEBCAST
(Transamerica Retirement Services)

Know Your Fiduciary Responsibilities -- Day 1: Basic Fiduciary Responsibilities
March 19, 2014 WEBCAST
(Employee Benefits Security Administration (EBSA), U.S. Department of Labor)

The Facts to Combat the Fiction When Assessing Fiduciary Risk
March 20, 2014 WEBCAST
(Multnomah Group)

Know Your Fiduciary Responsibilities -- Day 2: ERISA Reporting and Disclosure Provisions and Voluntary Correction Programs
March 20, 2014 WEBCAST
(Employee Benefits Security Administration (EBSA), U.S. Department of Labor)

Know Your Fiduciary Responsibilities -- Day 3: Basic Fiduciary Responsibilities
March 26, 2014 WEBCAST
(Employee Benefits Security Administration (EBSA), U.S. Department of Labor)

Oncology Management: The Aetna Experience in Personalized, Value-Based Care
April 9, 2014 WEBCAST
(Atlantic Information Services, Inc)

View All Webcasts and Conferences

[Official Guidance]

Text of CMS FAQ on Nondiscrimination in Healthcare Coverage of Same-Sex Spouses (PDF)
"Q: If a health insurance issuer in the group or individual market offers coverage of an opposite- sex spouse, may the issuer refuse to offer coverage of a same-sex spouse? No.... This section does not require a group health plan (or group health insurance coverage provided in connection with such plan) to provide coverage that is inconsistent with the terms of eligibility for coverage under the plan, or otherwise interfere with the ability of a plan sponsor to define a dependent spouse for purposes of eligibility for coverage under the plan. Instead, this section prohibits an issuer from choosing to decline to offer to a plan sponsor (or individual in the individual market) the option to cover same-sex spouses under the coverage on the same terms and conditions as opposite sex-spouses." (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

[Official Guidance]

Text of CMS Casework Guidance for Issuers in Federally-Facilitated Marketplaces, Including State Partnership Marketplaces (PDF)
"In most QHP-related matters, the [Health Insurance Marketplace] Call Center and HHS will direct consumers to the QHP issuer to address their concerns, disputes, and grievances. HHS strongly believes the best source for the resolution of issues involving a QHP is the QHP issuer, along with any other appropriate state resource. Consequently, HHS will notify QHP issuers of casework from consumers, providers, and other stakeholders and expects issuers to work in close contact with HHS to facilitate satisfactory resolution of cases within the time periods specified in 45 C.F.R. 156.1010.... The HHS casework tracking system will help provide oversight and accountability for QHP issuers, to help ensure that QHP issuers are appropriately responsive to consumer cases.... HHS will work with consumers and their authorized representatives directly if it becomes apparent that the QHP issuer is not working to resolve the concern, dispute, or grievance pursuant to the regulatory timeframes." (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

[Guidance Overview]

HIPAA: Health Care, Employers, Confusion, and Controversy
"The core problem is that the line between the 'group health plan' and the employer/plan sponsor is a legal fiction. HHS has established a regulatory framework, covering virtually every employer that provides any kind of health benefits to its employees, which is based on the idea that there is a distinction between this 'group health plan' and the 'plan sponsor' of that health plan.... So, HHS has created a complicated set of regulatory provisions based on a legal fiction. Therefore, there has always been real confusion about even these core rules." (Wiley Rein LLP via Lexology; free registration may be required)  

[Guidance Overview]

Final Regs Streamline ACA Reporting Rules
"The final regulations include two alternative methods by which a large employer may satisfy its Section 6056 reporting obligation. These alternative methods are designed to minimize the costs and administrative burdens for employers by not requiring monthly, employee-specific reporting.... The plan administrator of a multiemployer plan may prepare the returns under Section 6056 that pertain to the full-time employees who are covered by an applicable collective bargaining agreement and who are eligible to participate in the multiemployer plan. The contributing employer would then prepare the returns pertaining to its remaining full-time employees (i.e., those who are not eligible to participate in the multiemployer plan)." (Spencer Fane)  

[Guidance Overview]

Final Regs Issued Regarding Employer Reporting Requirements Under ACA
"Recently issued final regulations on the employer reporting requirements under the [ACA] clarify and streamline the process for reporting information relating to the provision of minimum essential coverage and health insurance coverage offered under employer-sponsored plans.... Most significantly, the final regulations permit an employer to satisfy its reporting obligations using a combined single form." (McDermott Will & Emery)  

[Advert.]

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A revolutionary agenda that moves beyond Wellness 101 and lays out the framework for real discussion and real idea exchange through real employer experiences. Challenge the way you think about wellness and reposition your program. BLINK3 for discount.

[Guidance Overview]

Final Regs Implementing ACA 90-Day Waiting Period Limit Include Multiemployer Example
"The example refers to a multiemployer plan that aggregates hours in a calendar quarter. If enough hours are earned in that quarter, the plan provides coverage on the first day of the next calendar quarter. The final rule notes that such a plan has an eligibility provision that is designed to accommodate a unique operating structure and, therefore, is not considered to be designed to avoid compliance with the 90-day waiting period limitation." (Segal)  

Can an Employer Designate FMLA Leave When an Employee Refuses to Provide Medical Certification?
"Where an absence may trigger the FMLA, it's always advisable to obtain medical certification. That said, it is not necessary to obtain medical certification in order to designate the absence as FMLA leave." (FMLA Insights)  

Private Health Exchanges: Who's Buying It?
"[M]ost mid-size employers ... can save six-to-eight percent through self-funding their health plan instead of choosing a fully insured plan.... Some private exchanges offer self-funded health plans, but by choosing this option the employer gives up its ability to customize its plan design. In essence, the employer switches from controlling the costs and results of its in-house administration to paying for the exchange's administration. If the exchange offers multiple carriers and plan options, the employer may see increased costs from the added complexity of having employees with vastly different health plans." (Marsh Consulting Group)  

Evaluation of Tools and Metrics to Support Employer Selection of Health Plans (PDF)
91 pages. Excerpt: "The report describes a conceptual framework of health plan features, evaluates the current availability of quality measures and decision tools to employers, and describes how employers make decisions when choosing a health plan. This report will be of interest to national and state policymakers, employers and employer coalitions, consumer advocacy organizations, measures developers and health researchers, and others with responsibilities related to achieving better transparency on the quality that different health plans provide and facilitate employer decisionmaking." [Editor's note: The report is dated 2013, but it was first announced and posted online by DOL on March 12, 2014.] (RAND Corporation, produced for the U.S. Department of Labor)  

17 States and Washington, D.C., Implementing 'SHOP' Health Insurance Marketplaces for Small Businesses; Most Offer Competitive Choice of Plans and Insurers
"Nearly all states have opted to offer small employers a key feature generally not available outside the SHOP marketplaces: the ability to offer employees a choice of plans from multiple insurers, while making predictable contributions towards coverage. Seven states ... have chosen to go beyond the law's requirements by allowing employers to give employees the choice of any plan in the SHOP marketplace.... For 2014, the 14 states that, along with the District of Columbia, are allowing employers to offer a choice of plans also make it possible for employers to make a fixed premium contribution toward their employees' insurance, regardless of which plans workers choose." (The Commonwealth Fund)  

Behind the Numbers: 2014 Health Care and Medical Cost Trends
"Defying historical patterns -- and placing added tension on the health industry -- medical inflation in 2014 will dip even lower than in 2013. Aggressive and creative steps by employers, new venues and models for delivering care, and elements of the [ACA] are expected to exert continued downward pressure on the health sector." (PricewaterhouseCoopers)  

Looming Healthcare Tax Lights a Fire Under Corporate America
"The nation's largest employers are leading the trend toward consumerism, relying increasingly on employees to share more of the costs and manage expenses at a time when household budgets and family to-do lists are stretched to the limit. Fortunately, corporate benefit directors have been gearing up to guide employees through the process of being smarter consumers of healthcare while also helping them to stay as healthy as possible." (HealthLeaders InterStudy)  

ACA Is Not Hurting Companies' Performance
"Many ACA-related costs are fairly niggling and aren't cumulatively great enough to move the needle on profit for most companies. But there were some potentially legitimate concerns. For one, some employers had fretted that the ACA's newly effective individual mandate would drive many workers who previously hadn't signed up for coverage to reverse course. As things turned out, they had little to fear." (CFO)  

Insurers May Get Cost Break Thanks to Rocky ACA Rollout
"Carriers had to scramble when the administration announced that consumers could keep substandard plans that were previously doomed under the health law. The shift required extra mailings and call-center resources for many insurers.... [T]he administration will propose temporarily allowing a higher proportion of premiums to be spent on administrative costs. It's unclear exactly which expenses will qualify for the exemption and when the rules will be proposed." (The Washington Post; subscription may be required)  

[Opinion]

Does Obamacare Deserve the Credit (or Blame) for Rising Deductibles?
"[It] is not possible for employers to shift 'costs and responsibility' for health benefits onto workers because workers always bear 100 percent of the cost and responsibility for their health benefits. In our employer-based system, money is siphoned away from their wages before it even hits their paychecks. This is one reason why wages have stagnated for years: More compensation has come as benefits. A consumer-driven health plan puts more health-care dollars under patients' control than under control of insurers and employers.... [It] is hard to fathom how this shift of control benefits employers." (John Goodman's Health Policy Blog)  

Would an IRA Withdrawal Count as Income for Exchange Subsidies?
"Withdrawals from traditional or rollover IRAs would be considered income for the purposes of calculating modified adjusted gross income, the figure on which eligibility for premium tax credits on the exchanges is based ... A withdrawal from a Roth IRA, however, would not count as income in this case because the individual would already have paid taxes on that income when he made the retirement contribution.... [W]ithdrawing enough money from a taxable IRA to bring [an individual] up to the poverty level could enable him to qualify for premium tax credits." (The Washington Post; subscription may be required)