Business Development Associate
Capital Strategies Investment Group
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Guardian Life Insurance Company
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Account Executive II - Retirement Services
The Principal Financial Group
in MO

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Fifth Third Bank
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Top Ten Corrections Not Covered by EPCRS
April 16, 2014 WEBCAST
(SunGard Relius)

Same Gender Marriage - Retroactivity: Plan Amendments
April 17, 2014 WEBCAST
(SunGard Relius)

Employment Relations Seminar: Keeping Your Workplace Healthy, Wealthy and Wise
April 29, 2014 in OH
(Porter Wright)

2014 Webinar: IRA Excess Contributions
May 1, 2014 WEBCAST
(Ascensus)

Medical Provider Claims and ERISA Litigation
May 8, 2014 WEBCAST
(Practising Law Institute)

Value Proposition Of A Private Exchange
May 22, 2014 WEBCAST
(Employee Benefit News)

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[Official Guidance]

Key Priorities for Compliance Reviews of Issuers and Plans on Federally-facilitated Marketplaces for the 2014 Benefit Year (PDF)
"CMS will perform compliance reviews of issuers offering Qualified Health Plans (QHPs) in the Federally-facilitated Marketplaces (FFM). For purposes of this document, QHPs include stand-alone dental plans, unless otherwise indicated.... CMS will review data at both the issuer and the QHP level. Policies, procedures and any other applicable documentation may be requested, as part of the compliance review process, to show compliance with issuer standards. As additional final regulations and operational guidance are published, those standards may be included as part of the compliance reviews ... [T]his list should not be construed as a comprehensive listing of all standards applicable to QHP issuers in the FFMs, nor a limitation on CMS' authority or ability to review compliance with standards not appearing on this list." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services)  

[Advert.]

4th Annual Prevention & Wellness Congress - May 7-8 - San Diego

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.

[Official Guidance]

Text of IRS PLR 201415011: VEBA Can Extend Benefits to Domestic Partners of Participants (PDF)
"Trust represents that the total amount Trust will expend to provide impermissible benefits to domestic partners who are not dependents ... would not exceed three percent (3%) [in any year of the Trust's operation] ... therefore, Trust's Section 501(c)(9) tax-exempt status will not be jeopardized.... [T]he HRA coverage provided to a domestic partner who is a dependent of a Participant within the meaning of Section 152 (or child as defined in Section 152(f)(1)) is not includible in the Participant's gross income.... The fair market value of the coverage provided by Plan to a non-dependent domestic partner of a Participant ... is includible in the gross income of the Participant under Section 61, and is wages for FICA, FUTA, and income tax withholding purposes. The amount of employee FICA attributable to the coverage that is paid by Plan on a Participant's behalf that is not withheld from the Participant's wages is also includible in the Participant's income, and is wages for employment tax purposes.... Trust is the employer under Section3401(d)(1) for purposes of the employment taxes on the amount of wages that result from the HRA coverage provided to a Participant's non-dependent domestic partner. Thus, Trust is required to withhold income tax and the employee portion of the FICA tax on such wages. Trust must also pay the employer portion of the FICA tax and the FUTA tax.... Trust may treat the coverage as provided on an annual basis for purposes of employment tax withholding." [Dated January 13, 2014; released April 11, 2014.] (Internal Revenue Service [IRS])  

[Guidance Overview]

CMS Issues Medicare Part D Benefit Parameters for 2015
"These parameters will be used by group health plan sponsors to determine whether their plans' prescription drug coverage is creditable for 2015. The information is needed for the disclosures that must be made annually and at other specified times to Part D eligible individuals and to CMS." (Thomson Reuters / EBIA)  

CMS Identifies Key Priorities for 2014 Compliance Reviews of Qualified Health Plans in the Federally Facilitated Marketplace
"These key priority areas include, among others: [1] ongoing compliance with issuer participation standards, [2] not employing marketing practice or benefit designs that will have the effect of discouraging enrollment of those with significant health needs, [3] executing appropriate delegation agreements with delegated and downstream entities, [4] ensuring compliance of appointed agents/brokers, [5] making sure that the provider network is sufficient so that services are accessible without unreasonable delay, and [6] ensuring that the qualified health plan (QHP) makes health plan applications and notices accessible to individuals in accordance with the Americans with Disabilities Act and for individuals with limited English proficiency." [Source document: Key Priorities for FFM Compliance Reviews for the 2014 Benefit Year.] (Epstein Becker Green)  

Eleventh Circuit Says Plaintiff Waived Her FMLA Rights by Signing Severance Agreement, Despite DOL Proscription Against Prospective FMLA Waivers
"According to the Court, it is well-settled that an employee may not waive 'prospective' rights under the FMLA, but an employee can release FMLA claims that concern past employer behavior. But what are 'prospective rights'? The Court said that such rights, under the FMLA, are those allowing an employee to invoke FMLA protections at some unspecified time in the future, so that an employee may not waive FMLA rights, in advance, for violations of the statute that have yet to occur. The Severance Agreement Paylor signed did not ask her to assent to a general exception to the FMLA, but rather to a release of the specific claims she might have based on past interference or retaliation. Hence, Paylor did not waive prospective rights." [Paylor v. Hartford Fire Insurance Company, No. 13-12696 (11th Cir. Apr. 8, 2014)] (Cary Kane ERISA Lawyer Blog)  

[Advert.]

BenefitsLink app for iPad, iPhone and iPod touch now available!

Stay up-to-date while you're on the go with the BenefitsLink App -- now available for iPad, iPhone 5, and iPod touch.

Ninth Circuit Finds Reconsideration of Benefit Denial Does Not Extend Statute of Limitations (PDF)
Summary provided by the Court: "[U]nder federal law, the plaintiff's claim accrued no later than the date her administrative appeal right expired, and the ERISA plan insurer's reconsideration of her claim did not revive the statute of limitation. The panel held that the ERISA plan was not estopped from asserting a statute of limitation defense based on the insurer's representation that the plaintiff could bring an ERISA action. Turning to California law for guidance, the panel held that the plan did not waive its statute of limitation defense based on the insurer's representation. Dissenting, Judge Reinhardt wrote that the plan waived its right to invoke the statute of limitation by inviting the plaintiff to reopen her case, submit new documents, and appeal if dissatisfied." [Gordon v. Deloitte & Touche, LLP Long Term Disability Plan, No. 12-55114 (9th Cir. Apr. 11, 2014)] (U.S. Court of Appeals for the Ninth Circuit)  

District Court Holds ERISA Plans Can't Recoup Overpayments from Healthcare Providers without Following Procedural Steps
"[A] federal district court in Illinois recently held that health plans may not simply unilaterally recover overpaid funds from health care providers, but rather must provide the appeal and other procedural protections required under the [ERISA] ... While it has long been the rule that ERISA's appeal and other procedural rights must be allowed when ERISA plans issue 'adverse benefit determinations' on claims submitted for reimbursement, it has not always been clear that these same procedures are required with respect to recoupment decisions." [Pennsylvania Chiropractic Association v. Blue Cross Blue Shield Association, No. 09 C 5619 (N.D. Ill. Mar. 28, 2014)] (Arent Fox)  

CBO's Estimate of the Effects of the Insurance Coverage Provisions of the ACA, Updated April 2014
"Relative to their previous projections made in February 2014, CBO and JCT now estimate that the ACA's coverage provisions will result in lower net costs to the federal government: The agencies currently project a net cost of $36 billion for 2014, $5 billion less than the previous projection for the year; and $1,383 billion for the 2015-2024 period, $104 billion less than the previous projections ... The estimates of the net costs for 2014 stem almost entirely from spending for subsidies that are to be provided through insurance exchanges (often called marketplaces) and from an increase in spending for Medicaid." (Congressional Budget Office)  

Health Care Reform Spurs Move to Defined Contribution Model
"Employers say the top two reasons for contemplating a switch to DC benefit models are to lower health care costs and to offer their employees more choice in the allocation of their benefit dollars (59% and 40%, respectively). Employees report they would allot 75% of their benefit dollars to health, dental, and vision coverage, leaving 25% for other coverages such as voluntary life, disability, accident, and critical illness insurance. Even with this allocation by employees, 42% of brokers feel the shift to DC plans will lead to an uptick in sales for voluntary products." (Prudential)  

Middle Market Employers See Twofold Increase in Wellness Programs in 2013
"The highest percentage of plans offering wellness programs came from employers with 1,000 or more employees (58.2%), however, middle market employers with 100 to199 employees increased their wellness offerings by approximately 12.5% in 2013 -- double that of any other employer size subset. Surprisingly, employers with 1,000-plus employees decreased their wellness offerings by 0.7%." (United Benefit Advisors)  

Top 10 Ways Companies Cut Healthcare Costs
"The most implemented strategies of top performers last year: Procured a pharmacy benefit manager in an attempt to tamp down pharmaceutical costs; Provided employees with healthcare cost transparency ... Contributed funds to employees' health savings accounts ... The most popular strategies for 2014: Make plan design changes after analyzing how they'll impact other parts of employee compensation -- like retirement contributions and salary ... Increase employee contributions in tiers with dependent coverage at a higher rate than individual coverage ... Adopt payment methods that hold healthcare providers more accountable for the quality and cost of care; Offer telemedicine programs[.]" (HR Benefits Alert)  

Employers Shouldn't Strike Out on Leave for New Dads
"The criticism that Mets second baseman Daniel Murphy has drawn ... after heading to Florida for his son's birth, and the backlash that criticism inspired, should serve as a reminder for employers that despite any socially entrenched aversion to paternity leave that may exist, laws such as the [FMLA] -- and possibly Title VII -- protect new dads' rights to take time off ... But offering some paid time off for new dads isn't a silver bullet, because a parental leave policy that treats men and women differently could inspire a worker to bring a private suit or even catch the attention of the [EEOC]." (Mintz Levin, via Law360)  

[Opinion]

Flaws in Bobby Jindal's Health Reform Proposal
"Like the Republican Study Committee's plan, Jindal's proposal replaces the current exclusion of employer-based tax benefits with a standard tax deduction. The problems: It is regressive, giving more tax relief, the higher your income tax bracket. It is not helpful to the half of the population that does not pay income tax." (John Goodman's Health Policy Blog)  

[Opinion]

The Twilight of the British Public Health System? (PDF)
"The NHS -- like all health care systems -- is, and always has been, imperfect. Yet replacing it with a semi-privatized, commercialized, corporatized, and fragmented body -- still funded by general taxation but otherwise a pale reflection of its former self -- will only exacerbate its weaknesses, while hollowing out its universal, moral core." (Andrew Gaffney, in Dissent)  

Alternatives for Severance Payments After Supreme Court Nixes FICA Tax Break for Downsizing Firms (PDF)
"A company with a defined benefit pension plan may be able to amend the plan to increase the benefits of laid-off workers, then give them the option of receiving the increase as a lump sum or in installments over a relatively short period. Distributions from qualified plans are exempted from FICA wages by section 3121(a)(5). The need for care arises from a variety of obstacles, including nondiscrimination requirements, restrictions on lump sum and installment payments by underfunded pension plans and penalty taxes on participants who receive distributions before age 55. The possible savings for both companies and workers may nonetheless make this alternative attractive where it is feasible." (Steptoe & Johnson LLP)  

Executive Pay: Invasion of the Supersalaries
"The current system of executive compensation, with its emphasis on performance, can theoretically constrain pay, but in practice it has not stopped companies from paying their top executives more and more.... Economists have long known that high executive pay has contributed to the widening gap between the very rich and everyone else. But the role of executive compensation may be far larger than previously realized." (The New York Times; subscription may be required)  

Pay for Performance? It Depends on the Measuring Stick
"[P]ay for performance is only as good as the metrics used to determine it. And as a recent study shows, some metrics -- including the most popular -- are downright ineffective at motivating executives to create shareholder value.... Some boards award incentive pay based on a company's total shareholder return or earnings-per-share growth; others use return on invested capital or return on equity. Most companies use more than one measure. And all argue that their methods justify the incentive pay they award." (The New York Times; subscription may be required)  

TIAA-CREF to Purchase Nuveen Investments
TIAA-CREF

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