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Hand-picked links to the web's best news articles,
official guidance, jobs, webcasts and more.
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[Official Guidance]
Text of Rev. Proc. 2014-30: 2015 Inflation-Adjusted Amounts for Health Savings Accounts (HSAs) (PDF)
"For calendar year 2015, the annual limitation on deductions under Section 223(b)(2)(A) for an individual with self-only coverage under a high deductible health plan is $3,350. For calendar year 2015, the annual limitation on deductions under Section 223(b)(2)(B) for an individual with family coverage under a high deductible health plan is $6,650. For calendar year 2015, a 'high deductible health plan' is defined under Section 223(c)(2)(A) as a health plan with an annual deductible that is not less than $1,300 for self-only coverage or $2,600 for family coverage, and the annual out-of-pocket expenses (deductibles, co-payments, and other amounts, but not premiums) do not exceed $6,450 for self-only coverage or $12,900 for family coverage."
(Internal Revenue Service [IRS])
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[Guidance Overview]
2015 Transitional Reinsurance Fee and Out-of-Pocket Limits
"Self-insured health plans may use one of the following methods to determine the number of covered lives under their major medical coverage: [1] An actual count of the number of covered lives over the first three quarters of the year.... [2] A snapshot count, which totals the number of lives covered on representative dates in each of the first three quarters of the year.... [3] The snapshot factor method ... [where] the number of lives covered on a date is calculated by multiplying the number of employees with family coverage by 2.35 and then adding it to the number of employees with self-only coverage.... [4] The Form 5500 method, which obtains the number of lives covered from the most recently filed Form 5500."
(Towers Watson)
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With Cadillac Tax Looming, Employers Scale Back on Medical Plan Designs
"[A recent] report shows a steady increase in the number of medical plans with individual, in-network out-of-pocket maximums (OOPMs) of $2,500 or more. In 2014, 2/3 of plans have OOPMs of at least $2,500. In 2013, it was 58%, and in 2012, it was 49%. The percentage of plans with high deductibles grew by three percent in 2014 from 23% to 25%. Also, more plans charge coinsurance for office visits, up to 42% in 2014, from 35% in 2013. Emergency room (ER) And average costs for visits to the ER have been rising slightly, about $3 per year since 2009, with a 2014 average of $113 per visit."
(Wolters Kluwer Law & Business)
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Private Health Insurance Exchanges: Tax and ERISA Issues (PDF)
9 pages. Excerpt: "Private exchanges are largely unregulated as an entity, raising persistent concerns regarding the potential application of ERISA and tax rules for health plans.... [N]ew complexity surrounding the use of HRAs to fund employer-sponsored plans has caused private exchange sponsors to reevaluate the use of HRAs as a vehicle for funding employer premium subsidies. Although it appears that current HRA integration rules should apply to coverage offered on a private exchange, the guidance to date has not addressed the use of HRAs alongside private exchange coverage, and the path to full compliance remains unclear."
(Sutherland)
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Some Things Are Worth Repeating: Beware of PTO Cash-Outs!
"Most people ... have a hard time appreciating why an employee with hundreds of hours of unused PTO would be taxable on the value of PTO that they do not either take or cash out. But ... 'constructive receipt' can make a person taxable on income (cash) that the person could take, but chooses not to.... Employers with such policies have almost certainly under-reported income taxes and payroll taxes!"
(Focus on Public Benefits)
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Sixth Circuit Decision Highlights Importance of Antitrust Considerations in Health Care Consolidation Planning
"Finding that the merger would increase ProMedica's pricing and bargaining power in an already compressed market without creating any procompetitive efficiencies to offset these anticompetitive effects ... the administrative law judge ordered ProMedica to divest St. Luke's.... The Sixth Circuit [on April 22] concurred ... Coupled with the recent decision ... which ordered the complete divestiture of an Idaho hospital's acquisition of a large physician group following a similar challenge by the FTC, [this] decision reinforces the FTC's continuing focus on the health care industry and highlights the crucial importance of antitrust considerations and analysis in the evolving health care marketplace. " [ProMedica Health System, Inc. v. Federal Trade
Commission, No. 12-3583 (6th Cir. Apr. 22, 2014)]
(Vorys, Sater, Seymour and Pease LLP)
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California Court Finds Fitness-for-Duty Exam after Employee Restored to Job is Permitted under FMLA
"[The employee] argued that, once her physician certified her to return to work, the [employer] could not require her to undergo a fitness-for-duty evaluation because the evaluation would undermine her return-to-work certification. The Court rejected this argument.... [and] concluded, 'the FMLA should be interpreted to render the employee's health care provider's opinion conclusive on the issue of whether the employee should be immediately returned to work, but to permit the employer to thereafter require a [fitness-for-duty evaluation], if it has a basis to question the employee's health care provider's opinion.'" [White v. County of Los Angeles, No. B243471 (Cal. Ct. App. Apr. 15, 2014)]
(Jackson Lewis LLP)
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Text of Amicus Brief by 38 Members of Congress Supporting Challenge to Administration's Enforcement of ACA (PDF)
35 pages. Excerpt: "Instead of faithfully implementing and executing the ACA, the Executive Branch has claimed open-ended authority to suspend or modify that law. The result has been a wholesale rewrite of the ACA by executive fiat.... In its initial implementation of the ACA, the Executive Branch eviscerated the grandfathering protection by promulgating regulations eliminating grandfathered status whenever insurance plans make even the most minor adjustments over time (which all of them must inevitably do).... [By] fiat, the Executive has now suspended [the employer mandate and reporting requirements] by twice postponing their effective date. Even worse, the second of the suspension orders purports to modify substantive law as well as effective dates, and to create regulatory categories with no statutory basis whatsoever."
(Judicial Education Project and 38 Members of the United States Congress)
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Visualizing Health Policy: A Snapshot of U.S. Global Health Funding
"[This] infographic shows global health funding's share of the U.S. federal budget, the flattening of U.S. funds for global health during the 21st century, where U.S. dollars for global health are spent, the major areas receiving U.S. global health funding, and how the U.S. public overestimates the percentage of the federal budget that is spent on foreign aid."
(Kaiser Family Foundation)
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[Opinion]
Changes to Current Population Survey Questions About Health Insurance Coverage Are Devastating
"To drop everything that has gone before in favor of a brand new set of questions is unprecedented. And to do so at the very moment of the biggest revision of health care in American history is completely irresponsible. We simply will not be able to compare before and after ObamaCare, at least not based on the CPS. This is a tragedy."
(John Goodman's Health Policy Blog)
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[Opinion]
Obamacare: Observations from the Marketplace
"About half of the enrollments are coming from people who were previously insured and half are not.... About 15% to 20% of new enrollees are not completing their first month's enrollment by not paying their premium... The back-end of HealthCare.gov, that reconciles enrollment between the feds and the health plans, is still not fully built and won't be for months to come.... There is a lot of dissatisfaction being communicated from consumers to insurance company call centers and their agents about the new health insurance plans, particularly compared to the plans people are used to.... What will the 2015 rate increases be? 9.9%... Will any health plans exit the Obamacare exchange markets in 2015? No."
(Bob Laszewski's Health Care Policy and Marketplace Review)
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Benefits in General; Executive Compensation
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Does Use of Non-GAAP Performance Metrics Mean Executives are Gaming the System?
"[W]hile the Audit Analytics study found an increase in the prevalence of non-GAAP metrics in incentive plans over the past few years, this likely reflects the fact that companies are adopting plans that incorporate the key metrics being presented to investors in corporate financial statements.... A key to proper target setting is consistent application of the metric between when the target is set and when performance is evaluated. If certain aspects of the financial statement are being excluded from a non-GAAP incentive metric ... it shouldn't result in higher incentive awards as long as they are excluded consistently from both the initial budgeted level of performance and actual performance."
(Towers Watson)
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[Opinion]
Fast Food Failure: How CEO-to-Worker Pay Disparity Undermines the Industry and the Overall Economy
"Accommodation and Food Services had a CEO-to-worker pay ratio of 543-to-1 in 2012. Over the period from 2000 to 2012 the average ratio was 332-to-1, 44 percent higher than the sector with the next-highest compensation ratio. In 2012, the compensation of fast food CEOs was more than 1,200 times the earnings of the average fast food worker.... [T]he ratio remained above 1,000-to-1 in 2013.... Fast food workers are the lowest paid in the economy.... The most unequal sectors are among those providing the greatest numbers of new jobs in the economy, replacing jobs in sectors with lower income inequality."
(Demos)
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Press Releases
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