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Employee Benefits Jobs
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Webcasts and Conferences
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Hand-picked links to the web's best news articles,
official guidance, jobs, webcasts and more.
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[Guidance Overview]
How to Estimate ACA Employer Penalty Costs
"[L]arge employers that have a monthly average of 50-99 employees may apply for transitional relief if the employer meets three specific criteria. If the criteria are met, an employer will not be required to offer health insurance to their full-time employees until January 1, 2016. If an employer does not meet the three criteria or chooses not to apply for relief, the employer must offer health insurance beginning on January 1, 2015.... [A]ny penalty that an employer is liable for due to the ACA will not receive a tax benefit as a cash expense to the business."
(Adam Kantrovich and Dave Schweikhardt, Michigan State University Extension)
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[Guidance Overview]
Final ACA Reporting Requirements (PDF)
8 pages. Excerpt: "The final rules clarify that the Section 6055 reporting is meant for [Minimum Essential Coverage (MEC)] only, not for supplemental coverage. Thus the IRS does not require reports for health reimbursement arrangements (HRAs) tied to a medical plan or for onsite clinics, wellness plans or any other medical benefits ancillary to the MEC."
(McGraw Wentworth)
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[Guidance Overview]
IRS Addresses HRA Coverage for Non-Dependent Domestic Partners
"[PLR 201415011] is consistent with other rulings on the tax treatment of health coverage for non-dependent domestic partners but is noteworthy because the health plan at issue is expressly identified as an HRA. The ruling is also consistent with previous informal agency comments on providing HRA coverage to non-dependent domestic partners and the ability to withhold on an annual basis when non-dependent health coverage is provided.... Note that providing HRA coverage to non-dependents raises issues not addressed in the ruling, such as how to determine the coverage's fair market value. To date, the IRS has not approved any particular valuation method and has avoided ruling on such matters."
(Thomson Reuters / EBIA)
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[Guidance Overview]
Section 125 Rollovers and Health Savings Accounts (PDF)
"[IRS Chief Counsel Memorandum 201413005] addressed the impact of the FSA rollover on HSA contributions. The memo covered seven different scenarios related to FSA rollovers and HSA contributions. The good news is that employers can offer options that employees could elect that would not block them from contributing to an HSA if the employer plan offered a year-end FSA rollover."
(McGraw Wentworth)
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On the Way: Employee Premium Tax Credit Notices from Exchanges
"[E]mployers should be prepared to start receiving notices from the exchanges to indicate if an employee has received a premium tax credit. Since the employer mandate was delayed until 2015 or 2016 depending on the size of the employer, these notices are not as important this year as they will be in 2015 and beyond. However, employers need to have a procedure in place[.]"
(Wolters Kluwer Law & Business)
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Sixth Circuit Rejects Change of Union Retirees' Coverage from Group Health Plan to HRA (PDF)
"[The Court finds] that the unilateral implementation of the HRAs breached the [collective bargaining agreements], not because HRAs are 'unreasonable' ... but because the HRAs are simply not what the parties bargained for in the first instance. Again, upon the commencement of their retirement, plaintiffs were entitled to the continuation of the same coverages they had as employees. Upon retirement, they all had company-provided group health insurance coverage, with Kelsey-Hayes paying the full premium for that insurance. The HRAs are not company-provided group insurance; they are health care vouchers -- essentially cash.... [F]ar from the company paying the full premium, the HRAs shift significant risks, including the potential costs of medical care, from the company to plaintiffs." [United Steel, Paper and Forestry, Rubber, Manufacturing Energy, Allied Industrial And Service Workers
International Union, AFL-CIO-CLC v. Kelsey-Hayes Company, No. 13-1717 (6th Cir. Apr. 22, 2014).]
(U.S. Court of Appeals for the Sixth Circuit)
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Resources for Frequently Asked Questions About the ACA (PDF)
18 pages. Excerpt: "This report provides resources to help congressional staff respond to constituents' frequently asked questions (FAQs) about the law. The report lists selected resources regarding consumers, employers, and other stakeholders, with a focus on federal sources. It also lists CRS reports that summarize ACA's provisions."
(Congressional Research Service)
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PTO Policy: What Are Your Obligations as an Employer?
"There are several ways to get more out of a paid time off policy at your company, including: [1] Giving employees the chance to self-schedule paid time off ... [2] Using a paid time off accrual system that encourages employees to have good attendance levels throughout the year; [3] Offering alternatives to standard paid time off, such as giving employees the option to volunteer in the community in exchange for more hours off; [4] Flexibility that makes it possible for employees to use up their paid time off days with 1-2 last minute personal days... [5] Saving up or rolling over a portion of unused paid time off into the next year[.]"
(PayScale)
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Understanding the Full Ramifications of 'If You Like Your Current Plan ...'
"Every small employer will lose their current plan (unless grandfathered) over the next two years. This is guaranteed because of the strict requirements under Obamacare. These requirements include a provision called Actuarial Value (AV). AV is the amount of the average claims an insurance plan must pay under a policy. If a plan falls outside of one of the four narrow bands it must be eliminated."
(InsureBlog)
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Key Compliance Messages in New HIPAA Settlements: Encrypt Mobile Devices, and Clean Up Management Documentation
"Along with the importance of encryption, however, [two recent] Resolution Agreements also contain equally significant, more broadly applicable lessons to Covered Entities, business associates and their leaders about some of the specific processes, actions and documentation that OCR them to implement and be prepared to defend the adequacy of their HIPAA 'culture of compliance' if they file a breach report or otherwise face a HIPAA audit or investigation from OCR."
(Solutions Law Press)
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ACA Insurance Policies Pose Actuarial and Rate Challenges for Insurers
"'We're working with about a third of the information that we usually have,' said Brian Lobley, senior vice president of marketing and consumer business at Pennsylvania's Independence Blue Cross.... [C]arriers selling medical plans on HealthCare.gov must file initial 2015 rate requests with federal regulators in late May or June -- even though they have little idea about the health and potential costs of their newly enrolled members.... WellPoint, the biggest player in the online exchanges, is talking about double-digit rate hikes for 2015."
(The Washington Post; subscription may be required)
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Consumer-Driven Health Plans Help Employees 'Own' Their Healthcare
"Cigna CDHP customers were nearly 50 percent more likely to complete a health risk assessment, and those with a chronic illness were up to 41 percent more likely to participate in a disease management program than those enrolled in a traditional plan.... Cigna CDHP medical cost trend was 12 percent lower than traditional plans during the first year. Cumulative savings over 5 years of $7,900 per employee can be achieved. Cost reductions were achieved without employers shifting out-of-pocket health expenses to their employees."
(Healthcare Trends Institute)
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New York Will Not Require Out-of-Network Coverage for ACA Plans
"New York State health officials said on [April 25] that they would not require out-of-network coverage on [ACA] health plans next year, a decision likely to disappoint customers who have complained that they can no longer use their favorite doctors and hospitals. Restricting consumers to a fixed network of doctors and hospitals, called in-network coverage, helps keep costs down, and for the first year, none of the 16 insurance companies in New York's exchange deviated from that model."
(The New York Times; subscription may be required)
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Who Really Pays for Health Care?
"If you're insured through an employer that files an income tax return, your coverage is heavily subsidized by the feds.... Business spends more than half a trillion dollars annually on employee health care.... The household portion of the health spending pie shrank from 37% in 1987 to 28% in 2012. It's still larger than the federal government's 26% share or business's 21%.... If your company has at least 500 workers, it is probably self-insured. In such plans, the employer is the insurance company. And it's the employer calling the shots."
(USA TODAY)
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Overview of CMS Surveys of Marketplace and QHP Enrollees (PDF)
"This issue brief provides background information about two new consumer experience surveys authorized by the [ACA]. The surveys measure consumer experience with the Health Insurance Marketplaces and Qualified Health Plans. Both were developed by the [CMS] with support from American Institutes for Research (AIR)."
(Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services)
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[Opinion]
Text of Comments by U.S. Chamber of Commerce to EBSA on 90-Day Waiting Period Limitation Proposed Rule (PDF)
"We urge the Departments to clarify the interplay between these two requirements in instances where employees are not known to be full-time employees, given the regulatory framework for determining the full-time employee status of variable-hour, part-time, and seasonal employees who are not reasonably expected or hired to work full-time. The Chamber asks that the Departments clarify that the 90-day waiting period limitation does not require employers to provide minimum essential coverage effective after 90 days of employment to those employees who have not (or have not yet been determined to have ) met full-time employee status, should that be an eligibility requirement."
(U.S. Chamber of Commerce)
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[Opinion]
How Should Doctors Get Paid?
"[M]any patients are shocked to hear that doctors essentially cannot bill for any work that isn't done face to face with a patient. This fact, not technophobia, is probably the biggest reason why doctors and patients aren't emailing ... Taking a primary care physician away from direct patient care for just an hour can cost the employer somewhere around $400 in lost revenue. In today's economic climate, few health care organizations can afford to fully embrace the notion of all the different indirect care activities others think physicians should engage in besides seeing patients one by one for a fee."
(The Health Care Blog)
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[Opinion]
Text of Comments by American Benefits Council to EBSA on 90-Day Waiting Period Limitation (PDF)
"The Proposed Rules provide that a reasonable and bona fide employment-based orientation period may not exceed one month, and the maximum 90-day waiting period would begin on the first day after the orientation period.... [We] support the proposal that a determination of whether an orientation period is 'reasonable' and 'bona fide' be made on a facts-and-circumstances basis, as this provides needed flexibility to employers to tailor the orientation period to the needs of their employees and business practices."
(American Benefits Council)
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Benefits in General; Executive Compensation
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[Guidance Overview]
Employee Benefits in Post-DOMA Minnesota
"Until recently, the State of Minnesota recognized marriage only between individuals of opposite sexes and did not officially recognize any sort of 'civil union' or 'domestic partnership' between same-sex partners. Legislation legalizing same-sex marriage ... took effect August 1, 2013.... The changes in the law require Minnesota employers to offer spousal benefits under both state and federal law to spouses in same-sex marriages, regardless of the state in which the marriage occurred."
(Moss & Barnett)
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Employer Must Prove Physical Presence in Workplace is Essential Function, Sixth Circuit Rules
"Likely making it easier for employees to telecommute from home as an accommodation under the Americans with Disabilities Act, the [Sixth Circuit] has determined that 'attendance' is no longer synonymous with physical presence in the workplace.... Employers should be prepared to identify the job requirements that cannot be performed remotely. Further, employers who must accommodate an employee should plan for the related employment issues that go along with working from home, including tracking hours for non-exempt employees, monitoring employee productivity and performance remotely, and maintaining data privacy and security of sensitive company and client information when this information is accessed remotely or maintained at an employee's residence." [EEOC v. Ford Motor Company, No. 12-2484 (6th Cir. Apr. 22, 2014)]
(Jackson Lewis LLP)
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Sixth Circuit Affirms Claim Denial and Penalty for Failure to Provide Plan Documents
"With this decision, the Sixth Circuit joins several other appellate courts in adopting the 'clear notice' standard and provides a reminder to review document requests carefully and interpret them broadly. Documents may need to be furnished even if the request does not identify them by name, and per-day penalties can add up quickly. In addition, among other best practices, the SPD should clearly identify the address to which written document requests should be delivered, in order to avoid delays caused by misdirected requests." [Cultrona v. Nationwide Life Ins. Co., Nos. 13-3558/3585 (6th Cir. Apr. 9, 2014)]
(Thomson Reuters / EBIA)
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Considerations for Transitioning Out of a Professional Employer Organization
"While PEOs can provide a good employee benefits solution for a small company in the early stages of development, they will not necessarily be a cost-effective way to provide benefits once the company has grown. After crossing the 25-employee threshold, it becomes critical to consider other options for providing competitive employee benefit programs. Employers must be cognizant of the many cost, transitional and investment control issues that come with using a PEO."
(William Gallagher Associates)
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Press Releases
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