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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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[Official Guidance]
Text of IRS Correction to Final Regs on Information Reporting of Minimum Essential Coverage
"[A sentence is corrected to read as follows:] 'For example, a reporting entity that makes an unsuccessful initial solicitation for a TIN in December 2015 must make the first annual solicitation by January 31, 2016. The second annual solicitation must be made by December 31, 2016, to have acted in a responsible manner. Assuming that request is also unsuccessful, the reporting entity would not be penalized if its section 6055 reporting submitted in early 2017 reported a date of birth in place of TIN for the individual in question.'
(Internal Revenue Service [IRS])
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[Guidance Overview]
On the Pay-or-Play Requirements of the ACA (Video)
Two video presentations, approximately 6 minutes each. An overview of the 4980H regulations, and the reporting requirements under Sections 6055 and 6066.
(Helen H. Morrison of Ernst & Young via Bloomberg BNA)
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[Guidance Overview]
Medicare Part D Amounts Will Increase in 2015
"Plan sponsors should note the new benefit amounts for planning purposes for 2015 -- both with respect to expected [retiree drug subsidy (RDS)] income and to the design of any Medicare Part D prescription drug plan that is offered to retirees. Prior to making benefits designs for 2015 final, plan sponsors may wish to analyze the benefits of contracting with a Medicare [prescription drug plan (PDP)] as opposed to retaining the RDS.... Plan sponsors that continue to apply for the RDS should take several actions to make sure that RDS income continues and that they are prepared for potential audits by the HHS Office of Inspector General[.]"
(Segal)
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[Guidance Overview]
The Employer Shared Responsibility Rules: Who is a 'Full-Time' Employee?
"A new variable, seasonal or part-time employee is measured during their initial measurement period. Their status (as a full-time employee or not) applies for the following stability period, for so long as they remain an employee. A new variable, seasonal or part-time employee is also measured again during the first standard measurement period that commences after his or her start date. As a result, there may be an overlap of the initial and standard measurement period.... Meanwhile, ongoing employees (regardless of status) are measured each standard measurement period, and their status (as a full-time employee or not) applies for the following stability period, for so long as they remain an employee."
(Foley & Lardner LLP)
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[Guidance Overview]
The Employer Shared Responsibility Rules: What Does It Mean to 'Offer' Coverage?
"The pay or play rules treat 'evergreen' elections that automatically continue from one plan year to the next unless the employee affirmatively opts out as an offer of coverage. In addition, an employer that auto-enrolls its full-time employees in mandatory health care coverage will be treated as offering coverage to its employees, so long as it provides the employees an effective opportunity to opt out of the coverage at least once with respect to each plan year."
(Foley & Lardner LLP)
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[Guidance Overview]
The Employer Shared Responsibility Rules: Who is an 'Applicable Large Employer'?
"For many employers, this determination is a no-brainer. But an employer that is on the cusp should complete the following five steps to determine whether it is an applicable large employer subject to the final shared responsibility rules. [1] Determine the 'Employer' ... [2] Identify who is an 'Employee'... [3] Capture Each Employee's Hours of Service... [4] Counting Full-Time Employees and FTEs... [5] Determine Applicable Large Employer Status."
(Foley & Lardner LLP)
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[Guidance Overview]
Skinny Plans and Other Low Cost Coverage Strategies Under the ACA
"Some employers are considering offering coverage that, in most cases, would intentionally fail the affordability test. These unaffordable plans are low-cost because employees would be required to pay most or all of the premiums. In a plan that is designed to be unaffordable, the required employee premium would be set at a level that is projected to readily exceed 9.5% of household income for most employees."
(Bond, Schoeneck & King)
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ML Strategies Health Care Update, April 28, 2014: Health Care Narrative Shifting to Delivery & Payment Reform (PDF)
"With open enrollment behind us, policymakers have begun to shift their focus on the rising cost of health care in a significant way.... For ACA supporters, recent actions are a sign of how important other factors are to blame for the high cost of health care. The starkest example of this was the recent letter sent by high ranking House Democrats to the manufacturer of Sovaldi, asking them to justify the [$1,000 per pill] price of its Hepatitis C drug, causing Gilead's stock to take a significant dive on fears that policymakers or other stakeholders would intervene to limit the price of the costly drug."
(ML Strategies, LLC)
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Cost of Healthcare Claims Continue to Rise; Interest in Private Exchanges Increases
"Reflecting claim activity over a six-month period, projected increases in the national average cost of claims include the following: Health maintenance organizations (HMO), 7.5 percent; Point-of-sale (POS), 7.7 percent; Preferred provider organizations (PPO), 8.3 percent; Consumer driver health plans, 8.6 percent; Exclusive provider organizations (EPO), 8.9 percent; Indemnity plans, 9.5 percent; Prescription plans, 8.6 percent."
(Wells Fargo)
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Constellium Retiree Subclasses Certified In Lawsuit for Lifetime Health Benefits
"A group of more than 1,700 Constellium Rolled Products retirees seeking lifetime health benefits at no cost can proceed as two certified subclasses, the U.S. District Court for the Southern District of West Virginia ruled.... One subclass consists of hourly, union-represented employees who retired from an aluminum fabrication plant before 2003 and who were subject to average annual benefit caps under the retiree health plan. The other subclass consists of hourly, union-represented employees who retired before Sept. 17, 2012, and who were subject to the Medicare Part B subsidy cap." [Barton, et al., v. Constellium Rolled Products-Ravenswood, LLC, No. 2:13-cv-03127 (S.D. W.V. Apr. 25,
2014)]
(Bloomberg BNA)
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Do Integrated Health Care Systems Provide Lower Cost, Higher Quality Care?
"It is widely believed that [Integrated Delivery Systems (IDS)] reduce costs and improve quality of care through better integration and coordination of services. This article attempts to shed light on this issue by analyzing the costs and quality of care provided by 52 medical group practices in a large upper Midwest community.... The researchers found that the IDS group practices were often outperformed by relatively small physician-owned practices."
(Robert Wood Johnson Foundation)
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American Academy of Pediatrics Policy Statement on High Deductible Health Plans (PDF)
"[High-deductible health plans (HDHPs)] promote adverse selection because healthier and wealthier patients tend to opt out of conventional plans in favor of HDHPs. Because the ill pay more than the healthy under HDHPs, families with children with special health care needs bear an increased cost burden in this model. HDHPs discourage use of nonpreventive primary care and thus are at odds with most recommendations for improving the organization of health care, which focus on strengthening primary care. This policy statement provides background information on HDHPs, discusses the implications for families and pediatric care providers, and suggests courses of action."
(American Academy of Pediatrics)
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Consumer-Driven Plans Are Driving Increase in Health Management
"CDHP plan enrollees 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 enrollees in traditional plans.... Participants in HSA plans were more likely than those in traditional plans to choose generic medications. In addition, CDHP enrollees used the emergency room at a 5 percent lower rate than enrollees in HMO and PPO plans."
(Society for Human Resource Management [SHRM])
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[Opinion]
If You Like Choice, Competition And Entrepreneurship, Obamacare Is Not For You
"At the state level, the exchanges are actually less competitive than the individual markets prior to Obamacare.... [T]here is even less insurer competition at the county level. In one of every six counties in America (17 percent), the state exchange offers only one insurer-a monopoly. For another 35 percent of counties, only two insurers offer coverage. In another 25 percent, only three insurers are selling coverage."
(Forbes)
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