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May 9, 2014          Get Retirement News  |  Advertise
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Employee Benefits Jobs


Webcasts and Conferences

Ethical Responsibilities from an Employee Benefits Perspective, and Social Media Techniques
May 21, 2014 in FL
(ASPPA Benefits Council of Central Florida)

The Rise of Consumer Engagement: Making CDHPs Work for You and Your Employees
June 5, 2014 WEBCAST
(Employee Benefit News)

Tax Forms Workshop: 5500 and More - Portland
June 6, 2014 in OR
(SunGard Relius)

Tax Forms Workshop: 5500 and More - Houston
June 6, 2014 in TX
(SunGard Relius)

Time to Retire the Idea of Retirement?
July 16, 2014 WEBCAST
(ThinkAdvisor)

View All Webcasts and Conferences


  LinkedIn   Twitter   Facebook Hand-picked links to the web's best news articles,
official guidance, jobs, webcasts and more.
[Official Guidance]

Text of Rev. Rul. 2014-15: Guidance to Employers Funding Retiree Health Benefits Through a Wholly Owned Subsidiary (PDF)
"[T]he risks being indemnified are the covered retirees' and their dependents' risks of incurring medical expenses during retirement due to accident and health contingencies. Although the VEBA entered into Contract A [to secure reimbursement from the unrelated Insurance Company for medical expenses], the covered retirees' health insurance is an economic benefit to the retirees since it relieves them of the expense of purchasing health insurance for themselves and their dependents. Furthermore, at the time that Contract A goes into effect, neither [the employer (X)] nor the VEBA have any commitment or obligation to offer health benefits to the covered retirees and their dependents, and both X and the VEBA may cancel any provided coverage at any time. Consequently, the risks that are shifted in the situation above are those of the covered retirees and their dependents and not risks of the VEBA or X. These risks are reinsured by S1 [a wholly-owned subsidiary of X] under Contract B. The risks under Contract B are distributed among this large group of covered individuals ... Accordingly, the risks under Contract B are insurance risks, and Contract B constitutes insurance for federal income tax purposes." (Internal Revenue Service [IRS])  


[Advert.]

What Employers Need to Know About the Pay or Play Mandate in 2014

Sponsored by Lorman and BenefitsLink

Enroll in this May 14 live webinar to learn the latest in employer reporting requirements and tweaks to regulations and transition rules on the "Pay or Play" Employer Mandate under the ACA. Special BenefitsLink discount.



[Guidance Overview]

Updates in Implementing Health Care Reform: New Model COBRA Notices
"Group health plans are not required to use the model notices, but plans that do use the model notice are presumed to meet COBRA notice requirements. In any event, the notice must be modified if the plan is not a single employer plan." (The Lowenbaum Partnership, LLC)  

Reminder: ACA's Out-of-Pocket Limits Differ from HSA-Qualified High-Deductible Health Plans, Starting in 2015
"Under the ACA, HHS is required to use a different methodology for calculating any annual adjustments than the IRS uses for HDHPs. Therefore, starting in 2015, the two limits will begin to differ ... [In] addition to the HDHP limits being lower than the ACA limits in 2015, expenses will accumulate toward the HDHP limit more quickly because the HDHP limits apply to all covered in-network benefits, not just essential health benefits." (Proskauer's ERISA Practice Center)  

Network Providers May Be Entitled to ERISA Claims Procedures When Overpaid Claims are Recouped
"Although the scope of this decision is not clear, or whether it is an aberration, the court's opinion indicates that provisions in a plan document that provide for in-network claims to be paid directly to providers may afford such providers with 'beneficiary' status under ERISA, thus requiring the plan to follow ERISA's notice and appeals procedures when seeking to recover overpayments made to such providers. A plan sponsor should consider adding language to the plan to preclude this type of claim." [Pennsylvania Chiropractic Association v. Blue Cross Blue Shield Association, No. 09 C 5619 (N.D. Ill. Mar. 28, 2014)] (Haynes and Boone, LLP)  

First Circuit Finds No FMLA Violation Despite Employer's Improper and Untimely FMLA Notices
"On one hand, the employer technically violated the FMLA when it failed to provide Scott proper and timely FMLA notices. On the other hand, however, Scott took about 16 weeks of leave, which outstripped the 12 weeks provided for under the FMLA. Thus, the deciding factor for the court was that Scott failed to provide any evidence that he actually could return before his leave ended or that he would have structured his leave differently had he been provided appropriate notice.... For the court, 'nothing was lost, nor was any harm suffered, by reason of the [failure to provide proper and timely notices].'" [Scott Bellone v.Southwick-Tolland Regional School District, No. 13-1341 (1st Cir. May 2, 2014)] (FMLA Insights)  

Are There Advantages to De Novo Review Versus Arbitrary and Capricious Review?
"You already know that plans that contain 'discretionary language' should enjoy a more deferential review by the trial court. But when the plan administrator decides and funds the benefit decision, courts view this as a 'structural conflict' and impose additional expectations on the claims process....When a court reviews a decision under the arbitrary and capricious standard, and the plan has a structural conflict, then a court may question the 'thoroughness and accuracy of a benefit decision' if the plan relied only on a 'pure paper review.'" [Inciong v. Fort Dearborn Life Insurance Company, No. 12-15997 (9th Cir. April 22, 2014)] (Lane Powell PC)  

Despite Supposed Death Knell of Employer-Sponsored Coverage, Mass Exodus Seems Very Unlikely
"From a cost perspective ... the same factors that drive the cost of employer-sponsored coverage will also drive the cost of exchange coverage. Sure there's the 'you aren't tied to your job' benefit, but there are also more out of pocket costs. In the end, from an employer's perspective, ACA exchanges are just another way of delivering the same benefit. It's another choice with its own set of pros and cons to be weighed and analyzed, as different as night and later that night." (Benefits Bryan Cave)  

Why Not Just Eliminate the Employer Mandate?
"[E]liminating the employer mandate will not reduce insurance coverage significantly. In addition to having little effect on coverage, eliminating the employer mandate would eliminate labor market distortions in the law and lessen opposition to the law from employers." (Robert Wood Johnson Foundation)  

$4.8 Million Is Largest HIPAA Settlement to Date
"Entities should review server configurations and make sure appropriate safeguards are in place. It is unclear why the amount was so large; however, there continues to be a trend of larger settlement amounts for larger-sized entities.... The initial breach was reported in 2010, demonstrating that it can take more than three years before OCR ultimately resolves a reported breach. [New York and Presbyterian Hospital (NYP)] got hit with the larger settlement amount, while the breach occurred due to the actions of a [Columbia University] employee. OCR appears to put more blame on NYP for not controlling how its health information was accessed, rather than the covered entity that accessed the information." (Davis Wright Tremaine LLP)  

Cost Per Enrollee in Each State's Exchange (PDF)
"The average cost-per-enrollee for all 50 states plus DC was $922. For the 15 jurisdictions running their own Exchanges it was $1,503, while for 36 states in which the federal government operates the Exchange it was $647.... The state with the highest cost-per-enrollee of the 36 federally-operated Exchange states, based on allocating 1/36 of federal Exchange spending to each state, was North Dakota, at $7,089. The state with the lowest cost-per-enrollee was Florida, at $76.... [T]he more states in which the federal Exchange operates, the more money taxpayers save.... [S]tate officials refusing to establish their own Exchanges appear to have unwittingly contributed to the efficient implementation of the Exchange in their states." (Mehri & Skalet PLLC)  

Obamacare's Health Insurance Tax Could Cost Up to 286,000 Jobs
"[By one estimate,] the Health Insurance Tax (HIT) will result in a reduction in private sector employment of 152,000 to 286,000 jobs by 2023, with 57 percent of the job losses coming from small businesses. This will amount to a reduction of U.S. real output (sales) by between $20 billion to $33 billion during the same time frame. [A chart] breaks out how individual states will be affected. The HIT, which went into effect on January 1, 2014, levies a tax on health plans sold on the fully-insured market. Eighty-eight percent of it is made up of small businesses. Revenue from the tax will rise by 41% in 2015 and reach $14.3 billion in 2018." (U.S. Chamber of Commerce)  

Workplace Wellness Programs May Greatly Decrease Health Risk Factors
"Participants in the program -- who have access to resources like telephone coaching, tobacco-cessation aid and online help -- cut their smoking rates by 35 percent, according to the study. They reduced cancer risks by 25 percent, depression risks by 25 percent and stress risks 23 percent in a three-year period, the research found." (Denver Business Journal)  

Benefits in General; Executive Compensation

ERISA Section 510: Wanting to Be a Participant, Versus Being a Participant
"[O]utside of a collective bargaining scenario, no law that I am aware of requires an employer to put (or keep) an employee into a benefits-eligible employment classification just because the employee wants this. [This case] suggests that immediately upon hiring, every employee becomes a participant in every plan sponsored by the employer, regardless of plan terms. That simply cannot be reconciled with ERISA Section 202, and given the additional costs this would impose on plans, I would call this actuarial heresy[.]" [Sanders v. Amerimed, No. 1:13-cv-813 (S.D. Ohio Apr. 25, 2014)] (Porter Wright Morris & Arthur LLP)  

Press Releases

DOL Obtains Consent Judgment Ordering 401(k) Plan Trustees to Restore More Than $5,900 in Benefits
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

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