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May 12, 2014          Get Retirement News  |  Advertise
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Webcasts and Conferences

Federally-facilitated Small Business Health Options Series: Agent/Broker Policies and Procedures
May 13, 2014 WEBCAST
(Centers for Medicare & Medicaid Services (CMS))

Federally-facilitated Small Business Health Options Series: Group BSD Updates and Group XML Transactions
May 20, 2014 WEBCAST
(Centers for Medicare & Medicaid Services (CMS))

Federally-facilitated Small Business Health Options Series: Companion Guide Updates and 834 Enrollment Transactions
May 27, 2014 WEBCAST
(Centers for Medicare & Medicaid Services (CMS))

2013 Form 5500 SB: What You Need to Know
May 28, 2014 WEBCAST
(ASPPA [American Society of Pension Professionals & Actuaries])

The Five Most Dangerous Trends in Employee Wellness and What You Can Do to Avoid Them
June 5, 2014 WEBCAST
(Thompson Interactive)

Advanced Top Heavy Testing and Plan Design
June 11, 2014 WEBCAST
(ASPPA [American Society of Pension Professionals & Actuaries])

View All Webcasts and Conferences


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official guidance, jobs, webcasts and more.
[Guidance Overview]

Implementation FAQs Address Out-of-Pocket Maximums, Preventive Services, Health FSA Carryovers, and More
"Q&As-2 through -4 address the extent to which certain items must be counted toward the annual limit on out-of-pocket maximums for essential health benefits (EHB) ... [S]elf-insured and large group health plans that wish to exclude certain items from counting toward the plan's out-of-pocket maximum will need to clearly define these terms in their plan documents and, for ERISA plans, communicate them in their SPDs." (Thomson Reuters / EBIA)  


[Advert.]

Download your free report: Final Regulations on the ACA Employer Mandate

Sponsored by Bloomberg BNA

Understand your role and obligations to the ACA employer mandate final regulations. Download Bloomberg BNA's "Final Regulations on the ACA Employer Mandate" to get the latest on the ACA compliance standards facing benefits professionals.



[Guidance Overview]

Final Regs Include Employer Plan Information in Reports by Exchanges to IRS
"The reports will contain detailed information about the individuals enrolled for coverage, with more detail being required when advance premium tax credits have been paid. This includes the identity of each individual's employer, whether the employer offered affordable minimum essential coverage that provided minimum value, and if so, the amount of the employee's required contribution for self-only coverage. The preamble confirms that this employer information is reported only to the extent the information was provided to the Exchange and that there is no obligation to verify accuracy." (Thomson Reuters / EBIA)  

Health Plan Sponsors Need to Obtain Health Plan Identifier
"By November 5, 2014, all health plans must obtain an HPID (or November 5, 2015 for ... health plans with annual receipts of $5 million or less).... Employers will probably never use the HDIP if they do not perform HIPAA standard transactions. However, a plan's third party administrators and business associates will be using this number a lot, so be sure to share your HDIP with them when you receive it. (You might even consider asking your third party administrator to obtain this number for you!)" (Winston & Strawn LLP)  

Private Exchanges: Know Before You Go
"Employers offering both health and retirement benefits should keep in mind how those benefits work together to meet objectives.... If you are in a high-turnover industry and your main objective is cost control, your concerns will be very different from an employer who prioritizes employee satisfaction." (Manning & Napier)  

What to Do About Those Section 419 Plans?
"For more than a decade, numerous promoters have touted Section 419 plans as a legitimate way to reduce taxes at the corporate level. These plans have been sold as 'welfare benefit trusts' or 'death benefit only trusts' for the ostensible purpose of providing non-retirement type benefits to employees.... [It] is the policy of the IRS to attack the legitimacy of deductions taken for contributions to Section 419 plans in all circumstances.... All taxpayers, whether under audit or not, should take immediate steps to disentangle themselves from the Section 419 arrangement." (Fox Rothschild LLP)  

Virginia Filings Give First Look at 2015 Health Rate Increases
"In the first look at how insurers plan to adjust prices in the second year under the federal health-care law, filings from Virginia carriers show they are opting for premium increases in 2015 that will pinch consumers' pocketbooks but fall short of some bigger rate predictions. The new premium proposals, detailed in official filings to the state's insurance regulator, show health plans all opting for some increases." (The Wall Street Journal; subscription may be required)  

D.C. Health Insurance Tax Triggers Insurer Pushback
"The tax, which gained the council's unanimous approval May 6, will be effective for 90 days on an emergency basis. The council will vote again in early June on whether to extend the assessment for another 225 days. However, it must undergo congressional review before it can be made permanent. Under the council's approach, the 'taxable' health plans would include long-term care, disability, vision, dental, worker's compensation and hospital indemnity, among others." (Kaiser Health News)  

North Carolina May Add More Mandates on Health Policies
"North Carolina insurance policy holders will pick up $10.5 million in additional premium costs if a bill requiring expanded coverage of chiropractic services ... is approved in the General Assembly's short session opening this week. Critics of the health mandate to lower patients' co-pays for chiropractic services from the current, higher specialist rates say Senate Bill 561 would entice other specialists, such as physical and occupational therapists, to seek similar payment parity. That would shift more costs from individual patients to all insurance consumers.... The chiropractic co-pay parity bill is one of 10 insurance mandates the General Assembly is expected to consider this session." (Carolina Journal)  

Designing Silver Health Plans with Affordable Out-of-Pocket Costs for Lower- and Moderate-Income Consumers (PDF)
28 pages. Excerpt: "[This] research sought to identify ways to design silver plans with more affordable upfront cost-sharing. [The authors] analyzed the silver plans that are offered in the 34 federally facilitated marketplaces and the standardized silver plan designs that are required in six state-run marketplaces.... This brief discusses the findings of [that] analysis, and it provides detailed cost-sharing information for the plan designs ... . The brief also outlines policy and advocacy strategies for promoting similar plan designs in marketplaces, and it discusses opportunities for measuring how well these plan designs work for consumers." (Families USA)  

Implications of Individual Subsidies in the ACA: What Stakeholders Need to Understand (PDF)
20 pages. Excerpt: "This article discusses the details of the ACA provisions of federal subsidies that affect consumers' cost of coverage in the individual market, and breaks down how the net effect of these provisions will shape consumers' decisions to buy a new level of coverage, retain current coverage, or elect to be uninsured (or underinsured according to the ACA definition) despite new tax penalties. Prior to diving into the consumer-directed affordability mechanisms crafted in the ACA, it is worthwhile to review other new market impacts that will also affect affordability." (Wakely Consulting Group)  

Decrease in Difficulty Paying Medical Bills Predates Full Implementation of ACA
"Despite the fact no one was covered by plans through the health insurance marketplace until 2014, an early release of data from the Centers for Disease Control and Prevention (CDC) shows that the percentage of people who were in families that had problems paying their medical bills decreased from the first six months of 2011 (21.7 percent) to the first six months of 2013 (19.8 percent)." (Wolters Kluwer Law & Business)  

U.S. Health Spending Trends by Age and Gender: Selected Years 2002-10
"[A]ggregate spending on children's health care increased at the slowest rate. However, per capita spending for children grew more rapidly than that for working-age adults and the elderly. Per capita spending for the elderly remained about five times higher than spending for children." (Health Affairs)  

Health Law's Cost-Sharing Could Limit Patient Access to Prescription Drugs
"Silver plans that combine prescription and medical costs into one deductible ... have average deductibles of $2,275, and similar bronze plans have an average of $4,986 ... The average amount for plans that have separate prescription drug deductibles is $470 for a silver plan and $956 for a bronze one. For a typical employer-sponsored health plan, on average people pay about 22 percent of the cost of prescription drugs and their insurance covers the rest ... [T]he health law's bronze and silver plans require more than twice that amount." (Kaiser Health News)  

[Opinion]

Why Did Health Spending Slow Down Before It Sped Up?
"It's too soon for ObamaCare to have resulted in a big boost in spending. And the previous slowdown was underway over a decade. Over the longer period, what does track the slowdown very closely are three other developments: the growth of Health Savings Accounts (HSAs), the growth of Health Reimbursement Accounts (HRAs) and the general trend toward higher deductibles. All three changes mean that patients are paying more medical bills out of their own pockets. And that has produced profound changes[.]" (John Goodman's Health Policy Blog)  

Benefits in General; Executive Compensation

[Guidance Overview]

IRS Makes It More Difficult to Defer Taxation of Restricted Stock and Similar Awards
"Even though these final regulations tighten the definition of substantial risk of forfeiture, and make the analysis of whether such property is subject to a substantial risk of forfeiture more complex, if the transaction is properly structured, restricted stock and similar awards continue to be powerful compensation tools that provide for meaningful opportunities to defer tax." (Fox Rothschild LLP)  

Texas Supreme Court Holds That Severance Arrangements Relating to an ERISA Plan Are Preempted by ERISA
"The first group [of plaintiffs] was promised severance pay under a schedule that referenced the ERISA Plan, copied and used terms from the ERISA Plan, and purported to supersede 'any prior plan.' The second group was promised severance pay in written and oral promises that referenced the schedule, but did not refer to the ERISA Plan. The Texas Supreme Court held that (i) ERISA preempted the contract claims with respect to the first group because the schedule that contained the severance benefits clearly referenced the ERISA Plan, depended on that plan for interpretation of terms, and amended that Plan, and therefore related to an ERISA plan; and (ii) ERISA preempted contracts claims with respect to the second group because those promises referenced the schedule, which in turn referenced the ERISA plan." [Arsenio Colorado v. Tyco Valves & Controls, L.P., No. 12-0360 (Tex. Mar. 28, 2014)] (Haynes and Boone, LLP)  

Restrictive Covenants in Stock Award Agreements: Important Lessons for Employers and Stock Plan Administrators
"[1] Courts will enforce restrictive covenants contained in stock award agreements.... [2] Courts will enforce electronic agreements.... [3] Courts may enforce all remedies set forth in the stock award agreement, including remedies that go beyond simply the forfeiture of the stock award, such as an injunction against the former employee." [Newell Rubbermaid Inc. v. Storm, No. 9398-VCN (Del. Ch. Mar. 27, 2014)] (Winston & Strawn LLP)  

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