Retirement Specialist
District of Columbia Retirement Board
in DC

Plan Administrator
The Newport Group
in CA, FL, TX, VA

Part-time Retirement Planning Consultant
Transamerica Retirement Solutions
in MI

Executive Assistant - Investment Industry
Financial Services Firm
in PA

Retirement Plan Consulting Actuary
Shore Tompkins Actuarial Resources
in IL

Post Your Job

View All Jobs

RSS Feed: All Jobs

Spring 2014 Policy Forum
May 15, 2014 WEBCAST
(EBRI [Employee Benefit Research Institute])

No Time to Slow Down – Looking Ahead to 2015 HIX Open Enrollment
May 29, 2014 WEBCAST
(Deloitte)

Medical Savings Accounts and Cafeteria Plans Under the ACA – What PEOs Need to Know!
June 3, 2014 WEBCAST
(National Association of Professional Employer Organizations (NAPEO))

DOL Consolidates Its Strengths In Revolutionizing ERISA Plan Enforcement
June 11, 2014 WEBCAST
(Fiduciary Doctors LLC)

401(k) Plan Workshop 2014 - Denver
June 12, 2014 in CO
(SunGard Relius)

401(k) Plan Workshop 2014 - Norfolk
June 12, 2014 in VA
(SunGard Relius)

401(k) Plan Workshop 2014 - San Francisco
June 12, 2014 in CA
(SunGard Relius)

Selling Ancillary Products on Private Exchanges: New Opportunities for Health Plans
June 18, 2014 WEBCAST
(Atlantic Information Services, Inc)

Medical Pharmacy – The Future of Pharmacy Benefit Management
June 19, 2014 WEBCAST
(Atlantic Information Services, Inc)

2014 Webinar: QRP Beneficiary Rollovers to Inherited IRAs
June 24, 2014 WEBCAST
(Ascensus)

2014 Fall Forum
September 22, 2014 in IL
(Ascensus)

View All Webcasts and Conferences

[Guidance Overview]

Risk Corridors and Budget Neutrality
"The Final Notice allows for relatively greater risk corridor payments in states where more pre-ACA policies are extended. But the adoption of the budget neutrality criterion represents an important change that has the potential to constrain risk corridor payments significantly.... [If] promised payments exceed receipts for 2014 ... insurers whose costs exceed the thresholds will receive after July 1, 2015, lower payments, perhaps much lower, than reasonably would have been anticipated given the statute and prior HHS statements. They would likely be made whole a year later from receipts for 2015." (Health Affairs Blog)  

[Advert.]

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

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.

Text of Sixth Circuit Opinion: Concealment of Administrative Fees by Blue Cross Blue Shield Was Breach of Fiduciary Duty to Plan Sponsor (PDF)
"[W]hile a formal trust was never created in this case, common law supports the conclusion that [Blue Cross Blue Shield of Michigan (BCBSM)] was holding the funds wired by Hi-Lex 'in trust' for the purpose of paying plan beneficiaries' health claims and administrative costs.... BCBSM committed fraud by knowingly misrepresenting and omitting information about the Disputed Fees in contract documents. Specifically, the [administrative services agreement], the Schedule As, the monthly claims reports, and the quarterly and annual settlements all misled Hi-Lex into believing that the disclosed administrative fees and charges were the only form of compensation that BCBSM retained for itself ... Hi-Lex can validly invoke the extended six-year period permitted by the fraud or concealment exception." [Hi-Lex Controls v. Blue Cross and Blue Shield of Michigan, Nos. 13-1773/1859 (6th Cir. May 14, 2014)] (U.S. Court of Appeals for the Sixth Circuit)  

Eighth Circuit: Deciding Who Is the Beneficiary under a Group Life Plan
"Can the deceased's will prove the deceased's intent designating the correct beneficiary? It depends on the language of the will. A Plan administrator, vested with discretion, can choose to excuse technical errors in beneficiary-designation forms or it can elect to enforce strictly the terms of the plan." [Hall v. Metropolitan Life Ins. Co., No. 13-1332 (8th Cir. May 8, 2014)] (Lane Powell PC)  

Eighth Circuit Revises Liquidated Damages Claim Where Jury Had Found Intentional Retaliation for FMLA Leave
"Affirming in part a judgment entered in favor of a city employee on his FMLA retaliation claim, the Eighth Circuit found the jury's verdict supported by evidence ... The appeals court further found that the trial court erred in denying liquidated damages to the employee, explaining that the jury's finding that the employer acted in good faith was only 'advisory,' that the jury's rejection of the proffered reasons for not rehiring the employee was binding, and that a finding of intentional retaliation sets a very high bar for showing good faith." [Jackson v. City of Hot Springs, Nos. 13-1772/13-1875 (8th Cir. May 12, 2014)] (Wolters Kluwer Law & Business)  

Health Care Costs Projected to Increase More Slowly During 2014 (PDF)
"Projected cost increases for all types of medical plans are anticipated to be down by between 0.1 and 0.5 percent in 2014 ... This continues the favorable trend of slow, steady declines generally experienced since 2010.... Health insurers reported an average prescription drug trend of 9. 2 percent, a decrease of 0.7 percent from the prior survey.... [P]harmacy benefit managers, who generally do not take any underwriting risk, reported a weighted average trend factor of 4.1% -- less than half of the factor reported by health insurers -- but still up by 0.3% from the 3.8% reported in the prior survey." (Buck Consultants)  

[Advert.]

Expert Strategies for Leading Litigators and In-House Counsel

The premier employment discrimination litigation conference returns for its sixth year, with more in-house counsel client presence and top federal and state jurists who are actively involved in these cases. July 31 - August 1, New York.

Results of the 2014 Global Medical Benefits Trends Survey
"The average medical trend was 7.9% for 2013 and is projected to be slightly higher for 2014. More than half of health insurers in all regions anticipate higher or significantly higher medical trend over the next three years. Globally, there is more consistency among the medical conditions causing the highest prevalence of claims (e.g., cardiovascular disease, cancer) than in the past, although there are a few notable differences by region. Traditional methods of cost management still dominate globally; however, health promotion and well-being programs are growing in availability and prevalence." (Towers Watson)  

Drivers of 2015 Health Insurance Premium Changes (PDF)
"How 2015 premiums differ from those in 2014 will depend on many factors. Key drivers include how the composition of the risk pools for 2014 compared to what was projected (to the extent this is identifiable), the reduction of funds available through the temporary reinsurance program, and the underlying growth in health costs. How enrollment differs from expected will vary by insurer and by state, with larger premium increases possible in states that adopted the transition policy allowing non-ACA-compliant plans to be renewed." (American Academy of Actuaries)  

Obamacare Deductibles May Be as High as $6,600 in 2015
"Annual increases in employer penalties and cost-sharing limits are determined by what the law defines as the premium adjustment percentage ... But the law provides wide latitude to the HHS secretary to estimate average premium growth ... [T]his key cost-indexing factor will be tied only to the rise in employer-sponsored insurance premiums -- estimated by Medicare actuaries to be 4.2%.... HHS said that including all private insurance -- as it originally intended -- would have yielded a 6% average hike. With that yardstick measure, deductibles would peak at $6,700 per adult next year. Employer penalties would rise to $3,180." (Investor's Business Daily)  

Impact of the Health Insurance Marketplace on Participant Cost Sharing for Pharmacy Benefits (PDF)
"Silver plans offered on HIX are nearly four times more likely to have a single combined deductible for medical and pharmacy benefits than typical employer-sponsored plans (46% of the time compared to 12%, respectively). Silver plans with combined deductibles impose significantly higher member cost sharing for pharmacy benefits than a typical employer-sponsored plan (130% higher)." (Milliman, prepared for Pharmaceutical Research and Manufacturers of America [PhRMA])  

ACA Exemptions and Special Enrollment Periods
"[This article includes] three tables that describe the exemptions and [special enrollment periods (SEPs)] in the ACA. The first table enumerates the exemptions and the method by which an individual may claim them. The second table ... lists several specific events that will qualify as a hardship exemption and how to claim them. The third table describes the SEPs, including the rationale behind them and who is affected." (Health Reform GPS)  

A Look at ACA Special Enrollment Periods (PDF)
"Currently, federal regulations authorize eleven specific special enrollment periods (SEPs), or qualifying events, that every marketplace -- whether state-based or federally facilitated -- must provide consumers.... In general, the currently available SEPs fall under four broad categories: Loss of minimum essential coverage; Changes in life circumstances; Enrollment problems; and Exceptional circumstances." (National Health Law Program [NHeLP])  

Text of Wyoming Federal District Court Opinion Denying ACA Contraceptive Mandate Injunction for Catholic Diocese and Related Organizations (PDF)
"[It] is not Plaintiffs' self-certification that authorizes or obligates the TPA to ensure the objectionable contraceptive coverage; it is the ACA that does so.... Completing and submitting the form to the TPA 'simply shifts the financial burden from [Plaintiffs] to the government.' ... Through the ACA's accommodation, Plaintiffs have the right to be exempted from participating in, providing, or paying for the costs associated with the objectionable contraceptive coverage based on their sincere religious beliefs, but they have no right to prevent a third party (who does not hold those same religious objections) from meeting the ACA's requirements." [Diocese of Cheyenne v. Sebelius, No. 14-CV-21-SWS (D. Wyo. May 13, 2014)] (U.S. District Court for the District of Wyoming)  

[Opinion]

Mr. Spock, Social Influence, and Eliminating the ACA Employer Mandate
"[The ACA employer] mandate is not simply a dollars-and-cents proposition. It also says that the government disapproves (and therefore we should all disapprove) of pushing employees to the marketplaces. Eliminating the mandate sends the opposite message: that it's okay to send employees to the marketplaces, so do what you want. Since this effect isn't easily measurable, its exact influence is hard to pin down and nearly impossible to disaggregate from the economics and employee relations concerns (both of which are also valid considerations)." (Benefits Bryan Cave)  

Minnesota District Court Applies De Novo Review, Finds SPD Discretionary Language Ineffectual Where Plan Document Failed to Grant Discretion
"If the Life Policy was ambiguous as to whether it conferred discretion to [the defendant Life Insurance Co. of North America (LINA)], this SPD language may have resolved the ambiguity in LINA's favor. Because the Life Policy is not ambiguous, however, the SPD cannot by itself confer discretion to LINA at beneficiaries' expense." [Bowers v. Life Ins. Co. of North America (LINA), No. 13-891 (D. Minn. May 14, 2014)] (U.S. District Court for the District of Minnesota)  

Eighth Circuit Decision Reminds Employers of Importance of Expressly Granting Plan Administrators Discretion to Interpret Plan Terms
"The Eighth Circuit's interpretation of the law in Hall provides employers with a vivid example of the importance of ensuring their plan administrators are granted the discretion to interpret plan terms and determine eligibility for benefits. When plans explicitly provide administrators with such authority, the decisions of plan administrators will be granted much greater deference by the courts and increased protection from challenges based on federal common law." [Hall v. Metropolitan Life Ins. Co., No. 13-1332 (8th Cir. May 8, 2014)] (Stinson Leonard Street)  

Investigating and Deciding Severance Benefits Claims
"A threshold question for those charged with the responsibility for deciding severance benefit claims and appeals is [often] whether the employee was in fact terminated 'for cause.' ... What is required of plan fiduciaries under these circumstances? May they accept the employer's stated reason for the employee's discharge? Must they conduct an independent investigation into the reasons for the employee's discharge?" (Proskauer's ERISA Practice Center)  

Rising Tide Lifted Most Boats in 2013, But What About 2014?
"[C]ompany-specific performance will drive stock prices in the coming months more than overall market movements. Skepticism about potentially weak or mixed financial performance has already started to catch up with some companies. While most companies were winners in 2013, in 2014 the market is differentiating between winners and losers. [This article] examines some of the implications of recent stock market and business trends for executive pay[.]" (Towers Watson)  

IHC FORUM & Expo Hits Largest Number of Attendees as Industry Validates Health Care Consumerism Mega-Trend
The Institute for HealthCare Consumerism

New Wrap SPD Generator Shatters Price Barriers
HR360, Inc.

Merrill Lynch Clear Offers Dynamic Approach to Preparing for and Living Your Best Life in Retirement
Bank of America

New ‘Pay Or Play’ Tools From Unum Help Businesses Evaluate Next Steps In Health Care Reform
Unum

View All Press Releases