Retirement Plan Administrator
United Retirement Plan Consultants
in NJ

DC Implementation/Conversion Specialist
Milliman
in OR

Senior Retirement Plan Administrator
CORBCO, Inc.
in MA

Senior Client Manager
15-year old Retirement Services Company
in OH

401(k) Plan Administrator
Southfield Third Party Administration firm
in MI

Consultant
USI Consulting Group
in CT

Senior Defined Benefit Calculation Analyst
Transamerica Retirement Solutions
in MA

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Federally-Facilitated Marketplace Issuer Summit
May 20, 2014 in MD
(Centers for Medicare & Medicaid Services (CMS))

Choosing a Health Plan for Your Small Business -- Recorded
June 3, 2014 WEBCAST
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

What a 401(k) Administrator Needs to Know About IRAs Series
June 5, 2014 WEBCAST
(McKay Hochman Co., Inc.)

Benefits Boot Camp
June 12, 2014 in OH
(Worldwide Employee Benefits Network [WEB] - Cleveland Chapter)

Fiduciary Responsibilities: What Every TPA Needs to Know
June 12, 2014 WEBCAST
(ASC Institute)

Health Benefits Laws Compliance Assistance Seminar
June 17, 2014 in CO
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

Evaluating Your Employee Health Benefits
July 31, 2014 WEBCAST
(Lorman Education Services)

2014 Fall Forum
October 20, 2014 in LA
(Ascensus)

2014 Fall Forum
November 17, 2014 in AZ
(Ascensus)

View All Webcasts and Conferences

[Official Guidance]

Text of IRS Q&As on Employer Shared Responsibility Provisions Under the ACA
56 Q&As; topics include: [1] Basics of the Employer Shared Responsibility Provisions; [2] Which Employers are Subject to the Employer Shared Responsibility Provisions; [3] Identification of Full-Time Employees; [4] Liability for the Employer Shared Responsibility Payment; [5] Calculation of the Employer Shared Responsibility Payment; [6] Making an Employer Shared Responsibility Payment; [7] Transition Relief; [8] Basics for Small Employers; [9] Related Provisions; and [10] Additional Information. (Internal Revenue Service [IRS])  

[Advert.]

ERISA Audits: What We All Knew but Forgot

June 5 live webinar. Understand potential audit triggers and hot button areas, the scope of audits, what to expect in such audits, and best practices to avoid audit complications. BenefitsLink discount.

[Official Guidance]

IRS Q&As About Small Business Health Care Tax Credit : Determining FTEs and Average Annual Wages
16 Q&As, including: "[1] Who is an employee for purposes of determining FTEs and average annual wages? ... [2] Can I be counted as an employee if I own my small business? A. No.... [3] Do seasonal workers count in FTEs and average annual wages? A. Generally, no.... [4] Do part-time workers count in FTEs and average annual wages? A. Yes ... [5] What are the permissible ways to count hours of service? ... [6] How is the number of FTEs determined? ... [7] How is an employer's average annual wages determined? ... [8] How is the credit reduced if the number of FTEs exceeds 10 or average annual wages exceed $25,000? ... [9] How is eligibility for the credit determined if the employer is a member of a controlled group or an affiliated service group?" (Internal Revenue Service [IRS])  

[Official Guidance]

Text of IRS FAQ on Employer Health Care Arrangements: Reimbursement to Employees for Individually-Owned Policies
"What are the consequences to the employer if the employer does not establish a health insurance plan for its own employees, but reimburses those employees for premiums they pay for health insurance (either through a qualified health plan in the Marketplace or outside the Marketplace)? ... [S]uch an arrangement fails to satisfy the market reforms and may be subject to a $100/day excise tax per applicable employee (which is $36,500 per year, per employee) under section 4980D of the Internal Revenue Code." (Internal Revenue Service [IRS])  

[Official Guidance]

Text of CMS Final Master FAQs on Health Insurance Market Reforms and Marketplace Standards (PDF)
7 pages (May 16, 2014); 12 Q&As, including: "[1] For plans that must provide coverage of the essential health benefit package ... if an issuer imposes a waiting period before an enrollee can access a covered benefit, is that a violation of 45 CFR 156.125? ... We are concerned that waiting periods for specific benefits discourage enrollment of or discriminate against individuals with significant health needs or present or predicted disability.... [2] Are conversion policies offered to individuals losing group health insurance coverage considered to be minimum essential coverage ...? Yes ... [3] Would a large employer with 51-100 employees who is a large group policyholder be covered by the March 5, 2014 bulletin with respect to a renewal of its 2013 plan at its 2014 renewal date if the policy is not compliant with the provisions of the ACA that apply to the large group market? No.... [4] Is a large group employer who employs 51-100 employees required to remain with the same insurer between 2013 and 2016 in order to be eligible for transitional relief in 2016? No.... [5] If an individual or small employer purchased a 2014 ACA-compliant plan, are there circumstances where the policyholder can have the 2013 plan reinstated and be eligible for the transitional policy relief? No.... [6] Does the large employer transitional policy starting in 2016 apply to large employers with 51-100 employees who did not have health insurance coverage at the time the transitional policy extension bulletin was issued March 5, 2014, but who purchase a large employer policy after March 5, 2014 but before January 1, 2016? Yes." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services)  

[Official Guidance]

Text of HHS Final Regs: ACA Exchange and Insurance Market Standards for 2015 and Beyond
436 pages. Excerpt: "[T]he rule establishes standards related to product discontinuation and renewal, quality reporting, non-discrimination standards, minimum certification standards and responsibilities of qualified health plan (QHP) issuers, the Small Business Health Options Program, and enforcement remedies in Federally-facilitated Exchanges. It also finalizes: a modification of HHS's allocation of reinsurance collections if those collections do not meet our projections; certain changes to allowable administrative expenses in the risk corridors calculation; modifications to the way we calculate the annual limit on cost sharing so that we round this parameter down to the nearest $50 increment; an approach to index the required contribution used to determine eligibility for an exemption from the shared responsibility payment under section 5000A of the Internal Revenue Code; grounds for imposing civil money penalties on persons who provide false or fraudulent information to the Exchange and on persons who improperly use or disclose information; updated standards for the consumer assistance programs; standards related to the opt-out provisions for self-funded, non-Federal governmental plans and related to the individual market provisions under [HIPAA] including excepted benefits; standards regarding how enrollees may request access to non-formulary drugs under exigent circumstances; amendments to Exchange appeals standards and coverage enrollment and termination standards; and time-limited adjustments to the standards relating to the medical loss ratio (MLR) program. The majority of the provisions in this rule are being finalized as proposed." (U.S. Department of Health and Human Services)  

[Official Guidance]

CMS Technical FAQs for Operation and Processing of FF-SHOP Enrollments and Changes, May 13, 2014
16 Q&As regarding operational issues for FF-SHOP issuers and enrolled employers, including: "Should issuers include cancellations when reporting enrollment/reconciliation files for SHOP in 2014? ... For issuers that participate in SHOPs in several states, can CMS confirm that issuers should submit a separate file per state?... When will the first SHOP enrollment/reconciliation file be due to CMS?... What evidence would the issuer need to obtain from a broker in order to comply with the requirement to validate broker certification?" (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services; free registration may be required)  

[Official Guidance]

CMS Technical FAQs for Operation and Processing of FF-SHOP Enrollments and Changes, May 8, 2014
19 Q&As regarding operational issues for FF-SHOP issuers and enrolled employers, including: "How will the FF-SHOP handle paper checks and ensure initial payments are received prior to the coverage effective date? ... What are the employer reporting requirements for terminations?... Is CMS allowing groups to make retroactive changes?... How can Issuers contact the SHOP Call Center to receive payment status for a group enrolled in FF-SHOP beginning in 2015?" (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services; free registration may be required)  

[Guidance Overview]

CMS Overview of FF-SHOP Agent/Broker Policies and Procedures (PDF)
23 presentation slides, dated May 13, 2014. Excerpt: "The launch of the FF-SHOP online experience will change how Agents and Brokers interact with SHOP consumers and the FF-SHOP Marketplace.... The 'side-by-side' approach will not be supported in FF-SHOPs for the 2015 plan year.... Agents and Brokers will have more direct interactions with the FF-SHOP Marketplace in 2015. As a result, the requirements for SHOP Agents and Brokers are changing for 2015.... Employers will have the ability to authorize one Agent or Broker through the online FF-SHOP Enrollment Portal.... Employees at a company are automatically associated with the employer's Agent/Broker. Employees may not establish relationships with a different Agent/Broker." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services)  

[Guidance Overview]

CMS Issues Final 2015 Exchange and Insurance Market Standards Rule: Part 1
"The rule not only establishes exchange and insurance market rules for 2015, ... it also addresses a range of issues that had been left unresolved by earlier rulemaking.... This [article covers] five of the most important and controversial issues addressed by the final rule: [1] the regulation of navigators; [2] changes in the premium stabilization programs; [3] the regulation of fixed-indemnity plans; [4] provisions for state regulators to veto employee choice in the SHOP exchange for 2015; and [5] procedures for enrollees to obtain an exception to formulary restrictions in exigent situations." (Timothy Jost in Health Affairs Blog)  

[Guidance Overview]

CMS Issues Final 2015 Exchange and Insurance Market Standards Rule: Part 2
"Several provisions of the rule address the question of when coverage is terminated and when it is merely modified.... The final rule makes a number of changes in special enrollment period rules ... provides definitions of termination, cancellation, and reinstatement ... modifies the SHOP exchange rules to provide for an annual open enrollment period for all SHOPs that will be aligned with the open enrollment period for the individual market ... [and] provides additional guidance on the exchange quality reporting system.... For 2015 and subsequent years, the annual limit on cost sharing found in the statute is to be increased under a formula found in the [statute].... Finally, the rule makes some changes in minimum medical loss ratio requirements." (Timothy Jost in Health Affairs Blog)  

[Guidance Overview]

CMS Fact Sheet on Exchange and Insurance Market Standards for 2015 and Beyond
"Key policies outlined in [the 2015] final rule include: [1] Standardizing Notices to Improve Consumer Education and Choices ... [2] Strengthening the Prescription Drug Exceptions Process ... [3] Implementing Quality Standards ... [4] Providing Additional Options for SHOP in 2015 ... [5] Strengthening Standards for Navigators and Other Assisters ... [6] Clarifies Premium Stabilization Policies." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services)  

[Guidance Overview]

90-Day Waiting Period Rule under ACA Can Lead to Problems Between Employers, Unions and Health Plans
"Even though a proposed 90-day waiting period rule was released last year, and despite the fact that the rule took effect for plan years beginning on or after January 1, 2014, many plan sponsors have yet to update their work policies (e.g., employee handbooks and collective bargaining agreements) in order to coordinate their provisions with the rule and/or with plan document language that incorporates the rule.... Fortunately, there are exceptions to the 90-day rule that allow additional time to be tacked on to the 90-day waiting period; these are for certain orientation periods, cumulative hours of service requirements and rules developed by multiemployer plans in the collective bargaining context." (Fox Rothschild LLP)  

New Responsibility for Self-Funded Employers: Obtaining a Health Plan Identifier (PDF)
"Insurance carriers will likely apply for the 10-digit HPID number for all of their insured group health plans. Employers will have to apply for their 10-digit HPID for self-funded medical plans. The health plan needs to use the HPID number for any of the standard transactions the Code Set rules cover. Every health plan considered a covered entity must obtain an HPID." (McGraw Wentworth)  

Obamacare Increases Large Employers' Health Costs
"Over the next ten years, Obamacare could cost large employers $151 billion to $186 billion. That's about $163 million to $200 million in additional cost per employer -- or $4,800 to $5,900 per employee -- solely attributable to the health reform law. Employers will likely pass along these costs to their workers." (Forbes)  

Obamacare Enrollment Doesn't Get Any Easier Going Forward
"Just 54 Kentucky businesses signed up a total of roughly 500 employees in the state's SHOP ... Other successful states have seen lackluster enrollment in the SHOP exchanges for several reasons -- they offer limited advantages over the current insurance market for small businesses, and many employers renewed their health plans early last year." (The Washington Post; subscription may be required)  

ACA Unlikely to Trigger Employer Exodus from Health Coverage
"The [ACA] will not trigger a rapid exodus from employer-sponsored health plans, panelists [at a recent EBRI policy forum] agreed, because large employers still see value in continuing to offer health benefits.... Employers don't see the cash savings as the sole factor.... [H]ealth care reform could weaken employer commitment to health plans... in sectors where firms pay low wages, have high worker turnover, and where workers prefer cash in hand.... Factors that could weaken large employer plan enrollment include: [1] rates of health inflation; [2] the continuation of tax-free health benefits; [3] the impact of the so-called Cadillac tax (on expensive health plans); [4] employees' continued desire for coverage from firms; and [5] customer satisfaction (or dissatisfaction) with exchange coverage." (Thompson SmartHR Manager)  

More Insurers Lower Premiums: Evidence from Initial Pricing in the Health Insurance Marketplaces
"There are 3.9 participants, on (population-weighted) average, in the 395 ratings areas spanning the 34 states with federally facilitated marketplaces (FFMs). Using data on the plans offered in the FFMs, together with predicted market shares for exchange participants (estimated using 2011 insurer-state market shares in the individual insurance market), [the authors] study the impact of competition on premiums.... [They] estimate that United's nonparticipation decision raised the second-lowest-price silver premium (which is directly linked to federal subsidies) by 5.4 percent, on average. If all insurers active in each state's individual insurance market in 2011 had participated in all ratings areas in that state's HIM, [the authors] estimate this key premium would be 11.1% lower and 2014 federal subsidies would be reduced by $1.7 billion." (National Bureau of Economic Research [NBER])  

Is Medicaid an Opportunity for Employers? (PDF)
"Employers need to understand Medicaid. Medicaid can offer comprehensive low-cost health coverage to qualifying employees. If a qualifying employee selects Medicaid, employers shift the risk for that employee into a tightly managed, government-funded program. Employers need to be mindful of the strategies they can use to encourage employees to consider Medicaid." (McGraw Wentworth)  

Errant Attempt to Deactivate Server Leads to HIPAA Settlements Totaling $4.8 Million
"These resolution agreements highlight the importance of identifying and understanding all of the information systems where electronic PHI is stored (including on devices and media that are owned or controlled by workforce members), and then conducting a thorough risk analysis and implementing a risk management plan to address potential threats and hazards for each of those systems." (Thomson Reuters / EBIA)  

[Guidance Overview]

Final Regs on Insurance Premiums Paid by Qualified Plans Allow Disability Replacement Contributions
"The final regulations largely track the proposed version (and the 2003 revenue ruling), so the big news here is the new exception for replacement contributions. A disability jeopardizes not only future salary but also future retirement savings -- this exception allows employers to offer qualified plan participants an opportunity to better protect themselves." (Thomson Reuters / EBIA)  

Manning & Napier Helps Advisors Navigate New Fiduciary Risk Through Microsite Launch
Manning & Napier, Inc.

PBGC Director Josh Gotbaum Talks Pensions with Fox Business News
PBGC [Pension Benefit Guaranty Corporation]

View All Press Releases