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May 23, 2014          Get Retirement News  |  Advertise
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Employee Benefits Jobs

ERISA Counsel - Tax Qualifications
T. Rowe Price
in MD

Regional Vice President/Retirement Plan Wholesaler
Ohio National Financial Services
in CA, GA, KS, MO, NE, TX

Retirement Plan Design & Drafting Consultant
AUL / OneAmerica Financial
in IN

Retirement Plan Services Consultant or Plan Manager
AUL / OneAmerica Financial
in IN

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Webcasts and Conferences

Form 5500 for Welfare Plans 2014 - 2-part Web Seminar
June 2, 2004 WEBCAST
(SunGard Relius)

Pension Plan De-risking & Terminated Vested Buyouts: Why Now?
May 28, 2014 WEBCAST
(Findley Davies, Inc.)

Washington Update
June 3, 2014 in FL
(ASPPA Benefits Council [ABC] of North Florida)

New Ways to Avoid Late Filing Penalties
June 9, 2014 WEBCAST
(SunGard Relius)

Washington Update
June 17, 2014 in TX
(ASPPA Benefits Council [ABC] of Dallas/Fort Worth)

Voluntary Fiduciary Correction Program
June 18, 2014 WEBCAST
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

Yes, You're a Fiduciary
July 24, 2014 WEBCAST
(TRI-AD)

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 Letter from HHS to American Hospital Association on Third-Party Payment of Qualified Health Plan Premiums (PDF)
"We believe that existing guidance related to third-party payments of premiums and cost sharing made on behalf of Marketplace QHP enrollees by private, not-for-profit foundations is sufficient to put the public on notice that as a general matter, such payments are not prohibited by HHS's rules to the extent they are provided in a manner consistent with the February 7, 2014 FAQ. Therefore, we do not intend to issue additional guidance in this area at this time." (U.S. Department of Health and Human Services, via American Hospital Association)  


[Advert.]

ERISA Audits: What We All Knew but Forgot

Sponsored by Lorman and BenefitsLink

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]

Text of CMS FAQ: Reinsurance Contributions Process (PDF)
"HHS will implement a streamlined process for the collection of reinsurance contributions. A contributing entity, or a third-party administrator (TPA) on behalf of the contributing entity, can complete all required steps for the reinsurance contributions process on Pay.gov: registration, submission of the annual enrollment count, and remittance of contributions.... We anticipate offering training on this process beginning in late June." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services)  

[Guidance Overview]

Third-Party Payments and Reference Pricing
"Neither the February 7 [HHS] FAQ nor the May 21 letter specifically bless payment by 'hospital-affiliated' foundations, but it seems that it would be difficult for HHS to challenge such payments in the wake of the May 21 letter.... [ACA FAQ Part XIX, issued May 2] addresses the use of reference pricing by large-employer and self-insured plans. It explicitly does not apply to non-grandfathered plans in the individual and small group market.... [T]he FAQ's endorsement of reference pricing is equivocal. The Departments express concern 'that such a pricing structure may be a subterfuge for the imposition of otherwise prohibited limitations on coverage, without ensuring access to quality care and an adequate network of providers.'" (Timothy Jost in Health Affairs Blog)  

[Guidance Overview]

Waiting Periods on Essential Health Benefits May Cause Prohibited Discrimination
"The first FAQ clarifies that insurers in the individual and small group market may not impose waiting periods on specific essential health benefits. For example, insurers cannot impose waiting periods for transplants, as they would discriminate against people with kidney, heart and liver diseases. 'Any issuer that currently has a waiting period in its plan policy for an EHB needs to amend the policies to remove the waiting period within a reasonable timeframe of the release of this document,' CMS states." (Thompson SmartHR Manager)  

[Guidance Overview]

Preparing for the ACA: Employer Information Reporting Requirement (PDF)
39 presentation slides. Excerpt: "New tax reporting requirements are the foundation of IRS enforcement of various tax provisions of the ACA ... Reporting requirements largely focus on different ACA provisions ... Returns must be provided to the IRS by March 31st of the following year (or February 28th if filing by paper). Statements must be provided to applicable taxpayers/employees by January 31st of the following year. These rules apply regardless of calendar or non-calendar year plans." (Groom Law Group, for American Benefits Council)  

Court Finds No ERISA Sec. 510 Violation for Self-Insured Plan That Denied Coverage to Same-Sex Spouse
"A same-gender couple had argued that, in light of U.S. v. Windsor, because the plan declined to cover the spouse, the employer interfered with the attainment of benefits. However, the court noted, that only narrower ERISA claims were the focus of the lawsuit -- not other federal laws or constitutional issues. As such, as ERISA currently stands, employers have the right to design their plans as they see fit -- as long as someone's employment is not adversely affected." [Jane Roe and Jane Doe v. Empire Blue Cross Blue Shield and St. Joseph's Medical Center, No. 12-cv-04788 (S.D.N.Y. May 1, 2014).] (Thompson SmartHR Manager)  

Supreme Court to Decide Whether Retiree Health Benefits Last a Lifetime (PDF)
"Because of the differing legal rules the circuits apply, where retirees and/or unions file the lawsuit -- rather than the relevant language in the CBA -- can often determine the outcome of the dispute. This reality encourages 'forum shopping' ... In the Sixth Circuit, the Yard-Man inference applies only in the collectively bargained benefits context. Other circuits apply a single standard regardless of whether the benefits are grounded in a CBA." (Buck Consultants)  

Court of Appeals Upholds Breach of Fiduciary Duty Determination Against Self-Insured Health Plan's TPA
"The court rejected the argument that [Blue Cross Blue Shield of Michigan (BCBSM)] was not a fiduciary because it simply adhered to contract terms giving it the unilateral right to retain funds as compensation because BCBSM exercised discretion with respect to this right by not imposing such fees uniformly on all self-insured clients. The court also rejected the argument that the funds that were used to pay the disputed fees were Hi-Lex corporate assets and not plan assets subject to ERISA protections. The court noted that under ERISA regulations, employee contributions constitute plan assets as soon as they are segregated from an employer's general assets. With respect to employer contributions, which formed the bulk of the funds provided to BCBSM, the court noted that the assets of a welfare plan generally include any property, tangible and intangible, in which the plan has a beneficial ownership interest." [Hi-Lex Controls v. Blue Cross Blue Shield of Michigan, Nos. 13-1773/1859 (6th Cir. May 14, 2014)] (Winston & Strawn LLP)  

Detroit, Chicago Stop Covering Retirees' Health Care
"Before the health insurance marketplaces went online in October, a number of state and local governments considered the cost-saving measure of sending their employees and retirees to the exchanges instead of continuing to cover their health insurance. Much of the talk has been speculative, but a few cities are actually making moves -- at least where retirees are concerned." (Governing)  

Temporary Fee on Big Businesses Funds Obamacare
"The government collects $63 from large self-insured employers and insurance companies for every covered life under a plan, which includes each employee and each dependent it insures. That money goes into a fund for health insurance companies, that reimburses them for some extra costs involved in providing coverage to high-risk individuals on the Obamacare exchanges. You might think of it as a subsidy from big business for making insurance coverage available to everyone without regard to pre-existing conditions." (Kaiser Health News)  

What Does PPACA Stand For? 'Punitive Penalties Are Clearly Authorized.'
"[In] other compliance areas, the federal agencies have repeatedly indicated that they are not seeking to penalize employers as they try to come into compliance with the new rules; rather they are trying to encourage compliance. The statement in this new Q&A might signal a shift in attitude, at least on this one issue." (Proskauer's ERISA Practice Center)  

Employers Are Significantly More Informed About Health Plan Options This Year Than in 2013
"In a 2013 benchmark study, only 37 percent of employers reported being very informed about their companies' options for providing health insurance; in the 2014 study, 69 percent report being very informed. Among small businesses ... only six in ten of those with fewer than 50 full-time equivalent employees are aware of the Small Business Health Options Program (SHOP), compared to eight of ten businesses overall. Just 7 percent of small businesses intend to offer employees coverage through the SHOP." (Wolters Kluwer Law & Business)  

[Opinion]

A Physician Responds: Thoughts on the 2014 Milliman Medical Index
"Although the rate of increase in the MMI has decreased to 5.4%, that is still a one year increase in health spending of $1,185.... [I]ncreasing proportions of the cost increases have nominally been shifted to the family -- through higher payroll deductions and greater out-of-pocket costs. In actuality, most economists agree that the employer's share of the costs is actually paid by the employee in the form of forgone wage increases.... Thomas Piketty's treatise on Capital in the 21st Century describes our inequality in income and wealth. It takes very little imagination to see how a publicly financed single payer system would slightly temper the inequities while ensuring health care for everyone." (Physicians for a National Health Program [PNHP])  

[Opinion]

NCVHS Makes Recommendations on Various Standards and Code Sets for HIPAA Transactions, Including HPIDs for Self-Insured Health Plans (PDF)
"To mitigate the confusion about the HPID among the health care industry, HHS should: [1] provide more guidance on the HPID/OEID specifically, clarifying when an HPID should be requested; [2] clarify the definition of health plan ... [3] explain the applicability of HPID to self-insured and fully-insured group health plans, specifically the extent to which all self-insured plans are required to obtain a HPID, where the HPID is to be used in the transaction and when a third party administrator is the entity processing the transaction on behalf of the self-insured plan ... [4] provide guidance on benefits and value of the HPID for health plans and providers and administrative simplification requirements[.]" (National Committee on Vital and Health Statistics)  

Benefits in General; Executive Compensation

[Guidance Overview]

New Regs Allow Disability Insurance Premiums to Be Paid from Retirement Plan Accounts
"[A]mounts from a qualified plan used to pay for accident or health insurance premiums generally are taxable distributions ... However, the general rule does not apply to special 'plan contribution replacement' disability insurance policies ... If certain conditions are met, the premium payments by the plan are not treated as taxable distributions and the benefits paid to the participant's account in the plan are treated as investment earnings rather than contributions." (Holland & Knight)  

Use Caution: The Effect of Inversions and Entity Expatriations on Key Executive Compensation
"A recent scenario highlights the costly consequences of [Internal Revenue Code sections] 7874 and 4985 on companies that seek to protect the benefits they pay executives.... [A corporation] eventually determined that it would have to treat the transaction as an inversion under section 7874, thereby resulting in the 15% penalty tax for its executives and directors on their options and specified stock compensation. Reasoning that the executives and directors should not be penalized for a transaction that was in shareholders' best interests, [the company] agreed to make tax reimbursements that totaled $31 million -- a sizeable dent in the tax savings they forecasted they would make from the inversion." (Bloomberg BNA)  

Multiple Say-on-Pay Failures Reveal Common Themes
"[W]hile these companies often engaged with shareholders following an earlier failed vote, those engagement activities and/or compensation program changes often fell short of fully addressing shareholder concerns.... [I]nfluence is often concentrated with the CEO, who was frequently the company founder or occupied both the CEO and board chairman roles with no additional independent board leadership." (Towers Watson)  

2014 Trends and Developments in Executive Compensation (PDF)
"Companies are going to greater lengths to evaluate and demonstrate a strong relationship between executive pay and performance ... 96% of companies expect shareholder support above 70% in 2014, typically in the mid to high 90's. Merit increases remained relatively modest (median of 3%) for both executives and non-executives.... Long-term performance plans now make up 53% of total [Long-Term Incentive] award values, with stock options down to only 18%." (Meridian Compensation Partners, LLC)  

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