Senior Retirement Plan Administrator
Benefit Equity Inc.
in CA

Qualified Account Representative
Pen-Cal Administrators, Inc.
in CA

Sales Manager - Qualified Plans
Polycomp Administrative Services, Inc.
in CA

Senior Team Manager-Employer Sponsored Retirement Plans
Edward Jones
in MO

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Qualified Health Plan (QHP) Series - Dental Template Scenarios Demo and General Q&A
June 5, 2014 WEBCAST
(Centers for Medicare & Medicaid Services (CMS))

Federally-facilitated Small Business Health Options Program (FF-SHOP) Series III - Update and Issuer Q&A
June 10, 2014 WEBCAST
(Centers for Medicare & Medicaid Services (CMS))

Form 5500: Lessons Learned, New Issues and Best Practices for the 2013 Filing Season
June 18, 2014 in NY
(Worldwide Employee Benefits Network [WEB] - New York Chapter)

Milliman's Mid-Market Employer Benchmarking Survey
June 24, 2014 in TX
(Worldwide Employee Benefits Network [WEB] - Dallas Chapter)

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[Official Guidance]

CMS Technical FAQs for Allocation of Risk Corridor Expenses, May 28, 2014
"Which types of plans should be considered when allocating expenses for the risk corridor calculation? ... If there are administrative expenses or taxes and fees that relate specifically to a QHP, do those expenses have to be allocated proportionally across all non-grandfathered plans? ... Is there any reason to make the risk corridor calculations by each QHP? ... Will Risk Adjustment and Reinsurance transfers need to be allocated to each plan based on premium or do the resulting transfers have to be directly assigned to the QHP from which the transfer resulted?" (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services)  

[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.

[Guidance Overview]

Overview of ACA Reporting Requirements for Multiemployer Health Plans
"This [article] summarizes the reporting requirements and the guidance in the final rules, which generally follow proposed rules issued last fall. It includes checklists for information that plans must report and detailed information that employers must report. Special rules apply to employers that contribute to multiemployer plans. Employers with self-insured plans will welcome the news that the final rules permit combined reporting. The [article] concludes with some notes about action items for plan sponsors." (Segal Consulting)  

[Guidance Overview]

ACA Countdown to Compliance for Employers: ERISA Section 510 and Limiting Employee Hours
"Capping the hours of an ongoing employee during a standard measurement period would result in the withdrawal of coverage or at least eligibility for coverage. These individuals 'are or may become eligible for a benefit ... from an employee benefit plan,' i.e., they are participants for ERISA purposes. If the employee can demonstrate that the reason an employer imposes a 1,560 hour (or some similar) cap is to reduce exposure for penalties under Code Section 4980H, it would seem that the employee would have little difficulty establishing the requisite level of interference required to state a claim under ERISA Section 510." (Mintz Levin)  

IRS Says Pre-Tax Payment Plans Won't Satisfy ACA Employer Mandate
"The Internal Revenue Service has clarified that employers will not escape taxes and penalties under the Affordable Care Act if they choose to send their employees to the exchanges and reimburse them with tax-free dollars for premiums in lieu of offering an employee-sponsored health insurance plan.... The IRS clarification is directed as much at benefit advisers and agents as it is at employers, since, according to one industry lawyer, the FAQ was prompted by consultants and brokers selling pre-tax reimbursement plans to employers in defiance of the IRS' direction." (Employee Benefit News)  

Am I Required to Pay My Employees for Holidays Occurring During FMLA Leave?
"Put in simple terms, you first look to treat the leave in the same manner you treat other forms of non-FMLA leave. If FMLA is being taken in conjunction with paid leave, look to the manner in which you treat employees on paid leave." (FMLA Insights)  

Autism Spectrum Disorder and ABA Treatment -- New Legal Theories Facing Self-Insured Plans?
"Since the [Mental Health Parity and Addiction Equity Act] regulations expressly provide that a 'permanent exclusion of all benefits for a particular condition or disorder' is not an impermissible treatment limitation, ERISA plan sponsors can avoid suit by reducing the scope of both medical and mental health benefits but this legal solution raises concerns regarding employee satisfaction with the offered benefits package." (Benefits Bryan Cave)  

Are Part-Timers Losing Health Coverage? (PDF)
"[I]n relative terms, part-time workers have experienced a much larger decline in coverage than full-time workers ... [B]etween 2007 and 2012, workers employed 40 or more hours per week experienced a 3 percent reduction in the likelihood of having coverage from their own job, while those employed 30-39 hours per week experienced a 12 percent decline, and those employed fewer than 30 hours per week experienced a 20 percent decline." (Employee Benefit Research Institute [EBRI])  

Does ERISA Preempt a State Law Claim of Fraudulent Plan Representation?
"Each of the employer's claims stemmed from alleged misrepresentations and omissions made by the plan and its representatives to induce the employer to invest in the plan before it was formed, so the claims were not subject to ERISA, the federal district court said. Further, the court said that all of the complained-of conduct occurred before the plan's formation and 'does not implicate the administration, interpretation, or recovery of benefits of the plan or relate to a violation of the plan's terms.'" [Patel v. Sea Nine Assocs., Inc., No. 3:13-cv-04491-B (N.D. Tex. May 15, 2014)] (Bloomberg BNA)  

Employee Health Care Premiums Boosted Under Obamacare
"In the first year that the health care law's regulations and coverage are active, 86 percent of workers expect their personal medical costs to increase ... That's in line with employers' projections as well. In 2013, 56 percent of companies increased their employees' share of health care premiums or co-pays; another 59 percent plan to do the same by the end of 2014." (The Daily Caller)  

[Advert.]

ACA Compliance Analysis – An affordable Executive Summary provides options!

Are we a large or small employer? Should we offer a health plan, are we subject to a tax penalty? What's a measurement period? Do we have the info we need to make a business decision about our employee benefit plan? Get answers and more, call 404-305-0600 today!

CMS Presentation: Distributed Data Collection for Reinsurance and Risk Adjustment (PDF)
35 slides dated May 28, 2014. Excerpt: "Program implementation requires claims and enrollment data from issuers in states where HHS is operating the [risk adjustment (RA)] and [reinsurance (RI)] programs.... In 2013, CMS introduced the EDGE (External Data Gathering Environment) server concept as the distributed data collection method... All processing of claims and enrollee data, as well as calculation of individual risk scores and reinsurance amounts, would occur on the EDGE server.... CMS is offering issuers a choice in the type of EDGE server that is used: [1] Virtual server in the Amazon cloud; or [2] On-premise server in a location of the issuer's choice." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services)  

Paid Sick Leave Moves Ahead While Paid Family Leave Lags Behind (PDF)
"Because large employers often provide paid sick leave for their employees either on a stand-alone basis or as part of a PTO program, sick leave laws are apt to have a greater impact on small employers.... While the formula may change based on a city's demographics and business climate, the basic construct ... likely will continue to be used as additional cities explore the viability of paid leave laws. Notably, the recently proposed Chicago ordinance expressly references the paid sick leave policies of Jersey City, New York City, San Francisco, Seattle, and Portland." (Buck Consultants)  

Preparing for Implementation of the ACA in New Jersey
"[1] A Basic Health Program could provide a higher level of benefits at a lower cost to eligible low-income individuals, but it would pose some significant financial and other risks to the state. [2] The state must adopt a model plan covering the Ten Essential Benefits. Monitoring and enforcement will be necessary to ensure that health plans offer and pay for these benefits. [3] Few New Jerseyans reported having trouble finding a physician, and most of them found one eventually. Finding a doctor who would accept their insurance proved more challenging." (Robert Wood Johnson Foundation)  

CalPERS Reference Pricing Policy Yields Big Return on Investment
"A reference pricing policy for elective surgeries, implemented by Anthem and [CalPERS], returned $5.5 million in aggregate savings and a 26 percent reduction in price paid for the first two years of the policy's existence. The model ... was originally put in place for elective knee and hip replacements and has since been expanded to outpatient elective cataract surgeries, colonoscopies, and arthroscopy procedures." (HealthData Management)  

[Opinion]

The Biggest Myths of Obamacare
"[1] If you like your health plan, you can keep it.... [2] If you like your doctor, you can keep your doctor.... [3] There is an 'employer mandate' to offer affordable coverage.... [4] Health reform will lower the cost of health insurance by $2,500 a year for the average family.... [5] There is an 'individual mandate' that ensures everyone has health coverage.... [6] Individuals cannot be denied individual coverage due to pre-existing conditions.... [7] Health insurers no longer can cancel a policy after an insured individual gets sick.... [8] Medicare has been strengthened." (John R. Graham, National Center for Policy Analysis)  

[Opinion]

Why Not Just Eliminate the Employer Mandate? (PDF)
"[E]liminating the employer mandate will not reduce insurance coverage significantly, contrary to its supporters' expectations. Eliminating it will remove labor market distortions that have troubled employer groups and which would harm some workers. However, new revenue sources will be required to replace that anticipated to be raised by the employer mandate." (Linda J. Blumberg, John Holahan and Matthew Buettgens, via Urban Institute)  

[Opinion]

Latest IRS Rule Outlaws Decades-Old Benefits, But Will Not Stop Employers Dumping Workers Into Obamacare's Broken Exchanges
"[N]otwithstanding its effect on participation in ObamaCare's exchanges, [a new IRS] rule has destroyed [pre-tax premium payment] arrangements that some employers and workers have had 'for decades'. However, employers' motives to dump workers into ObamaCare exchanges [are] not primarily driven by the ability to bribe workers with pre-tax dollars to do so. ObamaCare is so good at socializing benefits costs that post-tax dollars work just fine." (John Goodman's Health Policy Blog)  

[Opinion]

The Affordable Care Act's Nonparticipating States
"[N]ow that enrollment numbers are available, it is becoming clear that nonparticipating states have enjoyed only limited success in preventing the ACA from taking root in their jurisdictions. More than 3 million individuals have enrolled in a health plan through the marketplaces in nonparticipating states ... In seven of the 12 states, enrollment exceeded projections, including by more than 50 percent in Florida, Georgia, and North Carolina. Even Medicaid enrollment rose in half of the nonparticipating states[.]" (The Commonwealth Fund)  

[Guidance Overview]

GASB Proposes Major Improvements for Governmental Reporting of Liability for Health Insurance and Other Retiree Benefits
"The most significant effect of the OPEB Exposure Drafts would be to require governments to recognize their net OPEB liabilities on the face of their financial statements -- providing all financial statement users with a more comprehensive understanding of these significant OPEB promises than is currently available.... The OPEB Employer Exposure Draft proposes that governments be required to report a liability for the OPEB that it will provide on the face of the financial statement.... The OPEB Employer Exposure Draft also proposes significant changes to how a government would calculate its OPEB liability and annual expense.... The OPEB Plan Exposure Draft addresses the financial reports of [DB] OPEB plans that are administered through trusts that meet certain criteria. It also details proposed note disclosure requirements for [DC] OPEB plans.... The Exposure Drafts, including instructions on how to submit written comments, are each expected to be available in mid-June on the GASB website[.]" (Governmental Accounting Standards Board)  

Beneficiary Designation Practices Survey
NICSA

HighRoads Announces Two Vice President Promotions
HighRoads

Retirement Savings on the Rebound, Research Shows
Principal Financial Group

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