ERISA / Benefits Attorney
Choate Hall & Stewart
in MA

Defined Benefit Calculation Developer
Transamerica Retirement Solutions
in MA

Senior Defined Benefit Data Analyst
Transamerica Retirement Solutions
in MA

Consulting Actuary
Transamerica Retirement Solutions
in MA

Retirement Planning Consultant
Transamerica Retirement Solutions
in CA

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Pension Plan De-risking & Terminated Vested Buyouts: Why Now?
June 17, 2014 WEBCAST
(Findley Davies, Inc.)

Transitional Reinsurance Program: An Overview of Policy and Operations for Reinsurance Contributions
June 25, 2014 WEBCAST
(Centers for Medicare & Medicaid Services (CMS))

Using Decision Support Tools to Optimize Consumer-Directed Health Plan Adoption
June 26, 2014 WEBCAST
(Tango Health)

Retirement Plans After Windsor
June 26, 2014 WEBCAST
(IRS [Internal Revenue Service])

COBRA After Health Care Reform: Impacts and Implications for Employer Plans
July 8, 2014 WEBCAST
(Thomson Reuters / EBIA)

DOL Compliance Audits & Investigations
July 8, 2014 WEBCAST
(Ford & Harrison LLP)

An Update on DOL Disclosures
July 8, 2014 WEBCAST
(ASPPA [American Society of Pension Professionals & Actuaries])

Health Care Reform and Other Key Compliance Requirements: Roadmap for 2014 and Beyond
July 15, 2014 WEBCAST
(Thomson Reuters / EBIA)

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International Foundation of Employee Benefit Plans [IFEBP]

[Official Guidance]

Text of CMS FAQ 2070: Processing Qualified Health Plan Auto-Renewals from 2014 to 2015
"What is CMS's approach for auto renewals from 2014 to 2015 QHPs? Answer: CMS is developing a template for issuers to complete that would cross walk 2014 Qualified Health Plan (QHP) plan ID and service area combinations (e.g., Plan ID and County combinations) to a 2015 QHP plan ID. This data will facilitate 834 enrollment transactions from CMS to the issuer in December 2014 for those enrollees who have not actively selected a different QHP during open enrollment at that time.... The attached template is not the final design but illustrates the concept CMS anticipates implementing for automatic renewals and enrollment for the 2015 benefit year." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services)  

[Advert.]

Form 5500 Reporting Update

June 25 -- This live webinar will help you understand when you need to file a Form 5500 and what you need to file, and will focus on some recent changes that may impact your filings. BenefitsLink discount.

[Guidance Overview]

Text of CMS FAQ 2139: Source Documents for Understanding Required Benefits of the State Benchmark Plan
Contains a list of websites and documents for both federal and state sources. Excerpt: "[P]lans must offer benefits and limits that are substantially equal to the benefits and limits in the benchmark, as established in 45 CFR 156.115. Summaries of the EHBs for each state as well as a guide to reviewing benchmark plans are available on the CCIIO website[.]" (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services)  

[Guidance Overview]

HHS Releases Final Rule Governing Exchanges, Qualified Health Plans for 2015 and Beyond
"[The final rule] establishes regulations relating to discontinuation and renewal of insurance, quality reporting, non-discrimination, and enforcement remedies in Federally-facilitated Exchanges, and finalizes a modification of HHS's allocation of reinsurance collections in the event the collections do not meet projections. [It] also sets forth an approach to index the required contribution used to determine eligibility for an exemption from the shared responsibility payment ...The majority of the items found in the earlier Proposed rule were finalized as they were proposed." (Wolters Kluwer Law & Business)  

[Guidance Overview]

Latest Guidance on the ACA's Rules for Out-Of-Pocket Limits and Preventive Services Requirements
"Plan sponsors may have separate out-of-pocket limits on different categories of benefits (e.g., medical and prescription drugs) as long as the combined amount of all such limits does not exceed the allowed amount.... The out-of-pocket limit applies to in-network expenses only. A plan may limit a participant's out-of-network expenses, but is not required to do so. A plan sponsor is not required to count expenses for non-covered items or services toward the out-of-pocket limit." (Segal Consulting)  

[Guidance Overview]

The Treatment of Adjunct Faculty Members under the ACA
"[If] the school credits at least 2-1/4 hours of service for each hour of teaching or classroom time per week, plus all additional hours of service for those required duties outside the classroom (e.g., office hours, coaching, research, and serving on committees), this will be deemed good faith compliance at least until the end of 2015.... [T]he 2-1/4 rule is found only in the preamble to the regulations and is not found in the regulations themselves.... [F]ollowing the guidance from the IRS may not provide full protection against a claim for coverage by an individual." (Michael Best & Friedrich LLP)  

Sixth Circuit Rejects Challenges to ACA Contraception Mandate by Catholic Non-Profits
"The Sixth Circuit agreed with the district courts that the contraception mandate does not substantially burden the plaintiffs' free exercise of religion because all of the plaintiffs are eligible for either an exemption from the contraception mandate or an accommodation developed by the government for certain non-profits that object to the mandate on religious grounds.... The Sixth Circuit also ... concluded that the contraception mandate does not unconstitutionally compel speech because it does not require the plaintiffs to provide contraceptive counseling or otherwise to pay for it." [Michigan Catholic Conference and Catholic Family Services d/b/a Catholic Charities Diocese of Kalamazoo v. Burwell, Nos. 13-2723/6640 (6th Cir. June 11, 2014)] (Squire Patton Boggs)  

Supreme Court Declines to Review Action Involving Reimbursement of Benefits Under ERISA 502(a)(3)
"The Second Circuit's decision ... joined the majority of circuit courts in allowing ERISA fiduciaries to recover overpaid benefits under ERISA 502(a)(3) even if those funds have been dissipated.... [In] refusing to grant certiorari, the Supreme Court allowed a circuit split to remain on this issue ... Therefore, the ability of ERISA plan administrators and fiduciaries to recover overpayments may vary depending on the location of the case." [Thurber v. Aetna Life Insurance Co., No. 12-370 (2d Cir. Mar. 13, 2013; cert. denied June 9, 2014)] (Edwards Wildman)  

'Derivative Standing' Allows Medical Provider to Obtain Reimbursement from ERISA Plan
"Medical providers often have a patient/ERISA plan participant assign rights under an ERISA health care plan to allow the medical provider to seek payment for medical services provided. But what if the patient/plan participant never was billed for the medical services? What rights are there to assign? Is that an effective assignment? Yes." [Univ. of Wisconsin Hospital and Clinics, Inc. v. Aetna Life Ins. Co., No. 13-cv-197-jdp (W.D. Wis. June 6, 2014)] (Lane Powell PC)  

Equitable Surcharge Awarded to Life Insurance Plan Beneficiary
"A federal district court in California awarded relief in the form of surcharge to a life insurance plan beneficiary who claimed that a plan administrator failed to provide complete and accurate information in response to inquiries about how to prevent coverage from lapsing." [Echague v. Metropolitan Life Ins. Co., No. 12-cv-00640-WHO (N.D. Cal. May 19, 2014)] (Proskauer's ERISA Practice Center)  

Play 'or' Pay? Employers Say More Like Play 'and' Pay
"Very few employers have plans to discontinue coverage in 2015. There is some uncertainty regarding employer-sponsored coverage five years from now; however, most organizations say they likely will continue coverage. If discontinuing coverage in the future, most organizations say they likely or definitely would provide a subsidy. The most common reason given for potentially discontinuing coverage was cost." (International Foundation of Employee Benefit Plans [IFEBP])  

The Effects of the ACA on Small Business
"The consequences for employers (and individual workers) who must purchase coverage are already becoming apparent. A 2014 survey of 148 insurance brokers by the investment firm Morgan Stanley found that rates in the small group market have risen substantially.... Premiums rose 66 percent in Pennsylvania, 37 percent in California, 34 percent in Indiana, 30 percent in Kentucky and 29 percent in Colorado." (Devon M. Herrick, National Center for Policy Analysis)  

Aetna CEO Says Obamacare Causing Half of 2015 Rate Increases
"Health insurer Aetna Inc is submitting premium rates to regulators for Obamacare insurance plans for 2015 that generally increase less than 20 percent from 2014, its Chief Executive Officer Mark Bertolini said ... Bertolini said about half the rate of increases the insurer has submitted for 2015 were due to changes in Obamacare." (Reuters)  

Retiree Health Costs Hold Steady
"[A] 65-year-old couple retiring this year will need an average of $220,000 (in today's dollars) to cover medical expenses throughout retirement.... For many Americans, health care is likely to be one of their largest expenses in retirement. What's more, that $220,000 in estimated costs does not include any costs associated with nursing-home care, and applies only to retirees with traditional Medicare insurance coverage." (Fidelity)  

Data on HIPAA Compliance and Breaches Provides Lessons for Health Plans, Providers and Business Associates
"Required by the Health Information Technology for Economic and Clinical Health (HITECH) Act, the two new reports discuss various details about HIPAA compliance for calendar years 2011 and 2012. They include the following: [Annual Report to Congress on Breaches of Unsecured Protected Health Information], discussing the breach notification requirements and reports OCR received as a result of these breach notification requirements; and [Annual Report to Congress on HIPAA Privacy, Security, and Breach Notification Rule Compliance], summarizing complaints received by OCR of alleged violations of the provisions of Subtitle D of the HITECH Act, as well as of the HIPAA Privacy and Security Rules at 45 CFR Parts 160 and 164." (Solutions Law Press)  

Changing Provider Networks in Marketplace Health Plans: Balancing Affordability and Access to Quality Care
"A number of states have enacted -- or are considering enacting -- quantitative standards for provider networks, such as a maximum time and distance a consumer must travel to see a provider. Other states maintain a network adequacy standard but it is predicated on a subjective expectation that insurers provide access to care 'without unreasonable delay.' While quantitative standards have significant drawbacks, [the authors] conclude that a clear numeric adequacy standard is preferable to a subjective 'reasonableness' standard." (Health Affairs Blog)  

[Official Guidance]

Text of Amendments to PCAOB Accounting Standards Regarding Executive Compensation (PDF)
223 pages. Excerpt: "Clarifications ... explicitly provide that the auditor's work relating to a company's financial relationships and transactions with its executive officers does not include an assessment of the appropriateness or reasonableness of executive compensation arrangements.... [The] amendments strengthen existing requirements by requiring the auditor, as part of the audit risk assessment process, to perform procedures to obtain an understanding of the company's financial relationships and transactions with its executive officers." (Public Company Accounting Oversight Board [PCAOB])  

[Guidance Overview]

Transcript of IRS Phone Forum, January 29, 2014: Ethical Standards for Employee Benefits Practitioners (PDF)
"[We] would like to focus on the standards of practice applicable to a practitioner's communications with clients and the IRS.... We also want to give you a brief overview of Circular 230, and talk about what Circular 230 is.... [We] will analyze some hypothetical fact patterns, which we believe illustrate the application of some key provisions of Circular 230 that apply to a practitioner's offering of tax advice relating to employee benefit plans." (Internal Revenue Service [IRS])  

Employer Costs for Employee Compensation, March 2014
"Total employer compensation costs for private industry workers averaged $29.99 per hour worked in March 2014. Total employer compensation costs for state and local government workers averaged $43.10 per hour worked in March 2014.... Private industry employer costs for paid leave averaged $2.09 per hour worked (7.0 percent of total compensation), supplemental pay averaged 85 cents (2.8 percent), insurance benefits averaged $2.50 (8.3 percent), retirement and savings averaged $1.15 (3.8 percent), and legally required benefits averaged $2.44 (8.1 percent)." (U.S. Bureau of Labor Statistics)  

New Book De-Mystifies Operating a 401(k) Plan
401k Essentials

MassMutual Commences Participation in Penbridge Pension Risk Transfer Database
Penbridge Advisors

Pavilion Financial Corporation Announces Acquisition of Plan Sponsor Advisors, an Investment and Retirement Benefit Consultancy
Pavilion Financial Corporation

TRA Introduces Premier Advisor Group Program
The Retirement Advantage [TRA]

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