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Employee Benefits Jobs
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Webcasts and Conferences
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Hand-picked links to the web's best news articles,
official guidance, jobs, webcasts and more.
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[Official Guidance]
Text of IRS Final Regs: Tax Credit for Employee Health Insurance Expenses of Small Employers
60 pages. Excerpt: "[T]hese final regulations adopt the provisions of the proposed regulations with certain modifications ... The final regulations ... add definitions for the term 'tobacco surcharge' ... and for the term 'wellness program' ... The final regulations incorporate the uniform percentage requirement provisions from the proposed regulations, but also contain additional rules for how to apply the uniform percentage requirement if SHOP dependent coverage is offered ... [If] an employer opts to provide SHOP dependent coverage to employees in addition to employee-only coverage, the final regulations provide that the employer does not fail to satisfy the uniform percent age requirement by contributing a different amount toward that SHOP dependent coverage than to either employee-only coverage or family coverage, even if that contribution is zero[.]"
(Internal Revenue Service [IRS])
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[Official Guidance]
Text of CMS Proposed Regs: Annual Eligibility Redeterminations for Exchange Participation and Insurance Affordability Programs
33 pages. Excerpt: "This proposed rule would specify additional options for annual eligibility redeterminations and renewal and re-enrollment notice requirements for qualified health plans offered through the Exchange, beginning with annual redeterminations for coverage for plan year 2015.... [We] propose that the Exchange may utilize the existing procedure... described in 155.335(b) through (m).... [We also] propose that the Exchange may utilize alternative procedures specified by the Secretary for the applicable plan year.... Third ... we propose that the Exchange may utilize alternative procedures approved by the Secretary based on a showing by the Exchange that the alternative procedures would facilitate continued enrollment in coverage for which the enrollee remains eligible, provide clear information about the process to the qualified individual or enrollee ... and provide adequate
program integrity protections.... We solicit comment regarding standards for approving alternative procedures, and on other elements of the annual redetermination process, as well as how it affects renewal for individuals who are enrolled in a QHP through the Exchange."
(Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])
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[Official Guidance]
Text of CMS Guidance on Annual Redeterminations for Coverage for 2015 (PDF)
"These alternative procedures preserve an important feature of the annual redetermination process specified in 45 CFR 155.335(g), namely, that an enrollee may take no action and still have his or her coverage renewed for 2015, which is important in promoting continuity of coverage while limiting administrative burden for enrollees, issuers, and Marketplaces. The procedures described [in this memo] constitute the alternative procedures specified by the Secretary for plan year 2015, as proposed in 45 CFR 155.335(a)(2)(ii). These procedures will have no effect or application unless a final rule is promulgated authorizing their use."
(Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])
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[Official Guidance]
Text of CMS Information Bulletin: Draft Standard Notices When Discontinuing or Renewing a Product in the Small Group or Individual Market (PDF)
21 pages. Excerpt: "This bulletin provides draft standard notices that health insurance issuers would use when discontinuing or renewing coverage under a product in the small group or individual market.... CMS intends to finalize these notices in conjunction with the Annual Eligibility Redeterminations final rule based on the results of consumer testing and input from the public comment period. CMS will consider issuers that use either these draft notices or the final standard Federal notices to have met the Secretary's specification regarding the form and manner of the required discontinuance and renewal notices in case where the State does not develop and require the use of a different form consistent with this bulletin, at least through September 30, 2015." [Also see Instructions for these notices.]
(Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])
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[Official Guidance]
Text of CMS Instructions for Draft Standard Notices of Product Discontinuation and Renewal (PDF)
14 pages. Includes instructions for: [1] Renewal notice for the individual market where coverage is being renewed outside the Marketplace; [2] Renewal notice for the individual market where coverage is being renewed in a QHP offered through the Marketplace; [3] Discontinuation notice for the individual market outside the Marketplace; [4] Discontinuation notice for the individual market where coverage being discontinued was in a QHP offered through the Marketplace; [5] Renewal notice to employers for the small group marketplace; and [6] Discontinuance notice to employers for the small group marketplace. [Also see Draft Standard Notices.]
(Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])
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[Advert.]
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This unique event has been researched and developed for executives working on all stages of ACO development -- specifically for Health Systems, Hospitals, IPAs, Physician Groups, and Health Insurance firms. Continuing Education Credits offered!
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[Guidance Overview]
Text of HHS Announcement on Auto-Enrollment Plans for Current Marketplace Consumers for 2015
"In today's health insurance market, the vast majority of consumers are generally auto-enrolled in their plan year after year.... These guidelines aim to bring the Marketplace in line with this practice in the existing insurance market. As with existing open enrollment periods for employer-based coverage, consumers are strongly encouraged to use the open enrollment period as an opportunity to update their information and reevaluate their health coverage needs for the coming year."
(U.S. Department of Health and Human Services [HHS])
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[Guidance Overview]
Impending Qui Tams and False Claims Act Cases Involving Health Exchanges (PDF)
"The government has stated its intent to use the [False Claims Act (FCA)] with these programs.... Between the application process and the continued data submission requirements under the transparency, reinsurance, risk corridors, and risk adjustment program requirements, there are potentially significant opportunities for the government or a relator to allege that some erroneous data is the basis of FCA liability.... QHP issuers ... need to develop strong compliance protocols regarding claims and data submission."
(Bass, Berry & Sims)
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[Guidance Overview]
Risk Corridors: What's the Issue?
"The risk corridor program has proven to be one of the more controversial aspects of the ACA with critics ... [who] argue that as a result of HHS and state officials putting pressure on insurers to keep premiums low in the exchanges, the federal government will end up picking up the tab to bail out insurers if they underpriced. Critics also claim that the program encourages insurers to underprice their plans in order to gain market share, knowing the government will offset their losses.... In fact, risk corridors have broad support from economists, health policy experts, insurance companies, and regulators."
(Health Affairs)
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Proposed Legislation Aims to Codify 'Yard-Man Inference' as a Rebuttable Presumption
"The Act would: [1] Require employers to include in their SPDs whether the employer may unilaterally modify or terminate benefits. If the employer's rights are not clearly communicated to employees, there will be a presumption that benefits have 'fully vested and cannot be modified or terminated for the life of the employee or, if longer, the life of the employee's spouse.' ... [2] Make it an 'unfair labor practice' to change the terms of a CBA that governs retired employees' benefits. [3] Only allow reductions in benefits that are "necessary to prevent the liquidation of the debtor.'"
(Benefits Bryan Cave)
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Most HSAs Receive Contributions in 2013, But Few Max Out (PDF)
"[J]ust over one-half (52 percent) of HSA owners contributed to their account in 2013. Twelve percent made a contribution in the range of $1,000-$1,999 and 15 percent contributed between $2,000 and $4,999. Similarly, just over one-half (51 percent) of HSA accounts had an employer contribution."
(Employee Benefit Research Institute [EBRI])
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Push for Paid Parental Leave Grows
"This article summarizes activity at the state level, what's going on at the federal level, and what employers should do as they observe the debate over parental leave."
(Thompson SmartHR Manager)
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California's Paid Family Leave Program Expands the Definition of a Family Member
"On July 1, 2014, the program will expand to provide paid leave benefits [PFL] for workers to care for parents-in-law, grandchildren, grandparents and siblings.... PFL benefits do not provide job protection or return rights.... However ... employees may be confused by the 'Paid Family Leave' terminology and assume that they are receiving protected leave [under FMLA or the California Family Rights Act]. In addition, if an employer wishes to obtain certification to document the need for leave, it will need to create new documentation for that purpose."
(Nixon Peabody LLP)
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Premiums for Many in the Individual Market May Change Next Year
"Health insurance premiums for people with subsidies could increase substantially in some markets -- but consumers who shop around may not end up paying more ... Shopping around may not be as likely, however, under proposed rules ... which will automatically re-enroll the vast majority of those who are signed up for plans through the online marketplaces. Automatic re-enrollments might ease the experience, but will also make it less likely consumers will check out other options."
(Kaiser Health News)
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The Global Slowdown in Health Care Spending Growth
"[In] recent years, rates of excess health care spending in the United States and OECD have declined below their historical norms; in 2010 and 2011 (and 2012 for countries with available data), excess spending was either negligible or negative. The slowdown in health care spending growth has been a global phenomenon; in fact, US excess growth in 2010 and 2011 was slightly higher than average relative to other industrialized countries."
(JAMA)
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Half of Benefit Advisers Considering Leaving the Industry
"Nearly half (49%) of brokers say they are considering leaving the benefits industry altogether ... up 4% from the same poll last year. In fact, 67% of benefit advisers say they have peers who have left the business in the past year. Yet many brokers and agents also identify a huge opportunity as employers have steadily increased their use of brokers in the past three years."
(Employee Benefit Adviser)
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Benefits in General; Executive Compensation
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Press Releases
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