Retirement Plan Administrator
Actuarial Consultants, Inc.
in CA

401(k) Administrator
TPS Group
in CT

Manager, Defined Contributions Operations
Employee Benefit Firm
in DC, MD, PA, VA

Advisor's Assistant
RiverSource LLC
in GA

Defined Benefit Client Services Manager
Charles Schwab
in OH, TX

Vice President, Retirement Planning Services
USI Consulting Group
in IL, KY, WV

Compliance & Technical System Consultant
USI Consulting Group
in CT

Transition Manager - Client Integration
Transamerica
in NY

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PPA Pre-approved Plan Web Seminar - PPD Document
July 7, 2014 WEBCAST
(SunGard Relius)

What the New Healthcare Law Means for Your Small Business
July 10, 2014 WEBCAST
(Small Business Majority)

PPA Pre-approved Plan Web Seminar - Corbel Document
July 15, 2014 WEBCAST
(SunGard Relius)

Tax Obligations for International Investments and Retirement Plans
July 15, 2014 WEBCAST
(McGladrey LLP)

Defined Benefits 415 Calculations Plus
July 17, 2014 WEBCAST
(ASC [Actuarial Systems Corporation])

Private Exchange Strategies for Insurers: What’s Working? What’s Not?
August 6, 2014 WEBCAST
(Atlantic Information Services, Inc)

Hot Issues in Executive Compensation 2014
September 12, 2014 WEBCAST
(Practising Law Institute)

Dual-Eligibles Programs: Initial Results, Successes and Remaining Challenges
September 17, 2014 WEBCAST
(Atlantic Information Services, Inc)

View All Webcasts and Conferences

[Guidance Overview]

HHS Establishes Standards, Penalties to Protect Exchange Consumers
"The rule gives HHS broad authority to impose civil monetary penalties (CMPs) against assisters who violate any federal requirements applicable to their activities....These standards include rules requiring assisters to obtain authorization before accessing consumer's personally identifiable information; prohibiting charging consumers; prohibiting receipt of any consideration directly or indirectly from a payer in connection with enrollment of any individuals in a qualified health plan (QHP) or non-QHP; requiring assisters to maintain a physical presence in the exchange service area ... and prohibiting assisters from making specific plan recommendations." (HighRoads)  

[Advert.]

Evaluating Your Employee Health Benefits

July 31 live webinar. Learn how private markets have responded to the ACA with innovative ways to comply with the new law, while maintaining quality and controlling cost. BenefitsLink discount.

[Guidance Overview]

HHS Issues Final Reinsurance Fee Regs (PDF)
"The final regulations adopt most of the changes introduced by the proposed regulations issued last year. A handful of changes apply to the reinsurance program.... CMS expects to collect the reinsurance payment only once per covered life.... The attachment point will be $45,000, and the coinsurance rate will be 80 percent. The cap on reinsurance benefits is $250,000... Reinsurance contributions should be used for claims in the current year." (McGraw Wentworth)  

[Guidance Overview]

Agencies Finalize Regs Permitting One-Month Orientation Period Prior to 90-Day Waiting Period
"Imposing a one-month orientation period prior to a plan's waiting period provides additional flexibility and generally allows coverage to start on the first day of the month after 90 days of employment ... But, as the preamble cautions, large employers wishing to avoid play or pay penalties will need to be careful since some coverage start dates permitted under the waiting period rules may be too late to avoid Section 4980H penalties." (Thomson Reuters / EBIA)  

[Guidance Overview]

New Model COBRA Notice Language Issued; Individuals Eligible for COBRA Have Special Enrollment Period
"The model notices are for use by single-employer group health plans. Multiemployer plans may want to use a modification of the models or to make changes to their existing notices. While updating your SPD or issuing a Summary of Material Modification is not currently required, Plans may want to consider this language if they are in the process of updating their SPD." (Cheiron)  

[Guidance Overview]

Exchange Eligibility Redeterminations; Small Employer Tax Credit
"The biggest change in the proposed rule is to provide for two new redetermination processes in addition to the one set out in the 2012 rule.... During the 30 days between November and December 15, the exchanges will be receiving and verifying eligibility information from millions of individuals, many of whom are changing plans at the same time.... This process is going to present a massive technological challenge." (Timothy Jost in Health Affairs Blog)  

Supreme Court Rejects Contraceptives Mandate for Some Corporations
"Justice Samuel A. Alito Jr., writing for the court's five more conservative justices, said a federal religious-freedom law applied to for-profit corporations controlled by religious families. He added that the requirement that the companies provide contraception coverage imposed a substantial burden on the companies' religious liberty.... Justice Ruth Bader Ginsburg, writing for the court's four-member liberal wing, said the contraception coverage requirement was vital to women's health and reproductive freedom. Justices Stephen G. Breyer and Elena Kagan joined almost all of the dissent, but they said there was no need to take a position on whether corporations may bring claims under the religious liberty law." (The New York Times; subscription may be required)  

Supreme Court Exempts Some Companies from ACA Contraceptive Coverage Mandate on Religious Grounds
"Justice Alito framed the ruling as 'very specific' to the case before the court, and argued that no women would be burdened with the costs of contraceptives because their employers objected. Instead, he suggested that the Obama administration extend to for-profit companies the same accommodation it had to religiously affiliated nonprofits that object to contraception --- that is, requiring that insurers provide contraceptives without charging premiums to employers or copayments to individuals. [HHS] 'has provided no reason why the same system cannot be made available when the owners of for-profit corporations have similar religious objections,' Justice Alito wrote. He was joined by Chief Justice John Roberts and Justices Antonin Scalia, Anthony Kennedy and Clarence Thomas." (The Wall Street Journal; subscription may be required)  

Text of Supreme Court Opinion: Closely Held Corporations Cannot Be Required to Provide Coverage for Contraceptives (PDF)
"In holding that the HHS mandate is unlawful, we reject HHS's argument that the owners of the companies forfeited all RFRA protection when they decided to organize their businesses as corporations rather than sole proprietorships or general partnerships. The plain terms of RFRA make it perfectly clear that Congress did not discriminate in this way against men and women who wish to run their businesses as for-profit corporations in the manner required by their religious beliefs. Since RFRA applies in these cases, we must decide whether the challenged HHS regulations substantially burden the exercise of religion, and we hold that they do. The owners of the businesses have religious objections to abortion, and according to their religious beliefs the four contraceptive methods at issue are abortifacients. If the owners comply with the HHS mandate, they believe they will be facilitating abortions, and if they do not comply, they will pay a very heavy price-as much as $1.3 million per day, or about $475 million per year, in the case of one of the companies. If these consequences do not amount to a substantial burden, it is hard to see what would." [Burwell v. Hobby Lobby et al., No. 13-354 (U.S. June 30, 2014)] (Supreme Court of the United States)  

ACA Employer Mandate: Reporting and Tracking Hours
"When deciding whether to track hours and/or use the alternative reporting method, an employer will need to closely scrutinize its level of comfort that 98% of all reported employees (which generally should be full-time employees) have been offered ACA-compliant coverage. Remember, collectively bargained employees and leased employees present special issues that should be carefully vetted." (Benefits Bryan Cave)  

Starting July 2014, California's Paid Family Leave Expands
"While each employee's situation is different, generally, an employee who is entitled to FMLA and [California Family Rights Act (CFRA)] leave must take [Paid Family Leave (PFL)] concurrent with leave taken under those acts. But, note that the definition of family member under the FMLA, CFRA, and PFL differ. For example, an employee can take PFL to take care of his seriously-ill grandfather (starting July 1, 2014), but the FMLA's definition of family member does not cover grandparents. So employers will first need to figure out which leave would in fact apply to the employee." (Mintz Levin)  

Seventh Circuit Finds Employee Was Not Required by FMLA to Provide Specific Return Date
"[The Court found that] the regulation applicable to unforeseeable leave does not require employees to tell employers how much leave they need, if they do not know yet themselves. Instead, it tells workers to comply with employer policies (which might, for example, require updated estimates on about how long leave will last). Here, the employer required the employee to call in monthly, and it was conceded that she did so." [Gienapp v. Harbor Crest, No. 14-1053 (7th Cir. June 24, 2014)] (Wolters Kluwer Law & Business)  

Supreme Court Declines to Review Decision Allowing Equitable Recoupment of Benefit Overpayments
"The U.S. Supreme Court has denied an ERISA plan beneficiary's request to clarify whether an ERISA plan could enforce an equitable lien for benefit overpayments where the plan had not identified a fund that was in the possession and control of the plan participant at the time the plan asserted its lien.... The Second Circuit ... [found] that because Aetna had the right to reduce the insured's short-term disability benefits at the time she received them, Aetna retained the right under its subrogation provision to compel return of the overpayments." [Thurber v. Aetna Life Ins. Co. No. 12-370 (2d Cir. Mar. 13, 2013; cert. denied June 9, 2014)] (Wolters Kluwer Law & Business)  

Increased Coverage of Preventive Services with Zero Cost Sharing Under the ACA (PDF)
"[A]pproximately 76 million Americans ... are now eligible to receive expanded coverage of one or more preventive services because of the [ACA].... [The authors] examined [various] age/gender groups, and provide here examples of the services now available to them without any cost sharing. Note that this is not an exhaustive list of recommended preventive services required to be covered for people under age 65 and is only meant to highlight illustrative examples." (Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS])  

Re-Enrollment Policy Would Benefit and Challenge Insurers
"Under the proposed rule, in the 38 states that will be using federally-facilitated exchange ... health plan members will receive [later in 2014] notices outlining ways to update their personal information ... The exchange will then automatically re-enroll them in their current plan and notify them of any tax credit changes that would increase or decrease their share of premiums. Insurers would be tasked with reaching out to members before the start of open enrollment to explain the auto-enrollment and reconciliation process and to inform them of their premium obligations and any changes." (Healthcare Payer News)  

The ACA and America's Cities: Fewer Uninsured and More Federal Dollars
"Under the ACA, [the authors] project that employer coverage would increase by 4.4 percent (from 46.4% of the nonelderly to 48.2%) in Medicaid expansion cities and 2.5 percent (from 45.9% to 46.9%) in nonexpansion cities ... Employer-sponsored health insurance increases primarily because the ACA's individual coverage requirement would increase take-up of coverage more than the availability of subsidized marketplace coverage and Medicaid would decrease it." (Robert Wood Johnson Foundation and Urban Institute)  

[Opinion]

Four Reasons Why Automatic Health Insurance Renewal Isn't Going to Work
"[1] Due to strict actuarial value parameters and changing limits on certain benefits the plans offered in 2014 may have to be cancelled in 2015.... [2] Each plan will have different premiums than last year. New companies to the market will add their plans.... [3] Changes in income or life status result in varying subsidies.... [4] Everyone's situation changes." (InsureBlog)  

What Happens When the Limitations Provision in the Plan as Applied Creates an Impossible Accrual Date?
"The plan contained a deadline for commencing legal action of three years from the date that the proof of claim was due. The plaintiff could not have sued within three years of the date that proof of claim was due because he received benefits for two years and did not exhaust his internal remedies until after three years from proof of claim.... The U.S. District Court for the Northern District of Illinois ruled in the defendants' favor and dismissed the complaint with prejudice on the ground that it was not filed within the contractual limitations period found in the plan." [Nathan v. Unum Life Ins. Co. of America, No. 13-cv-8706 (N.D. Ill. June 25, 2014) (Ogletree Deakins)  

Trap for the Unwary: Employee Benefit Plans and the Fiduciary Exception to the Attorney-Client Privilege
"Both the settlor exception and the liability exception to the fiduciary exception are grounded in the identity of interest between the fiduciary and beneficiary. The attorney-client privilege tends to be preserved where the fiduciary's interest and the beneficiary's interest have sufficiently diverged.... Indicative of divergent interests is the retention of counsel by a beneficiary, the threat of litigation, and the discussion of potential litigation." (The Metropolitan Corporate Counsel)  

Start Assembling Resources for Pay Ratio Disclosure for Use in 2016 Proxy Season
"[C]ompanies should be setting their compliance strategy by: [1] finding out where the data is held and the number of payroll systems involved, [2] determining which data elements can be isolated in a particular country, [3] understanding the different elements of compensation in various countries, [4] mapping the workforce, [5] understanding where data gaps exist and [6] thinking about data privacy issues." (Bloomberg BNA)  

Report Claims Wal-Mart's Executive Pay Plan Exploits Tax Break
"A report by two Washington groups takes Wal-Mart Stores Inc. to task for exploiting performance-based pay breaks in Internal Revenue Code Section 162(m) to subsidize excessive executive compensation at taxpayer expense. The retailer, which is the largest private employer in the U.S., saved about $104 million over the past six years by deducting performance-based compensation paid to eight top executives, said the June 4 report[.]" (Bloomberg BNA)  

Compensated Study Seeking Employee Benefits Brokers, Producers and Consultants
JR Research Inc.

IRI: Send NARAB II to the President
Insured Retirement Institute [IRI]

bswift and GetInsured Announce Private Health Insurance Exchange Partnership
bswift

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