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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 Rev. Proc. 2014-41: Premium Tax Credits and Deduction of Health Insurance Costs for Self-Employed Individuals (PDF)
15 pages. Excerpt: "This revenue procedure is intended to provide taxpayers with calculation methods that resolve the circular relationship between the Section 162(l) deduction and the Section 36B tax credit and that satisfy the requirements of applicable tax law. Using the calculations in this revenue procedure is optional. A taxpayer may determine amounts of the Section 162(l) deduction and the Section 36B tax credit using any method, provided that the amounts claimed satisfy the requirements of applicable tax law[.]"
(Internal Revenue Service [IRS])
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[Official Guidance]
Text of IRS Rev. Proc. 2014-46: 2014 Monthly National Average Premium for Bronze-Level Qualified Health Plans (PDF)
"For purposes of Section 5000A(c)(1)(B) and Section 1.5000A-4, the monthly national average premium for qualified health plans that have a bronze level of coverage and are offered through Exchanges in 2014 is $204 per individual.... [and] the monthly national average premium for qualified health plans that have a bronze level of coverage and are offered through Exchanges in 2014 is $1,020 for a shared responsibility family with five or more members."
(Internal Revenue Service [IRS])
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[Guidance Overview]
FAQ by Agencies Addresses Disclosure Requirements for Reduction or Elimination of Contraceptive Services (PDF)
"Between the time the plan adopts and provides notice of the amendment, the unamended version of the plan will likely remain enforceable for participants and beneficiaries who incurred contraceptive coverage-related expenses in reliance on that version of the plan.... [A] plan that gives notice 60 days prior to the change will comply with the required SPD disclosure as well as the SBC rules for notice of material modifications."
(Buck Consultants at Xerox)
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[Guidance Overview]
Addressing the Needs of Victims of Domestic Abuse and Spousal Abandonment under the ACA
"Treasury and the Internal Revenue Service (IRS) [have] issued regulations to allow married victims of domestic abuse or spousal abandonment to claim a premium tax credit without filing a joint return for up to three consecutive years. An individual can access this relief by filing with the status of married filing separately, and indicating that he or she is living apart from a spouse and is unable to file a joint return due to domestic abuse, or because a spouse cannot be located after a reasonable effort."
(U.S. Department of the Treasury)
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IRS Says Uninsured Will Face Maximum Fine of Nearly $2,500
"[I]ndividuals who fail to get health insurance this year will be fined a maximum of $2,448 and families with five or more members can be fined up to $12,240. The maximum penalty would hit individuals without insurance whose income is above $244,800. For families of five or more, the maximum penalty would affect people making a combined yearly income of $1.2 million."
(The Hill)
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Split Subsidy Decisions No Excuse to Delay Preparation for ACA
"Large employers should continue to prepare for the January 1, 2015 effective date for the employer penalties.... Employers who wish to avoid ACA employer penalties should continue to develop systems for tracking hours to determine the full-time employees to whom health coverage should be offered.... [E]mployers with calendar year plans who wish to avoid penalties should make an offer of affordable, minimum value health coverage to full-time employees and their dependent children by January 1, 2015."
(Ice Miller LLP)
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Text of District Court Opinion: ERISA Does Not Preempt State Law Estoppel Claim Based on Employer Misrepresentation of Continued Coverage (PDF)
"Relying on [his employer's] assurances, [plaintiff Russell Toomajanian] decided to forgo paying for extended insurance coverage through COBRA or another insurance vehicle.... Toomajanian is not looking to recover benefits allegedly due him under the [group health] ERISA Plan (nor could he as his losses were incurred after his being ejected by his employer from the Plan). The financial harm suffered by Toomajanian -- his out-of-pocket medical bills -- are neither defined by, nor limited to, the benefits he would have been entitled to under the Plan had he remained an employee. Rather, the losses of a victim of misrepresentation are measured under the relevant Massachusetts tort law by the financial harm caused by his reliance on the underlying misrepresentation." [Toomajanian v. Insight Global, Inc., No. 14-12603-RGS (D. Mass. July 24, 2014)]
(U.S. District Court for the District of Massachusetts)
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Designation of Obesity as a Disease: Implications for Health Plan Sponsors
"To some extent, the designation of obesity as a disease will increase plans' immediate costs. However, over the long term, covering obesity treatments is likely to save plans money by avoiding serious and costly chronic diseases and conditions for which obesity is a major risk factor.... Ultimately, prudent plan sponsors will get ahead of this issue and structure benefit coverage to support effective weight-reduction and management programs in a manner that reduces wasteful spending and holds providers and patients accountable for taking action to best manage this disease."
(Sibson Consulting)
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Law Firm's Amicus Brief Attempts to Bring Broader View of Retiree Health Care
"By discussing the key provisions in [100 collective bargaining] agreements and tracing patterns in a larger sample size, the [amicus brief filed by Goldstein & Russell] offers a broader view of retiree healthcare in the United States. The study found that 60% of the sampled CBAs (70% in the private sector and 50% in the public sector) include at least one clause that is generally understood to preclude vesting. By contrast, 26% of the agreements (30% private; 22% public) contain at least one clause suggesting that benefits do vest. 14% of the sampled CBAs (6% private; 22% public) include language that is considered ambiguous, and 16% (14% private; 18% public) are completely silent on the question of vesting. There was overlap
across the categories." [M&G Polymers USA, LLC v. Tackett, No. 13-1010 (on appeal from 6th Cir., cert. granted May 5, 2014)]
(SCOTUSblog)
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Appellate Courts Split on Validity of Key ACA Regulation
"[Some] states, like Massachusetts, that have been considering migrating from a state exchange to a federal exchange for technical convenience should evaluate whether specific state legislation would be helpful. Some may take steps to establish their own state-operated exchanges, which would qualify them for subsidies even if the plaintiffs prevail."
(Foley & Lardner LLP)
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Future of ACA Could Be in Jeopardy in Many States
"The [D.C. Circuit] sided with the Appellants' argument that a plain reading of Section 36B did not permit the extension of the tax subsidies to federally-facilitated Exchanges, as they were not established by the State.... [But the Fourth Circuit] concluded that Congress did not speak directly to the question at issue, and therefore, it left the IRS with the ability to interpret the provision. Since the IRS' interpretation of the statute was based on the implementation of the ACA's stated policy of increasing the number of Americans covered by health
insurance and decreasing the cost of such insurance, the Court determined that the IRS's regulation was a permissible construction of the statutory language."
(Dinsmore)
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Obamacare Loophole Has Insurers Worried Customers Will Skip December Premium Payments
"[CMS Bulletin 10] says that if an Obamacare shopper goes online and re-enrolls in a new insurance plan, any payments towards that new, 2015 plan cannot be applied to outstanding debt on the old, 2014 plan. This ... could make December a bit of a no-man's land for insurers looking to get paid. Somebody could theoretically refuse to pay up in December 2014 and then rejoin their plan -- or buy a new one -- in January or February of 2015. The health plan they had in December can't terminate their coverage or use their new premiums to to cover the outstanding debt."
(Vox Media Inc.)
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Dear Employers: We Have to Stop Sticking It to Pregnant Moms and Expectant Dads
"[A] few employers apparently have made some rather foolish decisions lately when terminating the employment of an expectant parent, and it's making the rest of us look like we don't care much for moms and dads or, for that matter, the next generation.... The Timing of a Termination Decision is Important no matter what you think the courts say... When you terminate an employee shortly after they make a request for FMLA leave, please make sure you can back it up! ... Be mindful of the new EEOC guidance regarding pregnancy discrimination.... Moms and Dads make for sympathetic plaintiffs." [Rice v. Kellermeyer Company, No. 13-263 (N.D. Ohio July 15, 2014)]
(FMLA Insights)
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[Opinion]
How the IRS Harassed the Administration's Political Opponents and Saved its Healthcare Law
"The evidence shows that career officials at the IRS did indeed do as Treasury Department and Health and Human Services Department officials told them.... We know this thanks to a largely overlooked joint investigation and February report by the House Oversight and Ways and Means committees into the history of the IRS subsidy rule. We know that in the late summer of 2010, after ObamaCare was signed into law, the IRS assembled a working group -- made up of career IRS and Treasury employees -- to develop regulations around ObamaCare subsidies. And we know that this working group initially decided to follow the text of the law. An early draft of its rule about subsidies explained that they were for 'Exchanges established by the State.'"
(The Wall Street Journal; subscription may be required)
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[Opinion]
ERIC Joins Letter in Support of 'Auto Enroll Repeal Act'
"ERIC, along with approximately 170 other businesses and trade organizations, on July 22 wrote to Senator Johnny Isakson (R-GA) expressing support for his legislation, the Auto Enroll Repeal Act (S. 2546). The bill would repeal the requirement under the Affordable Care Act that employers with more than 200 full-time employees that offer enrollment in one or more health benefits plans enroll automatically all new full-time employees in one of those plans."
(The ERISA Industry Committee [ERIC])
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[Opinion]
A Big Hole in the Heart of Obamacare
"After-the-fact rationalizations notwithstanding, the concession that Obamacare's designers didn't anticipate so many state vetoes doesn't retroactively rewrite the plain language of the law. The fault lies squarely with those drafters, not the lawyers who point out the IRS abuse or the judges who strike it down."
(Ilya Shapiro, for CNN)
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[Opinion]
HHS Is Crowing About How Much Money Has Been Returned to Consumers Because of MLR
"Insurers are free to overcharge people, collect the money, earn interest on it during the course of a year, and rebate the overcharge 18 months later. So consumers in effect are simply giving the insurers an interest free loan for a year. That is why there has been $9 billion in rebates."
(National Center for Policy Analysis Health Policy Blog)
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Benefits in General; Executive Compensation
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BLS Report of Employee Benefits in the United States, March 2014 (PDF)
"Employer-provided medical care was available to 86 percent of full-time private industry workers in the United States in March 2014 ... By contrast, only 23 percent of part-time workers had medical care benefits available.... Retirement benefits followed a similar pattern as medical care benefits. In private industry, 74 percent of full-time workers had access to a retirement plan, significantly higher than 37 percent of part-time workers."
(U.S. Bureau of Labor Statistics [BLS])
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Arbitration of ERISA Benefit Claims In Lieu of Judicial Review
"What would the Court do with an arbitration provision precluding judicial review of ERISA claim and appeal denials? ... ERISA is silent on mandatory arbitration in lieu of judicial review under Section 502(a) of ERISA (although a DOL regulation arguably prohibits it in the non-collective bargaining context). The recent Supreme Court decisions suggest, however, that plan sponsors may condition benefits on an agreement to arbitrate a final claim denial."
(Seyfarth Shaw LLP)
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Hobby Lobby Decision Poses New Questions for Litigation
"[B]ecause the court's decision in Hobby Lobby seems to impute a burden that is placed by the ACA on the plan to the plan sponsor, the effect of the holding could be to reverse that effect for suits against the plan. 'If the requirement on the plan burdens the religious beliefs of the plan's sponsor and owner, then what does that say about the independence of the plan and the ability to pierce the corporate veil,' [said Teresa Renaker, a shareholder at Lewis Feinberg Lee Renaker & Jackson P.C.]"
(Bloomberg BNA)
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Tips for Managing Executive Compensation in a Global Economy
"[E]xecutive compensation themes and practices migrate from one region or country to another.... [L]egislative requirements like say on pay and corporate governance trends, such as the separation of the chairman and chief executive roles, originated in certain countries before spreading to others.... The United Kingdom also has a longstanding practice of companies engaging with shareholders, a trend that is taking off in the United States. So it's important for professionals in the executive compensation field to stay attuned to global trends and emerging best practices."
(Towers Watson)
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Press Releases
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