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Corning, Inc.
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1199SEIU Family of Funds
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Verisight, Inc.
in CA, IL

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Towers Watson
in ANY STATE, IL, MA, MN, OR, PA, TX

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Buck Consultants a Xerox Company
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Agent and Broker Participation in the Federally-facilitated Marketplace for Plan Year 2015
August 5, 2014 WEBCAST
(Centers for Medicare & Medicaid Services [CMS])

What's Hot; What's Not – 401(k) Trends and Insights
August 28, 2014 in IL
(Worldwide Employee Benefits Network [WEB] - Chicago West Chapter)

Future of Health Care in America: The ACA and Beyond
September 3, 2014 in DC
(National Institute for Health Care Management Foundation)

Understanding Accounting for ESOPs: What Every CPA, CFO and Banker Should Know
October 22, 2014 WEBCAST
(Beyster Institute)

View All Webcasts and Conferences

[Official Guidance]

Text of CCIIO Guidance: Updated Procedures and Requirements for HIPAA Exemption Election by Non-Federal Governmental Plans That Are Self-Insured (PDF)
"An opt-out election for a self-funded, non-Federal governmental plan must meet the following requirements: [1] Be made in an electronic format ... [H]ard copy elections will not be accepted after December 31, 2014; [2] Be made in conformance with all the plan sponsor's rules, including any public hearing requirements; [3] Specify the beginning and end dates of the period to which the election is to apply[.]" (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Advert.]

Public Insurance Exchanges: Life After the Launch

The impact of price on market share, the role of the 3Rs in stabilizing plan profits, narrow networks, and the emergence of both co-op and provider-owned plans. Speakers from both traditional health plans and new emerging competitors. $200 discount with code BLINK2.

[Official Guidance]

Text of CMS User Manual: Health Insurance Oversight System for Non-Federal Governmental Plans (PDF)
56 pages. "Once the [ACA] amendments ... affecting the opt-out provisions became effective, the sponsor of a self-funded, Non-Federal Governmental Plan could no longer elect to exempt that plan from three of those requirement categories but did have the option to continue to exempt the plan from the remaining four requirement categories.... This manual provides step-by-step instructions for the features and functionalities available in the Non-Fed Module [ within the Health Insurance Oversight System (HIOS)]." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

IRS Increases Affordability Percentage Under Employer Mandate for 2015
"For plan years beginning in 2015, an applicable large employer's health coverage will be considered affordable under the pay or play rules if the employee's required contribution to the plan does not exceed 9.56 percent of the employee's household income for the year.... Individuals who are eligible for employer-sponsored coverage that is affordable and provides minimum value are not eligible for a premium tax credit." (Benefit Revolution)  

[Guidance Overview]

HHS Limits Scope of Insurance Market Reforms in U.S. Territories
"The new interpretation uses the ACA's definition of a state... to exempt insurers in the territories from the [insurance market] reforms.... To the extent that ERISA and the Code make health care reform mandates applicable to group health plans, group policies sold in the territories still will need to comply with those mandates (to ensure compliance by the employer plans that purchase the policies)." (Thomson Reuters / EBIA)  

King v. Burwell Plaintiffs Ask For Supreme Court Review
"There is really only one new argument in the petition that was not made below, namely that Congress' intent to deny premium tax credits in states that failed to establish exchanges has now been conclusively established by statements made by Jon Gruber two years after the statute was adopted.... It is unlikely ... that the Supreme Court will decide whether or not to accept the petition until it reconvenes in October. In the interim, the government has petitioned for a rehearing en banc [of Halbig v. Burwell] before the entire D.C. Circuit." [King v. Burwell, No. 14-1158 (4th Cir. July 22, 2014)] (Timothy Jost for Health Affairs)  

[Advert.]

COBRA: A Practical and Regulatory Update

August 12 live webinar. Legal land mines will be revealed, and special issues relating to consumer driven health benefit strategies will be discussed, along with other intermediate and advanced issues. BenefitsLink discount.

Text of Second Circuit Opinion: Terms of Collective Bargaining Agreement Do Not Constitute ERISA Plan Document
"The UMM Fund argued that by failing to comply with a term of the CBA, the 11 210 Fund violated the terms of an ERISA plan.... ERISA itself does not make plain where one looks to find the 'terms' of an ERISA plan ... Although the CBAs recite some of the provisions found in the Allied Fund and UMM Fund trust documents, those references do not transmute the CBA itself into a plan document; and it certainly does not make the employer contribution requirement, which does not appear in the UMM Fund Trust Indenture, an UMM Fund plan term." [Silverman, Trustee of the Union Mutual Medical Fund, v. Crowley, et. al., No. 13-392-CV (2nd Cir. Aug. 1, 2014)] (U.S. Court of Appeals for the Second Circuit)  

When Will D.C. Sick and Safe Leave Act Amendments Apply?
"Recent updates to the official District of Columbia Code appear to relieve employers at this time from any obligation to comply with the District's Sick and Safe Leave Act Amendments Act of 2013 -- after many employers in the District of Columbia ... already have made changes to their paid leave policies to comply with the amendments, as a precaution against possible private civil litigation." (Jackson Lewis P.C.)  

Hospitals Under Pressure with ACA But Still Offering Rich Medical and Prescription Plans to Their Employees (PDF)
"Seventy-two percent of the hospitals surveyed ... already offer coverage to employees who work hours falling below the mandated minimum. Many hospitals that were surveyed are concerned that employees not officially classified as full-time may exceed the hours requirements and inadvertently fall into an eligible status. The PPACA also had an impact on plan design, imposing out-of-pocket maximums for the first time on most plans." (Cammack Health)  

Tradeoffs in the Design of Health Plan Payment Systems: Fit, Power and Balance
"This paper proposes three metrics for grading these complex payment systems: fit, power and balance, each of which addresses a distinct market failure in health insurance.... [The authors] find that a simple reinsurance system scores better on fit, power and balance than the risk adjustment formula in use in the Exchanges." (National Bureau of Economic Research [NBER])  

Perspectives on Healthcare Spending Growth
"There's a heated and continuing debate over the recent slowing in the pace of health care spending growth: Is it a lasting change? Or a temporary one? This paper ... argues that it appears likely to be temporary. It explains the slowdown in health spending growth observed since 2002 as largely the result of two recessions that occurred in the last decade, rather than representing innovation in health-care delivery or a surge in efficiency." (The Brookings Institution)  

Health Care Spending Slowdown: The Consumer Paradox (PDF)
"[The current] trend of growth in out-of-pocket spending combined with increases in health insurance premiums that outpace increases in wages is not sustainable over the long term, and harms both patients and providers .... Both payers (including employers) and providers ... require some level of predictability and capital reserves. Major disruptions to the operating environment for providers, payers and/or employers may generate uncertainty, which ultimately could flow down to consumers in the form of higher premium contributions and out-of-pocket spending." (Dobson DaVanzo. for Federation of American Hospitals)  

Does Proposed Medicare NOTICE Bill Miss the Point?
"The bill would require hospitals to give meaningful notice to patients who have been assigned 'observation' status for over 24 hours. Observation status is different from inpatient status under the rules of Medicare and other insurers, and the difference can have real financial implications for a patient. For one thing, the patient's personal responsibility through copayments or deductibles is usually much greater with observation status." (Faegre Baker Daniels LLP)  

Hospital Subsidy of Patient Health Insurance Premiums May Be Risky
"While HHS and CMS have provided some guidance regarding payment of patient premiums by hospitals, the Internal Revenue Service (IRS) has not indicated its views on the issue.... It is possible the IRS could take the position that payment of insurance premiums on behalf of patients may affect a hospital's or other provider's status as a tax-exempt entity.... [In] some cases, paying premiums might be construed as conferring private benefits (for example, to insurers), especially where there is inadequate documentation of financial need." (Thompson Hine)  

Oregon Individual, Small Business Health Insurance Rates to Fall for 2015
"The Oregon Department of Consumer and Business Services" Insurance Division said Friday it has approved rates for 2015 individual and small employer health insurance plans, and on average, they are lower than 2014 rates. Although the rate changes vary by insurer, the average monthly premium for an individual standard plan for a 40-year-old in Portland in 2015 is estimated at $250, compared to $262 in 2014. For a similar small employer plan, the average 2015 premium is an estimated $308 per month, compared with $327 in 2014." (KTVZ.com)  

The PPACA Economy: A Crippled Recovery and Chronic Underemployment
"In looking at July and June's reports together, we see that the economy lost 238,000 full time jobs while adding 851,000 part timers.... As we continue to see less full and more part time work, it pushes older workers to continue working; forestalling retirement. The latest jobs report showed that fewer and fewer older workers are retiring making it tougher on the key 25-54 year old demographic to find and maintain any employment. The 25-54 year old group shed 142,000 jobs in the July report." (Benefit Revolution)  

[Guidance Overview]

August and September 2014 Filing and Notice Deadlines for Qualified Retirement and Health and Welfare Plans
"[This] filing and notice deadline table ... provides key filing and notice deadlines common to calendar year plans for the next two months.... [D]eadlines will be different if your plan year is not the calendar year.... [T]he table does not include all applicable filing and notice deadlines, just the most common ones." (King & Spalding)  

A Trap for the Unwary: Employee Benefit Plans and the Fiduciary Exception to the Attorney-Client Privilege (PDF)
"Employers who serve as ERISA fiduciaries should be conscious of the dual rationale for the fiduciary exception and understand that not all communications with attorneys regarding employee benefit matters are privileged.... [W]hen it becomes clear that the interest of an employer/fiduciary and that of a plan participant or beneficiary are set to diverge, communications with an attorney should be maintained separate from previous communications and the attorney's services should be billed directly to the employer." (Kelley Drye & Warren LLP, via The Metropolitan Corporate Counsel)