Plan Document Specialist
Lincoln Financial Group
in ANY STATE

Manager, 401k New Business
The Guardian Life Insurance Company of America
in PA

Pension Administrator/Operations Liaison
Associated Pension Consultants
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AUL/ OneAmerica Financial Partners
in IN

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2014 Retirement Plan Regulatory Update
August 20, 2014 WEBCAST
(Multnomah Group)

2014 Employee Benefits Fall Seminar
September 10, 2014 in CO
(Spencer Fane Britt & Browne LLP)

2014 Employee Benefits Fall Seminar
September 17, 2014 in MO
(Spencer Fane Britt & Browne LLP)

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[Official Guidance]

Text of CMS FAQs: Medicare and the Marketplace
"This document is a compilation of the most frequently asked questions (FAQs) regarding the intersection of Medicare and the Marketplace. Unless otherwise noted, these FAQs have been cleared for use in response to public inquiries." [34 questions and answers, dated Aug. 1, 2014. Topics include general enrollment, End Stage Renal Disease (ERSD), and coordination of benefits.] (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

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[Guidance Overview]

IRS Increases 9.5% Affordability Threshold -- Or Did It?
"Some vendors, consultants and others have announced that employers can now use the increased 9.56% to determine whether coverage is affordable for purposes of the safe harbor. Based on the literal regulatory rules, this is not correct.... [T]he IRS regulations on affordability have 'hard-wired' the 9.5% standard into those regulations; the regulations do not cross-reference to the statutory reference for affordability." (Proskauer's ERISA Practice Center)  

Text of Kansas District Court Opinion: Kansas Anti-Subrogation Statute is Preempted by Reimbursement Provisions of Federal Employees Health Benefit Plan (PDF)
"[T]he issue is whether the reimbursement terms in the contract 'relate to the nature, provision, or extent of coverage or benefits (including payments with respect to benefits).'... [T]he statutory language does not limit 'payments' to payments made by the insurance carrier, the implication being that 'payments with respect to benefits' may be read to include payments owed by the insured back to the carrier in the form of reimbursements ... Therefore, a natural reading of the statutory language reveals that Congress intended for a ... contract containing terms of reimbursement to preempt state law because, by definition, reimbursement relates to the extent of payment of benefits as required by Section 8902(m)(1)." [Helfrich v. Blue Cross and Blue Shield of Kansas City, No. 13-2620 (D. Kans. Aug. 5, 2014)] (U.S. District Court for the District of Kansas)  

U.S. Health Care Reform for Employer-Sponsored Plans: Are We There Yet?
"On average, 69.3% of respondents' employees enrolled in health plans in 2014, up only slightly from 69.1% in 2013, and employers predict that this number will rise only to 69.8% in 2015 ... Ten percent of respondents said they will have fewer employees working 30+ hours per week by 2015.... Number one on the list of significant or very significant employer concerns about the ACA is the increase in administrative burden.... Employers are making changes in anticipation of the 2018 excise tax to avoid it if they possibly can ... [M]ost US employers are very committed to offering benefits." (Mercer)  

Global Employers Step Up Commitment to Wellness
"Seventy-eight percent of the world's employers are strongly committed to creating a workplace culture of health, to boost individual engagement and organizational performance.... 43 percent say they created a brand identity for their employee wellness programs, 52 percent offer health insurance premium reductions, and 65 percent believe wellness programs are extremely or very important to attract and retain workers." (Buck Consultants at Xerox)  

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The Payment Reform Landscape: Accountable Care Organizations
"A growing number of large employers are piloting accountable care organizations (ACOs), working through their health plan; in some cases they are doing so directly with provider systems ... These leading purchasers intend to set the bar high. They cannot make the investment to pursue these ACO relationships if they are not assured that their populations will see meaningful, measurable gains in their health care and its affordability, as well as their health. That often means contractual commitments to lowering total costs of care and showing improved patient outcomes for targeted populations -- like high risk, medically complex patients." (Health Affairs)  

Why We Should Know the Price of Medical Tests
"After two years of the price transparency program, price variation between hospital and nonhospital facilities was reduced by 30 percent in areas where it was implemented ... The study also suggests that patients are more vigilant custodians of cost than their doctors. Several years ago, WellPoint gave physicians similar price information on scanning providers in their practice area but did not see a change in referral patterns[.]" (The New York Times; free registration required)  

Midyear HSA Market Statistics and Trends (PDF)
"HSA accounts rose to 11.8 million, holding assets totaling over $22.8 billion, a year over year increase of 26% for HSA assets and 29% for accounts for the period of June 30th, 2013 to June 30th, 2014.... HSA investment assets almost reached an estimated $2.9 billion in June, up 45% year over year. The average investment account holder has a $12,473 average total balance (deposit and investment accounts)." (Devenir)  

Tennessee Insurer Uses Its Monopoly to Deliver Bargain Premiums
"Though insurers have been regularly vilified in debates over health care prices, BlueCross' near monopoly here has been unusually good financially for consumers. Its cut-rate exclusive deal with one of three area health systems turned Chattanooga into one of the 10 least expensive insurance markets in the country, as judged by the lowest price mid-level, or silver, plan. The premium for a 40-year-old for that plan is $181 a month, 30 percent less than for the median cheapest silver plan nationally." (Kaiser Health News)  

Coverage Rates Lag in Health Law Holdout States
"States that chose to follow the ACA's provisions most closely, both by expanding Medicaid and establishing their own new health insurance marketplaces, as a group saw their uninsured rate drop nearly twice as much as states that declined to do so.... Arkansas saw the biggest decline in its uninsured rate, from 22 percent to 12 percent. Kentucky, Delaware and Colorado also saw significant declines." (Kaiser Health News)  

TIGTA Report on Accuracy of IRS Responses to ACA Exchange Requests for Income and Family Size Verification Information and Maximum Advance Premium Tax Credit Calculation (PDF)
"Our review of the IRS's response to [more than 100,000] requests received by the IRS between October 1 and October 4, 2013, showed that the IRS ... provided accurate responses for ... 99.97 percent [of the] requests.... In addition, TIGTA reviewed the IRS's response to [more than 120,000 Advance Premium Tax Credit (APTC)] requests received between October 1 and October 14, 2013. This review showed that the IRS, based on information furnished by the Exchange, accurately calculated the maximum monthly APTC for [each one of those] requests." (Treasury Inspector General for Tax Administration [TIGTA], U.S. Department of the Treasury)  

California Weighs Marketplace for Vision Care Coverage
"Building on the success of Covered California, the state's public health exchange mandated by the [ACA], the California Vision Care Council will create a 'vision care access marketplace,' which will be the place where people can access eye care options." (Employee Benefit News)  

Is California's 4.2% Renewal Increase Artificially Suppressed?
"California's increases in 2014 were between 22 percent and 88 percent for individuals ... Not only were premiums increased dramatically, but doctor networks were cut equally sharply; approximately in half for most plans and carriers operating in the exchange. By extracting that much premium from policyholders last year and greatly restricting doctor choices this year, insurers do not need as much of an increase in 2015 to keep the program afloat." (Benefit Revolution)  

Early Outlook: State Health Exchanges in 2015
"With rate filings in for 27 states plus the District of Columbia, the early word on 2015 appears to be expansion. At least 15 of the 28 jurisdictions in 2015 will offer new individual plans this year. Thirty-seven of the 176 health plan filings are new ... At the same time at least three non-profit health Co-Ops will move into additional markets.... [The] analysis found the average monthly premium across all plans in 2015 was $384, before any subsidies are applied." (The Health Care Blog)  

Research Shows Equity Award Practices at Companies Completing Private Equity-Backed IPOs
"Much of the general buzz in the market often surrounds high-growth IPOs that are founder- and/or venture capital-sponsored. However, there's been a significant volume of recent private equity-sponsored IPOs. At these companies, the executive compensation programs -- especially the equity and long-term incentive (LTI) plans -- often look quite different from those of other IPO organizations." (Towers Watson)  

Great-West Financial Builds Upon Retirement Services Leadership In Government Markets
Great-West Financial

Employers Worldwide Step Up Investments in Workers’ Wellness; Look to Wellness to Drive Company Performance
Buck Consultants

Dietrich & Associates Assists OneAmerica In Conducting Inaugural Pension Risk Transfer
Dietrich & Associates, Inc.

Donald J. Settina Is Certified For Fiduciary Excellence
Centre for Fiduciary Excellence [CEFEX]

New Fiduciary Awareness Quiz Helps Plan Sponsors Understand Their Fiduciary Obligations and Responsibilities
Guardian

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