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Multnomah Group, Inc.
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Pension Consultants, Inc.
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AUL / OneAmerica Financial
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Transitional Reinsurance Program: Submission of Supporting Documentation through Pay.gov
August 11, 2014 WEBCAST
(Centers for Medicare & Medicaid Services [CMS])

Strategies for Success: Employer Sponsored Population Health
August 13, 2014 WEBCAST
(Healthcare Web Summit)

Transitional Reinsurance Program: Submission of Supporting Documentation through Pay.gov
August 13, 2014 WEBCAST
(Centers for Medicare & Medicaid Services [CMS])

Transitional Reinsurance Program: Submission of Supporting Documentation through Pay.gov
August 15, 2014 WEBCAST
(Centers for Medicare & Medicaid Services [CMS])

2014 Western Benefits Conference Roundtable
August 19, 2014 in CA
(Western Pension & Benefits Council - Orange County Chapter)

Understanding Qualified Longevity Annuity Contracts (QLACs)
September 4, 2014 WEBCAST
(ABA Joint Committee on Employee Benefits)

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[Guidance Overview]

Agencies Issue Guidance on Notice Requirements When Dropping Preventive Services
"Of special interest is that the FAQ [issued on July 17, 2014] did not address the advance notice requirement under Section 2715 of the [ACA]. That section, in relevant part, provides that a health plan must issue notice of any material modification in coverage that is not reflected in the summary of benefits coverage provided to participants at enrollment at least 60 days before the effective date of the modification. Presumably, in light of the FAQ, the DOL will not require plans to comply with the 60-day advance notice requirement under the [ACA] when reducing or eliminating contraception coverage." (Bloomberg BNA)  

[Advert.]

Executive Forum on Creating a Culture of Health & Wellness

Wellness and HR executives with diverse viewpoints and experiences will come together to discuss, debate and exchange ideas on the impact of strong culture of health in the workplace on employee productivity and costs. $200 discount with code BLINK2.

[Guidance Overview]

IRS Final Regs Impose Complex Information Reporting Requirements (PDF)
"Beginning in 2016 ... insurers and self-funded plans will be required to report information about health coverage provided during the prior year to all enrollees, including Taxpayer Identification Numbers of all covered individuals and the specific dates that such individuals had such health coverage .... What transition relief is available for 2015? ... Who must file these forms? ... What form is used to report this information? ... How are these forms filed? ... When are these forms due? ... What information must be disclosed? ... What reporting penalty may apply?" [Article includes a detailed chart outlining the reporting requirements under each Code section.] (Groom Law Group)  

[Guidance Overview]

Code Sections 6055 and 6056: ACA Reporting Compliance Guide (PDF)
"All employers with 50 or more full-time equivalents, as well as all those that are self-funded, are required to comply with the 6055 and 6056 rules. For more detailed information on the 'who, what, where, and how', please see the information and table [in this article] ... With the simplified reporting, an applicable employer can file annually (versus monthly). To be an applicable employer ... the employer needs to make a 'qualifying offer' to full time employees for all 12 months of the year [and] the annual employee premium co-share cannot exceed $1,100 (employee-only coverage) for the year." (Kushner & Company)  

Text of Eighth Circuit Opinion Recognizing Surcharge Relief, Contract Reformation and Equitable Estoppel Claims (PDF)
"To obtain relief under the surcharge theory, a plan participant is required to show harm resulting from the plan administrator's breach of a fiduciary duty.... It was arguably fraudulent for MetLife to collect premiums from [the plaintiff,] a Savvis employee who, MetLife now argues, never had an approved policy. Further, MetLife did not just erroneously collect premiums from [the plaintiff] -- an internal MetLife investigation showed that roughly 200 Savvis employees had been paying premiums for policies that were never approved by MetLife. We conclude that [the plaintiff] is allowed to make his waiver argument on remand, and if successful, receive monetary damages" [Silva v. Metropolitan Life Ins. Co., No. 13-2233 (8th Cir. Aug. 7, 2014)] (U.S. Court of Appeals for the Eighth Circuit)  

Does Your ERISA Benefit Denial Letter Limit Time to File Suit? Maybe Not!
"A divided panel of the Sixth Circuit held ... that an employee was entitled to bring suit against after the contractual limitations period in his ERISA-governed long term disability plan had expired, because the claim administrator failed to include the time limit for judicial review in the benefit revocation letter itself. The majority held that, without the limitations period, the letter was 'not in substantial compliance with 29 U.S.C. Section 1133,' even though it included notice of the employee's right to judicial review and the limitations period was stated in other plan documents which were available to participants upon request." [Moyer v. Metropolitan Life Ins. Co., No. 13-1396 (6th Cir. Aug. 7, 2014)] (Squire Patton Boggs)  

[Advert.]

WEB's mission is to further the development of benefits professionals

We are committed to helping define the role of the benefits professional in the 21st century, and as changing market forces reshape the profession, WEB will help its members meet the challenges ahead.

Government Says Halbig Panel Was Wrong on ACA Subsidies, Seeks Rehearing
"In its request for rehearing, the government argued that the D.C. Circuit panel incorrectly focused on the plain meaning of a single phrase in its analysis ... The government noted other provisions of the ACA that treated federally- and state-run Exchanges similarly, noting that Sec. 1321 allows states that do not wish to operate their own Exchanges to allow HHS 'to establish and operate such Exchange within the state,' making it equivalent to an Exchange 'established by the State under [Section 1311].'" (Wolters Kluwer Law & Business)  

Colorado Helps Fund State Exchange with New Fee on Health Insurance
"The new fee of $1.25 per member per month will apply to large and small group employer policies issued in Colorado from July 1, 2014, through June 30, 2015, as well as individual insurance and stop loss coverage issued in Colorado. The fee applies to all health insurance that is sold in Colorado, including health insurance sold outside Colorado's health insurance exchange." (Lockton)  

Insurers and TPAS Must Complete ACA Reinsurance & Risk Adjustment Edge Server Pre-Registration Steps by September 27
"HHS says insurers and TPAs have work to complete by 9/27 to prepare to comply with the EDGE system data reporting that HHS will require them to conduct as part of ACA's reinsurance premium and risk adjustment risk sharing provisions.... In an August 7, 2014 webinar, HHS gave issuers and TPAs an overview of the EDGE server implementation schedule and guidance on the key pre-registration tasks that must be completed prior to the start of the EDGE server registration process scheduled to begin on September 27, 2014." (Solutions Law Press)  

FMLA-Compliant Leave of Absence Policy Was Unlawful, EEOC Says
"HealthCare System recently settled a lawsuit brought by the [EEOC] alleging that its leave of absence policy violated the Americans with Disabilities Act.... Employers should be aware that fixed leave policies and policies that require employees to return to work without any restrictions limit the interactive process and eliminate a potential reasonable accommodation. Complying with the FMLA is not enough. When developing leave of absence policies, employers must consider the requirements of the ADA and any applicable state or local disability discrimination laws." (Clifton Budd & DeMaria, LLP)  

FMLA Claims Reinstated Because Employer Couldn't Prove Employee Had Received FMLA Notice
"[The employer did not] present any evidence that the employee received the letter since it was not sent by registered or certified mail and it did not request a return receipt or use any of the now-common ways of tracking a letter. Its only evidence consisted of self-serving affidavits signed nearly four years after the alleged mailing date. Given the employee's denial, and the ease with which a letter can be certified, tracked, or proof of receipt obtained, the weak rebuttable presumption was insufficient to establish receipt as a matter of law." [Lupyan v. Corinthian Colleges Inc., No. 13-1843 (3rd Cir. Aug. 5, 2014)] (Wolters Kluwer Law & Business)  

If You Like Your Obamacare Plan, It'll Cost You
"People who decide to stick with the coverage they've already gotten through Obamacare, rather than switching plans, are at risk for some of the biggest premium spikes anywhere in the system. And some people won't even know their costs went up until they get a bill from the IRS. Insurance plans generally raise their premiums every year, but those costs are just the tip of the iceberg for millions of Obamacare enrollees. A series of other, largely invisible factors will also push up many consumers' premiums." (NationalJournal)  

Health & Welfare Plans and Same-Sex Spouses: Where Are We Now?
"While the IRS has yet to issue much guidance for health and welfare plans, employers need to look at state laws to determine whether the plan must provide the same benefits to same-sex spouses as it provides to opposite-sex spouses.... Some plans have not specifically defined 'spouse' to exclude a same-sex spouse from coverage, but have instead relied on state laws to exclude same-sex spouses from coverage. Since state laws that do not recognize same-sex marriage are under legal challenge, an employer that has relied on this approach should revise its plan's eligibility rules." (Warner Norcross & Judd LLP)  

Exclusion for Employer-Provided Health Coverage Tops Tax Expenditures in JCT Report
"[T]he JCT said the employer health exclusion will cost $785.1 billion from 2014 to 2018 ... Other top tax expenditures [include] ... net exclusion of defined contribution plans, at $399 billion ... The employer-provided health exclusion will cost more in the 2014-2018 period than in the 2013-2017 period, when the estimate in February 2013 was for $760.4 billion, the JCT said." (Bloomberg BNA)  

CalSTRS Selects State Street’s Private Equity Index for Policy Benchmark
State Street

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