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2nd Wednesday Teleconference: Employer Penalty and MEC Reporting
September 10, 2014 WEBCAST
(ECFC [Employers Council on Flexible Compensation])

Critical Illness Insurance Forum
September 15, 2014 in MD
(Society of Actuaries)

DI & LTC Insurers’ Forum
September 17, 2014 in MD
(Society of Actuaries)

10 Steps to Successful ESOP Administration
November 20, 2014 WEBCAST
(Beyster Institute)

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[Official Guidance]

Text of EBSA Request for Comments on Form 700, Self-Certification Form for Religious Organizations Requesting Exemption from Contraceptive Mandate
"The interim final regulations augment the final regulations and revise the EBSA Form 700 ICR in light of the Wheaton order. Specifically, the interim final regulations continue to allow eligible organizations to notify an issuer or third party administrator using EBSA Form 700, as set forth in the July 2013 final regulations... This notice requests public comment pertaining to the Department's request for extension of OMB's approval of its revision to EBSA Form 700. After considering comments received in response to this notice, the Department intends to submit an ICR to OMB for continuing approval. No change to the existing ICR is proposed or made at this time." (Employee Benefits Security Administration [EBSA], U.S. Department of Labor)  

[Advert.]

Private Exchanges: The Future of Commercial Health Insurance?

This conference will answer important questions about the viability of private exchanges, the role of single-source vs. multi-carrier platforms, and the product, pricing and benefit strategies of top insurers. $200 discount with code BLINK2.

[Guidance Overview]

New Accommodations for Employers on Contraceptive Coverage
"The interim final rule provides another alternative accommodation for non-profit religious organizations.... The proposed rule would, pursuant to the Supreme Court's judgment in Hobby Lobby, allow closely held for-profit organizations to qualify as 'eligible organizations' and thus claim the same accommodation as non-profit religious organizations.... The departments seek comments on how to define a closely held corporation, referring to two different approaches to defining 'closely held' both found in the Internal Revenue Code." (Timothy Jost, for Health Affairs)  

[Guidance Overview]

Emerging Strategies to Reduce or Eliminate Exposure for Assessable Payments under the ACA's Pay-or-Play Rules
"With the extension of coverage under an employer's existing, major medical insurance plan off the table, there have evolved a handful of alternative strategies, many of which are self-funded, which seek to drive down the top-line, aggregate premium cost of group health coverage. These strategies include ... Reference pricing models ... Major medical plans without inpatient hospital coverage ... Limited network arrangements." (Mintz Levin)  

[Guidance Overview]

Final Rules Adopted Clarifying Employers' Obligations Under the New York City Earned Sick Time Act
"The Rules provide that if an employee is employed jointly by two or more employers, all of the employee's work for each of the joint employers will be considered as a single employment for purposes of accrual and use of sick time under the ESTA. Joint employers may allocate responsibility for the requirements of the ESTA among themselves.... [E]mployers are permitted to set a minimum increment for the use of sick time, not to exceed four hours, so long as such a minimum increment is 'reasonable under the circumstances.' ... The Final Rules clarify how the 'regular rate of pay' should be calculated." (Littler)  

[Guidance Overview]

GASB Issues Two OPEB-Related Exposure Drafts (PDF)
"The most significant effect of the Exposure Draft is to require that governments report a Net OPEB Liability in their statement of financial position, the calculation of which differs significantly from the Net OPEB Obligation under the current GASB 45 standard. This amount is the difference between the total OPEB liability ... and the plan's fiduciary net position ... for governments that provide OPEB benefits through a trust meeting specified criteria. If there is no trust or the criteria are not met, the net OPEB liability reported in its statement of financial position is the entire OPEB liability. It also proposes significant changes to the calculation of the total OPEB liability and expenses.... Written comments are requested from the users of government financial information by August 29. Public hearings will be held on September 10, 11, and 12." (Milliman)  

[Guidance Overview]

CMS Explains When Individuals with Medicare May (and May Not) Enroll for Coverage Through Exchanges
"Medicare is complex and nuanced -- and so are these FAQs. Employers should, for instance, be aware that although the FAQs describe the creditable coverage notice requirement as one that will be met by insurers providing plans through a SHOP, group health plan sponsors are ultimately responsible for the notices, and there is no small employer exception." (Thomson Reuters / EBIA)  

[Guidance Overview]

CMS Webinar Slides: FF-SHOP Marketplace Payment Portal Demonstration and Premium Payment Timelines for 2015 (PDF)
"Purpose: [1] To provide issuers with updates on 2014 FF-SHOP Enrollment/Reconciliation mandatory reporting and development of the 2015 FF-SHOP online Marketplace; [2] To provide issuers with the issuer testing schedule, demonstration on how issuers will get started with issuer testing, test data and scenarios, defect management, next steps." [39 presentation slides, webinar dated August 19, 2014.] (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

Obama Administration Offers Contraception Compromise for Religious Employers
"Federal officials laid out fresh rules to create a multistep process in which employers opposed to including birth control in workers' insurance would state their objections in writing, and the federal government would take over responsibility for the coverage from there to ensure that employees can still obtain contraception without making copayments, as part of the law.... Catholic bishops, who have led a campaign against the contraception-coverage provision that has included numerous legal challenges since its announcement in August 2011, indicated the new rules make only minor changes and are insufficient." (The Wall Street Journal; subscription may be required)  

Text of Sixth Circuit Opinion: Insurer's Repeated Failure to Provide Full and Fair Indicates Claim Decision Was Arbitrary and Capricious (PDF)
"United's refusal to give Janie's benefits claim a fair review not once, not twice, but three times -- in spite of clear instructions from the district court -- casts a pall over United's handling of the claim from the start.... If a decision to deny benefits could never be arbitrary and capricious when backed by the insurer's reviewing physicians, court review would be for naught. The insurer would invariably prevail so long as the insurer had physicians on its staff willing to confirm its coverage rulings. That also does not make sense." [Butler v. United Healthcare of Tennessee, No. 13-6446 (6th Cir. Aug. 22, 2014)] (U.S. Court of Appeals for the Sixth Circuit)  

Large Wellness Penalties Can Trigger Big Problems Under the ADA
"Most employers don't shift the entire cost of coverage to employees who refuse to submit to a health risk assessment. Those that do can continue to argue that the assessment is a 'bona fide benefit plan' under the ADA safe harbor. The more strident the surcharge, however, the easier it might be for a court to conclude the surcharge is a subterfuge to evade the purpose of the ADA." (Lockton)  

Mental Health Parity Required Health Plan to Cover Autism Treatments
"When analyzing the plan's arguments, the [federal district] court seemed to suggest that it could have entirely excluded coverage for autism without violating the MHPAEA.... In addition to its MHPAEA holding, the court [also] ruled that the plan's exclusion was invalid under two state insurance statutes -- one requiring mental health parity and the other requiring coverage of minors with 'pervasive developmental disorders.' The bottom line: Plan provisions involving mental health benefits should be carefully scrutinized." [A.F. v. Providence Health Plan, No. 3:13-cv-00776-SI (D. Ore. Aug. 8, 2014)] (Thomson Reuters / EBIA)  

FSA Open Enrollment Reminders
"Open enrollment communications are an opportunity to provide employees with the following pointers on FSA use: Learn about plan extensions.... Keep track of deadlines.... Research eligible expenses.... Use an online FSA calculator to estimate yearly expenses and learn about the savings available to you through these plans.... Ask questions before open enrollment." (Society for Human Resource Management [SHRM])  

QBI, LLC Appoints Risë Spiegel as Chief Operating Officer
QBI, LLC

Consumer-Directed Health Care Solutions Leader ConnectYourCare Named to Inc. 500|5000
ConnectYourCare

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

PBGC Celebrates 40 Years of Protecting Pension Benefits of the Nation’s Workers and Retirees
PBGC [Pension Benefit Guaranty Corporation]

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