Health & Welfare Plans Newsletter

September 24, 2014

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Employee Benefits Jobs

Administrative Support Specialist - Retirement Planning
LoVasco Consulting Group, Inc.
in MI

Retirement Plan Consultant
LoVasco Consulting Group, Inc.
in MI

Defined Benefit - Systems Analyst
Milliman
in TX

Enrolled Actuary
PenSys, Inc.
in CA

Sr Account Executive - Retirement Services
Principal Financial Group
in MA

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Webcasts and Conferences

myRA: Making Retirement Planning Work Your Small Business
September 26, 2014 WEBCAST
(U.S. Small Business Administration [SBA])

Qualified Plan Terminations and Partial Plan Terminations
October 7, 2014 WEBCAST
(ASPPA [American Society of Pension Professionals & Actuaries])

Rise of Retail Health Coverage
October 15, 2014 WEBCAST
(Healthcare Web Summit)

Capital Market Expectations
December 10, 2014 WEBCAST
(Conference of Consulting Actuaries)

View All Webcasts and Conferences



[Guidance Overview]

IRS Health Coverage Reporting Instructions Leave Many Questions Unanswered (PDF)
"While the release of the instructions and forms allows issuers and employers to begin the process of designing systems for reporting, many unanswered questions remain regarding these complex requirements.... Some of the most significant are ... Reporting for a Group of Related Entities .... Reporting for Insurance Provided to Multiple Employers... Distribution of Filings to Employees... Reporting for Non-Employees.... Requirement to Provide a Single Form 1095-C to Employee.... [and] Requirement to Perform 1095-C Reporting Even if Transition Relief Applies." (Groom Law Group)  


[Advert.]

401(k) Plan Structure Training for Employers

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

Retirement plans can be designed in many different ways—does your plan best meet the needs of your organization? The new e-learning course, 401(k) Plan Structure, examines the many aspects to consider when structuring a 401(k) plan. Enroll Now!



[Guidance Overview]

Preparing for the ACA Employer Information Reporting Requirements
"Although no reporting is required until 2016, employers should take steps now to prepare for the new reporting requirements, including: [1] Reviewing the draft filing forms and instructions issued by the IRS to identify data elements, such as TINs and coverage months, required for the new reporting.... [2] Reviewing recordkeeping systems to ensure that necessary data elements are able to be captured.... [3] Modifying the open enrollment forms used this fall to include collection of TINs. [4] Implementing procedures to perform follow up requests, as needed, for TINs." (Vedder Price)  

How Workers and Employers Diverge on Wellness Programs
"The appeal of wellness programs has much to do with the popularity of wellness benefits among employees (and a belief that they can reduce absenteeism and improve productivity). The roughly $6 billion wellness industry aggressively sells products -- and wellness programs are a far easier cost-containment strategy to sell to employees than higher cost sharing or narrower provider networks." (The Wall Street Journal; subscription may be required)  

Now May Be a Good Time to Dust Off and Update Your Section 125 Cafeteria or Flexible Benefit Plan
"As employers consider whether to amend their Section 125 plans to allow these two new change events, which are beneficial to employees, they should give thought to other plan amendments that may be needed.... [1] Amend health flexible spending accounts to reflect the $2,500 cap on salary reduction contributions.... [2] Consider allowing carryover of $500 for health FSAs.... [3] Amend Section 125 plans to reflect the federal recognition of same-sex marriages.... [4] Amend Section 125 plans to prohibit providing qualified health plans offered through a Marketplace.... [5] Amend non-calendar-year cafeteria plans to allow mid-year election changes.... [6] Amend health FSAs to require participants to have a prescription for over-the-counter medications to be eligible for reimbursement under a health FSA." (Snell & Wilmer)  

Text of Federal District Court Opinion: ERISA Preempts State Law Claim of Insurer Attempting to Recover Duplicative Benefit Payments (PDF)
"No matter how MetLife frames its arguments, both of MetLife's proposed state law claims are premised upon and require a finding that MetLife was not required, under the Plan's terms, to make the optional coverage benefit payment.... Although a state law claim that only 'requires a cursory examination of plan provisions' or arises in the context of an ERISA plan, may not be preempted by Section 514(a), the proposed state law claims in this case clearly arise from an ERISA plan, direct the Court's inquiry to the Plan, require an analysis of the Plan 's terms, and involve the calculation and payment of benefits due to a Plan participant. Therefore, MetLife's proposed state law claims are preempted by Section 514(a)." [Metropolitan Life Ins. Co. v. DePalo, No. 13-3092 (D.N.J. Sept. 22, 2014)] (U.S. District Court for the District of New Jersey)  


[Advert.]

24th Annual National Health Benefits Conference & Expo (HBCE)

Sponsored by HBCE

Plan now to attend the National Health Benefits Conference & Expo, January 27-28 in Clearwater Beach, Florida. The conference provides cutting-edge case studies and advanced cost control strategies presented by national thought leaders. Register Now!



Joint Employers: FMLA Liability Can Be Costly
"To be covered by the FMLA, a private employer must employ at least 50 employees within a 75-mile area. If the employer doesn't meet this threshold, it is not obligated to provide FMLA leave to its employees. However, an employee can enjoy the protections of the FMLA if he is jointly employed by multiple companies that together have 50 or more employees.... Maintaining temporary employees or sharing employees with a related company is a risky endeavor and ... sets up at least the initial building blocks for an FMLA claim." [Cuff v. Trans State Holdings, Inc., No. 13-1241 (7th Cir. Sept. 19, 2014)] (FMLA Insights)  

Number of Marketplace Insurers to Rise 25 Percent, HHS Says
"The number of competitors on the marketplaces is considered important because it signifies the vitality of the exchange and can mean increased competition and lower prices for consumers. It also means that insurers see the health law's online marketplaces or exchanges, as a good business opportunity ... HHS officials could not elaborate on what 'tiers' of coverage the new entrants would offer or how much that coverage would cost. The report also does not say in which counties the insurers will offer coverage, a factor that would directly influence the level of competition in coverage and price." (Kaiser Health News)  

Health Insurance Issuer Participation and New Entrants in the Health Insurance Marketplace (PDF)
"Based on preliminary data for 36 Federally-facilitated Marketplace (FFM) states and eight additional State-based Marketplace (SBM) states, there will be a 25 percent increase in the number of health insurance issuers offering Marketplace coverage in 2015 compared to 2014. Four of the 36 states in the FFM will have at least double the number of issuers they had in 2014. At least 67 issuers in the FFM and 10 issuers in the SBMs will be new to the Marketplaces in 2015." (Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS])  

Narrow Networks Are Saving Money for Health Plans
"If narrow networks are like restricting the stores where your kids are allowed to shop, reference pricing is like telling your kids they can shop anywhere. But you will only pay, say, $30 towards the cost of a pair of jeans. If they choose to spend $100 on Buffalo jeans at the mall, they must pay the $70 difference. Several years ago insurer WellPoint partnered with [CalPERS] on a reference-pricing program to encourage enrollees to patronize lower-cost hospitals. It worked -- enrollees quickly shifted to hospitals that charged less for joint replacement surgery." (National Center for Policy Analysis Health Policy Blog)  

Benefits in General; Executive Compensation

Employees Give Low Grades for Benefits Education
"While most employers care how well they provide benefits education, many of them aren't sure how to go about providing the best service in this area ... [One approach is] a '3x3' strategy for strong benefits education, in which companies begin communicating with employees three weeks before enrollment, so they have enough time to review the current benefits and options, and use at least three different tools to communicate to employees.... [W]hile most younger workers may prefer to receive all or most of their information via technology, many older employees aren't as comfortable with these channels.... [S]ometimes employers have a traditional -- or outdated -- view of benefits education, which involves sending out large volumes of information to employees and assuming that they will read it all and automatically become educated[.]" (Human Resource Executive Online)  

Dealing with Legacy Costs: Pension and Health Benefits (PDF)
22 presentation slides. "Get a funding plan. Identify any changes you need to make. Agree on a transition plan (over how many years will you phase in changes). Make sure your funding policy complies with actuarial standards. Secure an actuarially determined contribution (ADC) so you can budget. Accumulate funding reserves." (Center for State & Local Government Excellence)  

Higher Stock Values Drive Increases in Pay for Directors
"The median Fortune 500 director's total compensation increased 6% this year to nearly $240,000, up from $227,000 in the prior year. The average mix of pay for directors is 44% cash and 56% stock.... Median total annual stock compensation increased 4%, with year-over-year increases to equity varying by industry sector. Four out of 10 industry sectors increased more than 10% at the median." (Towers Watson)  

Keeping and Motivating Employees: Getting Their Skin in the Game
"When a key employee demands to have skin in the game at the company, the natural assumption is that he or she wants to own company stock. In reality, the employee may not want to contribute capital when it's needed, pledge personal assets to cover a loan or share in the burden of company taxes on undistributed profits. There are other ways to satisfy their needs which may be just as, if not more, appealing." (Forbes)  

Press Releases

PBGC to Pay Pension Benefits at James River Coal Company
PBGC [Pension Benefit Guaranty Corporation]

$500K for Studies on Expanding Paid Family and Medical Leave Provided by US Labor Department Grants
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

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