Health & Welfare Plans Newsletter

October 1, 2014

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Employee Benefits Jobs


Webcasts and Conferences

Deep Dive on Recent Pension Buyout Activity
October 6, 2014 WEBCAST
(Mercer)

ERISA Workshop: Rollover Taxation and Other Developments
October 16, 2014 WEBCAST
(SunGard Relius)

Alternative Asset Training Camp, 2014
October 20, 2014 in CA
(Retirement Industry Trust Association [RITA])

Cafeteria Plan, Health FSA, and DCAP Mistakes: Finding, Fixing, and Preventing
October 30, 2014 WEBCAST
(Thomson Reuters / EBIA)

View All Webcasts and Conferences



[Guidance Overview]

IRS Modifies Cafeteria Plan Rules to Allow Certain Employees to Drop Employer-Provided Group Health Plan Coverage (PDF)
"This modification of the irrevocable election rules provided by the Notice does not apply to cafeteria plan elections to contribute to a flexible spending arrangement. [Notice 2014-55] applies to cafeteria plan elections to contribute to group health plans that provide minimum essential coverage. This means that cafeteria plan elections for stand-alone dental and vision plans or critical illness plans (which are excepted benefits and do not provide minimum essential coverage) cannot be changed based on this guidance." (Groom Law Group)  


[Advert.]

Earn Your Certificate in Health Care Plans

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

Get informed on the latest changes and trends in the health care industry! The Certificate in Health Care Plans program explores the employment-based health care system and offers an overview of the latest reform initiatives. Register Now.



Claim Based on Health Plan's Failure to Cover Same-Gender Spouse Survives under Title VII as Gender Discrimination Claim
"The district court found that BNSF's reading of Hall's claim as one of sexual orientation discrimination ignores the plain language of the Amended Complaint and improperly restricts the class of employees affected by the policy at issue in which Hall is a member. A careful reading of the Amended Complaint, construed in favor of Hall as the non-moving party, demonstrates that Hall alleges disparate treatment based on his [gender] ... specifically that he (as a male who married a male) was treated differently to his female coworkers who also married males." [Hall v. BNSF Railway Company, No. C13-2160 RSM (W.D. Wash. Sept. 22, 2014)] (Practical Law Company)  

Text of Oklahoma Federal District Court Opinion Disallowing Premium Subsidies for Health Insurance Purchased Through Federally-Facilitated Marketplace (PDF)
"Under 42 U.S.C. 18024(d), 'State' cannot mean the federal government. This definition is dispositive when combined with the interpretive hurdle presented by the phrase 'established by.' In other words, the 'legal fiction' reading does not appear to comport with normal English usage ... At the first step of the Chevron analysis, the court asks 'whether Congress has directly spoken to the precise question at issue' ... On this particular 'precise question,' however, case law does not provide 'wiggle room' for finding ambiguity. This is because tax credits must be expressed in 'clear and unambiguous language.'" [Oklahoma ex rel. Pruitt v. Burwell, No. CIV-11-30-RAW (E.D. Okla. Sept. 30, 2014)] (U.S. District Court for the Eastern District of Oklahoma)  

Text of Amicus Brief for Labor and Benefits Law Professors to Supreme Court on Appeal of Sixth Circuit Decision Upholding Lifetime Retiree Health Benefits Under Collective Bargaining Agreement (PDF)
"Petitioners and their amici argue that employers were and continue to be unlikely to grant vested retiree health benefits because of the potential for those benefits to become unpredictably expensive over time. Accordingly, they argue that a court should determine that retiree health benefits are vested only if the relevant CBA contains a clear statement to that effect. Whether or not this assessment of employer reasoning is correct today, it is seriously flawed as to the period of time during which many retiree health benefits clauses were first negotiated: the mid-1960s through mid-1970s. Moreover, because the language governing retiree health insurance has often been carried, basically unchanged, from CBA to CBA, the conditions surrounding initial negotiations remain relevant to interpretation of CBA language today." [M&G Polymers USA, LLC v. Tackett, No. 13-1010 (on appeal from 6th Cir., cert. granted May 5, 2014)] (33 Professors of Employment and Labor Law)  

District Court Rules Against Premium Tax Credits in ACA Federal Exchanges
"Judge White's decision is remarkably narrow.... Judge White proceeded to explicate the text of the ACA, concluding that only the text was relevant. He observed that 'where the meaning of a statute is clear, it is both unnecessary and improper to resort to legislative history to divine legislative intent.' Indeed, he stated, quoting Judge Easterbrook, 'Legislative intent is a fiction' and cannot be used to create ambiguity when the wording of statute is clear. It does not matter what Congress thought it was doing; only the words of the statute matter." [Oklahoma ex rel. Pruitt v. Burwell, No. CIV-11-30-RAW (E.D. Okla. Sept. 30, 2014)] (Timothy Jost, in Health Affairs)  


[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!



Oklahoma Federal Judge Limits Health Care Subsidies
"In Oklahoma, U.S. District Judge Ronald A. White of Muskogee became the latest to rule on the dispute. For the time being, his is the only ruling still in effect that would strike down the federal marketplace tax credits (and it is subject to appeal).... Meanwhile, a federal trial judge in Indianapolis ... is scheduled to hold a hearing [on October 9] on a challenge by Indiana and thirty-nine public school districts in that state, seeking to block subsidies for those buying insurance on an exchange that is run by the federal government." [Oklahoma ex rel. Pruitt v. Burwell, No. CIV-11-30-RAW (E.D. Okla. Sept. 30, 2014)] (SCOTUSblog)  

Text of GAO Legal Opinion on HHS Authority to Make 2015 'Risk Corridor' Payments to Qualified Health Plans (PDF)
"Section 1342 of PPACA directs the Secretary of HHS to collect from and make payments to qualified health plans. The CMS PM appropriation for FY 2014 would have been available to CMS to make the payments specified in section 1342(b)(1). The CMS PM appropriation for FY 2014 also would have appropriated to CMS user fees collected pursuant to section 1342(b)(2) in FY 2014. HHS stated that it intends to begin collections and payments under section 1342 in FY 2015. However, ... for funds to be available for this purpose in FY 2015, the CMS PM appropriation for FY 2015 must include language similar to the language included in the CMS PM appropriation for FY 2014." (U.S. Government Accountability Office [GAO])  

Quirky FMLA Counting Rules: Overtime
"[R]equired overtime hours must be factored into the FMLA entitlement calculation for eligible employees. In other words, employees who are normally required to work overtime are entitled to more than 480 hours (12 weeks x 40 hours per week) of FMLA leave in the applicable 12-month period." (Benefits Bryan Cave)  

Benefits in General; Executive Compensation

Best Practices in Employee Financial Security, 2014 (PDF)
"Provide employees with meaningful financial benefits to help them save for retirement.... Make it easy for employees to participate in securing their financial future, and give them incentives to do so.... Make a lifecycle fund the default asset allocation choice for 401(k) plans.... Help employees become more financially literate so they can take greater responsibility for their financial future.... Offer employees benefits, tools, and resources to help them achieve health wellness.... Design benefit programs that are accessible and flexible enough to accommodate changing lifestyles and needs." (The Principal Financial Group)  

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