Defined Benefit Administration Team Leader
Milliman, Inc.
in NJ

Regional Sales Manager
Aspire Financial Services LLC
in NJ, OH, PA

Pensions Field Service Manager
Nationwide Financial
in CO, TX

TPA Development Manager
Transamerica
in CA

401(k) Pension Administrator
Nicholas Pension Consultants
in CA

Client Relationship Manager
Goldleaf Partners
in CO, MN, NC, OH, SC

Of Counsel, Qualified Plans
Groom Law Group, Chartered
in DC

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5th Annual Executive Compensation Summit
October 16, 2014 in CA
(Forum for Corporate Directors)

National Conference 412(e)3 Plans
October 24, 2014 in UT
(National Pension Partners)

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[Guidance Overview]

Treatment of Unpaid Leaves of Absence Under the Look-Back Measurement Method
"Generally, employees returning from a break-in-service of 13 weeks or more (26 weeks in the case of an educational institution) may be treated as newly hired. Alternatively, under a 'rule of parity,' an employer may treat a rehired employee who has had a break of at least four weeks as a new employee if the employee's break in service (with no credited hours of service) is longer than the employee's period of service immediately preceding the break in service. But if an employee's break in service is less than 13 weeks (or 26 weeks in the case of an educational institution), and the employee previously qualified for coverage during the then current stability period, he or she is treated, upon rehire or resumption of service, as a continuing employee to whom coverage must be offered by the first day of the following month." (Mintz Levin)  

[Advert.]

NBCH 19th Annual Conference -- November 10-12, 2014 - Washington, DC

Employers, health plans, providers and other key stakeholders focus on improving health outcomes, lowering cost by benefit design, care management, payment reform, and reducing waste. Free admission for employers that are members of an NBCH coalition. Join us.

[Guidance Overview]

CMS Guidance Clarifies Who Must Obtain Health Plan Identifiers by November 5 Deadline
"With the November 5, 2014 deadline looming, this guidance arrives in the nick of time. Employers will need to read the FAQs carefully (the new HPID FAQs are mixed in with others on the [CMS] webpage) to determine which of their plans need an HPID or may be treated as [subhealth plans] for which an HPID is optional. And time is of the essence, since the enumeration process is complicated -- the quick reference guide identifies 25 discrete steps on the path to obtaining an HPID." (Thomson Reuters / EBIA)  

[Guidance Overview]

Agencies Finalize Dental, Vision, and EAP Changes to Excepted Benefits Under HIPAA and ACA
"The regulations amend the 2004 regulations on excepted benefits, finalizing proposed regulations on dental, vision, and [long-term care] coverage and EAPs that were issued last year ... with a few changes and clarifications. The final regulations do not address a proposal to treat limited wraparound coverage as an excepted benefit. According to the preamble, future regulations will address this topic, taking into account extensive comments on the proposal." (Thomson Reuters / EBIA)  

Text of Federal District Court Opinion: Intermittent FMLA Leave Can Be Used to Eliminate Mandatory Overtime Requirement (PDF)
"[T]he yearly leave entitlement under the FMLA would be sufficient to relieve Mr. Santiago from all of the overtime required for his position .... [U]nder this scenario, the FMLA could be used to essentially create a new position for Mr. Santiago that does not involve overtime.... To the extent that Mr. Santiago is able to use his FMLA leave to essentially obtain an accommodation that might not be available under the ADA, this is a result that is permitted by the statue and [has] been considered by the DOL since the statute's inception.... [N]othing in the FMLA restricts Mr. Santiago from using the statutory entitlement to eliminate overtime." [Santiago v. Conn. Dept. of Transportation, No. 3:12cv132 (D. Conn. Sept. 25, 2014)] (U.S. District Court for the District of Connecticut)  

EEOC Challenges a Second Employer's Wellness Program
"The question arising from the Orion Energy and Flambeau cases is what constitutes a 'voluntary' wellness program. The EEOC has defined a voluntary wellness program as one in which the employer neither requires participation nor penalizes employees for not participating in the program. But, the EEOC has not yet taken a formal position on what would amount to a penalty.... [E]mployers should advise their employees that participation in the wellness program is voluntary, and if the employer wishes to impose a financial penalty on employees who do not wish to participate, that penalty should not exceed 30 percent of the employee's health insurance premiums (or 50 percent for tobacco-related programs)." (Pepper Hamilton LLP)  

[Advert.]

Join us at IHC FORUM West November 10-12, 2014 in Las Vegas!

Come to the ONLY national event 100% dedicated to health care consumerism progress, collaboration and educational content. We'll provide a real-time look in at this year's open enrollment results and much more. Sign up today for the lowest rates!

Affordable Care Act 'Compliance Season' Begins November 15, 2014
"There used to be a brief three month respite between October 15, the final due date for extended Form 5500s, and the following January 1, when the annual administrative cycle began again. Not any more. The [ACA] provides another set of compliance deadlines starting on November 15, 2014. The new deadlines involve: Open Enrollment; Health Plan Identifiers (HPID); Reporting Requirements for Self-Funded Group Health Arrangements; Document Updates; [and] 2015 and beyond." (The Retirement Plan Blog)  

The ACA 'Cadillac Plan' Tax and Its Impact on the Market
"In your planning process, if you have a collectively bargained contract, ask the following questions, as they will most likely influence your actions: Does the term of the agreement straddle the Cadillac Tax implementation date or is a new agreement negotiated prior to the effective date of the Tax? Will the projected cost of the negotiated benefit plan exceed the threshold where a tax will be levied against the plan?" (The Institute for HealthCare Consumerism [IHCC])  

Findings from June 2014 Hearing on Coordination of Benefits, Health Plan Identifier, and ICD-10 Delay (PDF)
"Testifiers were in agreement that it is the lack of common and consistent practices in business operations and standardization of operating rules, rather than the adopted standard itself, that gives rise to current coordination of benefits issues.... A consistent message heard strongly across the industry at the June, 2014 hearing was the lack of benefit and value in the use and reporting of HPIDs in health care transactions. Testifiers were in consensus that HPID should not be required to be used in administrative transactions and it should not replace the payer ID currently used by the health care industry." (NCVHS [National Committee on Vital and Health Statistic])  

2015 Health Plan Cost Trend Survey Shows Variation in Trend Rates, Substantial Increase for Prescription Drug Plans
"Increases in medical trends are projected to range from a low of 6.2 percent for Health Maintenance Organizations (HMOs) to a high of 10.4 percent for fee-for-service coverage. A marginal decline from 2014 in the projected trend rate for open-access preferred provider organizations (PPO) and point-of-service (POS) plans for 2015 (7.9 to 7.8 percent). Higher trend rates for all prescription drug benefit plan types. The trend for carve-out coverage is projected to jump from 6.3 percent in 2014 to 8.6 percent in 2015. The carve-out trend for retirees 65 and older is projected to rise from 5.7 percent in 2014 to 7.5 percent in 2015, more than twice the rate of retiree medical cost trends." (Segal Consulting)  

Lawsuit Continues Over ACA Subsidies
"Arguing that minimizing the federal government's role in providing health care coverage was crucial to getting the new federal law passed, a group of businesses and individuals on [October 3] urged a federal appeals court in Washington to bar tax subsidies for anyone who gets insurance at a federal marketplace ... The arguments came in the opening brief before the en banc U.S. Court of Appeals for the District of Columbia Circuit, which is reconsidering a basic challenge to a key part of the [ACA].... 'There is no legitimate way' to read the ACA to allow subsidies in the federal marketplaces, the brief contended." [Halbig v. Burwell, No. 14-5018 (D.C. Cir. July 22, 2014)] (SCOTUSblog)  

Text of HHS Brief on Petition for Certiorari in Challenge to Premium Subsidies for Health Insurance Purchased Through Federally-Facilitated Marketplace (PDF)
"Petitioners identify no sound reason for this Court to depart from its usual practice by taking up the question presented in the absence of a disagreement among the courts of appeals and while the D.C. Circuit's en banc proceedings remain pending. Review is also unwarranted because the court of appeals' decision is correct." [King v. Burwell, No. 14-1158 (4th Cir. July 22, 2014; cert. pet. filed July 31, 2014)] (U.S. Supreme Court)  

ISS Issues 2014-2015 Policy Survey Results
"ISS highlighted the responses to several survey questions that dealt with [pay-for-performance (P4P)]. ISS indicates that investors liked the idea of having CEO pay limits relative to company performance (27% of investors supported, while only 12% of issuers agreed). The magnitude of CEO pay was considered when evaluating pay practices by 24% of investors and 50% of issuers. Based on these responses, and the additional follow-up questions, ISS may propose a refinement to its P4P policy that does more to evaluate the CEO pay versus both absolute and relative measures." (EdwardHauder.com)  

John Hancock Investments Announces Expense Reductions of up to 31 percent on Certain Target Date Funds
John Hancock Financial Network

Segal Names New Communications Practice Leader
Segal Consulting

Berkshire Hathaway Specialty Insurance Unveils Executive First Fiduciary Liability Insurance
Berkshire Hathaway Specialty Insurance

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