Health & Welfare Plans Newsletter

October 13, 2014

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Webcasts and Conferences

Advanced Top Heavy Plan Testing and Plan Design
October 21, 2014 WEBCAST
(McKay Hochman Co., Inc.)

Same-Sex Spouses: What the Changing Legal Landscape Means for Employers
October 22, 2014 WEBCAST
(McAfee & Taft)

2014 Webinar: IRA Frontline Fundamentals – Part 1
November 4, 2014 WEBCAST
(Ascensus)

12th Annual ERISA Update
November 6, 2014 in WA
(ASPPA Benefits Council [ABC] of Great Northwest)

2014 Webinar: Coverdell Education Savings Accounts
November 6, 2014 WEBCAST
(Ascensus)

2014 Webinar: IRA Frontline Fundamentals – Part 2
November 11, 2014 WEBCAST
(Ascensus)

Increase Productivity through Financial Wellness
November 12, 2014 WEBCAST
(Worldwide Employee Benefits Network [WEB] - Houston Chapter)

2014 Webinar: IRA Reporting
November 13, 2014 WEBCAST
(Ascensus)

Fall Workshop
November 18, 2014 in MA
(ASPPA Benefits Council [ABC] of New England)

Success Starts with Education
November 20, 2014 in NC
(ASPPA Benefits Council [ABC] of Carolinas)

View All Webcasts and Conferences



[Guidance Overview]

OCR Addresses Same-Sex Marriage for Purposes of HIPAA Privacy Rule
"OCR did not take this opportunity to address same-sex spouses as 'personal representatives' (those who have the legal authority to make health care decisions on behalf of another person) under HIPAA. OCR promises further guidance on this point, but its task may be complicated by the fact that personal representative status is generally determined based solely on state law -- and state laws often require something in addition to the spousal relationship (such as a health care power of attorney) to confer personal representative status. For now, health plans, and their business associates, should review their policies and procedures for recognizing same-sex spouses, taking into account this latest guidance." (Thomson Reuters / EBIA)  


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[Guidance Overview]

IRS Explains How Qualified Transportation Plan Rules Apply to Vanpools
"[IRS Information Letter 2014-0028] provides helpful clarification about this and other rules that apply when qualified transportation plans offer vanpooling benefits. Note that employee-owned vehicles used for carpooling typically do not qualify as commuter highway vehicles because of the seating capacity and 80/50 rules. However, qualified parking benefits may be available when these vehicles are used for commuting to work." (Thomson Reuters / EBIA)  

[Guidance Overview]

Implementing Health Reform: Reference Pricing and Network Adequacy
"On October 10, 2014, the Departments of Labor, Treasury, and Health and Human Services issued a frequently asked question (FAQ) regarding the use of reference-based pricing in non-grandfathered large group employer plans. Although the issue the FAQ addresses specifically is the use of reference pricing, the FAQ is remarkable insofar as it is the first departmental guidance that [the author is] aware of that addresses the use of networks by self-insured ERISA plans." (Timothy Jost, in Health Affairs)  

[Guidance Overview]

CMS Cost Sharing Reduction Reconciliation Reporting for Qualified Health Plans
"To implement the cost sharing reductions required by the Affordable Care Act, [qualified health plans (QHPs)] must develop and offer three silver plan variations in addition to their standard silver plan offering.... Until 2016, QHPs may choose one of two methodologies -- standard or simplified -- to calculate cost sharing reductions paid and to report this information to CMS in order to reconcile the cost sharing payments made by the QHPs with the amounts advanced by CMS. After 2016, QHPs may only use the standard methodology to calculate cost sharing reductions." (Epstein Becker Green)  

[Guidance Overview]

New Developments and Impending Deadlines for Employer Group Health Plans (PDF)
"There remain many questions about the application of the HPID rules -- including, for example, to which type of self-insured plans do the HPID rules apply -- and definitive answers are not expected from the applicable government agencies prior to the November 5, 2014 deadline. Therefore, employers of self-insured arrangements are urged to use their best efforts to timely comply with the requirements." (Patterson Belknap Webb & Tyler LLP)  

[Guidance Overview]

Health Plan ID Requirements and Other End-of-Year Considerations
"With the deadline less than a month away, plan sponsors should be preparing to apply for health plan IDs. The process is not at all streamlined, and plan sponsors should allow several weeks to account for difficulties and delays." (Ballard Spahr LLP)  

Deadlines and Reminders for Health Plans During 4th Quarter 2014
"Oct. 15, 2014[:] Deadline for employers with calendar-year plans to file Form 5500 if they obtained an extended due date; Deadline for Medicare Part D Notices of creditable or non-creditable prescription drug coverage to Medicare Part D-eligible participants and beneficiaries (unless provided in preceding 12 months). Nov. 5, 2014[:] Deadline for 'controlling health plans' with more than $5 million in annual receipts to obtain health plan identifiers. Nov. 15, 2014[:] Deadline for self-insured major medical plans to report their annual enrollment count, and arrange for payment of the transitional reinsurance fee based on that count, using online process available on pay.gov; Open enrollment begins for individuals to obtain coverage for 2015 via the Health Insurance Marketplace." (Lockton)  

[Guidance Overview]

Reinsurance Program Requires Self-Insured Health Plans to File Enrollment Data by November 15 and Pay Fee Later
"For 2015 and 2016, self-insured group health plans can be excluded from paying reinsurance contributions if they do not use a third party administrator for the 'core administrative functions' of claims processing or adjudications or plan enrollment. However, this is a narrow exclusion. To qualify, a self-insured plan cannot use the third party administrator for more than 5 percent of the plan's core administrative functions. The [HHS] expects that few plans will qualify and estimates that this exclusion will have a small effect on the rates in the future." (Snell & Wilmer)  

Employers Decide How to Manage Section 6055/56 Reporting
"Employers deciding how to comply with the Affordable Care Act's reporting requirements have important housekeeping questions to decide, such as: [1] who will take phone calls from the IRS and employees about ACA forms; [2] whether electronic filing (for the IRS) and transmittal (to employees) is needed; and [3] which workers have coverage that was reported on by another plan, so the employer doesn't submit a duplicate report on that employee." (Thompson SmartHR Manager)  

Harvoni, a Hepatitis C Drug From Gilead, Wins FDA Approval
"The first complete treatment for hepatitis C that requires taking only a once-a-day pill won approval Friday from the Food and Drug Administration.... Many patients will be able to take Harvoni for only eight weeks, at a cost of about $63,000." (The New York Times; subscription may be required)  

[Opinion]

Thanks to Obamacare, Health Costs Soared This Year
"The law reduced competition in most health-insurance markets. A limited analysis by the Kaiser Family Foundation found that in 2014, large states like California and New York were more competitive, but Connecticut and Washington were less competitive. The Heritage Foundation conducted a national analysis and found that between 2013 and 2014, the number of insurers offering coverage on the individual markets in all fifty states declined nationwide by 29 percent." (Robert Moffit, in The Daily Signal)  

Benefits in General; Executive Compensation

Coca-Cola Announces Equity Stewardship Guidelines
"In response to shareholder concerns over the potential dilutive impact of its 2014 Equity Plan, the Coca-Cola Company took the unusual step of announcing that it will use 'substantially fewer shares for long-term equity awards' by 'significantly reducing the use of stock options.'" (Meridian Compensation Partners, LLC)  

FASB Adds Stock Compensation Tax Accounting Topics to Its Agenda (PDF)
"On October 8, 2014, the FASB voted onto its technical agenda various topics related to improvements and simplifications to the current accounting for stock-based compensation. The topics include certain broadly applicable areas of income tax accounting ... The Board voted to include two income tax accounting topics to a stock-based compensation project and encouraged the FASB staff to continue researching the possibility of entirely eliminating the intraperiod tax allocation rules as a separate project." (PricewaterhouseCoopers)  

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