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Employee Benefits Jobs
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Webcasts and Conferences
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[Guidance Overview]
IRS Notice Addresses Changing Measurement Periods Under ACA
"Employers using the look-back measurement method for determining full-time employee status should become familiar with the context and approach for handling employee transfers, if these transfer issues apply to their workforce. The notice should prove particularly relevant where different employers within a single controlled group (referred to in the final regulations as 'applicable large employer members') use look-back measurement periods with varying lengths and/or different start and end dates, and following corporate transactions where the buyer and seller use different measurement methods."
(Towers Watson)
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Recent 11th Circuit Cases Provide Important HIPAA Guidance
"On Oct. 10, 2014, the 11th Circuit opinion in Murphy v. Dulay provides significant guidance regarding HIPAA authorization forms. One of the most important provisions of the opinion focuses on the fact that HIPAA authorizations need not be signed voluntarily to be valid. Another opinion by the 11th Circuit on Sept. 29, 2014, stated that the Notice of Privacy Practices referred to 'health information' as the contents of the patient's record, including not only treatment records and test results, but also 'billing-related information.' Mais v. Gulf Coast Collection Bureau, Inc. also confirms
that, when a patient, or someone on the patient's behalf, agrees to the provisions in those documents, that agreement will be binding."
(Holland & Knight)
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Rethinking ACA Compliance Strategies Involving Reference Pricing Models and 'MVP' Arrangements
"[C]ertain applicable large employers -- principally those in industries in which coverage was not previously offered across-the-board to most, if not all, full-time employees -- have sought less expensive ways to offer coverage that is both 'affordable' and provides 'minimum value.' ... [S]ome of the emerging compliance strategies [include] the reference pricing models and 'MVP arrangements' ... Two recent developments, one in the form of a set of FAQs issued by [HHS, DOL and IRS], and the other a mere (though troubling) rumor, may cause employers to reconsider both these approaches."
(Mintz Levin)
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ACA Subsidy Challengers See Dire Problems Soon
"The problem of fixing the federal health care program will only grow worse if the Supreme Court does not promptly resolve the legality of subsidies to help lower-income individuals pay for insurance, the challengers to the subsidy scheme told the Justices on Tuesday. This was the formal reply to the Obama administration's argument early this month that the Court should wait to see how a federal appeals court deals with the subsidies' legality.... The filing of this brief completes the written preparation of the case for the Justices, so it can soon be sent to the Justices to set up a vote on whether to grant or deny review, or to hold the case." [King v. Burwell, No. 14-1158 (4th Cir. July 22, 2014; cert. pet. filed July 31, 2014)]
(SCOTUSblog)
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IRS Announces Impending Tighter Enforcement of Employer-Provided Meals, Fringe Benefits
"The IRS announced as part of its Priorities Guidance Plan that it plans to issue new guidance regarding employer-provided meals ...The Wall Street Journal reported that IRS auditors have already started 'flagging the issue and demanding back taxes from companies amounting to 30% of the meals' fair market value.' ... [E]ven without any changes in the IRS definition, plaintiffs' attorneys have already shifted their focus to the value of these fringe benefits. Recently, employees at Anheuser-Busch sued the company because ... it allegedly failed to include the value of 'various forms of non-cash compensation, such as discounted and/or free beer' in calculations of those employees' regular rates of pay."
(Franczek Radelet PC)
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EEOC Files Two Lawsuits Challenging Employer Wellness Programs
"Until the EEOC provides further guidance on this issue, employers should ensure that their wellness programs are truly voluntary. Moreover, employers should make sure to avoid either significant penalties for employees who choose not to participate and/or significant rewards for employees who do participate in these programs. Finally, any medical information that employers obtain through a wellness program should be kept confidential and should not be used as a basis for making employment decisions involving the employee."
(Bond Schoeneck & King)
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What Every Family Should Know About High Deductible Health Insurance
"The average deductible for single coverage under employer plans this year is $1,217. That's almost double what it was in 2006. The trend is not going to abate. Next year 4 in 5 large employers will offer a high deductible plan and 1 in 3 will offer only a high deductible plan. Moreover, the deductibles in the plans offered on the (Obamacare) health insurance exchanges are more than twice as high as the average employer plan. High deductibles are not necessarily a bad thing. They may be a good thing. Here are ten things you should know in planning for your own health insurance needs."
(John Goodman, in Forbes)
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Cities Are Eliminating the Healthcare Benefits Once Promised to Retirees
"Employers have a legal obligation to continue paying pensions, although bankruptcy can change that. But most legal experts would agree that employers can do away or dramatically change health insurance for retirees -- even if they had promised it for life.... [P]ublic employers across the country may soon begin following Detroit's lead and withdrawing coverage for retirees, instead sending them to the health-care exchanges set up by the Affordable Care Act."
(The Atlantic)
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Benefits in General; Executive Compensation
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Text of Sixth Circuit Opinion: Forum Selection Clauses in ERISA Plans are Enforceable in Breach of Fiduciary Duty Actions as Well as Claims for Benefits (PDF)
"Appellant Roger Smith appeals the district court's dismissal of his claims without prejudice because of improper venue. The district court held that the venue selection clause in the [ERISA-governed] AEGON Pension Plan requiring that suit be brought in federal court in Cedar Rapids, Iowa, was enforceable and applied to Smith's claims.... We AFFIRM.... [N]one of the statutory provisions Smith cites provides a reason not to apply the venue selection provision to both his fiduciary and benefits claims. The venue selection provision applies to all actions brought by a participant or beneficiary, not just claims for benefits." [Smith v. Aegon Companies Pension Plan, No.13-5492 (6th Cir. Oct. 14, 2014)]
(U.S. Court of Appeals for the Sixth Circuit)
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Tibble v. Edison at the Supreme Court: What Does 'Six Years' Mean?
"[T]he federal courts continue to struggle with the interpretation and application of ERISA's six year statute of limitations. While written cleanly on its face, the statutory language is almost the walking embodiment of an insurance coverage concept, the latent ambiguity, which has to do with policy language that does not look ambiguous on its face (and thus would not appear to invoke various doctrines by which ambiguous policy language would be construed against the insurance company that issued the policy) but becomes ambiguous when applied to a particular fact pattern because, in application, it becomes unclear how the language should actually be applied."
(Stephen Rosenberg of The Wagner Law Group)
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First Circuit Rejects 'Continuing Violation' or 'Installment Contract' Accrual Theories for ERISA Benefits Claims
"The First Circuit ... joins the Second, Third and Ninth Circuits in rejecting the theory that each monthly benefit payment received by a participant under an ERISA plan is an accrual event giving rise to a new statute of limitations for benefits claims. To date, no Circuit court has adopted a continuing violation or installment contract theory with respect to the accrual of a claim for unpaid benefits under ERISA. Plan sponsors can breathe a collective sigh of relief that the Supreme Court apparently sees no reason to deviate from its Morgan analysis in the absence of specific legislative directives to the contrary."
(Paul Hastings LLP)
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Press Releases
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