Health & Welfare Plans Newsletter

October 16, 2014

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Employee Benefits Jobs

Staff Counsel - Benefits
Chrysler Group LLC
in MI

Defined Benefit Analyst
New York Life Retirement Plan Services
in MA

Retirement Benefits Consultant
PSA, a Division of Pavilion Advisory Group
in IL

Compensation & Benefits Manager
EJ
in MI

DB/DC Plan Administrator
Tepfer Consulting Group, Ltd.
in IL

Senior Benefits Actuary/Consultant
Occidental Petroleum Corporation
in TX

Retirement Services Manager
DC Retirement Board
in DC

Transition Manager
OneAmerica
in CA

Retirement Plan Analyst
Third Party Administrator
in NC

New Business Conversion Analyst
Third Party Administrator
in NC

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Webcasts and Conferences

The Fix Is In! Your Year-End Checklist for Using the IRS 403(b) Fix-It Guide
RECORDED
(ASPPA [American Society of Pension Professionals & Actuaries])

Help Provide a Comfortable Retirement
October 30, 2014 WEBCAST
(InvestmentNews)

Employer Mandate Penalties - Double Feature: Sledgehammer and Tack Hammer for Higher Education Organizations
October 30, 2014 WEBCAST
(Cammack Retirement Group)

COBRA Compliance Challenges: Identifying, Correcting, and Preventing the Big Problems
November 13, 2014 WEBCAST
(Thomson Reuters / EBIA)

Tax Man Asketh: Health Informational Reporting to Employees and the IRS
November 20, 2014 WEBCAST
(Cammack Retirement Group)

CCA 2015 Annual Meeting
October 25, 2015 in FL
(Conference of Consulting Actuaries)

View All Webcasts and Conferences



[Official Guidance]

Text of OPM Proposed Regs: Federal Employees' Group Life Insurance Program -- Providing Option C Coverage for Children of Same-Sex Domestic Partners
"[OPM] is issuing a proposed rule to amend the Federal Employees' Group Life Insurance (FEGLI) regulations to allow children of same-sex domestic partners living in states that do not allow same-sex couples to marry to be covered as family members under an eligible individual's FEGLI Option C enrollment. This rule expands the circumstances under which an employee experiencing a change in family circumstances may include eligible children of a same-sex domestic partner." (Office of Personnel Management [OPM])  


[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!



[Official Guidance]

Health Insurance Oversight System Health Plan and Other Entity Enumeration System User Manual (Updated October 2014) (PDF)
"The description of the Authorizing Official user role has been updated. Authorizing Official users will only be able to search and view applications.... Section 3.1.3.2, Section 3.1.3.3, and Section 3.1.3.4 have been updated to reflect the removal of the Authorizing Official approval process.... Section 3.1.4 has been updated to reflect the removal of the Authorizing Official's ability to approve or reject applications. Authorizing Official users will only be able to search and view applications." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Official Guidance]

Text of CMS Accountable Care Organization Investment Model Fact Sheet
"This fact sheet provides a general description of a new ACO model being offered to support the Medicare Shared Savings Program ACOs, the ACO Investment Model.... The ACO Investment Model is a new model of pre-paid shared savings that builds on the experience with the Advance Payment Model to encourage new ACOs to form in rural and underserved areas and current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

Does the Section 4980H(a) Penalty Really Cap the Section 4980H(b) Penalty?
"[J]ust the minimum value requirement can trigger the discrepancy and not the affordability requirement. There is a potential planning opportunity as a result. In certain instances a minimum value plan offered at full-cost to the employee (i.e. the employee pays all of the premiums) could completely alleviate the costs of employees in a limited non-assessment period.... [O]ffering skinny plans alone is almost never a good option for an employer.... [T]his is magnified as a result of the limited non-assessment periods." (Health Care Attorneys P.C.)  

[Guidance Overview]

IRS Releases Draft Instructions for ACA Reporting
"Applicable large employers must report coverage and enrollment data on Forms 1094-C and 1095-C so the IRS can enforce the individual and employer mandates. The instructions for Forms 1094-C and 1095-C also include a section on reporting IRC Section 4980H transition relief for 2015. Final forms and instructions are expected to be released before the end of 2014." (Towers Watson)  

[Guidance Overview]

What Is the Transitional Reinsurance Fee, and What Should Plan Sponsors Do Now?
"[1] Register with REGTAP (The Registration for Technical Assistance Portal) if you haven't done so already. When the Form becomes available, a notice will be sent to REGTAP registrants.... REGTAP also allows registrants to submit inquiries and sign up for events. [2] Determine how you will count reinsurance contribution enrollees. [3] Document, document, document." (ERISAdiagnostics)  

[Guidance Overview]

Quirky FMLA Counting Rules: Leave Prior to Eligibility
"[W]hile an employer is certainly permitted to provide an employee with leave when not otherwise required by the FMLA, the regulations are clear that such leave is not FMLA leave and may not be counted against an employee's 12-week FMLA entitlement.... Employers who generously grant 'FMLA-like leave' to all employees regardless of whether such employees meet the eligibility requirements need to recognize that when an employee becomes eligible, he or she can demand a full 12 weeks of FMLA leave." (Benefits Bryan Cave)  

ACA Resources for Frequently Asked Questions, Updated October 10, 2014 (PDF)
"The report provides basic consumer sources, including a glossary of health coverage terms. The next sections focus on health coverage: the individual mandate, private health insurance, and exchanges, as well as public health care programs ... It then lists sources on employer-sponsored coverage, including sources on employer penalties, small businesses, federal workers' health plans, and union health plans. It also provides sources on ACA's provisions on mental health, public health, workforce, quality, and taxes. Finally, the report lists sources on ACA costs and appropriations, legal issues, the treatment of non-citizens under ACA, and sources for obtaining the law's full text." (Congressional Research Service [CRS])  

Federal District Court Approves $1 Million Settlement in COBRA Notice Class Action Lawsuit
"A federal district court gave preliminary approval to a $1 million settlement agreement that would resolve a class action lawsuit alleging that an employer/plan administrator, in farming out its employees to clients, violated COBRA's initial and election notice rules, as well as its premium subsidy rules. The settlement would consist of a $375,000 payout to nearly 70 class members, as well as a separate payout of nearly $625,000 for attorney's fees and other costs. The plaintiffs' law firm contends that each class member could receive approximately $5,000, thus possibly making this 'the largest average per person recovery in any reported COBRA class action.'" [Slipchenko v. Brunel Energy, Inc., No. H-11-1465 (S.D. Tex. Sept. 30, 2014)] (Thompson SmartHR Manager)  

D.C. Circuit Court Orders Government to Respond in Challenge to ACA Under U.S. Constitution's Origination Clause
"In a new and surprising development, the U.S. Court of Appeals for the D.C. Circuit has ordered that the Federal Government respond to their challengers' petition for an en banc hearing. This case, Sissel v. [HHS], centers on the Origination Clause and alleges that the Affordable Care Act was passed in an unconstitutional way.... Although Matt Sissel did not initially succeed at the D.C. Circuit, he has filed now for an en banc hearing ... The Court has now ordered the Federal Government to respond, indicating that judges are taking this request for a rehearing seriously." (Independent Women's Forum)  

DOL Taking Hard Look at ERISA Health Plans
"The department has asked for additional funding and training programs and plans to hire additional staff. Can your plan documents pass a DOL inspection? ... DOL health plan audits will focus on: ACA compliance.... Claims denials.... Lack of fee transparency/disclosure." (International Foundation of Employee Benefit Plans [IFEBP])  

Majority of Companies Taking Immediate Steps to Minimize Exposure to Excise Tax on 'Cadillac' Health Plans
"Aon Hewitt's soon-to-be-released survey of 317 U.S. employers found that 40 percent expect the excise tax to affect at least one of their current health plans in 2018 and 14 percent expect it to immediately impact the majority of their current health benefit plans. Surprisingly, a quarter of employers said they still have not yet determined the impact of the tax on their health plans, and more than one-third reported that their executive leadership and finance teams have limited or no knowledge of the implications of the tax for their organizations. Of those employers that have determined the impact, 62 percent say they are making significant changes to their health plans for 2015[.]" (Aon Hewitt)  

Tracking the Excise Tax Impact on High-Cost Health Plans
"The levy is expected to particularly hit hard plans that are costly because they are tailored for employees in high-risk professions or for employers with a large proportion of older employees. Self-insured employers will have to pay the tax themselves. Insurance carriers will pay the tax on behalf of employers with fully insured plans. However, carriers almost certainly will pass along the cost of the tax to employers.... Until guidance is forthcoming, employers will have to settle for calculating any projected tax based on various scenarios." (Society for Human Resource Management [SHRM])  

Private Health Exchanges: Masquerading Cost Shifting as Savings?
"As the plan fiduciary, you have a considerable responsibility to run the plan in the interest of its participants. While it may seem daunting to uncover the details of the various exchange offerings, understanding the intricacies of the chosen plan model can arm you with the knowledge you need to make the best decision for your company and its employees.... [F]our financial areas to investigate: [1] Included services.... [2] Self-funding vs. fully insured.... [3] Defined contribution buy-down.... [4] Benefit limitations." (WorldatWork)  

AT&T Cancels Retiree Health Insurance
"The existing retiree plan will be replaced with an HRA (health reimbursement arrangement) for qualified purchases only.... The HRA money is currently $2700 for the retiree plus an additional $1500 for their qualified spouse.... AT&T literature indicates future contributions are not guaranteed. There are strings attached to the money." (InsureBlog)  

Supported State-Based Marketplace Model May Gain Traction
"The [supported state-based marketplace (SSBM)] is similar to the partnership model but allows for more state autonomy.... [A] primary point of difference between these two models is possession of final decision-making authority.... SSBM states will not be required to pay the 3.5 percent user fee for using Healthcare.gov in 2015.... SSBM states are provided full autonomy in setting the marketplace user fees and establishing a plan for sustainability, while partnership marketplaces are required to use the 3.5 percent premium assessment that is required by the FFM." (HighRoads)  

[Opinion]

Egg Freezing: A Unique New Benefit, or a Bad Idea?
"Earlier this year, Facebook began covering up to $20,000 for female employees to freeze and store their reproductive eggs, so they can put off pregnancy as they establish themselves during their prime career-building years. Apple has announced it will start doing the same in January 2015. Cryopreservation and egg storage could be seen as the latest advance from the tech firms that continue to blaze the trail for employee benefits that help attract and retain the best and brightest." (The Leader Board, by Human Resource Executive)  

Benefits in General; Executive Compensation

[Official Guidance]

Text of DOL Request for Public Comment on Proposed Extension of Information Collection Requests
"This notice requests public comment on the Department's request for extension of the Office of Management and Budget's (OMB) approval of [the following Information Collection Requests:] ... Consent to Receive Employee Benefit Plan Disclosures Electronically.... Furnishing Documents to the Secretary of Labor on Request Under ERISA 104(a)(6).... Affordable Care Act Section 2715 Summary Disclosures.... ERISA Section 408(b)(2) Regulation.... ERISA Procedure 76-1 Advisory Opinion Procedure.... ERISA Technical Release 91-1.... Disclosures by Insurers to General Account Policyholders.... Registration for EFAST-2 Credentials.... Notice of Blackout Period Under ERISA.... Affordable Care Act Internal Claims and Appeals and External Review Procedures for Non-Grandfathered Plans." (Employee Benefits Security Administration [EBSA], U.S. Department of Labor)  

Press Releases

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