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PVH Corp.
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The Newport Group
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Ogletree Deakins
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Reinsurance Contributions 101
November 3, 2014 WEBCAST
(Centers for Medicare & Medicaid Services [CMS])

Wellness Plans Under Attack!
November 7, 2014 WEBCAST
(Littler Mendelson)

2014 Fourth Quarter Update
November 19, 2014 WEBCAST
(McKay Hochman Co., Inc.)

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Biometric Screening Requirement Under Wellness Program Violates ADA and GINA, According to EEOC Suit
"Failure to participate in the screenings would subject the employee to financial penalties. For example, an employee that does not participate would not be able to receive a company contribution to the employee's health savings account of up to $1,500 for the year. Additionally, the employee would be subject to a $500 surcharge on medical plan costs, as well as tobacco surcharges of $1,000 that apply to the employee and the employee's spouse if they fail to take the screenings.... Because of the incentives ... the EEOC claims that the examinations are involuntary, effectively forcing employees to submit to the biometric screenings. The Eleventh Circuit rejected a similar challenge in Seff v. Broward County, FL, applying a separate 'safe harbor' provision of the ADA." [EEOC v. Honeywell Int'l Inc., No. 14-cv-04517-ADM-TNL (D. Minn., petition filed Oct. 27, 2014)] (Jackson Lewis)  

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Text of EEOC Memorandum on Law in Support of Application for Temporary Restraining Order Against Honeywell International (PDF)
"Based upon the EEOC's preliminary review, Honeywell's medical examinations are unlawful. The ADA prohibits employers from conducting medical examinations that are not job-related and consistent with business necessity. While an employer can ask the employees to undergo voluntary health exams, an examination is not voluntary when the employer imposes a penalty on the employee if he or she declines to participate. The EEOC's preliminary investigation also indicates that the ongoing medical testing violates GINA. Honeywell requires that the employees' spouses be tested or the employees will be penalized. GINA prohibits employers from offering inducements (or alternatively imposing penalties) to employees to obtain medical information about an employee's family members. Honeywell's program, if not enjoined, will irreparably harm the EEOC and Honeywell's employees. The EEOC's mission will be thwarted. It will be forced to sit by and watch Honeywell violate the ADA and GINA, thereby irreparably damaging the EEOC's role as the agency charged with enforcing those statutes and preventing discrimination under them." [EEOC v. Honeywell Int'l Inc., No. 14-cv-04517-ADM-TNL (D. Minn., petition filed Oct. 27, 2014)] (Equal Employment Opportunity Commission [EEOC], via Jackson Lewis)  

EEOC Sues Honeywell Over Employee Wellness Testing
"Honeywell employees could be penalized up to $4,000 each, through surcharges and lost contributions to health plans, if they or their spouses do not comply with the biometric testing, according to the lawsuit, filed on [October 27] in U.S. District Court in Minnesota.... Of Honeywell employees and spouses enrolled in a health plan, 77 percent of participated in the company's wellness program last year, up from 36 percent in 2011, the company said." [EEOC v. Honeywell Int'l Inc., No. 14-cv-04517-ADM-TNL (D. Minn., petition filed Oct. 27, 2014)] (Reuters)  

Common Wellness Program Designs Under Attack by EEOC (PDF)
"[C]ourts are loathe to assume that Congress intended to make laws that conflict with each other. Where laws appear to conflict, as the ADA and ACA/HIPAA appear to do with respect to wellness programs, courts will search for a way to reconcile them. It seems plausible to us that the courts will allow the ACA/HIPAA rules to trump the EEOC's more restrictive interpretation under the ADA. But all that remains to be seen." (Lockton)  

Honeywell: Driving Health Engagement
A description of the health & wellness program sponsored by Honeywell International. Excerpt: "Today, Honeywell has shifted from just offering health care as a benefit to engaging and equipping employees to lead healthier and productive lives, and has found that incentives coupled with targeted communications can be effective in engaging employees." (Business Roundtable [BRT])  

As Employers Try to Avoid ACA Excise Tax, Lower-Cost Health Plans Face Biggest Test
"The excise tax should be given a more middle-class status name, such as the 'Camry tax,' because it is to affect more than just high-cost plans, [said Helen Morrison, a principal with Ernst & Young LLP]. Even plans with a 70 percent actuarial value -- a silver-tier plan under the ACA -- will reach the thresholds soon after 2018 ... Because the tax threshold is tied to the urban consumer price index and not to health cost trends, which has been rising much faster, the tax will affect more than just high-cost plans, Morrison said." (Bloomberg BNA)  

Text of Fifth Circuit Opinion Upholding Denial of Accidental Death Benefits for Police Shooting Victim Who Was Suicidal (PDF)
"ReliaStar relied on an administrative record that supported finding Rice's death was not accidental. Rice was suicidal and had been drinking heavily on the day he was shot. Rice took eleven prescription pills while drinking, and he told the bartender at the bar where he had been drinking that he left his pills behind because 'it's over.' Rice was also heard revving the engine in his truck while the garage was closed, suggesting he may have been trying to kill himself through carbon monoxide poisoning. Further, Rice approached police officers with a loaded weapon even after the officers told him to put his gun down; he told the officers 'I want to commit suicide' and after Rice's death, the sheriff's investigation committee found a note Rice left his sister that appeared to be a suicide note.... Thus, ReliaStar did not abuse its discretion in finding that Rice's death was not accidental, that is, not an 'unexpected, external, violent and sudden event.' " [Rice v. ReliaStar Life Insurance Company, No. 13-30639 (5th Cir. Oct. 27, 2014)] (United States Court of Appeals for the Fifth Circuit)  

How Halbig and Three Related Cases Could Affect Health Insurance Under the ACA
"[I]f proponents of these lawsuits prevail, the government will strip premium tax credits from residents in all of the 36 states with federally facilitated marketplaces. Those tax credits help low- and moderate-income residents afford to pay their monthly health insurance premiums. Without this benefit, millions of residents would not be able to pay for their health insurance. The scale of the problem is large." (Families USA)  

[Opinion]

ERIC Outraged Over Latest Wellness Suit Brought by EEOC
"Workplace wellness programs have a central role to play in the nation's efforts to improve the health of American workers, and they have proved effective in containing health costs, reducing disability claims, and improving workers' productivity. 'These suits by the EEOC will undercut efforts by employers to create a healthier workplace, will put a damper on the future development of wellness programs, will deny employees and their spouses the opportunity to live healthier lives, and ultimately, if left unchecked, will lead to a sicker population,' [said Gretchen Young, ERIC Senior Vice President for Health Policy]." [EEOC v. Honeywell Int'l Inc., No. 14-cv-04517-ADM-TNL (D. Minn., petition filed Oct. 27, 2014)] (The ERISA Industry Committee [ERIC])  

[Opinion]

National Business Group on Health Sees Profound Implications for Corporate Wellness Programs from EEOC Lawsuit Against Honeywell International
"The EEOC is suing Honeywell International over a wellness program that provides financial incentives to employees and their spouses who undergo biometric screenings and participate in smoking cessation programs.... Wellness programs with incentives for biometric screenings are prevalent: According to a survey by the National Business Group on Health and Fidelity Investments, 95% of employers offer a health risk assessment, biometric screening or other wellness program in 2014. About three in four (74%) employers use incentives to engage employees in these programs." [EEOC v. Honeywell Int'l Inc., No. 14-cv-04517-ADM-TNL (D. Minn., petition filed Oct. 27, 2014)] (National Business Group on Health [NBGH])  

[Guidance Overview]

Final Regs Issued on ACA $500,000 Compensation Deduction Limit for Health Insurers (PDF)
"The final regulations largely adopt, with some modification, the provisions set forth in the proposed regulations. [They] apply to taxable years beginning on or after September 23, 2014.... [and] provide some relief and clarifications on the entities that are subject to the deduction limitation.... [If] an entity becomes a [Covered Health Insurance Provider (CHIP)] solely as a result of a corporate transaction, the entity generally will not be a CHIP for the taxable year in which the transaction occurs." (Groom Law Group)  

Many U.S. Companies Performed Executive Pay-for-Performance Analyses But Did Not Disclose in 2014 Proxies
"Six in 10 U.S. public companies have conducted analyses to assess how closely their executive pay levels align with company performance. However, nearly two-thirds of those companies did not disclose the results of those analyses in their 2014 proxy statements, mostly because they are awaiting soon-to-be-released pay-for-performance disclosure guidance from the Securities and Exchange Commission (SEC)[.]" (Towers Watson)  

15 Questions that Drive Payers Crazy
HighRoads, Inc.

Commercial Repayment Center Portal (CRCP) is Now Live
Centers for Medicare & Medicaid Services [CMS]

Gabriel, Roeder, Smith Statement on Serial Litigant Claims
Gabriel, Roeder Smith & Company

New Health Reimbursement Arrangement Solution from Aon Hewitt Enables Companies to More Efficiently Reimburse Retirees Transitioning to the Aon Retiree Health Exchange
Aon Hewitt

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