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Employee Benefits Jobs
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Webcasts and Conferences
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[Official Guidance]
Text of IRS Notice 2014-69 Regarding Group Health Plans That Fail to Cover In-Patient Hospitalization Services: Reliance on MV Calculator Not Sufficient (PDF)
"The Departments believe that plans that fail to provide substantial coverage for in-patient hospitalization services or for physician services (or for both) (referred to in this notice as Non-Hospital/Non-Physician Services Plans) do not provide the minimum value intended by the minimum value requirement and will shortly propose regulations to this effect with a view to being in a position to finalize such regulations during 2015 and make them applicable upon finalization. Accordingly, employers should consider the consequences of the inability to rely solely on the MV Calculator (or any actuarial certification or valuation) to demonstrate that a Non-Hospital/Non-Physician Services Plan provides minimum value for any portion of any taxable year ending on or after January 1, 2015, that follows finalization of such regulations. However, solely in the case of an employer that has entered
into a binding written commitment to adopt, or has begun enrolling employees in, a Non-Hospital/Non-Physician Services Plan prior to November 4, 2014 based on the employer's reliance on the results of use of the MV Calculator (a Pre-November 4, 2014 Non-Hospital/Non-Physician Services Plan), the Departments anticipate that final regulations, when issued, will not be applicable for purposes of Code section 4980H with respect to the plan before the end of the plan year (as in effect under the terms of the plan on November 3, 2014) if that plan year begins no later than March 1, 2015."
(Internal Revenue Service [IRS])
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[Guidance Overview]
Election Day Surprise: Skinny Plans Will Need to Fatten Up
"Early this morning, the IRS, in a coordinated effort with the DOL and HHS, issued guidance that basically said that so-called 'skinny' plans won't get employers out of the 'play or pay' penalties. Limited grandfathering is available for so called 'Pre-November 4, 2014' plans. All of this will be finalized in future regulations, but the guidance sets out what the agencies expect the regulations to say.... If you have already entered into a binding written commitment to offer one of these plans or have started enrolling your employees in these plans, as of this election day, then the agencies are expected to give you a pass on the play or pay penalties for 2015."
(Benefits Bryan Cave)
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[Guidance Overview]
The Transitional Reinsurance Program: Reinsurance Contributions Submission Process 101 (PDF)
46 presentation slides, dated Nov. 3, 2014. "Purpose and objectives: Provide a general overview of the reinsurance contributions submission process, including: [1] Who is a Contributing Entity? [2] The steps to complete the reinsurance contribution filing through Pay.gov. [3] How to update reinsurance contribution filing due to errors."
(Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])
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Court Denies EEOC Request for TRO in Wellness Lawsuit
"[On Monday, Nov. 3], Judge Montgomery asked the EEOC the question the corporate wellness world has been waiting for much more than a decade to ask: 'At what point does a monetary penalty result in a compulsion?' The EEOC responded that the agency cannot draw a clear line but that Honeywell had crossed it. At least three times during the oral argument, the Court pressed the EEOC to define the point at which voluntary wellness plan becomes involuntary because of the penalties involved. Each time, the EEOC responded that it cannot draw a line but that Honeywell had crossed it." [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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Honeywell Fends Off EEOC Bid to Bar Wellness Penalty
"After hearing arguments [on Monday Nov. 3], U.S. District Judge Ann Montgomery in Minneapolis denied the agency's request to block the company from assessing the health insurance-related surcharges. Montgomery was asked to decide whether the wellness program, which Honeywell said was enacted in furtherance of President Barack Obama's Affordable Care Act, conflicts with other federal laws. Saying she wasn't ready to make even a preliminary determination, she allowed the company's practices to continue." [EEOC v. Honeywell Int'l Inc., No. 14-cv-04517-ADM-TNL (D. Minn., petition filed Oct. 27, 2014)]
(Bloomberg)
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2014 End of Year 'To Do' List for Health & Welfare Plan Sponsors
Items include: [1] Consider impact of Supreme Court Defense of Marriage Act (DOMA) case and subsequent increase in number of states recognizing same sex marriage; [2] Reconsider need for domestic partner benefits; [3] Report and pay reinsurance fees; [4] Comply with large employer shared responsibility rules if applicable, or pay penalties; [5] Gear up for Code section 6055 and 6056 reporting; [6] Large employers must report on health coverage offered to full-time employees; [7] Amend Code section 125 cafeteria and flexible benefit plan by December 31, 2014 for recent changes in the law; [8] If a group health plan is a grandfathered plan, review grandfathered status; [9] Update CHIP notice; rethink COBRA under severance agreements; [10] Obtain HIPAA standard electronic transaction certifications.
(Snell & Wilmer)
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ACA Considerations for Severance Agreements
"It is not uncommon for employers to offer to pay for continuing COBRA coverage for a former employee as part of a severance agreement.... Let's say that an employee loses his job, and his or her employer agrees to pay for COBRA for three months. If the end date of this employer contribution does not fall during Covered California's open enrollment period, the employee will be forced to maintain COBRA coverage until the next open enrollment period in order to avoid any gaps in coverage."
(Liebert Cassidy Whitmore)
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Protecting Your Workforce: What You Need to Know About Ebola
"[U]nder the ADA, an employer cannot make medical inquiries of employees unless the inquiry is voluntary or job-related and consistent with business necessity. Further, if an employer does make such inquiries, the employer must follow the ADA guidelines pertaining to medical records. Specifically, the ADA (i) requires confidential maintenance of medical information, which should be kept separate and apart from the employee's personnel file, and (ii) limits the distribution of such information to individuals with a legitimate need to know."
(Epstein Becker Green)
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Group Health Plans for Same-Sex Spouses: Equal Treatment Required or Not?
"[O]ffering group health benefits to traditional 'spouses' while denying those same benefits to same-sex couples would likely result in litigation under Title VII and possibly even state discrimination laws.... [In] one case, Hall v. BNSF Railway Co., ... a plaintiff employee had already successfully made such a claim.... Employers that offer group health insurance coverage to opposite-sex spouses would be well-advised to seriously consider expanding that right to all legally married employees, or face the risk of a claim under Title VII."
(McAfee & Taft)
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Girding for Consumerization, Aetna Buys a Private Health Insurance Exchange
"Aetna bought bswift, a Chicago-based developer of insurance exchange and employee benefits administration technology, for approximately $400 million.... For Aetna, the addition of bswift offers a new way to keep or garner new employer clients looking to provide health benefits on a defined-contribution model, rather than the traditional group plan. It also offers a way to operate a single-insurer private exchange option, as Cigna and numerous Blue Cross insurers are doing."
(Healthcare Payer News)
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Franchise Industry: We're Already Cutting Hours Because of Obamacare
"[T]he International Franchise Association and the U.S. Chamber of Commerce commissioned a survey indicating that some employers have already cut hours and replaced full-time employees with part-timers to skirt the mandate.... Of franchise businesses, 31 percent said they have reduced hours because of the health-care law, compared to 12 percent for non-franchise businesses. A smaller number of franchises said they cut headcount or replaced full-time workers with part-timers because of the law -- even though the employer mandate was delayed over the summer until 2015."
(Bloomberg Businessweek)
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Healthcare Spending Continues Slow-Growth Trajectory in Q3
"A first look at health spending in the third quarter suggests demand for medical care hasn't sharply increased this year despite the greater number of Americans who now have health insurance because of the [ACA]. Health spending rose 3.5% during the third quarter compared with the same period last year, according to U.S. Commerce Department estimates."
(Modern Healthcare Online)
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Silence, and Speculation, on ACA Subsidies Case in Supreme Court
"The legality of tax credits for individuals who shop for health insurance on federally run marketplaces is also under review now by the en banc U.S. Court of Appeals for the D.C. Circuit. On Monday, the Obama administration filed its brief ... arguing that the challengers' view of the issue would lead to the operation of exchanges 'on which no individual could lawfully shop and no insurance plan could lawfully be sold.' The challengers' reply brief is due on November 17, and oral argument will be held on December 17.... The Supreme Court on Monday [prior to the government's filing of its brief to the D.C. Court of Appeals] set off a new round of questions and speculation about its view on a significant new threat to the federal health care law, taking no immediate action on an urgent plea to decide the issue swiftly. The Court did schedule another look at the case of King v.
Burwell at the Justices' private Conference this Friday, raising the prospect that something may emerge a week from today."
(SCOTUSblog)
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Text of HHS Brief to D.C. Court of Appeals on En Banc Review of Availability of Subsidies for Health Coverage Purchased Through Federally-Facilitated Exchanges (PDF)
"Plaintiffs seize on a feature of the Act designed to respect federalism, and they contort it into a provision that punishes States and their citizens.... Regardless of the type of Exchange any particular State chooses, the federal tax credits are available to lower the costs of insurance on Exchanges in every State.... Accepting plaintiffs' account of the Act requires accepting not merely that Congress would adopt this punitive, self-defeating scheme at all, but that Congress would do so exclusively through isolated phrases buried in the technical formula for calculating the size of an individual's tax credit, rather than forthrightly in provisions putting States and their citizens on notice of what Congress had done." [Halbig v. Burwell, No. 14-5018 (D.C. Cir. July 22, 2014)]
(U.S. Department of Health and Human Services)
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Private Exchanges Decrease Employer Costs, Change Employee Enrollment Behavior
"While only 38 percent of employees in general are aware of what employers pay for health benefits on their behalf, 94 percent of employees using [Glidepath, a private health insurance exchange sponsored by Blue Cross Blue Shield of Michigan,] were aware of their employer's benefit contribution.... Employees had a greater tendency to choose plans with lower premiums and higher deductibles.... Employers using Glidepath set a defined contribution amount and their employees use those funds to actively shop online to select a health plan using the exchange."
(InsuranceNewsNet.com)
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Attracting Attention: Freezing of Female Employees' Eggs as an Employee Benefit
"The most attention employee benefits has garnered in a long time occurred when Facebook and Apple recently announced they were offering a new benefit to their employees: paying for procedures that will take a woman's eggs and freeze them for use in in-vitro fertilization in the future.... It created such a strong reaction because some people see it as an admission that a serious commitment to work is incompatible with having a family, at least for women. Others view it as denigrating motherhood and family, implicitly suggesting that work could be -- or perhaps even should be -- important enough to push having a family into the background, even for those who want a family."
(Human Resource Executive Online)
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GE Sued for Moving to DC Model for Retiree Health Care
"The lawsuit claims GE assumed a fiduciary duty not to exercise or abuse its discretion to terminate the plans except for a serious and good faith reason of the kind set forth in the SPD. The lawsuit asks the court to preliminarily enjoin GE from terminating the plans, unless and until GE can demonstrate some serious and good faith reason to justify its action." [Kauffman v. General Electric Co., No. 14-cv-1358 (E.D. Wis., filed Oct. 28, 2014)]
(PLANSPONSOR)
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[Opinion]
American Benefits Council Applauds District Court's Denial of EEOC Petition for Injunction Against Honeywell's Wellness Program
"'The district court's denial of the EEOC's request for a temporary restraining order and preliminary injunction relied on a finding that the program does not pose 'irreparable harm' to participants,' [American Benefits Council President James A. Klein] said.... 'Like many other Council member companies, Honeywell has devoted substantial time and resources to the development and implementation of these programs. The recent legal action by the EEOC, particularly in the absence of formal guidance on wellness programs from the commission sends the wrong message,' Klein said."
(American Benefits Council)
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[Opinion]
Malpractice Reform Won't Do Much to Reduce Health Spending
"In 2003 ... Texas passed a law that capped noneconomic damages at $250,000 per year. The idea was to decrease the number of suits, lowering overall indemnity payments, which would lead insurance companies to decrease premiums for malpractice insurance. This, coupled with reduced claims, would make doctors feel safer, and therefore reduce their practice of defensive medicine. Health care spending didn't go down in Texas, though."
(Aaron E. Carroll in The New York Times; subscription may be required)
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Benefits in General; Executive Compensation
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Fewer Execs Compensated with Pensions or SERPs
"Nearly three-quarters of newly hired corporate executives are now treated like their rank-and-file when it comes to retirement benefits, with few being offered the traditional 'top-hat' defined benefit plan that used to be as common as a company car and stock options for senior managers.... Most of the Fortune 100 companies that closed or froze their qualified DB plans now provide DC-style retirement benefits to executives in the form of 'restoration plans,' which are nonqualified plans that restore benefits lost under qualified plan limitations imposed by the federal tax Code such as annual compensation and contribution caps."
(Thompson SmartHR Manager)
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Press Releases
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