Voluntary Benefits Account Manager
Buck Consultants a Xerox Company
in CA, CO, GA, TX

Client Manager
Hill, Chesson & Woody
in NC

Benefits Program Strategy Analyst 3/4
University of California Office of the President
in CA

Retirement Plan Administrator
Sikich, LLP
in WI

Senior Administrator 401k Plans
TPA firm in Northern Virginia
in DC, MD, VA

ERISA Consultant
New York Life Retirement Plan Services
in MA

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2014 Webinar: Understanding and Processing Transfers and Rollovers
December 2, 2014 WEBCAST
(Ascensus)

2014 Webinar: HSA Basics
December 4, 2014 WEBCAST
(Ascensus)

Defined Benefit Plan Terminations
December 9, 2014 WEBCAST
(ASPPA [American Society of Pension Professionals & Actuaries])

Certificate Program for Non-Professional ESOP Fiduciaries
February 22, 2015 in CA
(Beyster Institute)

View All Webcasts and Conferences

[Official Guidance]

Text of IRS Submission to OMB and Comment Request: Reporting of Health Insurance Premium Tax Credit
"Section 36B(f)(3) of the Internal Revenue Code requires exchanges to report information concerning individuals enrolling in qualified health plans that will assist the individuals to properly complete their tax returns and assist the Internal Revenue Service to determine a taxpayer's eligibility for the premium tax credit and the correct amount of the credit. The IRS developed Form 1095-A under the authority of ICR section 36B(f)(3) for individuals to compute the amount of premium tax credit and file an accurate tax return. Marketplaces also must report certain information monthly to the IRS about individuals who receive from the Marketplace a certificate of exemption from the individual shared responsibility provision." (U.S. Department of the Treasury)  

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[Guidance Overview]

IRS Puts the Kibosh on Health Plans That Fail to Cover Hospital or Physician Services
"In plain English, government actuaries have a lot of work ahead of them to figure out exactly how the online calculator should be reconfigured to produce the intended policy result of requiring hospital and physician coverage, and what the scope of that coverage should be.... Employers that have at least some written evidence, prior to November 4, 2014 of a binding commitment to adopt an MVP plan should qualify for relief. With respect to starting enrollment, circulation of enrollment materials clearly qualifies. Arguably, notifying employees that the enrollment will commence at some time in the near future also should qualify." (Mintz Levin)  

[Guidance Overview]

Plans Excluding Hospitalization or Physician Services Still Might Have a Role
"The IRS and HHS seem determined to close this perceived loophole in MV determinations quickly and decisively ... But, due to the two-tiered nature of Code Section 4980H penalties, there may still be a place for this type of plan design ... [Applicable Large Employers (ALEs)] should be able to avoid the steeper Code Section 4980H(a) penalty by offering a Non-Hospital/Non-Physician Services Plan to the applicable percentage of their full-time employees -- incurring the Code Section 4980H(b) penalty only if one or more of those full-time employees actually receive premium tax credits. And paying the Code Section 4980H(b) penalty could be less costly for the ALE than offering MV coverage that includes inpatient hospitalization and physician services." (Thomson Reuters / EBIA)  

[Guidance Overview]

No Pre-Tax or Post-Tax Reimbursement of Individual Health Insurance Premiums, Including Those Purchased on the Exchange/Marketplace
"While the logic of using an HRA to reimburse employees for purchasing coverage on the Marketplace may make some sense, [FAQ XXII] once again confirms that it is not an allowable practice and subjects the employer to significant penalties. The idea of 'Private Exchanges' does provide a legal means of applying similar logic, but in an allowable group health insurance realm." (Kushner & Company)  

[Guidance Overview]

ACA Implementation FAQs (Part XXII) Provide Guidance on Premium Reimbursement Arrangements
"While the FAQs reiterate the agencies' general opposition to employer funding of individual policies, the third question takes direct aim at a specific plan design that some vendors are marketing. Under this design, employees purchase individual insurance policies ... and then have their individual policy premiums reimbursed by their employer tax-free. The agencies emphasize that these employer reimbursement arrangements are not permissible under health care reform[.]" (Thomson Reuters / EBIA)  

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[Guidance Overview]

CMS November 6, 2014 FF-SHOP Updates and Live Q&A (PDF)
25 presentation slides. "CMS closed out all blockers to Go-Live as part of ACA independent testing. CMS continues to work and resolve open issuer-generated tickets as quickly as possible. Issuers should have received FF-SHOP generated back-end transactions by now.... CMS is receiving TA1, 999, and 834 effectuation transactions from issuers." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

FAQs on California's Paid Sick Leave Law
Detailed Q&As, covering: [1] Effective Date; [2] Coverage and Eligibility; [3] Reasons for Leave; [4] Accrual and Caps on Leave; [5] Use and Notice; [6] Payment; [7] Pay Statements; [8] Cash Out; [9] Local, State, and Federal Leave Laws; [10] Exemptions; and [11] Penalties. (Ogletree Deakins)  

Pleading a Successful Surcharge Claim under ERISA: California District Court Decision Outlines Essential Elements
"The Zisk decision leaves open the door for surcharge claims as an equitable remedy under ERISA's cramped list of available relief for plaintiffs. The defendant hoped to close that door by reliance on a Ninth Circuit opinion touching on the issue, Gabriel v. Alaska Electrical Pension Fund ... The district court rejected that claim, ruling instead that 'the state of the law in this area is unsettled as to the proper contours of an equitable surcharge remedy.' " [Zisk v. Gannett Co. Income Protection Plan, No. 3:2014cv00391 (N.D. Cal. Nov. 6, 2014)] (Health Plan Law)  

Argument Preview: Supreme Court to Consider Vesting of Retiree Health Care Benefits
"As granted, the case is supposed to present the question whether the Sixth Circuit's Yard-Man presumption ... correctly imposes a strong presumption that any grant of health-care benefits in a collective bargaining agreement 'vests' those benefits so that they continue, not subject to change, indefinitely after retirement....[A]fter last year's decision in Fifth Third v. Dudenhoeffer ... the question almost answers itself: no presumption in the statute presumably will mean (in the view of the Court) no presumption in the courts.... [N]ow that the case has been taken, ... the respondents ... decline to defend that presumption. Rather, they argue that collective-bargaining agreements, like all other contracts, should be interpreted in accordance with their plain meaning.... The difficulty is that a 'plain-meaning' standard is almost the same standard as the one that the the petitioners ... propose." [M&G Polymers USA, LLC v. Tackett, No. 13-1010 (on appeal from 6th Cir., cert. granted May 5, 2014; oral argument scheduled Nov. 10, 2014)] (SCOTUSblog)  

Employees Offered Financial Incentives Were 33 Times More Likely to Participate in Wellness Programs
"The health coach program began in October 2010, and any health plan member was eligible to work with a coach. Employers began offering incentives to work with a coach in 2011.... During the 2.75-year follow-up period, 4,898 members worked with a coach, including 1,693 among the 16,961 with incentives (10%) and 3,205 among the 974,782 without (0.3%). In 2011, 2012, and 2013, being offered an incentive was strongly associated with time until uptake of health coaching[.]" (The Obesity Society)  

IRS Form 5498-SA for 2015: HSA, Archer MSA, or Medicare Advantage MSA Information (PDF)
"This information is submitted to the [IRS] by the trustee of your health savings account (HSA), Archer medical savings account (MSA), or Medicare Advantage MSA (MA MSA).... Generally, contributions you or someone other than your employer make to your HSA are deductible on your tax return. Employer contributions to your HSA may be excluded from your income and are not deductible by you. You and your employer can make contributions to your HSA in the same year." (Internal Revenue Service [IRS])  

Health Insurance Without An Annual Expiration Date? A Case For Exchange-Based Long-Term Policies
"[A] greater role for exchange plans and price competition might inadvertently counteract current efforts to shift the payment system toward one that rewards providers for providing long-term health care management for their patients.... A possible solution is to introduce multi-year insurance products on insurance exchanges. Under a five-year plan, for example, insurers would find it more attractive to invest in services with long-term benefits. These investments, in turn, would reduce health care costs and some of those savings could result in lower premiums for consumers." (Health Affairs)  

Health Insurance Marketplace Offers Tool to Help Consumers Review Their Plan Options for 2015
"CMS is working to improve the consumer experience by making the shopping experience easier. Last year, a consumer had to answer nine questions before being able to view their plan options, this year a consumer can start looking at plans after entering just their zip code. Consumers can answer a few simple questions relevant to them to get an estimate on how much financial assistance they may qualify for when shopping for coverage. The window shopping tool has also been optimized for access through a smart phone or tablet." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

Massachusetts Voters Approve Paid Sick Leave Law
"The new law applies to all private sector employers in Massachusetts, but the requirements imposed by the law differ depending on the size of the company. All employers, regardless of their size, must provide sick leave to employees. Employers with 11 or more employees, however, must provide paid sick leave.... When calculating the total number of employees for purposes of the new law, employers must count all full-time, part-time and temporary employees. The new law, however, is not completely clear regarding how to perform this calculation." (Littler)  

Love, Toil, and Health Insurance: Why American Husbands Retire When They Do
"In households where the wife is the only one at risk of losing affordable health insurance if the husband retires, the husband is 30% less likely to retire than if neither spouse is at risk (a 5 percentage point decrease in the retirement rate). Based on these findings, prior research is missing one avenue that changes to the Medicare eligibility age and health insurance policy changes through the [ACA] might impact the labor supply of older workers." (Joshua Congdon-Hohman, College of the Holy Cross, via SSRN)  

[Opinion]

Just Because a Policy Causes a Death Spiral Doesn't Mean It's Unsustainable
"[A] Supreme Court ruling against the Obama administration in King v. Burwell would cause significant disarray in health insurance markets ... Health insurance would become unaffordable for many people ... And as healthy people drop out of the insurance market because of rising costs, the pool of participants could get sicker, driving premiums up further, driving even more people out of the market, and leading to what is known as a death spiral where only a handful of mostly very sick people buy insurance at a very high price. That would be a bad outcome. But it would not necessarily be an unsustainable one.... [T]his situation was sustained in New York for over two decades before Obamacare came into being." (The New York Times; subscription may be required)  

[Opinion]

A Welcome Grant for a Straightforward Statutory Case
"Why didn't the Court wait for the D.C. Circuit to decide Halbig en banc? Because King involves straightforward questions of statutory interpretation worthy of more timely resolution. This litigation creates substantial uncertainty about the operation of the law ... It is also possible that the grant of certiorari indicates at least four Justices are skeptical of the decision below.... Why might the Justices be skeptical of the decision below? Because the U.S. Court of Appeals for the Fourth Circuit was at pains to explain away the plain language of the statute." [King v. Burwell, No. 14-1158 (4th Cir. July 22, 2014; cert. pet. granted Nov. 7, 2014)] (SCOTUSblog)  

Detroit's Bankruptcy Plan: A Phoenix Emerges
"Under the agreement both pensioners and bond holders will take pain, albeit at varying degrees. The pensions of retirees will be cut by 4.5% and the cost-of-living adjustments (COLA) will go. Retirees from the police force and the fire brigade will have to live with a reduction in COLA from 2.25% to 1%. Health-care benefits will be reduced by 90% for all retirees." (The Economist)  

A Blank Page in the SEC Rule Book, Four Years Later
"Under the law, the SEC was supposed to direct the stock exchanges to bar securities from trading if they were issued by companies with no clawback policies. That should be a huge incentive for companies to write such policies. But what those policies should include seems to be stymieing the SEC's rule writers." (The New York Times; subscription may be required)  

Blue Cross and Blue Shield of Texas Expands Access to Health Insurance Choices for Small Businesses
Blue Cross and Blue Shield of Texas

Former PBGC Legend Passes
PBGC [Pension Benefit Guaranty Corporation]

Transamerica Retirement Solutions Debuts New Augmented Reality App To Help Boost Retirement Savings
Transamerica Retirement Solutions

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