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Blue Ridge ESOP Associates
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New York Life Retirement Plan Services
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a unique firm in 401k space. I can prove it.
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Employee Benefits Attorney
Bradley Arant Boult Cummings LLP
in TN

DB Administrator / Actuarial Assistant
Pension Actuarial Consulting Firm
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Benefits Account Manager & Team Lead
Owen-Dunn Insurance Services
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The Benefit Advantage
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IRA Distribution Concepts
December 4, 2014 WEBCAST
(Ascensus)

Cross-testing: Budget Design & 401(a)(4) Testing
December 9, 2014 WEBCAST
(ASC)

2015 IRAs: What You Need to Know!
December 10, 2014 WEBCAST
(Ascensus)

Narrow-Network Medicare Advantage Plans: Strategies for Insurers and Providers
January 21, 2015 WEBCAST
(Atlantic Information Services, Inc)

Looking Forward: Health Reform in 2015
January 22, 2015 WEBCAST
(Lockton)

View All Webcasts and Conferences

[Official Guidance]

Text of OPM Proposed Regs: Federal Employees Health Benefits Program 'Self Plus One' Enrollment Type
"The self plus one enrollment type will be available starting in the 2015 Open Season for the 2016 plan year. A self plus one enrollment will cover the enrollee and one eligible family member, designated by the enrollee.... Eligible family members under a self plus one enrollment will be a spouse or an eligible child ... The government contribution calculation, determined by statute ... Because actual enrollment data for a new three tier structure will not be available in advance, OPM will determine the weighted average for use in calculating the Government contribution and the employee contribution for the first plan year in which the self plus one enrollment type is made available." (Office of Personnel Management [OPM])  

[Advert.]

24th Annual National Health Benefits Conference & Expo (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]

Text of CMS Proposed Regs: Medicare Shared Savings Program -- Accountable Care Organizations
429 pages. "This proposed rule addresses changes to the Medicare Shared Savings Program (Shared Savings Program), including provisions relating to the payment of Accountable Care Organizations (ACOs) participating in the Shared Savings Program. Under the Shared Savings Program, providers of services and suppliers that participate in an ACO continue to receive traditional Medicare fee-for-service (FFS) payments under Parts A and B, but the ACO may be eligible to receive a shared savings payment if it meets specified quality and savings requirements." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Official Guidance]

Text of CMS Bulletin 14: Guidance for Issuers on 2015 Reenrollment in the Federally-facilitated Marketplace (PDF)
"[This] guidance outlines the process that the Federally-facilitated Marketplace (FFM) and issuers will follow to send and receive reenrollments for current 2014 enrollees.... Reenrollment is the general term used to describe 2014 coverage being continued into 2015, whether the 2015 coverage is in a plan offered under the same product or a different product. Renewal specifically refers to reenrollments into the same product. This bulletin also describes ... the process by which issuers will [1] non-renew 2014 coverage for existing enrollees who have actively selected another issuer for 2015; and [2] reenroll remaining enrollees in advance of receiving the passive reenrollment 834 transaction from the FFM. This guidance works in conjunction with final rules related to annual eligibility redeterminations and notice requirements for renewals and reenrollments issued on September 5, 2014." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

Final Individual Mandate Regs Explain How Employer Contributions Affect Affordability of Employer-Sponsored Coverage
"The regulations provide further guidance on the exemption that applies when employer-sponsored [minimum essential coverage (MEC)] is considered unaffordable. For this purpose, affordability is based on whether the employee's 'required contribution' for coverage would exceed 8% (subject to indexing adjustments) of household income. (The 8% standard is related to, but distinct from, the affordability threshold that applies under Code Section 36B when determining eligibility for premium tax credits and liability for employer shared responsibility penalties.) Largely following proposed regulations that were published earlier this year ... the final regulations address how [certain] employer contributions factor into employees' required contributions[.]" (Thomson Reuters / EBIA)  

[Guidance Overview]

'Tis the (Retail) Season: Are Seasonal Workers Entitled to Health Care Coverage? A 2014 Update
"Do the company's seasonal employees in 2014 push it into 'large' employer status for 2015 so that because of the seasonal workforce the company must offer health care coverage to substantially all full-time employees in 2015? ... Must 'large' employers offer health care coverage to seasonal employees who work full time for a few weeks or months during the busy season? ... Will the employer mandate rules be different after 2015?" (Ogletree Deakins)  

[Advert.]

Reduce costs. Improve cash flow. Curb rising benefit premiums.

Explore the advantages of a Self-Funded Health Plan! By bringing together cutting edge cost containment strategies, excellent service and outstanding resources, IPMG's EBS division can help you make a difference for your plan.

[Guidance Overview]

CMS Releases New Proposal to Improve Accountable Care Organizations
"The Shared Savings Program [SSP] now includes more than 330 ACOs in 47 states, providing care to more than 4.9 million beneficiaries in Medicare fee for service. Recently, CMS announced first year [SSP] results: 58 SSP ACOs held spending below their benchmarks by a total of $705 million and earned shared savings payments of more than $315 million. Another 60 ACOs had expenditures below their benchmark, but not by a sufficient amount to earn shared savings.... CMS is seeking comment on a number of adjustments to improve the Medicare Shared Savings Program[.]" (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

CMS Fact Sheet: Proposed Changes to the Medicare Shared Savings Program
"The proposed rule addresses proposed changes to several program areas including beneficiary assignment, data sharing, available risk models, eligibility requirements, participation agreement renewals, and compliance and monitoring. Additionally, the proposed rule seeks comment on issues related to financial benchmarking and waivers for program and other payment rules." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

New ACO Rules Would Delay Penalties an Extra Three Years
"Health care systems experimenting with a new way of being paid by Medicare would have three extra years before they could be punished for poor performance, the federal government proposed [on December 1]. The proposal is one of dozens of changes that [CMS] wants to make to rules governing accountable care organizations. ACOs are affiliations of doctors, hospitals and other providers that jointly care for Medicare patients with the goal of pocketing a portion of what they save the government. Those that spend above Medicare estimates stand to lose money." (Kaiser Health News)  

[Guidance Overview]

HHS Regs Propose 2016 Payment Parameters, Along with Adjustments and Clarifications of Other Wide-Ranging Standards
"The details of these proposed regulations primarily affect insurers, including the new proposal that would trigger rate review at the newly defined 'plan' level rather than the larger product level.... Nevertheless, plan sponsors and their advisors should still take note -- the proposed parameters and standards have wide-ranging direct and indirect effects on many aspects of health care reform compliance. Among those directly affecting employers is a proposed requirement that non-federal governmental non-ERISA plans distribute MLR rebates within three months." (Thomson Reuters / EBIA)  

Employers Continue to Shift a Greater Share of Expenses to Employees
"The average annual health plan cost per employee for all plan types is $9,504, with an average employer cost of $6,276 per employee, and an average employee cost of $3,228.... Premiums increased an average of 5.6% for all plans -- up very slightly from last year's 5.5% increase. However, there was a nearly 322% increase in the number of plans utilizing an early renewal strategy, which delayed many effects of PPACA.... While average in-network deductibles remained fairly level at $1,901, out-of-pocket maximums for 2014 increased more than 6% over last year." (United Benefit Advisors)  

Health Insurance: How Much Do We Hate SHOPping for It?
"52 percent of Americans making $50,000 a year or more would rather have a plan with a low premium but high deductible, while just 39 percent of those earning less would make the same choice. 46 percent of young people between the ages of 18 and 29 prefer a plan with a high monthly premium and a low deductible, compared with just 33 percent of those 50 or older. 16 percent of seniors 65 or older say they like neither option, versus just 3 percent of the youngest respondents." (Bankrate)  

National Association of Insurance Commissioners Weighs In on Issues of Network Adequacy
"While an update to the Model Act seems necessary in the new and evolving healthcare landscape, it is yet unknown what role it will play in catalyzing or shaping reform. An initiative such as this easily runs the risk of being too specific and prescriptive or, in the interest of flexibility, too vague or broad to be useful. Still, even if it is not adopted, the Model Act could act as a signal to legislators and regulators that changes to the regulatory framework are needed." (Sheppard Mullin)  

Updated DOL Self-Compliance Tool Includes Mental Health Parity Overhaul
"Explaining that participants and beneficiaries may request plan documents and instruments related to whether the plan is providing benefits in accordance with the mental health parity requirements (and that copies must be furnished within 30 days), [the compliance tool] adds that this may include documentation illustrating how the health plan has determined that any financial requirement, quantitative treatment limitation, or nonquantitative treatment limitation complies with the MHPAEA. It also points out that -- even absent any specific adverse benefit determination -- participants, beneficiaries, and contracting providers may request information to determine whether benefits under a plan are being provided in parity." (Thomson Reuters / EBIA)  

EEOC v. Honeywell and the Future of Wellness Programs
"The problem, put simply, is that without telling anyone what the rules are, the EEOC has begun to challenge a subset of popular wellness programs, the design of which is expressly sanctioned by the ACA. Of course, simply because a wellness program satisfies one Federal law does not mean that another may not also apply.... What is different here is the insistence of the EEOC to push ahead with enforcement compliance while at the same time obstinately refusing (following a deluge of requests from industry and other groups as well as damning adverse judicial precedent) to issue regulations." (Mintz Levin)  

Treasury Inspector General Report: Improvements Are Needed to Strengthen Security and Testing Controls for the ACA Information Returns Project (PDF)
44 pages. "The ACA Information Returns (AIR) Release 1 Project is an information technology project managed under the IRS's ACA Program.... The overall objective of this review was to determine if the IRS is adequately mitigating systems development risks ... TIGTA evaluated the IRS's key management controls and processes for risk management, requirements and change management, testing, security, and fraud detection ... [I]mprovements are needed to ensure the long-term success of the AIR system by adherence to systems development controls for security and testing activities in accordance with applicable guidance.... These security control weaknesses could impact the AIR system's ability to reliably process the electronic form reports and to accurately determine the applicable fees." [Dated Sept. 29, 2014; published online Dec. 1, 2014] (Treasury Inspector General for Tax Administration [TIGTA], U.S. Department of the Treasury)  

GAO Report on Private Health Insurance: Concentration of Enrollees Among Individual, Small Group, and Large Group Insurers from 2010 Through 2013
"While several insurers participated in each state's individual, small group, and large group health insurance markets in 2013, enrollment was concentrated among the three largest insurers in most states.... In more than half of these states, a single insurer had more than half of the total enrollees and in 5 of these states there was at least one market segment in which the largest insurer had at least 90 percent of all the enrollees. In the remaining states -- 12 states' individual markets, 14 states' small group markets, and 11 states' large group markets -- more insurers participated and the market segments were less concentrated, with enrollment spread out among more insurers." (U.S. Government Accountability Office [GAO])  

Shared Parental Leave Introduced in the U.K.
"Under the new rules, couples with babies due or children matched or placed for adoption on or after April 5, 2015, will be allowed to share the mother's maternity leave. Following two weeks of mandatory maternity leave, the new rules allow working couples to share up to 50 weeks of leave and up to 37 weeks of pay. [The Department of Business, Innovation and Skills] estimates that as many as 285,000 working couples will be eligible to share leave beginning in April 2015 and that the changes in how maternity leave can be used will encourage fathers to take time off for childcare." (Bloomberg BNA)  

[Opinion]

'Biggest Loser' Contests at Work? Only If They Pass Muster With the EEOC
"The benefits are undeniable. An individual may learn that they have a disease, which if treated early, may save their life. There is no reason why an employee's confidentiality cannot be protected under the ADA, ACA and HIPPA. But still, the EEOC dislikes wellness programs." (Fisher & Phillips LLP)  

Economist Sounds Warning on Reality of Retirement
"[Alicia Munnell, director of Boston College's Center for Retirement Research,] has been writing about Social Security and retirement for nearly five decades, and has no plans to stop working. She said she recognizes her book makes proposals that workers and policy makers may not want to hear. But the reality is retirement for this and coming generations has changed. Workers are increasingly on their own and denying that -- and failing to take steps such as working a few more years -- will only lead to serious problems in the future." (The Boston Globe)