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Employee Benefits Jobs
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Webcasts and Conferences
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[Official Guidance]
Culturally and Linguistically Appropriate Services (CLAS) County Data, December 2014 (PDF)
"PHS Act section 2719 requires non-grandfathered group health plans and health insurance issuers offering non-grandfathered health insurance coverage to provide relevant notices in a culturally and linguistically appropriate manner ... Section 2715 of the PHS Act requires group health plans and health insurance issuers offering group and individual coverage to provide the summary of benefits and coverage (SBC) and uniform glossary in a culturally and linguistically appropriate manner ... The list [in this report] includes all counties which meet or exceed the 10 percent threshold ... for the 2009-2013 ACS data and is applicable until the next edition.... Sullivan County in Missouri has been added as a county that meets the 10 percent threshold with respect to Spanish. In the last update, no counties in Missouri had met the threshold."
(Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])
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[Official Guidance]
2014 Instructions for IRS Form 1095-A, Health Insurance Marketplace Statement (PDF)
"Form 1095-A is used to report certain information to the IRS about individuals who enroll in a qualified health plan through the Marketplace. Form 1095-A also is furnished to individuals to allow them to claim the premium tax credit, to reconcile the credit on their returns with advance payments of the premium tax credit (advance credit payments), and to file an accurate tax return.... Health Insurance Marketplaces must file Form 1095-A to report information on all enrollments in qualified health plans in the individual market through the Marketplace. Marketplaces may be State Marketplaces, regional Marketplaces, subsidiary Marketplaces, or the Federally-facilitated Marketplace." [Also available: Form 1095-A, Health Insurance Marketplace Statement.]
(Internal Revenue Service [IRS])
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[Guidance Overview]
CMS Webinar Slides: FF-SHOP Updates, December 11, 2014 (PDF)
28 presentation slides. Topics include: [1] FF-SHOP 2014 Enrollment/Reconciliation Reporting Requirements; [2] User Fees for FF-SHOP Issuers; and [3] QHP ID and New Termination Codes.
(Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])
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[Guidance Overview]
Individual Mandate Regs Address Affordability, and Here's Why Employers May Care
"If employer-sponsored coverage is unaffordable, and the employee does not enroll in it, then the employee may be eligible for a premium tax credit for ACA Marketplace/Exchange coverage. Receiving that tax credit could trigger a play or pay penalty for the employer. We say 'could' because the employer play or pay regulations do have safe harbors for determining affordability[.]"
(Benefits Bryan Cave)
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Text of Eighth Circuit Opinion Upholding 'Prejudice and Good Faith' Standard When Awarding Penalties for Failure to Provide COBRA Notice (PDF)
"The Coles finally contend the district court abused its discretion by considering the wrong factors when declining to award statutory penalties.... We believe instead the district court did not abuse its discretion where there was no evidence Trinity Health willfully failed to notify the Coles of their COBRA rights or of the retroactive termination of their coverage, and where the district court reasoned 'if Trinity Health intended to act in bad faith, free health care coverage would not have been extended to the Coles.' " [Cole v. Trinity Health Corp., No. 14-1408 (8th Cir. Dec. 15, 2014)]
(U.S. Court of Appeals for the Eighth Circuit)
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Retiree Health Care Benefits for State and Local Employees in 2014
"The brief discusses how different plan designs, coverage levels, and financing arrangements are associated with varying costs for sponsoring state governments. Among the findings: [1] States' unfunded OPEB liabilities (UAAL) remained relatively unchanged when compared to 2013 data; [2] Over three-fourths of the total state OPEB UAAL is held by 10 states; [3] 33 states set aside assets to prefund OPEB in FY13, up from 18 for the period FY09-FY11."
(National Association of State Retirement Administrators [NASRA])
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U.S. Corporate Health Exchanges Find No New Blue Chip Clients
"By last year, blue chip names like Sears Holding and Walgreen Co had signed on and industry experts predicted that more than 20 percent of the nation's employees would soon buy their health insurance in this way, compared with less than 2 percent today. But Reuters interviews with nearly a dozen industry executives has found that no major U.S. company signed up their employees for the first time to a private health insurance exchange for 2015. Many of those executives expect a similar situation in 2016, as blue chip employers wait for proof that the new exchanges will save them enough money to warrant the switch, raising doubts about this new business model."
(Reuters)
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EEOC Cracking Down on Workplace Wellness Programs
"It seems unlikely, given the lawsuits brought to date, that the EEOC would spend finite resources attacking wellness programs designed so that the premium differential is not dependent on medical examinations or completion of HRAs. However, most employers have routinely rejected such wellness programs as failing to provide sufficient return on investment. Will the EEOC continue to challenge more typical wellness programs where failure to participate only triggers penalties in the 30-50% range specifically permitted under HIPAA and PPACA? ... Is there a direct correlation between the amount of the financial impact to the employee and the risk of a lawsuit being brought by the EEOC?"
(Warner Norcross & Judd LLP)
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Small Businesses Drop Coverage as ACA Offers Alternatives
"Companies ... with fewer than 50 workers ... provide medical coverage to roughly 20 million people. Unlike larger employers, they have no obligation under the health law to offer a plan. Now they often have good reason not to.... Anthem, the largest seller of small-business health insurance, lost almost 300,000 members in such plans -- many more than expected -- in the first nine months of the year. That was 15 percent of the enrollment."
(Kaiser Health News)
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Health Insurers Provide Additional Flexibility for Premium Payments
"To provide a smooth transition in the first year of the auto-enrollment and renewal process, America's Health Insurance Plans' (AHIP) Board of Directors today announced that health plans are voluntarily providing flexibility with payment deadlines for consumers purchasing coverage through the federal Marketplace."
(America's Health Insurance Plans [AHIP])
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[Opinion]
Bye, Bye 'Bailout': Cromnibus Takes a Small But Important Bite Out of Obamacare
"For the short term, the most important anti-Obamacare achievement is eliminating taxpayers' liability for Obamacare's risk corridors, often described as a 'bailout,' to health insurers participating in Obamacare's exchanges.... For what is actually a very small price to health insurers, Congress has given them a very big signal that they should move beyond Obamacare and participate in developing a replacement where their profits and losses will be determined by their ability to attract customers, not politicians' promises."
(National Center for Policy Analysis Health Policy Blog)
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Benefits in General; Executive Compensation
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[Guidance Overview]
Advance Copies of 2014 Form 5500s: Avoid Penalties by Confirming Compliance
"The MEWA Form M-1 compliance information that was filed as an attachment for 2013 now appears as three new questions on the Form 5500.... Filers are now required to provide the total number of active participants at the beginning of the plan year and at the end of the plan year on both forms. Form 5500-SF filers now must provide the number of participants that terminated employment during the plan year with accrued benefits that were not fully vested.... New Line 4f requires plans in critical status to indicate the plan year in which a plan is projected to emerge from critical status or, if the rehabilitation plan is based on forestalling possible insolvency, the plan year in which insolvency is expected."
(Solutions Law Press)
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The 2015 ABC's of Employee Benefits, Part 2
"From ERISA 510 to skinny plans and private health care exchanges, the ABC's of employee benefits outlines the issues benefit decision-makers need to be aware of in the coming year."
(Ed Bray, in Employee Benefit News)
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Press Releases
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Additional useful links:
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David Rhett Baker, J.D., Editor and Publisher
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