Health & Welfare Plans Newsletter

January 9, 2015

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Employee Benefits Jobs

Retirement Plan Analyst
Trinity Pension Group, LLC
in NC

Actuarial Analyst
USI Consulting Group
in CT

Regional Vice President, Sales
Transamerica Retirement Solutions
in FL, GA

Actuarial Services Consultant
CBIZ Insurance Services, Inc.
in MD, PA

Senior Retirement Plan Analyst
Trinity Pension Group, LLC
in NC

Employee Benefits Attorney
Wiggin and Dana LLP
in CT, NY

Part-time Retirement Planning Consultant
Transamerica Retirement Solutions
in FL

Retirement Planning Consultant
Transamerica Retirement Solutions
in VA

Actuarial Analyst
The Benefit Practice
in CT, FL

Defined Benefit Plan Consultant
The Pension Studio
in ANY STATE, FL

Retirement Plan Services Administrator
Dixon Hughes Goodman, LLP
in VA

Technical Director
Employee Benefit Resources, Inc.
in ANY STATE, MT

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Webcasts and Conferences

Avoiding Common Pitfalls in the Plan Restatement Process
January 20, 2015 in CA
(Western Pension & Benefits Council - Orange County Chapter)

Multiemployer Pension Reform Act of 2014
January 20, 2015 WEBCAST
(International Foundation of Employee Benefit Plans [IFEBP])

Practicing Before the IRS – Circular 230 A to Z
January 24, 2015 WEBCAST
(IRS [Internal Revenue Service])

Health Benefits Laws Compliance Assistance Seminar
February 10, 2015 in TX
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

Extreme Cross-Testing of Defined Contribution Plans
February 12, 2015 WEBCAST
(ASPPA [American Society of Pension Professionals & Actuaries])

View All Webcasts and Conferences



[Official Guidance]

Text of Instructions for 2014 IRS Form 8962 (PDF)
"Use Form 8962 to figure the amount of your [premium tax credit] and reconcile it with any [advance premium tax credit] paid.... You will need Form 1095-A, Health Insurance Marketplace Statement, to complete Form 8962. The Marketplace is required to provide or send Form 1095-A to the tax filer(s) identified in the enrollment application by January 31, 2015." (Internal Revenue Service [IRS])  


[Advert.]

Forum on Rewarding Healthy Behaviors – Feb 4-5 2015 – Las Vegas

Sponsored by World Congress

Learn from Employee Health leaders how innovative workplace wellness strategies, preventive health management initiatives and evidence-based success impact workforce productivity, improve overall employee wellness and increase ROI.



[Official Guidance]

Text of IRS Publication 5187: Health Care Law -- What's New for Individuals and Families (PDF)
"This publication covers some of the tax provisions of the Affordable Care Act (ACA). It provides information that explains how taxpayers satisfy the individual shared responsibility provision by enrolling in minimum essential coverage, qualifying for an exemption, or making a shared responsibility payment. It also provides information about the new premium tax credit. A glossary is included to help taxpayers understand new terms related to ACA." [Dated December, 2014.] (Internal Revenue Service [IRS])  

[Guidance Overview]

When Does ERISA Apply to HSAs? (PDF)
"In general, according to the [DOL], HSAs are not viewed as 'welfare benefit plans' subject to [ERISA]. However ... this exemption is contingent on the employer's limited involvement with the HSA, and advisers assisting employers with HSA arrangements need to be aware of such limitations." (The Wagner Law Group)  

Eighth Circuit: Choice-of-Law Provision Trumps Insurance Regulation Banning Discretionary Review
"[The employee] works in South Dakota ... [while the employer] is based in Minnesota and the long term disability policy was issued in Minnesota. The policy contained language requiring discretionary review, and the plan contained a choice-of-law provision requiring application of Minnesota law. South Dakota has banned discretionary review. Minnesota has no such regulation.... What standard of review applies: South Dakota law and de novo review, or Minnesota law and abuse of discretion review? [The Eighth Circuit] Court of Appeals held: Minnesota law and the abuse of discretion standard applies." [Brake v. Hutchinson Technology Inc. Group Disability Income Ins. Plan, No. 13-3421 (8th Cir. Dec. 29, 2014)] (Lane Powell PC)  

ACA Considerations in Mergers and Acquisitions
"The acquirer will need to consider potential operational issues following the transaction, especially those that relate to the determination of full-time employee status for purposes of the ACA employer mandate rules.... [If] the acquirer and the target each use different measurement methods for determining full-time employee status, difficulties may arise in applying those methods following the closing of the transaction." (Drinker Biddle)  

Twelve Things to Know About Health Care Reform for 2015 (PDF)
"[1] Beware of Excise Taxes.... [2] One-year delay for some small employers.... [3] Fiscal year plans.... [4] Section 6055 and 6056 reporting.... [5] Tracking hours of service.... [6] Applicable large employer status... [7] Transitional reinsurance fee for self-insured plans.... [8] PCOR fee for self-insured plans.... [9] W-2 reporting of the cost of coverage.... [10] Skinny plans and minimum value... [11] Cafeteria plan election changes.... [12] Health FSA limit." (Hinkle Law Firm LLC)  

House Votes to Modify ACA's 30-Hour Definition of Full-Time Employee, 252-172
"The House ... approved legislation that would waive fees on businesses that do not offer health insurance to employees working fewer than 40 hours per week.... Republicans said the current statute gives employers an incentive to cut workers' hours to avoid paying fines as a result of the healthcare law.... But Democrats argued that increasing the healthcare law's definition of a full-time workweek would result in more employees being forced to work more hours and still not be eligible for insurance." (The Hill)  

The ACA: Advancing the Health of Women and Children (PDF)
"Since 2013, the uninsured rate among women ages 18 to 64 declined 5.5 percentage points. Because of the Affordable Care Act, an estimated 48.5 million women are benefiting from preventive services coverage with no out-of-pocket costs. Of the total number who have selected a Marketplace Plan during the 2015 Open Enrollment period, more than half (56 percent) are women and nine percent are children ages 0 to 17." (Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS])  

Medical Debt Among Insured Consumers: The Role of Cost Sharing, Transparency, and Consumer Assistance
"The average annual deductible ... under job-based health plans exceeded $1,200 for an individual in 2014. For non-group health plans sold on new health insurance marketplaces, deductibles are even higher.... [C]onsumers were often surprised to learn how much they owed for care they thought would be covered by insurance.... Greater transparency in the details of health insurance plans cannot eliminate medical debt, but [it] can help consumers distinguish plan differences to make more informed choices and to plan ahead financially." (Henry J. Kaiser Family Foundation)  

The Potential Effect of Eliminating the ACA's Tax Credits in Federally Facilitated Marketplaces (PDF)
"Enrollment in the ACA-compliant individual market, including plans sold in the marketplaces and those sold outside of the marketplaces that comply with ACA regulations, would decline by 9.6 million, or 70 percent, in federally facilitated marketplace (FFM) states. Unsubsidized premiums in the ACA-compliant individual market would increase 47 percent in FFM states. This corresponds to a $1,610 annual increase for a 40-year-old nonsmoker purchasing a silver plan." (RAND Corporation)  

Potential Implications of Upcoming Supreme Court Decision in King vs. Burwell: 8.2 Million More Uninsured and 35% Higher Premiums
"[The authors] estimate that a victory for the plaintiff would increase the number of uninsured by 8.2 million people and eliminate $28.8 billion in tax credits and cost-sharing reductions in 2016 ($340 billion over 10 years) for 9.3 million people. With lower cost individuals leaving the market, average nongroup premiums in 34 states would increase by 35 percent, affecting those purchasing inside and outside those Marketplaces." (Urban Institute)  

Benefits in General; Executive Compensation

EBSA 2014 Report May Indicate Investigators Are Looking at Different Types of Plans and Finding Different Types of Violations
" 'I still talk to DOL investigators on a pretty regular basis, and they tell me they're really focused on health and welfare plans right now -- I don't think there's any doubt that is what's behind the drop for 2014 collections,' [said David Donaldson, a former senior investigator with the EBSA (2009 to 2011)]. 'During my last quarterly training session while I was still an investigator for the DOL, they were already instructing that for every 401(k) or retirement plan we had in our case file, we were to go ahead and open up a case for the health and welfare plan if one happened to exist. We can see now that the focus on health and welfare is intensifying.' " (planadviser)  

Ninth Circuit Lowers the Bar for Plaintiffs Seeking ERISA Plan Benefits in Court (PDF)
"Of particular interest are the Ninth Circuit's holdings that: [1] A contractual statute of limitations must be specifically stated in a particular location within the plan's summary plan description in order to be enforced; [2] A plan document must affirmatively and unambiguously state that a participant has to exhaust administrative remedies before filing a lawsuit in order for that requirement to be enforced; and [3] Claims administrators (and, potentially, other plan fiduciaries) may be proper defendants in claims for benefits brought under ERISA Section 502(a)(1)(B)." [Spinedex Physical Therapy USA Inc. v. United Healthcare of Arizona, Inc., No. 12-17604 (9th Cir. Nov. 5, 2014)] (Trucker Huss)  

ISS Releases FAQs on New Equity Plan Scorecard for 2015 (Part 2)
"The following egregious features will result in an 'against' recommendation from ISS, regardless of other [Equity Plan Scorecard] factors: [1] A change in control definition that could result in vesting of awards by any trigger other than a full double trigger; [2] If the plan would permit repricing or cash buyout of underwater options or SARs without shareholder approval ... [3] If the plan is a vehicle for problematic pay practices or a pay-for-performance disconnect; or [4] If any other plan features or company practices are deemed detrimental to shareholder interests. Such features may include, on a case-by-case basis, tax gross-ups related to plan awards or provisions for reload options." (Winston & Strawn LLP)  

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