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Employer Mandate Implementation: Do You Qualify for Transition Relief?
January 21, 2015 WEBCAST
(Hill, Chesson & Woody)

Nondiscrimination Testing in DC Plans – Beyond the Basics
February 4, 2015 WEBCAST
(Western Pension & Benefits Council)

SHOP Marketplace Series
February 17, 2015 WEBCAST
(Centers for Medicare & Medicaid Services [CMS])

Online Webinar: Fiduciary Education with the Department of Labor (DOL)
February 25, 2015 WEBCAST
(Western Pension & Benefits Council)

8th Annual Executive Summit on On-Site Employee Health Clinics
March 11, 2015 in GA
(World Congress)

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[Official Guidance]

Text of CMS Final 2016 Actuarial Value Calculator Methodology (PDF)
30 pages. "This document is revised from the 2015 version and also updated from the draft 2016 version, released on November 21, 2014, in response to comments received. Specifically, this document incorporates updates to account for the final 2016 AV Calculator. The first part of this document provides background that includes an overview of the regulation that allows HHS to make updates to the AV Calculator as well as the updates that are incorporated into the final 2016 AV Calculator. For the second part of the document, we provide a detailed description of the development of the standard population and the AV Calculator methodology." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Advert.]

Top 5 Employee Benefit Trends for 2015 -- February 12 webinar

This live webinar will discuss top employee benefit trends for 2015. including defined contribution and flexible benefit plans; single-carrier and multi-carrier exchanges; consumer-driven health plans; and voluntary benefits. BenefitsLink discount.

[Official Guidance]

Text of IRS Rev. Proc. 2015-15: Monthly National Average Bronze Plan Premium for 2015 (PDF)
"This revenue procedure provides the 2015 monthly national average premium for qualified health plans that have a bronze level of coverage for taxpayers to use in determining their maximum individual shared responsibility payment ... [T]he monthly national average premium for qualified health plans that have a bronze level of coverage and are offered through Exchanges in 2015 is $207 per individual... [T]he maximum monthly national average premium for qualified health plans that have a bronze level of coverage and are offered through Exchanges in 2015 is $1,035 for a shared responsibility family with five or more members." (Internal Revenue Service [IRS])  

[Official Guidance]

Text of IRS Notice 2015-08: Guidance with Respect to the Tax Credit for Employee Health Insurance Expenses of Certain Small Employers in Iowa (PDF)
"This notice provides guidance on section 45R of the Internal Revenue Code for certain small employers that cannot offer [a Qualified Health Plan (QHP)] through the [Small Business Health Options Program (SHOP)] Exchange because the employer's principal business address is in a county in Iowa in which a QHP through a SHOP Exchange will not be available for all or part of 2015 calendar year. Section IV of this notice includes a list of those counties." (Internal Revenue Service [IRS])  

[Guidance Overview]

Large Penalties Await Employers Who Reimbursed Certain Employee Health Insurance Premiums in 2014
"[W]hile the reimbursement of a more-than 2% shareholder has always been treated as wages to the shareholder ... it was not subject to payroll taxes ... Starting in 2014, however, in order for an employer to avoid the penalty the payments cannot be tied to the employee's premiums, and thus there must be no evidence of a 'plan.' As a result, the payments to the shareholders should now also be subject to payroll taxes. [The author] also of the opinion that because there can be no 'plan' under the meaning of Notice 2008-1 if the S corporation wishes to avoid the $36,500 annual penalty, the shareholder will no longer be permitted to deduct the premium on page 1 of Form 1040, but rather must take an itemized deduction on Schedule A, where it will be subject to a 10% of adjusted gross income floor[.]" (Forbes)  

[Guidance Overview]

IRS Releases 2014 Form 8839 for Excluding Employer-Provided Adoption Benefits
"[C]hanges to the 2014 form and instructions [include]: [1]The maximum adoption credit and exclusion amounts have been adjusted to reflect their 2014 values ($13,190 per eligible child).... [2] The instructions regarding adoption of children with special needs have been revised to explain that a child will not be considered a child with special needs before the state makes the required determination, and that it is not sufficient for a child to have a specific factor or condition that the state would use to determine special needs.... [3] The adoption credit carryforward worksheet in the instructions for line 16, which identifies unused credits that taxpayers may carry forward to 2015, has been modified[.]" (Thomson Reuters / EBIA)  

[Guidance Overview]

IRS Issues Guidance and Forms for Reporting 2014 Premium Tax Credits and Complying with the Individual Mandate
"Although this guidance is designed to prepare individuals for filing their 2014 returns, employer-sponsored plans are indirectly implicated.... [An] employee may qualify for premium tax credits for Exchange coverage if ... the employee is not eligible for affordable, minimum value coverage in an employer-sponsored plan. Starting in 2015, a full-time employee's receipt of premium tax credits could trigger employer shared responsibility (play or pay) penalties under Code Section 4980H. With the implementation of these rules looming, employers will want to familiarize themselves with the process by which Exchanges determine eligibility for advance payment of premium tax credits and timely appeal any erroneous determinations[.]" (Thomson Reuters / EBIA)  

[Guidance Overview]

CRomnibus Provisions Include Expatriate Health Plans / ACA Funding
"The act provides expat health plans with relief from the PPACA, requires additional PPACA disclosures and defunds some PPACA provisions.... The administration's 2016 budget submission must identify all funds spent by CMS on the public insurance exchanges." (Towers Watson)  

Employee Terminated Following Child's Large Medical Claims May Proceed With ADA Associational Discrimination Claim
"Explaining that the ADA prohibits discrimination against an employee due to expenses arising from a family member's disability, the court ... allowed the employee's claims to proceed.... [E]vidence indicated that the employer knew the large medical claims were the child's, that the claims had a significant impact on the employer's stop-loss premiums, and that the child might continue to have high claims. The court also allowed the employee's claim of interference with benefits under ERISA Section 510 to proceed." [Myers v. Hog Slat, Inc., No. C13-3032-LTS (N.D. Iowa Oct. 24, 2014)] (Thomson Reuters / EBIA)  

Are the Phase Two HIPAA Compliance Audits Here Yet?
"HHS OCR Director Jocelyn Samuels ... said phase two would be 'implemented expeditiously,' and said that OCR would also be releasing new guidance for the phase two audits. While she wouldn't provide a precise date for the implementation, she urged everyone to keep checking the OCR web site for additional information in the coming weeks and months." (Bloomberg BNA)  

Risk Adjustment and Shared Savings Agreements (PDF)
"[This article discusses] the role of risk adjustment in shared savings agreements, the uncertainties involved in its potential impact, and steps that can be taken to maximize its performance in shared savings agreements. These steps can help both providers and payors have increased confidence in the process, optimizing participation and motivation by all players." (Milliman)  

What's the Next Frontier in Health Reform? (PDF)
"Four key goals for reforming the health care system: [1] Securing health coverage for all ... [2] Ensuring that health coverage means access to needed care: creating a more equitable distribution of providers, ensuring that provider networks deliver meaningful access to care, and making dental coverage universally available [3] Transforming our health care system to provide care that is appropriate, high-quality, equitable, and patient-centered: paying for quality -- not quantity -- of care... [4] Reducing health care costs and making care more affordable: stopping uncompetitive provider consolidations, reducing high prescription drug costs, and making information on health care cost and quality transparent." (Families USA)  

2015 Expanded Reporting and Disclosure Requirements Calendar
42 pages. "The 2015 Expanded Reporting and Disclosure Requirements Calendar provides who, what, when and where reporting and disclosure information for single-employer pension and welfare plans under [ERISA]. Plan administrators can access concise instructions for filing reports with the Department of Labor, IRS and [PBGC], and for disclosing tax and benefit information to U.S. plan participants, beneficiaries and alternate payees." (Towers Watson)  

OneAmerica Hires New Regional Sales Director for Retirement Services
OneAmerica Financial Partners

Society of Actuaries Recognizes New Center of Actuarial Excellence in Santa Barbara
Society of Actuaries

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