Employee Benefits Jobs
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Webcasts and Conferences
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[Official Guidance]
Text of IRS Rev. Proc. 2015-17: Determination Letters for Qualified Nonprofit Health Insurance Issuers (PDF)
"The purpose of the CO-OP program is to foster the creation of member-governed [qualified nonprofit health insurance issuers (QNHIIs)] that will operate with a strong consumer focus and offer qualified health plans in the individual and small group markets.... [A] QNHII ... which has received a loan or grant under the CO-OP program may be recognized as exempt from taxation under Section 501(a), but only for periods for which the organization is in compliance with the requirements of Section 1322 of the [ACA] and of any loan agreement with the Secretary of [HHS].... QNHIIs seeking recognition of exemption under Section 501(c)(29) should follow this revenue procedure and, to the extent not inconsistent with this revenue procedure, Rev. Proc. 2015-9[.]"
(Internal Revenue Service [IRS])
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[Guidance Overview]
Congress Clarifies Expatriate Health Coverage Exemption
"Last December, Congress enacted the [Expatriate Health Coverage Clarification Act of 2014 (EHCCA)] as Division M of the Consolidated and Further Continuing Appropriations Act, 2015.... Particularly key for purposes of the ACA's minimum essential coverage requirement is the EHCCA's requirement that expatriate health plan sponsors have a reasonable belief that the benefits provide minimum value coverage requiring the plan to pay at least sixty [60] percent of the total allowed costs."
(Ogletree Deakins)
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[Guidance Overview]
Updated SBC Rules Reflect Full ACA Implementation
"In essence, the proposed regulations refresh SBC contents and terminology to reflect full ACA implementation, in particular its group market reforms and the rollout, over 2014-2016, of both individual and employer shared responsibility regimes.... The proposed regulations are intended to streamline SBC delivery rules and prevent duplicate delivery of SBCs in certain situations[.]"
(E is for ERISA)
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[Guidance Overview]
Agencies Propose Updates to SBC Requirements
"The preamble to the proposed regulations states that selecting and monitoring service providers to develop, provide or deliver SBCs is a fiduciary act under [ERISA]. The language indicates that the departments will be paying close attention to service provider arrangements in the SBC arena."
(Towers Watson)
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Bill Would Require All Minnesota Employers to Provide Paid Sick Leave
"Unlike the laws recently enacted in Connecticut and Massachusetts, which apply only to employers with at least 50 and 11 employees, respectively, this proposed legislation would require all employers in Minnesota to provide paid sick and safe time ... to their employees.... Currently, employers that employ less than 21 employees at any one site are not subject to Minnesota pregnancy and parenting leave laws (which were amended ... in 2014 to increase the required leave period to 12 weeks) or the Minnesota pregnancy accommodation law ... The proposed legislation would expand the coverage of these laws to all employers that employ one or more employees."
(Faegre Baker Daniels LLP)
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President Obama's FY 2016 Budget and the ACA
"The President's budget proposes a number of new health care initiatives, including ... reducing growth in payments for certain Medicare providers, raising the cost of Medicare coverage for higher-income enrollees, authorizing HHS to negotiate drug prices for biologics and high-cost drugs in the Medicare Part D program, ... and continuing to move Medicare payments away from fee-for-service toward value-based payment. For the core ACA health insurance access and affordability programs, the budget simply seeks full funding of the status quo.... The FY 2016 budget projects premium assistance tax credits to cost $39.164 billion and cost-sharing reduction payments to cost $6.215 billion.... Funding for enforcing the employer and individual responsibility provisions is not separately budgeted and is presumably found in the IRS general enforcement and operations support budgets."
(Timothy Jost, in Health Affairs)
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Insurance Brokers and the ACA: Early Barriers and Options for Expanding Their Role
"The Affordable Care Act's drafters envisioned a continuing, significant role for brokers in the reformed nongroup insurance markets, but circumstances limited their active participation in the first year of marketplace enrollment. This analysis delineates the early barriers to brokers' full engagement, highlights the main concerns with their having a more prominent role and offers options for making them more effective in enrolling the uninsured."
(Urban Institute)
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SHOPping for Health Care Makes 'Cents' for Consumers
"This data brief looks at: [1] Per capita out-of-pocket spending rates nationally and statewide; and [2] Average differences in consumer prices for a set of five common medical procedures: office visit for the evaluation of a new patient, colonoscopy, cataract removal, lower leg MRI; and ultrasound for pregnancy nationally and in nine states: Arizona, Colorado, Florida, Georgia, Maryland, New Jersey, Ohio, Texas, and Wisconsin. It finds consumer out-of-pocket spending for common health care procedures can vary from $10 to nearly $1,000, depending on the procedure."
(Health Care Cost Institute)
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State Support of the ACA in King v. Burwell: How the Tide Has Turned
"[O]nly seven states -- Alabama, Georgia, Indiana, Nebraska, Oklahoma, South Carolina, and West Virginia -- joined in friend-of-the-court (amicus) briefs supporting the plaintiffs' position that premium subsidies should be withdrawn in states with federally run health insurance marketplaces.... [M]ore than three times as many states -- 22 states plus the District of Columbia -- filed an amicus brief supporting the government's position that premium subsidies should continue to be provided in all states, regardless of whether the state or the federal government runs the marketplaces."
(Families USA)
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[Opinion]
A Better Idea: Let Workers Use HSAs to Save for Sick Days
"In his State of the Union speech, the president emphasized the plight of 43 million American workers whose employee benefits do not include paid sick leave.... However, the President's solution was a bad one: he proposed to force employers to provide up to seven days of paid sick leave to workers (and their families) annually. Imposing another costly employer mandate is a bad idea. Instead, the president should have proposed expanding health savings accounts (HSAs), allowing workers to replace income lost to sick days."
(National Center for Policy Analysis Health Policy Blog)
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[Opinion]
The Financial Sinkhole of Health Insurance Complexity
"Compared with countries that have a single health insurer (i.e., the government), we waste more than $375 billion per year in excess paperwork to pay medical bills. That's $1 billion per day. That's more than $1 trillion every three years. That's 15 percent of all health spending -- 1 in every 7 dollars spent on health care -- on excess paperwork.... This waste equals $1,200 per year for each and every person in the United States. It represents 89 percent of total state and federal spending for Medicaid ... It amounts to 2.3 percent of the U.S. economy. And this striking toll doesn't even count the effort expended by employers for their employees' health insurance or time spent by patients and families dealing with insurance and bills."
(Physicians for a National Health Program [PNHP])
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Benefits in General; Executive Compensation
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Six Cash-Saving Tips for Deferred Compensation Plans
"A discretionary contribution to a DCP account balance can meet a variety of corporate objectives by using vesting. An employer contribution can vest over time, be based on meeting employer objectives, be structured as discretionary contributions, or a combination of those. Flexibility, creativity and discrimination are your friends here."
(CFO)
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[Opinion]
Why the President's Proposal for Social Security Disability Insurance Makes Sense
"The budget calls for a five-year reallocation of payroll taxes from the Old-Age and Survivors Insurance (OASI) trust fund to the disability fund (DI), starting in January 2016 and ending in December 2020. The plan would increase the payroll tax allocated to DI by 0.9 percentage point, with a corresponding decrease in funds received by OASI. The change would have no overall effect on the longevity of the combined trust funds, which are expected to be exhausted in 2033."
(Mark Miller, via Reuters)
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Press Releases
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