Health & Welfare Plans Newsletter

February 5, 2015

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Employee Benefits Jobs


Webcasts and Conferences

M&A Basics: Pension, Savings, and Welfare Plan Issues
RECORDED
(Morgan Lewis & Bockius LLP)

2015 First Quarter Update
February 11, 2015 WEBCAST
(McKay Hochman Co., Inc.)

Lunch Meeting: Health & Welfare
February 17, 2015 in CA
(Western Pension & Benefits Council - San Diego Chapter)

Building Blocks for Powerful Wellness Leadership
February 19, 2015 WEBCAST
(myInertia LLC)

Certificate in Health and Welfare Plans
February 23, 2015 in FL
(International Foundation of Employee Benefit Plans [IFEBP])

How Sarah Staggs Connects Benefits to Corporate Strategy
February 25, 2015 in IL
(Worldwide Employee Benefits Network [WEB] - Chicago Downtown Chapter )

Review of the ASOPs Affecting Pension Actuaries
March 5, 2015 WEBCAST
(ASPPA [American Society of Pension Professionals & Actuaries])

CCA 2016 Annual Meeting
October 23, 2016 in NV
(Conference of Consulting Actuaries)

View All Webcasts and Conferences



[Guidance Overview]

ACA Reporting for 2014 Individual Tax Returns: Employer Statements Not Required
"[T]he IRS encourages preparers to review their client's documentation to determine the portion of the year during which the individual and any dependents did have qualifying coverage. The [IRS Fact Sheet on Best Practices] lists a statement or document from an employer indicating health coverage as substantiation that coverage was in effect for a portion of the year.... Employers are not required to provide any such statement or documentation relating to the 2014 tax year, although employers may choose to do so voluntarily. Employees utilizing a tax preparer may ask employers to provide documentation regarding coverage for the 2014 tax year, but this is not a requirement this year." (Hill, Chesson & Woody)  


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[Guidance Overview]

CMS Webinar Slides: Risk Adjustment and Reinsurance Discrepancy Reports & Data Quality Analysis Reports (PDF)
46 presentation slides. "This session will provide guidance specific to informal discrepancy reporting for EDGE-generated reports. Additionally, we will share information on the Data Quality Analysis Reports (DQARs) that are distributed to issuers, which provide data summaries and metrics." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

The Status of Health Insurance Marketplaces, by State
"Use this interactive map to review the status of state action on health insurance marketplaces, as well as estimates of the implications of a Supreme Court ruling in favor of King in states with federally run marketplaces." (The Commonwealth Fund)  

Health Insurer Anthem Hit by Hackers
"Anthem said it is likely that 'tens of millions' of records were stolen. The health insurer said the breach exposed names, birthdays, addresses and Social Security numbers but doesn't appear to involve medical information or financial details such as credit-card or bank-account numbers ... [T]he Anthem attack was 'sophisticated' and used techniques that appeared to have been customized, rather than broadly available tools, and were 'very advanced.' Investigators haven't yet concluded who was behind the Anthem breach." (The Wall Street Journal; subscription may be required)  

Anthem Data Breach Implications for Employers
"Some reports have indicated that the HIPAA breach notification rules will not apply to this breach. However, the information stolen appears to include individually identifiable information, potentially including health plan enrollment information. Enrollment information, in the hands of a health plan, is protected health information (PHI), so it is possible that the HIPAA data breach notification rules are applicable. As such, both insured and self-funded customers utilizing Anthem as their TPA should review information concerning the Anthem breach carefully before concluding that the HIPAA breach notification rules do not apply." (Benefits Bryan Cave)  


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For Drug Cost Crisis, Obama Wants to Let Federal Government Negotiate Prices
"Congress prohibited Medicare from negotiating prices with drug companies when it created Part D in 2003, and giving the agency that authority would require a legal change from Congress. But the Obama Administration's move, even just as proposal, sends a message to the drug industry and greater healthcare sector that some leaders in government want to enter a new regulatory territory -- with Part D drug spending projected to increase 30 percent, to $82 billion, over the next year. The drug industry is adamantly opposing the prospect of negotiating with Medicare." (Healthcare Payer News)  

GOP Chairmen Offer Alternative to ACA
"Like last year's document, the legislative framework would repeal the current law's requirements on individuals and employers to purchase health care coverage and the option for states to expand Medicaid, the joint federal-state health program for low-income people. It would give states more control of Medicaid, provide tax credits to help people buy health insurance -- but only to those who earn up to 300 percent of the poverty threshold, not the 400 percent in the current law -- and scrap the law's new taxes and fees. It would also eliminate the health insurance marketplaces set up under the federal health law and insurers would not be required to cover a specific set of benefits." (Kaiser Health News)  

Here's How the GOP Would Repeal and Replace Obamacare
"The Burr-Hatch-Upton plan ... caps the tax exclusion at $12,000 for an individual and $30,000 for family coverage, and amounts above that would be taxed as regular income.... The GOP plan also eliminates the ACA's employer mandate requiring businesses with 50 or more full-time employees to offer health insurance or pay a penalty.... Insurers would no longer be required to cover a set of 10 essential health benefits as they are under the ACA, but some ACA elements are kept in place. Young adults can stay on their parents' health plans until they turn 26, and the ban on lifetime coverage limits remains." (The Washington Post; subscription may be required)  

Few Mid-sized Employers Plan to Eliminate Healthcare
"Even with their continued healthcare commitment mid-tier enterprises are concerned about controlling the costs, according to the findings. When asked, 'In terms of employee healthcare coverage, which of the following do you expect to present the greatest challenge in the year ahead?' participants responded: Keeping healthcare costs under control: 77 percent; Helping employees make the best choice: 10 percent; Avoiding government penalties related to healthcare: 8 percent; and Avoiding confusion: 5 percent." (Wolters Kluwer Law & Business)  

IRS Seeks 9,000 New Employees as It Prepares to Enforce Obamacare
"The billions of dollars will help the agency bolster its staff by adding more than 9,280 full-time employees. The proposed jump in employment at the IRS is an 11 percent increase from 2015. To enforce the 46 new tax provisions of the Affordable Care Act specifically, the IRS asked for $67 million. That will cover 483 new employees related to Obamacare's implementation." (Melissa Quinn, in The Daily Signal)  

[Opinion]

King v. Burwell: Congressional Intent and the Statutory Language Are Aligned
"Some believe the King lawsuit is a contest between, on the one hand, congressional intent that premium subsidies should be provided in all states, versus, on the other hand, statutory language that says the opposite. Those who believe this formulation are half right: they are correct that Congress clearly intended subsidies to be provided to moderate-income families irrespective of whether their state of residence chose to run its marketplace directly instead of leaving it to the federal government; however, they are mistaken about the ACA's language, which equally clearly indicates that subsidies should be provided in all states." (Ron Pollack, in Health Affairs)  

Press Releases

PBGC to Pay Benefits at Hovensa
PBGC [Pension Benefit Guaranty Corporation]

CEFEX Introduces Fiduciary Certification Workshops
Centre for Fiduciary Excellence [CEFEX]

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