Defined Contribution Client Manager
Milliman
in CA

Daily Valuation Specialist
Howard Simon & Associates
in IL

Retirement Plan Consultant/Compliance Analyst
Alliance Benefit Group of Houston, Inc.
in TX

Sr. Counsel, Retirement Plans
American Council of Life Insurers
in DC

Part Time On Call Retirement Planning Consultant
Transamerica Retirement Solutions
in AR, CA, FL, GA, HI, IL, MI, MO, NJ, NY, TN, TX, UT

Employee Benefits Attorney
Hodgson Russ LLP
in NY

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New ACA Recordkeeping Requirements Including 1094-C and 1095-C Forms
February 11, 2015 WEBCAST
(Triton Benefits)

401(k) Advisor Symposium in Oak Brook, IL on February 18th
February 18, 2015 in IL
(401k Rekon)

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

ADA & FMLA Compliance Update
April 16, 2015 in IL
(National Employment Law Institute)

View All Webcasts and Conferences

[Official Guidance]

Text of Instructions for IRS Forms 1094-B and 1095-B (PDF)
Dated February 4, 2015. "Forms 1094-B and 1095-B are not required to be filed for 2014. However, in preparation for the first required filing of these forms (that is, filing in 2016 for 2015), reporting entities may, if they wish, voluntarily file ... Form 1095-B is used to report certain information to the IRS and to taxpayers about individuals who are covered by minimum essential coverage and therefore are not liable for the individual shared responsibility payment. Minimum essential coverage includes government-sponsored programs, eligible employer-sponsored plans, individual market plans, and miscellaneous coverage designated by [HHS].... Every person that provides minimum essential coverage to an individual during a calendar year must file an information return and a transmittal.... Most filers will use Forms 1094-B (transmittal) and 1095-B (return). However, employers (including government employers) subject to the employer shared responsibility provisions sponsoring self-insured group health plans will report information about the coverage [on] Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, instead of on Form 1095-B." [Here are links to the forms: Form 1094-B: Transmittal of Health Coverage Information Returns; Form 1095-B: Health Coverage.] (Internal Revenue Service [IRS])  

[Advert.]

Free web briefing: The new Congress and employer health plans

With a user-friendly website, daily emails, and regular web briefings, Mercer Select members stay informed about health, retirement, and other key benefit and HR issues. Register for a free Washington Update web briefing on Feb. 12 at 1 pm ET.

[Official Guidance]

Text of Instructions to 2014 IRS Forms 1094-C and 1095-C (PDF)
Dated February 4, 2015. "Forms 1094-C and 1095-C are not required to be filed by any employer for 2014. However, in preparation for the first required filing of these forms (that is, filing in 2016 for 2015), employers may, if they wish, voluntarily file ... [E]mployers with 50 or more full-time employees (including full-time equivalent employees) use Forms 1094-C and 1095-C to report the information required under sections 6055 and 6056 about offers of health coverage and enrollment in health coverage for their employees. Form 1094-C must be used to report to the IRS summary information for each employer and to transmit Forms 1095-C to the IRS. Form 1095-C is used to report information about each employee. In addition, Forms 1094-C and 1095-C are used in determining whether an employer owes a payment under the employer shared responsibility provisions under section 4980H. Form 1095-C is also used in determining the eligibility of employees for the premium tax credit. Employers that offer employer-sponsored self-insured coverage also use Form 1095-C to report information to the IRS and to employees about individuals who have minimum essential coverage under the employer plan and therefore are not liable for the individual shared responsibility payment for the months that they are covered under the plan." [Here are links to the forms: Form 1094-C: Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns; Form 1095-C: Employer-Provided Health Insurance Offer and Coverage.] (Internal Revenue Service [IRS])  

[Guidance Overview]

IRS Information Letters Reiterate Compliance Dangers of Assisting Employees with Individual Policy Arrangements
"The letters explain that, although health care reform does not change the tax treatment under Code Sections 105 and 106, these arrangements are group health plans that will violate health care reform's annual dollar limit prohibition since they reimburse a fixed amount of medical expenses or individual policy premiums.... Letter 2014-0039 notes that employers not providing group health plan coverage can pay employees additional compensation that can be used to purchase health coverage (provided it is not restricted to the purchase of that coverage). While this approach provides no tax benefit, it is one of the few safe courses available after Notice 2013-54." (Thomson Reuters / EBIA)  

How the 'Cadillac Tax' Could Drive Obamacare Over a Political Cliff
"[U]nder current projections the tax will grow so quickly that it will exceed the annual rising costs of the law's new entitlements, causing net spending on Obamacare actually to decline.... CBO made clear that the Cadillac tax, coupled with provisions slowing the growth of insurance exchange subsidies ... is central to making the law fiscally sustainable." (The Wall Street Journal; subscription may be required)  

Patient Responses to Incentives in Consumer-Directed Health Plans: Evidence from Pharmaceuticals
"In the first [employer's] CDHP, pharmaceuticals were subject to the deductible, while in the second [employer's plan] pharmaceuticals were exempt. Employees in the first firm responded along all three margins: they shifted the timing of drug purchases to periods with lower cost sharing and they were more likely to shift to low-cost drugs, but the largest effect of change in plan design was to reduce adherence. These findings vary across drug classes depending on the availability of lower-cost but equally effective drugs. Employees in the second firm also reduced adherence, but did not measurably shift the timing or use of low cost drugs." (National Bureau of Economic Research [NBER])  

[Guidance Overview]

CMS Presentation Slides: FF-SHOP Updates, February 3, 2015 (PDF)
31 presentation slides. "Purpose: [1] Provide FF-SHOP issuers with updates and announcements; [2] Provide issuers with information on the New Issuer Webinar Series; [3] Remind issuers of the 2015 QHP Certification Conference; [4] Provide issuers with an overview of the Data Center Migration." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

2015 ACA Reminder: Eligibility Rules Need to Be in Writing with Employer Mandate Now in Play
"[I]f you are modifying your eligibility rules for purposes of the Employer Mandate, you should first update any existing documents (SPDs, employee handbooks, open enrollment handouts, etc.) that contain eligibility language which now explicitly conflicts with the changes. Even if old SPDs or other documents do not have conflicting language, you still should clearly lay out any new eligibility provisions in writing. In addition to complying with ERISA, clearly laying out these new eligibility provisions should help you reduce potential conflicts with employees and risks of litigation, both from employees and the IRS, over who was offered coverage, and who was not." (Fisher & Phillips LLP)  

Health Data Breach: What HIPAA Requires (PDF)
"Over the last five years, there have been several alleged breaches of health care information potentially affecting millions of individuals ... including recent reports involving Anthem. Depending on the nature of the data affected, a breach of health information may require health plans to take certain actions, including notifying affected individuals, and potentially, the [HHS] and the media. [This] article ... generally describes HIPAA obligations and sets forth some considerations for employer plan sponsors when faced with potential a breach of health information." (Groom Law Group)  

Data Breach at Anthem May Lead to Others
"Medical identify theft is on the rise ... because it pays.... [At] one auction a patient medical record sold for $251, while credit card records were selling for 33 cents.... [Unlike credit card records] patient medical records typically include information not easily destroyed, including date of birth, Social Security numbers and even physical characteristics that make them more useful for things like identity theft, creation of visas or insurance fraud by falsely billing for expensive medical or dental procedures that were either never done or performed on someone else." (The New York Times; subscription may be required)  

The Anthem Data Breach: Overview of HIPAA and Other Consequences (PDF)
"Where Anthem is acting as an insurer, and the employer is not 'hands on' with the plan's PHI (i.e., it does not acquire, maintain, or transmit the plan's PHI), the notice and disclosure obligation is Anthem's.... Where the health plan is self-insured and Anthem is acting as a 'business associate' of the plan, Anthem (as the plan's third-party claims payor) has a duty under HIPAA/HITECH to notify the employer health plan of the breach. Generally, it is the health plan's responsibility to then supply notice to affected individuals and, in some cases, federal authorities and media outlets. However, health plans and their business associates may agree upon who will actually supply the notice.... Anthem has pledged to supply notice to all affected individuals." (Lockton)  

Lack of Encryption Standard Raises Health Care Privacy Questions
"[HIPAA] encourages encryption, but doesn't require it. The lack of a clear encryption standard undermines public confidence, some experts say, even as the government plows ahead to spread the use of computerized medical records and promote electronic information sharing among hospitals, doctors and insurers." (Associated Press)  

Scammers Begin Phishing Anthem Plan Members
"Anthem ... said it will probably take about two weeks to figure out how many of its 80 million current and former customers and employees had information ... exposed by hackers, and to start notifying them. The insurer warned ... that customers should beware of phishing e-mails that solicit personal information, including a 'click here' link for credit monitoring. Scam artists are also trying to trick consumers into revealing personal data over the phone[.]" (Bloomberg)  

Taxpayer-Funded Co-Ops Struggle to Survive
"After receiving $2.5 billion in taxpayer dollars from the federal government, the vast majority of nonprofit insurance companies created under the Affordable Care Act recorded losses in revenue.... 23 of these entities were created to foster competition in areas where few options are available. Now, CoOportunity, a co-op created to serve Iowa and Nebraska, will be liquidated. Some lawmakers question the viability of the remaining 22 co-ops." (The Daily Signal)  

Republican Healthcare Plan Calls for Health Courts
"Republican Senators Richard Burr and Orrin Hatch and Republican Representative Fred Upton call for the creation of health courts to reduce the costly practice of defensive medicine. Under the Patient CARE Act, states would be incentivized 'to establish a state Administrative Health Care Tribunal, or 'health court,' presided over by a judge with health care expertise who can commission experts and make the same binding rulings that a state court can make.' ... The health court concept ... has been endorsed by every health-care constituency ... President Obama has endorsed them on multiple occasions, as have bipartisan deficit reduction committees such as Simpson-Bowles." (Common Good)  

Overview Of King v. Burwell Amicus Briefs Supporting Availability of Tax Credits (PDF)
"Thirty amicus curiae briefs supporting the nationwide availability of tax credits that make health care affordable for millions of Americans under the Affordable Care Act have been filed in the Supreme Court case King v. Burwell. The briefs were filed on behalf of a broad array of significant voices, including the health insurance industry, statutory interpretation scholars, economists, government officials who wrote the law, states responsible for implementing it, affected individuals, hospitals, and health care providers, an d more. [This article is] a short overview of the arguments presented in these briefs." (Constitutional Accountability Center)  

Risk Considerations for Funding U.S. Group Life and Disability Insurance Programs through Captives (PDF)
"Large employers that sponsor group term life or long-term disability (LTD) programs may be motivated to enter into captive insurance arrangements to fund these benefits. Doing so offers potential reductions in costs, greater control over invested assets, and possible tax savings... This article presents an overview of the evolving captive insurance market for large benefit plan sponsors and discusses some of the more significant risks that employers contemplating these funding arrangements should consider." (Milliman)  

Lowering Deductibles Through Workouts
"By incenting employees to work out, Pact Health serves as a type of Health Reimbursement Arrangement vehicle that allows employees to lower their health deductibles with each workout.... For example, if a group increased their deductible to $2,000, Pact Health would reimburse employees for the first $1,000 of deductible expenses, so the plan essentially mirrors a $1,000 deductible plan. Then, for every time an employee completes a workout towards their 'pact', they could have the opportunity to exercise their way down to a $500 deductible. Conversely, if they miss their workouts, their deductible could grow to $1,500." (William Gallagher Associates)  

Recommendations to Achieve a More Transparent Health Care System for Consumers (PDF)
"Especially in the current health care environment, where consumers are taking on more of the cost burden through increasing out-of-pocket costs, particularly from the growth of high deductible health plans, they need and want more information.... If the goal is to change the priority from increasing volume of data to providing more practical and meaningful [information], attention to regulatory reforms is critical." (The Brookings Institution)  

Court Approves $1 Million Settlement in COBRA Class Action
"The employer in this case was in the staffing business -- it leased workers out to client companies for short-term assignments, after which employment and health plan participation generally terminated. One wonders if the nature of the business may have contributed to the employer's misunderstanding or neglect of its COBRA notice obligations." [Slipchenko v. Brunel Energy, Inc., No. H-11-1465 (S.D. Tex. Jan. 23, 2015)] (Thomson Reuters / EBIA)  

[Official Guidance]

Text of SEC Proposed Rule for Disclosure of Hedging Policies for Officers, Directors and Employees (PDF)
From a press release: "We are proposing amendments to our rules to implement Section 955 of the Dodd-Frank Wall Street Reform and Consumer Protection Act, which requires annual meeting proxy statement disclosure of whether employees or members of the board of directors are permitted to engage in transactions to hedge or offset any decrease in the market value of equity securities granted to the employee or board member as compensation, or held directly or indirectly by the employee or board member. The proposed disclosure would be required in a proxy statement or information statement relating to an election of directors, whether by vote of security holders at a meeting or an action authorized by written consent." (U.S. Securities and Exchange Commission [SEC])  

M&A Basics: Pension, Savings, and Welfare Plan Issues (PDF)
37 presentation slides. Topics: M&A 101 Review; Diligence; Acquisition Agreement Considerations; Defined Benefit Plan/Multiemployer Plan Considerations; Pre- and Post-Closing Actions and Considerations. (Morgan Lewis)  

Employers Debate the Merits and Challenges of Changing Domestic Partner Benefits
"Considering that 36 states and the District of Columbia now allow same-sex marriage for gay and lesbian couples, should the rules change when it comes to organizations' domestic-partner coverage? Would companies be overreaching if they require LGBT employees and their partners who live in those states to get married if they want to retain partner benefits?" (Human Resource Executive Online)  

PBGC and Cerberus Secure $212 Million for Safeway Workers’ Pension Plan
PBGC [Pension Benefit Guaranty Corporation]

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