Senior Retirement Plan Specialist
Sunwest Pensions
in AZ

Client Relationship Consultant (East Coast)
Kravitz, Inc.
in CT, FL, GA, NJ, NY

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Mastering 1095-C Forms for ACA Compliance
February 26, 2015 WEBCAST
(Tango Health)

Multiple Employer Welfare Arrangements
March 18, 2015 in NY
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

Form 5500 Update
March 26, 2015 WEBCAST
(McKay Hochman Co., Inc.)

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[Official Guidance]

Text of CMS Issuer Alert: New 'In Line' Special Enrollment Period Runs Through Sunday, February 22 (PDF)
"[CMS] will provide [a special enrollment period (SEP)] to consumers who: [1] Currently are not enrolled in coverage through the FFM, [2] Have not been terminated from coverage purchased through the FFM during the 2015 Open Enrollment period, and [3] Attest that they attempted to enroll during the annual Open Enrollment period but did not complete the process ['in line'] by February 15, 2015 because they experienced a technical issue with HealthCare.gov that prevented them from completing enrollment by February 15 or an extensive call center wait on February 13, 14 or February 15. The SEP will start on February 16, 2015, and end on February 22, 2015. Enrollments completed during the SEP will have an effective date of March 1, 2015 ... This guidance applies to the Federally-facilitated Marketplace, including State Partnership Marketplaces. State-based Marketplaces may elect to offer similar SEPs." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Advert.]

2015 Health Savings Accounts Facts

A recent explosion in the number of Health Savings Accounts (HSAs) has left many employers with unanswered questions. Turn to this book for answers to nearly 800 HSA questions! Order 2015 Health Savings Accounts Facts now.

[Guidance Overview]

Start Collecting Data: IRS Releases 'Final' Versions and Instructions for Forms 1094 and 1095
"Employers with 50-99 FTEs who were exempt from compliance in 2015 must still file these forms for the 2015 tax year.... [For] a full-time employee of a self-insured employer that accepts a qualifying offer and enrolls in coverage, the employer must provide that employee a 1095-C [in January of 2016]... For plans that exclude spouses covered or offered health coverage through their own employers, the definition of 'offer of health coverage' now provides that an offer to a spouse subject to a reasonable, objective condition is treated as an offer of coverage for reporting purposes.... There are some changes with respect to what days can be used to measure the 'count' for reporting purposes." (Fox Rothschild LLP)  

[Guidance Overview]

Open Enrollment Closes But Doors Remain Ajar
"[New CMS] guidance creates a special enrollment period for consumers 'in line' on February 15, 2015.... Enrollees who finish their enrollment during this period will have coverage as of March 1, 2015. Consumers are not able to access this special enrollment period through the direct enrollment process but must go through Healthcare.gov or the call center.... There are widespread calls for CMS to create an additional special enrollment period to allow individuals who will be penalized under the individual responsibility requirement for 2014 to avoid having to pay an additional, larger, penalty for 2015." (Timothy Jost, in Health Affairs)  

[Guidance Overview]

Philadelphia Mayor Signs 'Promoting Healthy Families and Workplaces' Ordinance
"Employees will begin to accrue paid sick time as of May 13, 2015, the effective date of the ordinance. Those hired after the effective date of the ordinance begin accruing paid sick time on their first day of employment. However, employees may not use their accrued paid sick time until their 90th day of employment. Employees may carry over unused paid sick time to the following year, unless the employer provides at least 40 hours of paid sick time at the beginning of the calendar year." (Ogletree Deakins)  

Actuarial Model for Wellness
"The Society of Actuaries is pleased to make available research material that explores the current wellness environment. The project consisted of three phases: a literature search summarizing current research, a survey of the actuarial and vendor community, and interviews with researchers in the field." [Editor's note: page includes links to Literature Search; Survey Results; two Appendices; Researcher Interviews; and a Study Report.] (Society of Actuaries)  

[Advert.]

WHCC HR/Benefits Employer Summit – Mar 22-25 2015 – Washington DC

This annual meeting convenes executives involved in managing employee health, benefits, incentives, and rewards whose primary focus is to provide quality care at reduced cost and achieve total well-being.

Employer's FMLA Dilemma: Doctor Says One Thing But Writes Another
"Based on [his doctor's] certification, the company determined that [the employee's] bronchitis wasn't actually a 'serious medical condition' for FMLA purposes and eventually terminated him. [The employee] responded with an FMLA interference lawsuit.... Since his doctor stated [on the certification] that he only treated [the employee] once, he clearly wasn't eligible for FMLA ... or so the company thought.... In court, [the] doctor contradicted what he wrote on the certification form and stated that he'd actually treated the patient twice: Once when [the employee] was first diagnosed ... and again when he filled out the certification. And that was all it took for the court to deny summary judgment for the company." [Kossowski v. City of Naples, No. 2:13-cv-728-FtM-29DNF (M.D. Fla. Feb. 6, 2015)] (HR Benefits Alert)  

Figuring Out Whether a Doctor Is in Your Plan's Network Is Harder Than You Think
"Just because a medical group is in someone's provider network, consumers can't be confident that all the physicians in the medical group are also in network.... That situation might occur if some of the physicians in a medical group agreed to accept the rates negotiated with an insurer, but others did not... The physicians who didn't accept the network rate would be out-of-network for a patient, even if other members of the medical group were in network." (Kaiser Health News)  

With or Without CO-OPs, Health Insurance to Follow Consumers
"CO-OPs are competing with traditional insurers in the exchange based on the pricing and networks, but also with better customer experiences and new digital products, services and rewards. Health reform for all insurers is an opportunity to become a consumer-oriented, if not consumer-operated, health plan. It's also a chance for some to rekindle their community-based mutual roots." (Healthcare Payer News)  

Millions at Risk of Losing Coverage if ACA Supreme Court Challenge Succeeds
"About the only thing both sides agree on is that the subsidies are critical to the health-care law ... If the Supreme Court bars subsidies for people in 34 states, some say, the law will unravel and the number of uninsured will soar. Others say that the White House and Congress may come up with a solution. And still others say that at least some states will rush to set up exchanges. But any alternative would raise a host of legal and practical questions and could be difficult to implement." (The Washington Post; subscription may be required)  

ERISA Advisory Council to Meet March 20
"The purpose of the open meeting, which will run from 1:30 p.m. to approximately 4:30 p.m. Eastern Standard Time, is to welcome the new members, introduce the Council Chair and Vice Chair, receive an update from the Assistant Secretary of Labor for the Employee Benefits Security Administration, and determine the topics to be addressed by the Council in 2015." (Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL])  

Companies Should Review Their Performance-Based Compensation Plans Following FASB Change Involving Extraordinary Items
"While this change might seem esoteric and of interest only to accountants, some housekeeping may be in order for compensation plans or grants that would exclude the effect of extraordinary items under the existing standard. In the short term, companies making multi-year performance grants in early 2015 should take the time to understand the impact of this change because it can relate both to how performance is measured and tax deductibility under Code Section 162(m)." (Towers Watson)  

Share Your Data: The ESOP Transaction Survey
National Center for Employee Ownership

Nontraditional Wellness Initiatives Emerging Among Workplaces
International Foundation of Employee Benefit Plans [IFEBP]

Wagner Law Group Welcomes ERISA Attorney Thomas E. Clark, Jr.
Wagner Law Group P.C.

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