Client Relationship Manager-Pensions
Nationwide
in GA

Field Service Rep - 401k Plans
Nationwide Retirement Services
in PA

Employee Benefits Specialist
Schechter Dokken Kanter
in MN

Account Executive - Benefits
HNI Risk Services
in WI

Account Administrator - Benefits
HNI Risk Services
in WI

Sr. ERISA Consultant
Great-West Financial
in WI

Account Manager
National Retirement Services, Inc.
in CA

Defined Contribution Plan Administrator
Retirement, LLC
in OK, SD

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Properly Defining Retirement Plan Compensation
RECORDED
(IRS [Internal Revenue Service])

Is Your Wellness Plan a Lawsuit Waiting to Happen?
February 24, 2015 WEBCAST
(Lorman Education Services)

What Businesses Should Know About Health Care Insurance
March 12, 2015 WEBCAST
(Findley Davies, Inc.)

Employment Law Institute
March 12, 2015 in NY
(New York City Bar Association)

Medical Pharmacy Trend Report: Discover Your Hidden Specialty Drug Spend
March 19, 2015 WEBCAST
(Atlantic Information Services, Inc.)

Washington Legislative Update
May 4, 2015 in DC
(International Foundation of Employee Benefit Plans [IFEBP])

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[Official Guidance]

Text of OPM Final Regs: Establishment of the Multi-State Plan Program for the Affordable Insurance Exchanges
69 pages. "The U.S. Office of Personnel Management (OPM) is issuing a final rule implementing modifications to the Multi-State Plan (MSP) Program based on the experience of the Program to date. OPM established the MSP Program pursuant to the [ACA]. This rule clarifies the approach used to enforce the applicable standards of the [ACA] with respect to health insurance issuers that contract with OPM to offer MSP options; amends MSP standards related to coverage area, benefits, and certain contracting provisions under section 1334 of the [ACA]; and makes non-substantive technical changes." (Office of Personnel Management [OPM])  

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[Official Guidance]

CMS Announces Special Enrollment Period for Tax Season
"For those who were unaware or didn't understand the implications of the fee for not enrolling in coverage, CMS will provide consumers with an opportunity to purchase health insurance coverage from March 15 to April 30. If consumers do not purchase coverage for 2015 during this special enrollment period, they may have to pay a fee when they file their 2015 income taxes." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

IRS Grants Limited Transition Relief to Small-Employer Premium Reimbursement Arrangements
"Although ALEs with 50 to 99 full-time employees (including full-time equivalents) may rely on a different transition rule to avoid any ACA 'play-or-pay' penalties during 2015, there is no similar relief in Notice 2015-17.... Note that this transition relief is limited not only in duration (i.e., only through June 30, 2015), but also in scope. It applies only to a small employer's reimbursement (or direct payment) of health premiums ... Small employers now have just over four months in which to wind down any impermissible premium-reimbursement arrangement. In its place, they may wish to adopt a plan through a SHOP Marketplace. Although individuals may enroll through a Marketplace during only annual or special enrollment periods, there is no such limitation on an employer's ability to adopt a plan through a SHOP." (Spencer Fane)  

[Guidance Overview]

IRS Provides Temporary Safe Harbor for Premium Reimbursement Arrangements
"Small employers and certain other plan sponsors can continue to reimburse individual premiums until July 1, without the threat of extreme penalties for offering coverage that does not comply with Affordable Care Act insurance mandates, under new guidance from the [IRS].... This stay on enforcement is good for 2014 and up to June 30, 2015. After July 1, 2015, employers previously enjoying this transition relief could be liable for the excise tax under Code Section 4980D." (Thompson SmartHR Manager)  

[Guidance Overview]

IRS Offers Limited Transition Relief for Certain Premium Reimbursement Plans
"The main problem that employer payment plans have is that they generally constitute 'group health plans' for ACA purposes, but unless they are paired or 'integrated' with ACA-compliant group health coverage they fail to meet ACA market reform requirements, including the requirement to cover preventive care, and the prohibition on an annual dollar limits." (E is for ERISA)  

[Guidance Overview]

Chart of Disallowed Pay or Play Tactics (PDF)
4-page chart lists seven common plan design techniques that can trigger pay-or-play penalties. (E is for ERISA)  

[Guidance Overview]

Agencies Issue Proposed Rule Amending SBC Requirements and Revising Templates Instructions and Uniform Glossary (PDF)
"Note, particularly, that the Agencies propose to require plans and issuers to use these new templates for this fall's open enrollment. As with the previous final SBC rule, given the complexity of the rule, and the potential for civil penalties, it is important that plan sponsors and health insurance issuers to carefully evaluate the time and resources necessary to comply with the rule." (Groom Law Group)  

Text of Third Circuit Opinion: Continued Service Can Provide Sufficient Consideration for Promise of Lifetime Retiree Benefits (PDF)
"The Plan, whose stated 'purpose . . . [was] to reward [Campbell] for her loyal and continuous service to the Company,' required Diamond State or its successor [here, Sussex] to provide lifetime health-insurance benefits to Campbell and her husband at its 'sole cost and expense' upon Campbell's retirement from the Company.... In granting Sussex's motion for summary judgment, the District Court ruled that the Plan is unenforceable for lack of consideration because Campbell 'was not required to work for any additional period of time ... after the Plan was adopted' ... Even if Campbell could have retired immediately and still received health-insurance benefits, she did not indicate any present intent to do so at the time of the Plan's adoption.... Because a reasonable trier of fact could find that the consideration for the Plan took the form of Campbell's 'continuous services and loyalty' up until her actual date of retirement ... the District Court erred in granting Sussex summary judgment on this ground." [Campbell v. Sussex County Federal Credit Union, No. 13-4141 (3d Cir. Feb. 19, 2015)] (U.S. Court of Appeals for the Third Circuit)  

Employers with Group Health Plans: Do You Notify State Regulators of Security Breaches?
"Over the past few years, there has been considerable confusion among employers with group health plans regarding the extent of their responsibility to notify state agencies of security breaches when a vendor or other third party with access to participant information suffers a breach. A critical concern to employers facing these challenges is: 'Assuming we comply with our obligations under HIPAA, do we have to notify [state] regulators under state data breach notification laws? Can we rely on the notifications provided by the breached insurer or vendor?' " (McDermott Will & Emery)  

Sears Gave Its Workers More Health Care Choices -- and Here's What Happened
"In the first year after Sears moved its employees into a private health insurance exchange, workers signed up for health plans that looked like the ones they had before. The next year, they shopped based on the price of premiums. But in year three, something interested happened: They signed up for the plans that offered the best value. Now, Chief Human Resources Officer (CHRO) Dean Carter says Sears employees like the choices that a private exchange affords them -- and it would be very hard to reverse that. And it's saving the giant retailer a lot of money; in the first year alone, the company saved $38 million, he says." (The Advisory Board Company)  

Defined Contribution Health Arrangements: The Finance Perspective
"Before transitioning to a DC arrangement, define objectives, weigh the multiyear implications, and ensure your approach aligns with the total rewards strategy and desired employee value proposition. If your primary objective is to de-risk the health benefit program or avoid the 2018 excise tax, a DC arrangement is not the right solution." (Towers Watson)  

2015 Survey on Retiree Health Care Strategies
"Nine out of 10 employers (89%) say retirement medical benefit security is somewhat to extremely important to their retirees. While plan sponsors want to honor their promises to their retirees, cost and risk concerns are influencing them to adjust their approach.... These factors (as well as the high cost of health care) are influencing employers to change their approach[:] ... [1] The accounting liability on their balance sheets (92%); [2] Ongoing administration and expense (90%); [3] ERISA obligations such as reporting, disclosure and fiduciary responsibilities (84%); [4] The absence of an efficient funding vehicle (54%)." (Towers Watson)  

The ACA Enrollment Story Is in the States
"[In] six states more than half of the potential market signed up, but in seven states less than 30% did. Florida led the way, with 64% of the potential market and 1.6 million people signed up. Iowa was at the bottom of the list, with 20% and 45,000 people signed up. Enrollment also varied a lot within states, with some counties reporting large gains late in the open-enrollment period." (The Wall Street Journal; subscription may be required)  

Obamacare Health Plans Shun the Sick More in 2015 than 2014
"Avalere has done it again, with a study of how Obamacare plans place drugs for the most serious diseases, as HIV, cancer, and multiple sclerosis -- on the highest drug formulary cost-sharing tier. Co-pays of 40 percent are not uncommon. And the situation is worse in 2015 than 2014. [A chart] shows how many silver plans ... place all single-source drugs (that is, branded drugs without generic competition) in a therapeutic category on their most expensive tier. For eight of ten of these categories, a larger share of silver plans do so in 2015 than 2014." (National Center for Policy Analysis Health Policy Blog)  

Risk Corridors: An Update
"In the latest proposed rule on benefit and payment parameters for 2016, HHS describes a process for adjusting the program should it take in more money under risk corridors than it pays out. HHS also reiterated that should the program fall short on collections needed to make payments, it will use other sources of funding subject to availability of appropriations. It remains to be seen whether HHS has something in mind should this occur." (Robert Wood Johnson Foundation)  

ACA Will Not Disappear Should Supreme Court Side with King v. Burwell Plaintiffs
"Other provisions in the healthcare reform law could fill the gap left by the elimination of subsidies. Both the individual mandate and employer mandate would still require individuals to get insurance, and employers to offer insurance. The market would have to overcompensate. It would be a burden, but it wouldn't be impossible." (FierceHealthPayer)  

[Opinion]

After a Slow Start, Federal Small Business Health Insurance Marketplace Offers New and Improved Functions
"The SHOP's initial struggles have been well documented, and it's not yet out of the woods. Ultimately, whether the SHOP finds success will depend on whether employers believe its features and plan choices offer value compared with options available outside the marketplace. But to be in a position to make this evaluation, small employers first needed a marketplace website with functionality that allows them and their employees to shop for coverage with relative ease and get help with the process if they want it." (The Commonwealth Fund)  

[Opinion]

The Unfortunate Propaganda of 'Shared Responsibility' in the ACA
"Congress' decision to call the requirement of employers to provide health insurance or pay a fine as a 'shared responsibility of employers' is a master stroke of propaganda to which we must tip our hats. However, we must see through this cute turn of phrase and realize that this section of the ACA simply enshrines some of the worst aspects of our current health insurance system and actively works against many of the actual goals of the ACA." (David Dranove and Craig Garthwaite, at Code Red)  

A Critical Appraisal of the Current State of ERISA Civil Procedure: How Courts Treat 'Civil Actions' Brought Under ERISA (PDF)
37 pages. "ERISA cases are uniquely adjudicated using procedures that deviate markedly from the Federal Rules of Civil Procedure. Surprisingly, since the Supreme Court has defined the meaning of 'civil action' on several occasions, ERISA cases are adjudicated more like administrative proceedings than other civil actions. Discovery is generally disallowed, and trials are essentially unheard of, while jury trials are simply out of the question.... [E]ven when claimants 'prevail,' victory is often hollow because rather than awarding benefits outright, courts generally remand claims for reconsideration by the same administrator that was found to have arbitrarily denied benefits. Neither the ERISA statute itself, nor the United States Constitution authorizes remands of ERISA cases; and the practice has proven problematic with respect to appellate review. Yet remands are today the norm in ERISA litigation." (Mark DeBofsky, via Employee Rights and Employment Policy Journal)  

How to Pick a TPA for a Nonqualified Plan: Seven Tips for Employers
"RFPs for nonqualified plans -- tax-deferred, employer-sponsored retirement plans that fall outside of ERISA guidelines -- are often triggered by mistakes made by a company's existing provider. Sometimes, a merger or acquisition forces a decision between two or more TPAs. And some companies just want to periodically test the market. Whatever the case, considering a change often involves a broader 'market' review." (CFO)  

[Opinion]

Case for Repealing the Investment Income Tax: Let Me Count the Whys
"Section 1411 of the Internal Revenue Code was inserted into the income tax system unannounced as an income tax. On the contrary, it was named as if it were a part of Medicare, and placed within the second of the two distinct acts which together have come to be called, colloquially, the Affordable Care Act.... [N]one of the proceeds of the tax are dedicated to the purposes of the [ACA], none of those revenues flows into the Medicare funds or contributes to Medicare in any way (its nomenclature as a 'Medicare contribution' notwithstanding), nor would section 1411 in any way impact the heath care provisions of the ACA were the tax to be repealed or ruled unconstitutional.... Little has been said in the legal literature, let alone in the broad press, op-ed commentary or public print generally, of the enormous complexity that this new statute has injected into the tax law of the Nation, and the inevitably resultant errors that will abound in all the places where its application will occur." (Alvin D. Lurie Esq.)  

Qualified Plan Solutions, LC is Certified to Industry Best Practices
Centre for Fiduciary Excellence [CEFEX]

Dietrich & Associates Inc., Named a 2015 PLANADVISER Top 100 Retirement Plan Adviser
Dietrich & Associates, Inc.

U.S. Chamber Examines Potential Harmful Impact of Fiduciary Regulation on Investors
U.S. Chamber of Commerce

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