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Employee Benefits Jobs
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Webcasts and Conferences
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[Official Guidance]
Text of DOL Final Reg: Definition of Spouse under the Family and Medical Leave Act
"The Department is moving from a state of residence rule to a rule based on the jurisdiction where the marriage was entered into (place of celebration) to ensure that all legally married couples, whether opposite-sex or same-sex, will have consistent federal family leave rights regardless of where they live.... A place of celebration rule provides consistent federal family leave rights for legally married couples regardless of the State in which they reside, thus reducing barriers to the mobility of employees in same-sex marriages in the labor market and ensuring employees in same-sex marriages will be able to exercise their FMLA leave rights. Moreover, such a rule also reduces the administrative burden on employers that operate in more than one State, or that have employees who move between States with different marriage recognition rules; such employers will not have to consider the
employee's state of residence and the laws of that State in determining the employee's eligibility for FMLA leave."
(Wage and Hour Division, U.S. Department of Labor [DOL])
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[Guidance Overview]
2016 Benefit and Payment Final Rule, Consumer & Provider Provisions
"The preface notes that CMS has become aware of benefit designs that discourage enrollment based on age or health condition and that this is prohibited, even if the benefit design is based on a state's benchmark plan.... The final rule clarifies that health plans may refuse to count out-of-network charges toward cost-sharing limits but are not required to do so. Cost-sharing for out of network services does not count toward actuarial value calculations, however."
(Timothy Jost, in Health Affairs)
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[Guidance Overview]
Administration Disallows Plans Without Hospital Coverage
"Plans lacking substantial coverage of hospital and physician services do not qualify as 'minimum value' coverage under the law and so do not shield employers from fines of $3,000 or more per worker, [HHS] said late Friday.... One way to certify a plan as minimum value is to plug its components -- benefits, deductibles and so forth -- into the official calculator. Many were shocked to learn that the calculator gave passing scores to plans with no inpatient hospital coverage. Now HHS is saying: Ignore the calculator. Large-employer plans must pay for substantial amounts of hospital care no matter what."
(Kaiser Health News)
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[Guidance Overview]
Under FAQ Guidance, Non-EHB Supplemental Coverage May Qualify as Excepted Benefits
"The agencies noted that some insurers have been marketing single-benefit supplemental coverage as an excepted benefit. Thus, the FAQ provides needed clarification of how these products will be treated by the regulators -- but it also means that plan sponsors, insurers, and their advisors will need to be familiar with the various state EHB requirements because coverage will not qualify as an excepted benefit under this guidance if any benefit in the coverage is an EHB in the state where the coverage is marketed. For example, states may differ as to whether alternative treatments (such as chiropractic care or acupuncture) are included in EHB."
(Thomson Reuters / EBIA)
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[Guidance Overview]
Small-Scale Excise Tax Relief for Small Employers
"The relief provided by Notice 2015-17 allows small employers only a short period of time (approximately 4-1/2 months) to continue the now disfavored method of contributing to the cost of their employees' health insurance coverage on a tax-favored basis.... [In] 2014 legislators made several inquiries challenging the September 2013 guidance, and introduced legislation that would permanently exempt stand-alone HRAs and EPPs offered by small business from the ACA market reforms.... As it is uncertain whether a permanent legislative solution will evolve, small employers should take advantage of the new compliance window to search for an alternative means of contributing to employee healthcare costs if they chose to do so."
(Verrill Dana LLP)
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[Guidance Overview]
Welcome Relief from Penalties for Medical Premium Reimbursement Arrangements
"The transition relief exempts employer payment plans from ... excise taxes [1] for 2014 for employers that are not 'applicable large employers' (ALEs) for 2014, and [2] for January 1 through June 30, 2015 for employers that are not ALEs for 2015. After June 30, 2015, all employers may be liable for excise taxes if they continue these 'employer payment plans' in effect.... The IRS transition relief exempts from the above excise taxes an arrangement that reimburses or pays for the premiums for individual medical insurance policies of 2% or more shareholders, until the later of the date further guidance is issued or December 31, 2015.... This transition relief does not apply to reimbursements or payments for the premiums for individual health insurance policies for employees of an S corporation who are not 2% or more shareholders."
(McKenna Long & Aldridge LLP)
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[Guidance Overview]
IRS Grants Relief for Small Employers, S Corporations, and Medicare/TRICARE Arrangements but Reiterates Excise Tax Risks of Paying Employees' Individual Insurance Premiums
"The IRS has gone out of its way to emphasize, repeatedly, the compliance problems and potential excise taxes posed by paying or reimbursing employees' individual insurance premiums (or reimbursing medical expenses other than through an integrated HRA). While the transitional relief provided here is welcome, the negative inference for employers not eligible for relief speaks volumes. The IRS expects employers with 50 or more FTEs to either discontinue employer payment plans or self-report their violations and pay excise taxes. And while the Notice refers to all of the relief as transitional, it does not specify any durational limit for the Medicare or TRICARE relief."
(Thomson Reuters / EBIA)
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[Guidance Overview]
IRS Provides Penalty Relief for Employer Payment Plans Offered by Small Employers
"In a notable Q&A from last year, ... the IRS emphasized that employer payment plans were subject to $100/day excise taxes, which could total $36,500 per year, per employee. The Departments acknowledge in Notice 2015-17 that some employers who have offered health coverage through an employer payment plan may need additional time to adopt an alternative ... However, the transition relief window provided under the Notice (that is, through June 2015) is relatively short."
(Practical Law Company)
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Administration Delays Another Health Care Rule for Small Businesses
"In the latest in a long string of delays in enforcing the rules under the health care overhaul, the [IRS] announced ... that they will wait until summer to start enforcing financial penalties on small businesses that provide so-called Health Reimbursement Arrangements to their employees.... Katie Vlietstra, vice president for government relations and public affairs at the National Association for the Self-Employed ... [called] the short delay 'welcome news for our community' but [insisted] that 'a long-term, legislative solution is still urgently needed.' She added: 'America's smallest employers need the stability of a permanent fix in order to continue to utilize this critical tool to help provide health care coverage to their employees.' "
(The Washington Post; subscription may be required)
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Planning for the Year Ahead in Benefits
"Preparing for Employer Shared Responsibility tax reporting ... Reporting coverage for employees ... Reporting coverage for retirees and COBRA or other non-employees.... Qualifying offer and 98% offer methods ... New limited temporary small employer safe harbors for offering certain health insurance reimbursement accounts ... Recent retiree medical litigation following the Supreme Court's decision in M&G Polymers USA, LLC v. Tackett ... Evolving families and beneficiary designations."
(Winstead PC)
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Utilization Patterns and Out-of-Pocket Expenses for Different Health Care Services Among American Retirees
[R]ecurring health care costs remain stable throughout retirement. The average annual expenditure for recurring health care expenses among the Medicare-eligible population was $1,885. Assuming a 2 percent rate of inflation and 3 percent rate of return, a person with a life expectancy of 90 would require $40,798 at age 65 to fund his or her recurring health care expenses.... Usage and expenses of non-recurring health care services go up with age. Nursing-home stays in particular can be very expensive. For people ages 85 and above, the average and the 90th percentile of nursing-home expenses were $24,185 and $66,600 during a two year period, respectively."
(Employee Benefit Research Institute [EBRI])
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Release of Employment-Related Claim May Unintentionally Release ERISA Benefit Claim
"[T]he court determined that Dr. Gonda was highly educated and had sufficient time to review and consider the settlement agreement, which he reviewed with an attorney who was representing him in the employment case. Dr. Gonda also received consideration for the release, which explicitly referenced ERISA claims against his employer and related parties. The court expressed concern that disability benefits were not discussed during the settlement negotiations and LINA also waited for three years while internal appeals were pending before raising the issue." [Gonda v. The Permanente Medical Group, No. 11-cv-01363-sc (N.D. Cal. Feb. 17, 2015)]
(DeBofsky & Associates, PC)
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Flood of Briefs on Legality of ACA Subsidies Hits the Supreme Court
"Liberal groups are emphasizing states' rights, a theme calculated to appeal to conservative Supreme Court justices. The insurance industry, once a foe, has come to the aid of President Obama. Conservatives are mining legislative history to discern the intent of Democrats who wrote the [ACA]. And those Democrats are firing back, saying they know exactly what their intent was: to provide affordable health insurance to all Americans.... Such arguments are set forth in legal briefs flooding into the nation's highest court ahead of oral arguments March 4 that will challenge the payment of subsidies for health insurance in more than 30 states and could determine the fate of the health care law."
(The New York Times; subscription may be required)
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Benefits in General; Executive Compensation
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Employers: Properly Administer Nonqualified Deferred Compensation Plans, or You May Be Held Liable to Participants for Adverse Tax Consequences
"FICA is just one area of federal tax law that often presents issues for (or is otherwise overlooked by) employers in the context of drafting and administering compensation arrangements... where failures in drafting or administration can result in adverse tax consequences to the employee. Among such other areas are the deferred compensation income tax rules of IRC Section 409A and the self-insured health plan nondiscrimination rules of IRC Section 105(h). If an executive is liable to the IRS for unanticipated taxes, penalties, and/or interest, more often than not the employee will look to the employer to be 'made whole,' and, as the Henkel case illustrates, litigation could ensue."
(McCarter & English)
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2015 Investor Survey: Deconstructing Proxy Statements -- What Matters to Investors
"Less than half (38 percent) of institutional investors believe that information about executive compensation is clear and effectively disclosed in the corporate proxy. Responses are consistently negative across all elements of compensation disclosure. Sixty-five percent say that the relation between compensation and risk is 'not at all' clear. Forty-eight percent say that it is 'not at all' clear that the size of compensation is appropriate. Forty-three percent believe that it is 'not at all' clear whether performance-based compensation plans are based on rigorous goals."
(Stanford Graduate School of Business)
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Dodd-Frank Mandated Disclosure of Hedging Policies: The SEC's Proposed Rule (PDF)
"The types of hedging transactions covered by the disclosure rules include not only prepaid variable forward contracts, equity swaps, collars, and exchange funds, but also all transactions that establish 'downside price protection,' such as short sales. If a company permits certain types of hedging transactions, the category of permitted transactions must be described. If all transactions are prohibited, or all are permitted, then a listing of categories covered need not be disclosed. If a company permits some of its employees to engage in hedging transactions, then it must specify those who are permitted and those who are not (i.e., if the policy prohibits hedging by executive officers and directors, but not by other employees)."
(Wilkins Finston Friedman Law Group LLP)
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FASB Continues Project to Improve and Simplify Accounting for Stock Compensation Under FASB ASC Topic 718 (PDF)
"The agenda for the February 4 meeting was dominated by the deliberation of transition and disclosure requirements for the proposed changes, which are summarized [in a chart in this article].... [An] Exposure Draft of an Accounting Standards Update (ASU) ... is expected to be issued during the second quarter of 2015 followed by a 60-day public comment period. The FASB decided to hold off on determining an effective date for the ASU until feedback is received from the comment period. However, a tentative date suggested by the FASB's staff was for fiscal years beginning after December 15, 2016, with a 1-year deferral for nonpublic companies."
(Frederic W. Cook & Co., Inc.)
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Press Releases
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