Health & Welfare Plans Newsletter

March 3, 2015

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Employee Benefits Jobs

Actuarial Analyst
USI Consulting Group
in NY

Actuarial Consultant
USI Consulting Group
in NY

Retirement Plan Administrator II
Fulton Financial Advisors (a subsidiary of Fulton Financial Corporation)
in PA

Retirement Plan Administrator
PenSys, Inc.
in CA, NC

Senior Actuarial Consultant
Consulting Actuaries Incorporated
in NJ

Data Conversion Specialist
Transamerica Retirement Solutions
in NY

Retirement Business Development Officer
PNC
in NJ, PA

Pension Administrator
Scholz, Klein & Friends Enlightened Retirement Group, Inc.
in TX

Financial Services Assistant
Mueller Financial Services, Inc.
in IL

Sales Consultant
Third Party Administration and Consulting Firm
in NC

401k Daily Valuation Administrator
Loren D. Stark
in TX

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Webcasts and Conferences

Winning Strategies for Collecting Social Security Benefits
March 10, 2015 in CO
(Western Pension & Benefits Council - Denver Chapter)

Temps, Contractors, Leased Employees and the ACA
March 11, 2015 WEBCAST
(Littler Mendelson)

Actuarial Standards of Practice No. 1: Its Importance to Smaller Insurance Company Actuaries
March 18, 2015 WEBCAST
(Society of Actuaries)

Getting It Right - Know Your Fiduciary Responsibilities: Part 3: ERISA Reporting For Employer-Sponsored Retirement Plans
March 19, 2015 WEBCAST
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

Employee Benefits Ready Series - Reducing Financial Risk
March 24, 2015 in NC
(Hill, Chesson & Woody)

The U.S. Biosimilars Market: Preparations Payers Should Make Now
March 31, 2015 WEBCAST
(Atlantic Information Services, Inc.)

Discipline Process Overview Audio/Webcast
April 1, 2015 WEBCAST
(Conference of Consulting Actuaries)

Cafeteria Plans
April 14, 2015 in OR
(Thomson Reuters / EBIA)

HSAs, HRAs, and Consumer-Driven Health Care
April 15, 2015 in OR
(Thomson Reuters / EBIA)

Private Exchange Strategies for Insurers: What’s Working Today? What’s Next?
April 21, 2015 WEBCAST
(Atlantic Information Services, Inc.)

View All Webcasts and Conferences



[Guidance Overview]

Potential Implications of the 2016 Expansion of the Small Group Definition to Include Employers with 51-100 Employees (PDF)
"[E]mployees in groups sized 51-100 comprise roughly 30 percent of [all employees in groups] sized 1-100. Groups sized 51-100 will face more restrictive rating rules, which will increase relative premiums for some groups and reduce them for others. Groups sized 51-100 will face additional benefit and cost-sharing requirements, which could reduce benefit flexibility and increase premiums. The more restrictive rating and benefit requirements could cause more groups sized 51-100 to self-insure, especially among those whose premiums would increase under the new rule." (American Academy of Actuaries)  


[Advert.]

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[Guidance Overview]

Treasury/IRS Take First Step in Implementing 40% High-Cost 'Cadillac' Excise Tax with Notice 2015-16 (PDF)
6 pages. "[T]he projected schedule means that taxpayers will have several opportunities to weigh in on the rules that will eventually apply to the 40% Excise Tax. But a protracted timeline also may mean that Treasury/IRS believe they will need to develop complex rules for implementation and administration of the Tax. This could mean that by the time final rules are published, employers, insurers, plan administrators and others impacted by the Tax may have very little time in which to implement necessary administrative processes to meet reporting obligations and little ability to plan for the economic impact of the Tax on their businesses. Affected parties may want to begin planning now based on [Notice 2015-16], since it gives the first clear indication of the views of Treasury/IRS on a number of significant issues." (Groom Law Group)  

[Guidance Overview]

IRS Offers Rules of the Road for Cadillac Plan Tax
"[E]mployers that have already conducted a preliminary excise tax analysis based on their pre-Notice interpretation of Code section 4980I should consider whether their current assumptions would need to be adjusted if the IRS issues guidance consistent with the approaches outlined in [Notice 2015-16]. This is particularly true for employers that did not anticipate that employee pre-tax HSA contributions would be treated as applicable employer-sponsored coverage or those who may benefit from certain rules regarding permissive disaggregation of similarly situated employees based on job-related criteria." (Sutherland Asbill & Brennan LLP)  

[Guidance Overview]

ACA Regulatory Update (PDF)
45 presentation slides dated Jan. 29, 2015. Topics: [1] 2015 Calendar; [2] SHOP and Small Business Tax Credit; [3] Guidance on Excepted Benefits; [4] Changing Limits and Fees; [5] Guidance on Cost-Sharing; [6] Guidance on SBCs; [7] Employer Reporting; [8] Guidance on Affordability; [9] Cracking Down on Creative Strategies; [10] Guidance on Expatriate Plans. (Assurex Global)  

10th Circuit Decides There Are No Vested Health or Life Insurance Benefits Where Plan and SPD Were Silent
"A plaintiff cannot prove his employer promised vested benefits unless he identifies 'clear and express language' in the plan making such a promise. Further, a promise to provide vested benefits must be incorporated into the formal written ERISA plan. Summary plan descriptions (SPDs) are considered part of the ERISA plan documents. Continuing, the Court said that, having reviewed the SPDs at issue in this matter, the Court concludes Plaintiffs cannot show that any plan contains clear and express language promising vested benefits. The SPDs presented either contained a reservation of rights clause, under which the employer could change or discontinue the benefits at any time, and/or had no clear and express or affirmative promise under which benefits will vest." [Fulghum v. Embarq Corporation, No. 13-3230 (10th Cir. Feb. 24, 2015)] (Cary Kane ERISA Lawyer Blog)  


[Advert.]

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

Sponsored by World Congress

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.



The Anthem Breach: Stanza Two Isn't Pretty
"So far, ten state attorneys general have complained that Anthem isn't moving fast enough in its notification efforts.... Meanwhile, questions abound about whether the breach was truly 'sophisticated' or not. The hackers had the skills to penetrate several Anthem security layers, but they were able to then access the vast database using a stolen password. Numerous reports suggest that Anthem had not encrypted the Social Security numbers found in that database." (Clearwater Compliance)  

EEOC Charges Employer with ADA Violation by Terminating Employment at End of FMLA Leave
"Employers assume at their own peril that their responsibility to an employee ends when an employee is unable to or fails to return to work following a FMLA or other medical leave. Instead, the employer should evaluate whether the affected employee qualifies as disabled under the ADA and if so, whether the employer has any responsibility to offer the employee an extended leave or other accommodations before terminating the employee." [EEOC v. ValleyLife, Civil Action No. 2:15-cv-00340-GMS (D. Ariz.)] (Solutions Law Press)  

The Great Cost Shift: Why Middle-Class Workers Don't Feel the Health Care Spending Slowdown
"In recent years, the growth in overall health care costs has slowed dramatically. But for millions of Americans with employer-sponsored insurance, or ESI, this slowdown is illusory.... The actual reason why employee and employer costs are increasing at different rates is because employers have, over time, shifted greater responsibility for health care expenses to their employees through higher deductibles, higher copayments, and higher coinsurance -- a practice that began long before the passage of the ACA." (Center for American Progress)  

King v. Burwell: What to Expect from the March 4 Supreme Court Oral Arguments
"Whether the reality lives up to the predictions remains to be seen. However, it seems that the Supreme Court considers King more important than the typical case challenging the validity of an agency regulation. One hour and 15 minutes of argument time per side has been scheduled for Wednesday, rather than the typical 30 minutes per side scheduled in well over 95 percent of Supreme Court arguments. For those interested in following the argument, here is a guide to the basic issues and some of the topics that the Justices might raise in questions for the advocates." (Ogletree Deakins)  

The Implications of King v. Burwell
"This one page summary highlights finding from three recent analyses of the implications of a Supreme Court finding for the plaintiffs in King v. Burwell. The Supreme Court will hear arguments in the case on March 4, 2015." (Urban Institute)  

In Four-Word Phrase, Challenger Spied ACA's Vulnerability
"[In December 2010,] Thomas M. Christina, an employment benefits lawyer from Greenville, S.C., ... found a new vulnerability in the sprawling law. 'I noticed something peculiar about the tax credit,' he told a gathering of strategists at the American Enterprise Institute. With a rudimentary PowerPoint presentation, Mr. Christina ... pointed to four previously unnoticed words in the health care law, enacted nine months earlier. They seemed to say that its tax-credit subsidies were limited to people living where an insurance marketplace, known as an exchange, had been 'established by the state.' " (The New York Times; subscription may be required)  

[Opinion]

NHeLP Comment Letter to EBSA on Proposed Regs for Summary of Benefits and Coverage and the Uniform Glossary (PDF)
"At a minimum, enrollees and applicants should be able to obtain synthesized, comparable information about coverage of essential health benefits. The plan administrator should be required to ensure that any separate SBCs are delivered as a package rather than as separately mailed or emailed documents." (National Health Law Program [NHeLP])  

[Opinion]

American Benefits Council Comment Letter to EBSA on Proposed Regs for Summary of Benefits and Coverage (PDF)
"The applicability date in the Proposed Rule does not allow plans and issuers sufficient time to update their internal processes to comply with the Proposed Rule's new requirements or changes in the SBC template.... Subject entities are not under the impression that they are absolved from liability after entering into a contract with a third party.... Additional regulation of such arrangements is simply not necessary ... . Mandating self-insured plans to post [plan] documents online and provide a web address where these documents can be reviewed and obtained would add an extra layer of disclosure that is unnecessary." (American Benefits Council)  

[Opinion]

Republican Senators' Proposal for Health Subsidies Lacks Substance
"The senators write that the plan would 'provide financial assistance to help Americans keep the coverage they picked for a transitional period,' but they don't furnish the most basic information about this assistance. Would people receive the same amount of help they do now, both for premiums and for deductibles and cost-sharing? How long would this transitional assistance be available? What, if any, financial assistance would be available when it expires -- and if it were available, who would be eligible and for how much? The senators don't say." (Center on Budget and Policy Priorities)  

Benefits in General; Executive Compensation

Ninth Circuit: Spousal Consent Not Required Under Top-Hat Plans
"[T]he Court found that: (a) the participant's first wife, who was designated as the primary beneficiary, had waived her rights to benefits as part of the couple's divorce; and (b) the participant's second wife had no rights to the benefits, since she was not a named beneficiary and top-hat plans are exempt from ERISA's spousal consent requirements." [E & J Gallo Winery v. Rogers, No. 13-55327 (9th Cir. Feb. 23, 2015; unpublished)] (Proskauer's ERISA Practice Center)  

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