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Employee Benefits Jobs
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Webcasts and Conferences
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[Guidance Overview]
Expansion of D.C. Accrued Sick and Safe Leave Act Creates New Hurdles for Employers
"In expanding the scope of the original law the ASSLA amendments have created a number of additional pitfalls for D.C. employers [including:] ... [T]he definition of 'employee' has been expanded to include, for the first time, restaurant and bar workers who receive regular tips.... [T]he definition of employer [has been] expanded to include businesses that use temporary staffing agencies ... [I]nstead of having to work for one year and 1,000 hours during that same year in order to accrue and use leave, employees only need to be employed for 90 days to use leave. Additionally, employee leave begins to accrue on the first day of employment[.]"
(Ogletree Deakins)
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King v. Burwell: Supreme Court Oral Argument Updates
"In the midst of a discussion of context and the consequences of petitioners' reading, Justice Kennedy ... pointed out that, under petitioners' reading, the federal government would be all but forcing states to create their own exchanges. That's true not just for the headline reason covered by this case -- that their citizens would be denied benefits -- but for a very perceptive reason that Justice Kennedy added: namely, state insurance systems will fail if the subsidy/mandate system created by the statute does not operate in that particular state. For Kennedy, that seemed to make this case an echo of the last healthcare decision, where the Court concluded that it was unconstitutional coercion for the federal government to condition all Medicaid benefits in the state on expanding Medicaid therein. Simply put, Kennedy expressed deep concern with the federalism consequences of a reading
that would coerce the states into setting up their own exchanges to avoid destroying a workable system of insurance in the state." [Update continues at this link.]
(SCOTUSblog)
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At Oral Argument, Supreme Court Justices Sharply Divided Over ACA Subsidies
"The liberal justices peppered lawyer Michael Carvin almost from the outset of his argument to limit the subsidies.... When Solicitor General Donald Verrilli Jr. stepped to the lectern, the liberal justices fell silent, and Justices Samuel Alito and Antonin Scalia took over.... Kennedy voted to strike down the health law in 2012, but on Wednesday he asked questions of both sides that made it hard to tell where he might come out this time. He suggested that challenger Carvin's argument raised a 'serious' constitutional problem affecting the relationship between states and the federal government. On the other hand, he seemed less than convinced by Verrilli's reading of the law to allow the subsidies nationwide."
(Associated Press)
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The Busy Reader's Guide to Amicus Briefs in King v. Burwell
"[On] March 4, 2015, the Supreme Court will hear argument in King v. Burwell about the legality of tax subsidies for insurance plans bought somewhere other than exchanges 'established by the State.' The case has certainly merited a great deal of attention from amici: 21 amicus briefs support petitioner/plaintiffs, and 34 briefs support the government.... [R]eaders are likely to be too busy to read all 55 briefs, but fear not, gentle reader: [this author] shall guide you."
(National Review)
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Anthem's Data Breach Affects Many Non-Anthem Plans: What Employers Need to Know
"Many employers and individuals have ignored publicity regarding the data breach because their health plan is not labeled 'Anthem.' However, because Anthem did the back-office work for (and therefore had information on file for) many other insurers and third-party administrators, the data breach potentially affects their plans as well ... Since the breach involves many associates and over 10 years of data, there may be multiple agreements to consider." [Editor's note: article includes a list of plans and locales that may be affected.]
(Sutherland Asbill & Brennan LLP)
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COBRA Compliance Failures Cost Employers Millions (PDF)
"Historically, courts have been hesitant to certify COBRA claims for treatment on a class action basis because proving a COBRA notice violation can involve individual, fact-specific issues. Plaintiffs have successfully established class certification in recent years, however, in lawsuits concerning systematic failures to comply with COBRA notice requirements.... Outsourcing COBRA administration to a TPA does not relieve the plan administrator of liability for COBRA-related errors. The plan administrator must monitor the TPA's systems and performance to ensure COBRA compliance."
(Buck Consultants at Xerox)
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The Value of Improving Employee Well-Being
"[This article] explore[s] the business value of health and productivity initiatives in today's business environment. Key insights include: [1] How health and productivity programs link to employee engagement, can improve workforce health, and also deliver key cost and competitive advantages. [2] How strengthening executive leader and manager effectiveness help drive wellness program engagement. [3] Practical actions that organizations can take to build a culture of health and employee well-being."
(Towers Watson)
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Senate, House Leaders Introduce Bill to Provide Certainty to Employers Offering Innovative Employee Wellness Programs
"The Preserving Employee Wellness Programs Act ... will reaffirm existing law, which allows for employee wellness programs tied to a financial reward. The legislation clarifies that an employee's spouse may participate in the program as well. It also provides employees up to 180 days to request and complete an alternative wellness program if it is medically inadvisable or unreasonably difficult for an employee to participate in the original employee wellness program. Finally, the legislation does not limit the EEOC's authority to investigate and litigate complaints of employment discrimination."
(Committee on Education and the Workforce, U.S. House of Representatives)
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UnitedHealthcare Piloting Fitness App That Pays for Healthy Behavior
"As part of an effort to make health insurance a more tangible and consumer-oriented tool, UnitedHealthcare is in the process of developing a new app that offers financial incentives for users who practice healthful behavior. The Minneapolis-based insurer is currently piloting the iPhone app, Reward Me, in Arizona and Illinois, offering users a litany of rewards based on both usage of the app and achievements in four categories: healthy eating, relaxation, healthy activity and life style[.]"
(MedCity News)
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How Many Employees are Covered by Disability Insurance at Work?
"In 1999, 36 percent of private industry workers had short-term disability insurance and 25 percent had long-term disability insurance. In 2014, 39 percent had short-term insurance and 33 percent had long-term insurance.... The percentage of workers in short-term disability plans in 2014 ranged from 19 percent for service workers to 53 percent for workers in management, professional, and related occupations. The percentage in long-term insurance plans ranged from 10 percent in service occupations to 57 percent in management, professional, and related occupations."
(U.S. Bureau of Labor Statistics [BLS])
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Time to Get Ready for OIG Marketplace Reviews
"A recent document from the OIG affirmed that the marketplaces will be the chief focus of the OIG's ACA oversight in 2015, and upcoming reviews will look at payment accuracy, eligibility and information security.... [T]he OIG will review all financial assistance payments made through the marketplaces, such as premium tax credits and cost-reduction payments. Additional reviews will target payments made to marketplace navigators as well as those made to contractors."
(Bloomberg BNA)
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[Opinion]
In King v. Burwell, an Easy Answer to the ACA's Definition of 'Exchange'
"King v. Burwell, the case that could torpedo the [ACA], is otherwise not particularly interesting. Rather it is a case that only a law professor, and a rather pedantic one at that, could love. No constitutional issue will be decided, and unlike the court's last encounter with the ACA, the power of Congress to do whatever it did in the Act is unquestioned. The question is exactly what did Congress do, or intend to do, when it passed the legislation and, in particular, did it intend a system which would become unworkable if a number of states refused to participate by creating exchanges. To state the question this way is to provide the answer." [King v. Burwell, No. 14-1158 (4th Cir. July 22, 2014; cert. pet. granted
Nov. 7, 2014)]
(The Brookings Institution)
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[Opinion]
As King Case Begins, House Republicans Offer an Important Obamacare Alternative
"[T]he outline includes a commitment to several insurance protections for Americans with health concerns. These include prohibitions on insurers imposing lifetime limits on benefits, or unfairly cancelling coverage, or discriminating against individuals with pre-existing conditions.... [T]he Ryan-Kline-Upton outline embraces a refundable, advanceable tax credit for health coverage meaning the assistance would be available to those paying little or no tax and would be available when premiums are due.... The House chairmen's plan would also give states an 'off ramp' from the ACA to pursue their own vision of coverage and avoiding federal mandates as they do so."
(The Brookings Institution)
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[Opinion]
State Exchange Problems Present ACA Concerns That Exist Beyond King v. Burwell
"This mounting evidence of serious cost, financing and other concerns in state-run exchanges creates new reason for concern about the future of ACA's health care reforms even for those citizens of states whose eligibility for subsidies is not challenged by the King v. Burwell Supreme Court challenge. These and other budget overruns and operational challenges raise serious questions about the ability of the federal government or the states to fund the promises currently made by ACA in its present form. Congress and state governments almost certainly will be forced to deal with these broader challenges regardless of the outcome of King v. Burwell."
(Solutions Law Press)
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[Opinion]
ACA's Complexity Invites Attack, Even as It Fails to Cure Ailment
"[The] arguments before the Supreme Court in the case of King v. Burwell demonstrate once again how the [ACA's] administrative complexity and flaws -- largely reflecting its accommodation to the private health insurance industry and other corporate, profit-oriented interests in U.S. health care -- make it vulnerable to legal attacks by its opponents. The ACA clearly lacks the simplicity and legal robustness that a single-payer plan would have. Single payer would be simple: everyone in the U.S. would be covered for all medically necessary care in a single program financed by equitable taxes."
(Physicians for a National Health Program [PNHP])
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Benefits in General; Executive Compensation
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Nonqualified Plan Beneficiary Was Not Determined by Terms of Qualified Plan
"A decision from the 9th U.S. Circuit Court of Appeals confirms a lower court ruling that a retirement plan membership letter and beneficiary designation form for a nonqualified plan 'did not clearly and unequivocally incorporate by reference the entirety' of the terms of a plan sponsor's qualified retirement plan. For this reason, the terms of the qualified plan cannot determine a beneficiary under the nonqualified plan, the court ruled." [E & J Gallo Winery v. Rogers, No. 13-55327 (9th Cir. Feb. 23, 2015; unpublished)]
(PLANSPONSOR)
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