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Employee Benefits Jobs
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Webcasts and Conferences
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[Official Guidance]
Text of CMS FAQs: 2015 Benefit Year Cost-Sharing Reduction Reconciliation Method Selection (PDF)
Dated March 16, 2015. "Although issuers must notify HHS of their choice of methodology for the 2015 benefit year by March 31, 2015, ... issuers that previously selected the simplified methodology may switch to the standard methodology up until the deadline for submitting cost-sharing reduction reconciliation data on April 30, 2016.... [I]ssuers that previously selected the standard methodology may not switch back to the simplified methodology.... [A] QHP issuer may not select the simplified methodology for a benefit year if the QHP issuer did not select the simplified methodology for the prior benefit year."
(Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])
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[Guidance Overview]
CMS Presentation Slides: Overview of Enrollment and Eligibility Provisions of 2016 Payment Notice (PDF)
"Overview of Key [Enrollment and Eligibility] Policy Proposals: [1] Premium Payment; [2] Annual Open Enrollment Period; [3] Eligibility Redeterminations; [4] Special Enrollment Periods; [5] Eligibility for Exemptions; [6] Termination of Coverage."
(Center for Consumer Information and Insurance Oversight [CCIIO], Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])
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[Guidance Overview]
Agencies Issue Wraparound Benefits Final Rule
"Under the new rule, employers may offer part-time and retired employees wraparound coverage that wraps around and increases the benefits covered through primary 'qualifying individual coverage.' This includes any individual coverage that is not grandfathered or transitional coverage or another form of excepted benefits. Specifically, the final rule clarifies that qualifying individual coverage includes coverage under the Basic Health Plan Program. Employers may also supplement marketplace coverage offered through the Multi-State Plan (MSP) to their employees."
(Timothy Jost, in Health Affairs)
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Employer's Lack of FMLA Compliance in Handling FMLA Leave Request is a Lesson for the Rest of Us
"When [the employee] sought a leave of absence, the HR rep assigned an arbitrary return to work date instead of obtaining the information directly from the certification.... When [the employee's] physician did not provide a complete and adequate certification, the employer did not seek to cure the certification and obtain the information necessary to make a determination about whether the absence was covered by the FMLA.... [T]he employer compounded the problem by failing to issue a recertification request when the employee requested an extension of leave.... [T]he employee provided enough evidence that she was engaging in good faith efforts to communicate with her physician to obtain an updated recertification. Yet, the employer declined to engage her further." [Patel v. St. Vincent Health Center, No. 12-298 (W.D. Penn. Feb. 12, 2015)]
(FMLA Insights)
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Taxability of Long-Term Disability Benefits: Where Do You Stand?
"Many will be surprised to learn that a LTD benefit that provides 60% of their monthly earnings will be taxed just like their income is taxed when they are working if the premiums were paid by the employer. And the majority of employer-paid LTD plans provide a LTD benefit that is less 50% of an employee's monthly earnings after taxes. Many disabled employees cannot survive on this income replacement."
(Frenkel Benefits)
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Are High Deductible Health Plans Right For Your Older Clients?
"Many investors are already aware of the tax advantages of HSAs and how savvy use of this financial tool can help with retirement planning. The fumble more retirees make when transitioning from their 50s into their 60s is the health-care dilemma: What plan to choose? Even knowing the financial advantages of choosing a high-deductible health plan through an employer or the public marketplace does not mean that is the right plan for a person, whether or not he or she is gearing up to build their retirement stash."
(Financial Advisor)
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ACA's Broadened Eligibility Rules Have Little Impact on Employee Enrollment Levels in 2015
"While there was a 1.6% increase in the absolute number of employees enrolled, that was the result of a 2.2% increase in the size of the workforce, rather than the changes required by the ACA.... Across all employers in the survey, the average percentage of employees who were eligible for coverage rose one percentage point, from 87% to 88%, but the average percentage of eligible employees who enrolled dropped a point, from 84% to 83%. That left the average percentage of all employees (both eligible and ineligible) who enrolled in 2015 essentially unchanged from 2014, at 74%[.]"
(Mercer)
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Collectively Bargained Health Plans: More Comprehensive, Less Cost Sharing Than Other Employer Plans
"National statistics on the cost and provisions of collectively bargained health plans show them to have similar single premiums, but lower family premiums, compared to employer-based plans not subject to collective bargaining. Union members contribute 4 percent and 6 percent of the cost of their premiums for single and family coverage, respectively, versus 18 percent and 29 percent for workers in employer-based plans. Cost sharing in collectively bargained plans is considerably less than in employer-based plans; coverage for prescription drugs is similar."
(Health Affairs; purchase or subscription required for full article)
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Small Area Health Insurance Estimates, 2013
"The estimates show the number of people with and without health insurance coverage for all states and each of the nation's roughly 3,140 counties. The statistics are provided by selected age groups, sex, race and Hispanic origin (state only), and at income-to-poverty levels that reflect the federal poverty thresholds for state and federal assistance programs. The Small Area Health Insurance Estimates program is the only source of single-year health insurance estimates for every county in the U.S." [Census Bureau Release CB15-TPS.24]
(U.S. Census Bureau)
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Five Years Later: Obamacare Hits Americans with Higher Premiums for Healthcare Coverage
"Studies show the healthcare law increased individual market premiums by almost 50 percent in 2014 relative to 2013 prices. On top of the substantial increase in 2014, there was an average increase of about 4 percent in 2015 for benchmark plans.... According to [the CBO], premiums will increase by about six percent per year."
(U.S. Senate Committee on Finance)
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Most New York Exchange Plans Lack Coverage for Out-Of-Network Care
"Except for offerings by a few insurers in far western New York and the Albany area, the only options available elsewhere in the state, including the entire New York City metro area, are health maintenance organization-style plans that cover care provided only by doctors and hospitals in the plan's network. People who go out of network for anything other than emergency care are generally going to be responsible for the entire bill."
(Kaiser Health News)
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Benefits in General; Executive Compensation
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[Official Guidance]
Text of IRS Notice 2015-27: Recommendations Invited for 2015-16 Guidance Priority Plan (PDF)
"The 2015-2016 Priority Guidance Plan will identify guidance projects that the Treasury Department and the Service intend to work on actively as priorities during the period from July 1, 2015, through June 30, 2016.... Please submit recommendations by May 1, 2015, for possible inclusion on the original 2015-2016 Priority Guidance Plan."
(Internal Revenue Service [IRS])
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ERISA Advisory Council Issues Outsourcing Report (PDF)
"The council believes that the DOL should clarify the legal standards applicable to plan fiduciaries in the following areas: [1] The plan sponsor's fiduciary duties when the plan document designates a named fiduciary other than the plan sponsor. [2] A plan fiduciary's scope of liability when the fiduciary hires a service provider who is not a fiduciary. [3] Whether a plan fiduciary who hires another fiduciary has obligations beyond the duty to select and monitor the hired fiduciary. [4] More guidance on the standard of knowledge required to hold a co-fiduciary liable for the actions of another fiduciary."
(Buck Consultants at Xerox)
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Sixth Circuit Rejects Claim that Disgorgement of Profits Is Appropriate Remedy in ERISA Benefit Denial Action
"The en banc Sixth Circuit determined that unless a plaintiff could show that the remedy for denied benefits under ERISA Section 502(a)(1)(B) is inadequate to make the plaintiff whole, equitable relief under ERISA Section 502(a)(3) is unavailable. The court reasoned that Rochow's ERISA 502(a)(3) claim constituted impermissible repackaging of a benefit denial claim because the remedy thereunder is duplicative or redundant when denied benefits are granted under ERISA Section 502(a)(1)(B). Accordingly, in order to seek additional equitable relief, a plaintiff must show that a breach of fiduciary duty, or other ERISA violation, caused damages separate and distinct from a mere denial of benefits." [Rochow v. LINA, No. 12-2074
(6th Cir. Mar. 5, 2015)]
(McDermott Will & Emery)
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The Sixth Circuit Vindicates the Fourth and Eleventh
"Ever since Cigna v. Amara ... some members of the plaintiff's bar found a renewed interest in tagging on a claim for equitable relief when seeking employee benefits under ERISA Section 502(a)(1)(B).... In the district courts of the Fourth and Eleventh Circuit, defendants consistently won this battle ... However ... [they] often were required to address Rochow v. LINA (6th Cir. 2013), a Sixth Circuit outlier showing up in the claimants' opposition briefs.... Over one year later, the [en banc Sixth Circuit] vacated the panel's earlier decision, relying upon the authority that seemed clear under Varity and its progeny that the plaintiff's claim for benefits was adequate relief, making the ERISA Section 502(a)(3) claim
duplicative and inappropriate[.]" [Rochow v. LINA, No. 12-2074 (6th Cir. Mar. 5, 2015)]
(National Law Review)
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More on GE's Accrued Pension Benefits Disclosure
"GE anticipated the potential optical issues associated with the change in pension value for this year and put together a number of extra proxy disclosures to help deal with this.... [T]he relevant proxy excerpts [are included in this article]. Other companies facing this artificial increase in pension values because of the quirky change in actuarial assumptions last year should consider reviewing this useful disclosure language."
(Winston & Strawn LLP)
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How Do You Report Stock Sales on IRS Form 8949 If the Cost Basis Is Wrong on Form 1099-B?
"Find the column entitled Adjustments to gain or loss, which is column (g) in both forms. On Form 8949, enter in this column the amount of stock compensation that was not included in the cost basis (Box 1e) reported to the IRS on Form 1099-B. Part of your W-2 income, this will be a negative number (in parentheses), as the incorrectly low basis reported on Form 1099-B will have made your gain too large (or your loss too small). In addition, you insert Code B in column (f). This indicates that the basis on Form 1099-B is incorrect and should be higher than what is shown."
(myStockOptions.com)
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Improper Administration of FICA's Special Timing Rule as Applied to Deferred Comp Arrangements Could Lead to Employer Liability
"[T]he case highlights the importance of properly handling FICA payroll taxes in connection with the administration of nonqualified deferred compensation plans.... [P]articipants could try to expand the rationale of Davidson to other situations where there is a perceived improper application of tax rules to nonqualified deferred compensation plans, specifically in the context of 409A.... [E]mployers should review and consider revising, as needed, any administrative language in plan documents that could be construed as creating participant rights in this regard. Additionally, employers may want to consider including disclaimers of tax warranties in any such documents." [Davidson v. Henkel Corp., No. 12-cv-14103 (E.D. Mich. Jan. 6, 2015)]
(Nutter McClennen & Fish LLP)
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[Opinion]
Group Letter to SEC Urging Issuance of Regs for Dodd-Frank Executive Compensation Provisions (PDF)
"As the Commission drafts its proposed rule, we ask that the following be incorporated. [1] Empower shareholder oversight of claw back practices by requiring that claw backs be disclosed.... [2] Require claw back of proportional incentive compensation where it is not numerically connected to financial results.... [3] Identify 'executive officers' as those provided under the SEC's Rule 16a-1(f).... [4] Identify the date triggering the three-year look back as the date of the first accounting misstatement."
(Public Citizen and 9 other Consumer and Labor Organizations)
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Press Releases
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