Health & Welfare Plans Newsletter

March 25, 2015

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Employee Benefits Jobs

Account Manager
Lincoln Financial Group
in ANY STATE

Sr Manager, Retirement Plan Services Operations - Client Administration
T. Rowe Price
in CO

Compliance Analyst/Paralegal
HUB International
in CA, UT

Pension Administrator
Qualified Pension Services, Inc.
in MA

Senior Pension Administrator
A rapidly growing Center City, Philadelphia 401(k) Third Party Administration and Recordkeeping Firm
in PA

Plan Administrator for Retirement Plans
Multi-State TPA Firm
in ANY STATE

Retirement Plan Consultant
CDM Retirement Consultants, Inc.
in MD

Defined Benefit Plan Administrator
Pension Planners, Inc.
in FL

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Webcasts and Conferences

HIPAA Omnibus Compliance: How to be Ready for an OCR Audit
March 26, 2015 WEBCAST
(Aegify Inc)

Re-Thinking Your ESOP Plan Design and Operations
March 31, 2015 WEBCAST
(National Center for Employee Ownership)

Roundtable: Issues Involving Overfunded Defined Benefit Plans
April 1, 2015 in NY
(ASPPA Benefits Council [ABC] of New York)

Help Clients Navigate the Audit Quality Crisis
April 2, 2015 in TX
(ASPPA Benefits Council [ABC] of Central Texas)

ERISA Litigation and Enforcement: The Role of the Independent Fiduciary and Best Practices for Financial Advisors
April 8, 2015 WEBCAST
(fi360)

401(k) Plan Workshop 2015
April 23, 2015 in CO
(SunGard Relius)

Form 5500 Workshop 2015
April 24, 2015 in CO
(SunGard Relius)

Charging for COBRA Coverage: Cadillac Tax Proposals Prompt a New Look
May 12, 2015 WEBCAST
(Thomson Reuters / EBIA)

Getting It Right - Know Your Fiduciary Responsibilities
June 4, 2015 in UT
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

Health and Welfare Benefit Plans National Institute
October 19, 2015 in DC
(ABA Joint Committee on Employee Benefits)

View All Webcasts and Conferences



[Guidance Overview]

Who Can Incur Qualified Eligible Medical Expenses in an FSA, HRA, or HSA?
"[A] child that files his or her own taxes and has not turned 27 by December 31st may still incur qualified medical expenses against the employee's FSA or HRA for that child. Whether the child is enrolled in college, or is actually enrolled in the employer's group health plan does not have any effect on whether they may incur qualified medical expenses against the employee's FSA or HRA.... For HSA purposes, unlike an FSA or HRA, the rules remain as they were prior to 2010 to exclude a child who is not a tax dependent from having their expenses reimbursed from the HSA." (Kushner & Company)  


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Use E-File for Health Provider Information Form, IRS Advises
"The IRS is encouraging covered entities that are subject to the health insurance provider fee under the [ACA] to submit Form 8963 via e-file.... [T]he IRS notes that e-file reduces the risk of transcription errors and reduces the report processing time. In addition, electronic filers receive immediate acknowledgment of receipt and are able to track submission status online." (Wolters Kluwer Law & Business)  

Supreme Court Repudiates Case Law on Retiree Health Care -- What Should Employers Do?
"Employers wishing to modify healthcare benefits for existing retirees would be wise ... to negotiate with the retiree group -- with or without the involvement of the union.... Some large employers have sought to make changes through non-opt out class action litigation and a settlement in response to the action which binds all affected parties.... Another strategy is to approach retirees with an offer to establish and contribute to a VEBA ... designed to provide funds for the increasing costs to retirees or to entirely fund retiree benefits after a certain date. This entity can also be governed entirely by elected retirees, giving the retirees a direct stake in prudently managing health benefit strategies and controlling costs to assure the longest feasible continuation of retiree benefits." (Warner Norcross + Judd LLP)  

Employers May Still Designate Leave as FMLA Even If the Employee Wants It to Be Considered Differently
"When the Ninth Circuit Court of Appeals ... issued its decision in Escriba v. Foster Poultry Farms, Inc. last year, the decision was viewed as a victory for employers. Now, however, the decision is raising more questions than answers as employers struggle with designating FMLA leave.... Sometimes employees will attempt to prevent employers from designating FMLA by not providing a medical certification. If this happens, the employer can still designate FMLA if it has enough information to determine that the leave qualifies under the FMLA. While obtaining medical certification is strongly recommended, the regulations do not expressly require it." (Liebert Cassidy Whitmore)  

Preparing for OCR Phase 2 HIPAA Audits
"[R]ecent announcements by the OCR indicate that while most audits in Phase 2 will still be desk audits, the OCR is planning to conduct more on-site, comprehensive audits than previously planned.... [A] table outlines OCR's expectations for Phase 2 Audits.... What can your organization do to prepare for the Phase 2 Audits?" (Ice Miller LLP)  


[Advert.]

Register -- MBGH Annual Conference for Health Benefits and Health Care

Sponsored by Midwest Business Group on Health [MBGH]

The Midwest Business Group on Health's 35th Annual Conference will be held April 29-30 in Chicago, featuring leading employers and industry experts providing objective, timely and practical information on the latest research, trends and best practices.



How Private Exchanges Should Integrate Well-Being (PDF)
"One way that employers can embrace well-being for their employees is by selecting a private exchange with a well-being program that is fully integrated with other benefits services -- one that yields measurable outcomes and addresses all aspects of health (physical, mental and social) and financial well-being. And while companies can certainly integrate well-being using other types of programs, this article focuses on the integration of well-being with private exchanges." (Buck Consultants at Xerox, via workspan magazine)  

121 Employee Wellness Program Ideas
"The key to having a successful corporate wellness program is by encouraging overall wellbeing while still keeping it fun ... If you can't get people engaged then your wellness program ideas will quickly lose steam. So make your initiatives fun, try new ideas and see what your team values the most. [This article includes a] list of 121 employee wellness program ideas that you can easily implement at your office." (SnackNation)  

Unpacking the Burr-Hatch-Upton ACA Replacement Proposal
"As with the previous proposal, the Patient CARE Act [would repeal] the ACA's individual mandate and [replace] it with a framework under which no one can be denied coverage or charged higher premiums because of a pre-existing condition as long as they remain continuously enrolled in a health plan. Insurance regulation would be returned to the states.... Income-related tax credits would be available to those who do not have access to employer-sponsored health insurance and to workers in small firms with 100 or fewer employees.... Tax credit amounts under the current proposal are 26 percent higher than the subsidies suggested last year." (Health Affairs)  

Repayments and Refunds: Estimating the Effects of 2014 Premium Tax Credit Reconciliation
"[The authors] focus on reconciliation based only on income changes (prior year v. current year), and estimate that 50% of subsidy-eligible tax households would owe some repayment and 45% would receive a refund. Subsidy-eligible tax households with starting incomes under 200% of poverty would be somewhat more likely to owe a repayment (54%) and somewhat less likely to receive a refund (40%)." (Henry J. Kaiser Family Foundation)  

[Opinion]

Testimony on Behalf of American Benefits Council to House Labor and Workforce Committee Hearing on the 'Preserving Employee Wellness Programs Act ' (PDF)
Presented by Tamara M. Simon of Buck Consultants. "[This] testimony will describe the current state of employer-sponsored wellness programs. Not only are these programs important for achieving better health outcomes for employees, they also have the potential to increase employee productivity, improve workforce morale and engagement and reduce health care spending.... [O]ngoing legal and regulatory uncertainty is preventing more employers from sponsoring wellness programs[.]" (American Benefits Council)  

[Opinion]

Moving Past the SGR: What It Means
"[The bipartisan agreement] does more than make our outdated system more reliable --it reforms the system so that it's more focused on making the patient better. Right now, doctors in Medicare are reimbursed based on the quantity, not the quality, of the care they provide. That leads to higher costs and lower quality care. Instead, this agreement creates a new system that rewards positive health outcomes. This approach will put patients at the center of the system." (Committee on Ways and Means, U.S. House of Representatives)  

Benefits in General; Executive Compensation

Health, Wealth and Happiness in Retirement: The Impact of Health on Retiree Lifestyles and Satisfaction with Life (PDF)
"Healthcare expenses are higher than what retirees had expected. Pre-retirees are worried about encountering health problems in retirement. Retirees share pre-retirees' sentiment, and they are acutely aware of the increasing cost of healthcare. Retirees are concerned about their ability to manage healthcare expenses in the case of chronic and debilitating illness, including the cost of long-term care.... Retirees are concerned about the potential for health declines in the future and they indicate wanting to avoid placing any burden on their family, particularly their children." (MassMutual)  

Disgorgement of Profits Not Available for Arbitrary and Capricious Benefits Denial -- This Time
"The decision leaves room, however, for an award of equitable relief under Section 502(a)(3) where the restoration of benefits alone is not sufficient to make the claimant whole or where there is an injury separate and distinct from the denial of benefits. By way of example, the court pointed to its [2005] decision in Hill v. Blue Cross and Blue Shield of Michigan, where it found a separate and distinct injury beyond the mere derivation of benefits necessitating equitable relief under 502(a)(3). There, the court ordered other equitable relief (injunction), in addition to payment of benefits due, to redress an alleged improper plan-wide claim-handling methodology, which the court found to be a separate injury affecting the entire plan." [Rochow v. LINA, No. 12-2074 (6th Cir. Mar. 5, 2015)] (Wilson Elser)  

Longer CEO Lives Spur Pay Growth as Companies Cushion Pensions
"Standard & Poor's 500 Index companies that have filed proxy statements for fiscal 2014 contributed an average $1.5 million to their CEOs' pensions, compared to an average of about $550,000 in 2013 ... Pensions comprised about 11 percent of total CEO pay at those companies, compared to 4 percent in 2013. The ballooning pensions were often triggered by preset agreements on CEO retirement pay, rather than new decisions by boards to give their executives more. Longer lifespans and lower discount rates are forcing companies to add more to their CEOs' pensions to meet return expectations and support future payouts[.]" (Bloomberg)  

Ten Myths of Executive Compensation
"[1] The board and CEO cannot be supportive partners in designing compensation plans.... [2] More pay results in better performance.... [3] We cannot afford to hire or recruit that executive.... [4] We should constantly adjust our compensation plans.... [5] Our compensation plan should look like that of our peers.... [6] Disclosing executive compensation always will backfire.... [7] There is nobody like us, so comparisons don't work.... [8] It is too difficult to set reliable, measurable long-term goals.... [9] Employment agreements are restrictive and will tie our hands.... [10] Compensation is the only reward that matters." (Meridian Compensation Partners, LLC)  

Ninth Circuit Decision Illustrates Importance of Clearly Designating Beneficiaries Under a Nonqualified Plan
"[T]his decision provides two takeaway items for plan sponsors. One is to make sure that the plan document and communications with the participants clearly explain how participants may designate beneficiaries. The other is that plan sponsors should consider periodically sending reminders to participants to make sure that their beneficiary designation forms are up-to-date." [E & J Gallo Winery v. Rogers, No. 13-55327 (9th Cir. Feb. 23, 2015; unpublished)] (Porter Wright Morris & Arthur LLP)  

Press Releases

NAPA Welcomes Joseph F. DeNoyior as President
National Association of Plan Advisors [NAPA]

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