Health & Welfare Plans Newsletter

March 26, 2015

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Employee Benefits Jobs

Pension Administrator - DC
T R Paul Inc.
in CT

Vice President of Retirement Planning Services
USI Consulting Group
in AZ

Benefits Account Manager & Department Manager
Owen-Dunn Insurance Services
in CA

Pension Customer Service Representative
Small Benefits Firm in Middle Tennessee
in TN

Voluntary Benefits Support Specialist
Northwestern Benefit Corporation of Georgia
in GA

Onboarding/New Client Implementation Associate
The Benefit Practice
in CT, FL

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Webcasts and Conferences

Communicating Employee Benefits Workshops: Strategies to Streamline, Organize and Improve Performance
April 16, 2015 in NY
(The Conference Board)

401(k) Plan Workshop 2015
April 28, 2015 in WI
(SunGard Relius)

Form 5500 Workshop 2015
April 29, 2015 in WI
(SunGard Relius)

Getting It Right - Know Your Fiduciary Responsibilities
June 24, 2015 in CO
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

Western Benefit Conference: Past, Present and Future
July 19, 2015 in CA
(ASPPA [American Society of Pension Professionals & Actuaries])

ERISA Basics National Institute
October 28, 2015 in IL
(ABA Joint Committee on Employee Benefits)

View All Webcasts and Conferences



[Guidance Overview]

Penalties and Reporting for Violations of ACA Requirements
"Given the magnitude of the potential excise taxes that could become due under Code Section 4980D, and the possibility of a complete waiver if errors are quickly addressed, you should: quickly determine whether you have any issues with the portability, access and renewability requirements imposed by the ACA on your single employer group health plan(s), especially any medical reimbursement programs or health reimbursement accounts (HRAs), and periodically review your compliance with these requirements to make sure that problems are promptly identified, corrected and reported (if required)." (McKenna Long & Aldridge LLP)  


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[Guidance Overview]

HHS Finalizes 2016 Reinsurance Contribution Rate and Out-of-Pocket Maximums (PDF)
"HHS also finalized the clarification of the treatment of other than self-only (family) OOPs that was included in the proposed guidance. Under this guidance, an 'embedded' individual OOP is required for family coverage.... High-deductible plans with health savings accounts (HSAs) often apply a single overall family deductible, and/or family OOP maximum, without an underlying or embedded self-only deductible or OOP maximum. That design is no longer allowed, unless the family-deductible and OOP are no greater than the ACA maximum for the self-only OOP ... If the family deductible in 2016 exceeds the self-only $6,850 OOP limit, then an embedded self-only deductible and OOP is required." (Buck Consultants at Xerox)  

[Guidance Overview]

Health Insurance Premium Credits in the ACA in 2015 (PDF)
"New federal tax credits, authorized under the [ACA], first became available in 2014 to help certain individuals pay for health insurance. The tax credits apply toward premiums for private health plans offered through exchanges (also referred to as health insurance marketplaces). The ACA also established subsidies to reduce cost-sharing expenses." [CRS Report R43945] (Congressional Research Service [CRS])  

[Guidance Overview]

Text of IRS Q&As: Reporting Social Security Numbers to Your Health Insurance Company
"Q: Why is my health insurance company asking for this information now? A: The new reporting requirement will begin for the 2015 tax year and health insurance companies need advance time to program and test systems to make certain that this new reporting is done correctly and efficiently. Q: Is there a specific [IRS] form that will be mailed to me to provide the information to my health insurance company? A: No. Your health insurance company may mail you a written request which discusses these new rules." (Internal Revenue Service [IRS])  

Companies Spend More on Wellness Programs But Employees Leave Millions on the Table
"[E]mployers will spend an average of $693 per employee on wellness-based incentives in 2015, up from $594 in 2014 and $430 five years ago. Of the 79 percent of employers who offer health improvement programs, larger companies, those with more than 20,000 employees, are spending the most on these programs, where the per-employee average climbed to $878, up from $717 in 2014. The average for companies with between 5,000 and 20,000 workers rose to $661, up from $493 in 2014.... Fewer than half (47 percent) of employees earned their full incentive amount in 2014, while 26 percent earned a partial amount. Together, this translates into millions of dollars of unclaimed incentives." (Fidelity Investments and the National Business Group on Health [NBGH])  


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Health Plan Features: Implications of Narrow Networks and the Trade-Off between Price and Choice (PDF)
"Research on the impact of narrow networks is limited, but early studies suggest that several factors affect whether narrow network strategies will succeed. These factors include the way networks are constructed, the characteristics of the broader market in which narrow network plans operate, and whether consumers have the knowledge and tools to make informed choices about coverage. Additional research is needed to help policymakers better understand how to define and develop enforceable standards to measure the adequacy of narrow networks. Research can also help identify the quality considerations to be incorporated into the network design process, the development of network adequacy standards, and the type of guidance that can help consumers understand plan differences when making choices among products." (AcademyHealth)  

Employer and Worker Contributions to Health Reimbursement Arrangements and Health Savings Accounts, 2006-2014
"Among the 15 percent of individuals enrolled in a CDHP, 57 percent (or 9.3 million) had an HRA or had opened an HSA, while 43 percent were enrolled in an HSA-eligible health plan but had not opened an HSA.... Among individuals with traditional, employment-based health benefits and a choice of health plans, 35 percent were eligible for an HRA or an HSA-based plan in 2014 ... Two out of 3 workers (67 percent) with an HRA or HSA reported that their employers contributed to the account in 2014[.]" (Employee Benefit Research Institute [EBRI])  

Employer Contributions to HSAs Decreasing
"In 2014, employees saw a 10 percent decrease in their average single Health Savings Account (HSA) employer contribution from the previous year, from $574 in 2013 to $515 in 2014 ... Average family contributions also decreased 7 percent during the same period, from $958 to $890. Survey results reveal a correlation between enrollment in HSAs and Consumer Driven Health Plans (CDHPs), linking higher HSA contributions to increased enrollment in the cost-saving plans." (United Benefit Advisors)  

High-Deductible Plans Bring Lower Costs Now, But Will They Have Pricey Consequences?
"Consumers with high deductibles sometimes skip procedures, think harder about getting treatment and shop for lower prices when they do seek care. What nobody knows is whether such plans, also sold to individuals and families through the health law's online exchanges, will backfire. If people choose not to have important preventive care and end up needing an expensive hospital stay years later as a result, everybody is worse off." (Kaiser Health News)  

Lifetime Retiree Health Care Cost Projections Up 6.5%
"A healthy couple retiring at 65 this year will likely spend more than $266,000 on Medicare Part B, which covers doctors' visits and outpatient services, and Part D prescription drug plans as well as supplemental Medigap insurance over their lifetime ... That is up 6.5% from last year's projection ... When expected dental, vision, hearing costs not covered by Medicare, as well as co-pays and other out-of-pocket medical costs are included, lifetime cost estimates increase to nearly $395,000 for a 65-year-old couple retiring this year." (InvestmentNews)  

Taking Aim at Tech Industry Inequality, Microsoft Mandates Paid Leave for Contractor Employees
"Microsoft is ... requiring all its vendors with more than 50 workers to offer those detailed to Microsoft contracts no fewer than 15 days of paid leave.... Requiring suppliers to offer any level of benefits appears to be at least a rare step for a company of this size, and perhaps an unprecedented one." (The Washington Post; subscription may be required)  

The Federal Medical Loss Ratio Rule: Implications for Consumers in Year Three
"[T]otal rebates for 2013 were $325 million, less than one-third the amount paid out in 2011, indicating much greater compliance with the MLR rule. Insurers' spending on quality improvement remained low, at less than 1 percent of premiums. Insurers' administrative and sales costs, such as brokers' fees, and profit margins have reduced slightly but remain fairly steady. In the first three years under this regulation, total consumer benefits related to the medical loss ratio -- both rebates and reduced overhead -- amounted to over $5 billion." (The Commonwealth Fund)  

Health Plan Enrollment Fears Prove Moot
"Across all 600 employers that participated in the survey, the average percentage of employees who were eligible for coverage rose just one percentage point. And the average percentage of eligible employees who enrolled actually 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%." (CFO)  

Many Families May Face Sharply Higher Costs If Public Health Insurance for Their Children Is Rolled Back
"Millions of US children could lose access to public health care coverage if Congress does not renew federal funding for the Children's Health Insurance Program (CHIP), which is set to expire September 30, 2015 ... For many children at risk of losing eligibility for public coverage, the primary alternative pathway to coverage would be through their parents' employer-sponsored insurance, yet relatively little is known about the cost and quality of that coverage.... [Estimates] show that many families would face sharply higher costs of covering their children. In many cases, the only employer-sponsored coverage available would be a high-deductible plan." (Health Affairs)  

[Opinion]

How King v. Burwell Could Harm Us All
"Although we may not all receive subsidies from the ACA ... the 158 million Americans who receive employer-sponsored insurance still get government subsidies because their health care benefits are tax exempt. This tax break costs the federal government almost $250 billion every year.... So, while many are cheering for cutting down ACA subsidies, they are simultaneously pocketing their own government benefits. In truth, government supports health care at all levels of society, and the nation is greater for it." (The Century Foundation)  

[Opinion]

It's Prices, Not Coverage
"[B]enefit design alone cannot address the outrageous increases in prescription drug prices. Skyrocketing drug prices have a harmful ripple effect throughout the health care system, raising monthly premiums and increasing health care costs for individuals, families, and employers. This is an oft-overlooked point, but a critical one. Affordable health care coverage requires affordable treatments." (America's Health Insurance Plans [AHIP])  

Benefits in General; Executive Compensation

Balancing Compensation Costs (PDF)
"Employers tend to view pension and welfare plan benefits costs as added costs rather than as an integral part of an employee's commercial value. One consequence is a growing number of longer-service employees have little hope of meaningful pension benefits when they retire, so may cling to their jobs beyond productive years.... An employee not willing to accept Form W-2 wages that support his commercial value after his pension and welfare benefit costs will not remain with the employer if he finds other work that pays higher direct compensation wages that will be with reduced benefits unless his commercial value is greater to another employer." (H.C. Foster & Company)  

Explaining Pay for Performance: An Inexact Science, for Now
"[C]ompany explanations of how pay is linked to performance vary widely -- when they're offered at all. While the prevalence of pay-for-performance discussions in proxy statements increased steadily since Dodd-Frank was enacted in 2010, it appears to have plateaued in the last year. Just over a quarter (27%) of Fortune 500 companies provided some type of pay-for-performance discussion in 2014, which was down slightly from the 28% of companies that included such a summary in 2013." (Towers Watson)  

Recurring Proxy Statement Disclosure Issues: Performance Share Reporting
"Nearly every company in America is making at least some of its equity award performance-based. Many have done so for years. In addition to the Form 4 reporting, two other questions ... relating to the unique reporting status of performance shares (or units) are: ... [1] Reporting Performance-Based Awards that Vest on the Last day of the Fiscal Year ... [2] Reporting Performance-Based Awards in the Summary Compensation Table." (Winston & Strawn LLP)  

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