Health & Welfare Plans Newsletter

April 1, 2015

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Employee Benefits Jobs

Defined Contribution Consultant
Pavilion Advisory Group, Inc.
in IL

Defined Contribution Plan Administrator
San Diego Pension Consultants
in CA

Conversion Specialist
The Newport Group
in NC

Executive Director
Taft-Hartley Benefit Funds
in NY

Retirement Plan Account Manager
Johnson & Dugan
in CA

Implementation Partner
Lincoln Financial Group
in ANY STATE

Employee Benefits and Executive Compensation Attorney
Baker & Hostetler LLP
in OH

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Webcasts and Conferences

Employer Mandate Implementation: Measurement Method Administration and Coverage Requirements
RECORDED
(Hill, Chesson & Woody)

Filings, Audits, and Late Deposits, Oh My!
April 14, 2015 in MN
(ASPPA Benefits Council [ABC] of Greater Twin Cities)

Fundamentals Series 10: Top-heavy Testing 2015
April 27, 2015 WEBCAST
(SunGard Relius)

Protecting Your ESOP Fiduciary
May 5, 2015 WEBCAST
(National Center for Employee Ownership)

Opt-Out Incentives and Other Cost Cutting Measures for Health Plans
May 28, 2015 WEBCAST
(Lorman Education Services)

Developing Practices in Contemporary Executive Compensation
May 28, 2015 in DC
(HR Policy Association)

Cafeteria Plans
October 6, 2015 in WA
(Thomson Reuters / EBIA)

View All Webcasts and Conferences



[Official Guidance]

Text of CMS Guidance Ending Special Enrollment Periods for Coverage During Calendar Year 2014 (PDF)
"As of April 1, 2015, CMS will no longer accept new requests that would enable consumers to enroll in a Qualified Health Plan (QHP) with 2014 coverage effective dates through the Federally-facilitated or State Partnership Marketplaces through a Special Enrollment Period (SEP). As of April 1, 2015 all SEP requests to CMS seeking 2014 coverage, with the exception of SEPs issued as a result of an eligibility appeal described [in this guidance], if eligible for retroactive coverage, will be given a coverage effective date of January 1, 2015." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  


[Advert.]

Starting Soon! Employee Benefits Producer Training Program

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

Don't miss your chance to attend the Employee Benefits Producer Training Program. Instructors teach a proven sales process, including selling skills and the technical side of employee benefits. Program begins April 20 -- Register Today!



[Guidance Overview]

'Cadillac Tax' Notice Requests Comments (PDF)
"[A table in this article] highlights some areas that the Notice appears to clarify, assuming that the language in the Notice is not changed in the proposed or final regulation ... [A second table] shows a more complete list of coverages to include/exclude as addressed in the Notice ... In the context of the broad overview of a computation method, the IRS and Treasury identified at least 35 areas where they invite comments." (Cheiron)  

[Guidance Overview]

SBC Final Rules to Be Issued Soon; Templates Delayed
"The final regulations are expected to apply for: [1] Coverage that begins or renews on the first day of the first plan year beginning on or after January 1, 2016. [2] Fall 2015 open enrollment periods for coverage that begins on or after January 1, 2016.... [T]he Departments anticipate that the template and related documents will: [1] Be finalized by January 2016. [2] Apply to coverage that begins or renews on the first day of the first plan year beginning on or after January 1, 2017 (including fall 2016 open enrollment periods for coverage beginning on or after January 1, 2017)." (Practical Law Company)  

Abstract of 2012 Form 5500 Annual Reports Reflecting Statistical Year Filing (PDF)
"In 2012, 21,000, or 41 percent, of the approximately 50,000 private sector employer-sponsored group health plans that filed a Form 5500 can be categorized as self-insured. Of the remaining 30,000 group health plans, approximately 4,000, or 8 percent, can be categorized as mixed-insured, and 26,000, or 51 percent, can be categorized as fully-insured.... Of [these] 50,000 group health plans ... 83 percent offered other welfare benefits in addition to health benefits (such as dental, vision, life, disability, etc.).... Fifty-three percent of all private sector single employer group health plans that filed a 2012 Form 5500 provided fully-insured health benefits to their employees.... More than 19,000 of the group health plans categorized as self-insured are single employer plans; the remaining 1,000 are multiemployer plans." [Report data available in Excel Tables and also in XML Tables.] (Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL])  

Sixth Circuit Provides Employers With a Harsh Reminder to Carefully Draft Their FMLA Policies
"The Court explained that 'in certain circumstances equitable estoppel applies to employer statements regarding an employee's FMLA eligibility, preventing the employer from raising non-eligibility as a defense.' In order to prevail on such an 'equitable estoppel' argument, an employee must show a definite misrepresentation by the employer, a reasonable reliance on the misrepresentation, and a resulting detriment to the employee who reasonably relied on the misrepresentation." [Tilley v. Kalamazoo County Road Commission, No. 14-1679 (6th Cir. Jan. 26, 2015)] (Bond Schoeneck & King)  


[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.



Supreme Court to Resolve How a Fiduciary Can Identify and Recover Plan Assets Wrongly in Participant Hands
"Affirmance of the Eleventh Circuit's decision would represent a practical solution to a common problem faced by fiduciaries who attempt to recover from non-fiduciary plan participants or service providers asserting a right to plan benefits based on assignment.... Should the Supreme Court reverse, non-fiduciary recipients of plan funds would be provided with a perverse incentive to spend plan money immediately upon receipt so as to avoid any repayment obligations set forth by plan terms." [Bd. of Trustees of the National Elevator Industry Health Benefit Plan v. Montanile, No. 14-11678 (11th Cir. Nov. 25, 2014; cert. pet. granted Mar. 30, 2015)] (Seyfarth Shaw LLP)  

Supreme Court Will Address Tracing Requirement for ERISA Benefit Overpayments
"[ERISA] Section 502(a)(3) ... places limits on plan fiduciaries who attempt to sue participants who received erroneous benefit payments or who received plan benefits for injuries later compensated by third-party settlements, as is common in cases involving car accidents. The circuit courts have split on whether this provision -- which requires that any suits by plan fiduciaries seek only 'equitable relief' -- allows a fiduciary to sue a participant who is no longer in possession of the disputed benefit payments." [Bd. of Trustees of the National Elevator Industry Health Benefit Plan v. Montanile, No. 14-11678 (11th Cir. Nov. 25, 2014; cert. pet. granted Mar. 30, 2015)] (Bloomberg BNA)  

IRS Asked to Clarify Tax Treatment of Employer-Provided Vehicle Charging
"Senate Finance Committee ranking member Ron Wyden, D-Ore., has asked the IRS to issue guidance clarifying that electrical vehicle charging provided by employers is a de minimis fringe benefit under Code Sec. 132(e), meaning it should not be included as an employee's income because it is so small as to make accounting for it unreasonable or administratively impractical." (Wolters Kluwer Law & Business)  

ACA Exchange Plans Miss Compliance with Smoking Cessation
"Only 60 exchange plan issuers out of 348 (17 percent) listed all the FDA-approved and Preventive Services Task Force-recommended tobacco cessation medications and therapies without any cost-sharing, as required by the ACA and federal essential health benefit regulations. In only one state, West Virginia, were all plans in the marketplace (from one insurer, Highmark Blue Cross) noting coverage for all the tobacco cessation medications[.]" (Healthcare Payer News)  

Benefits in General; Executive Compensation

[Guidance Overview]

Qualified Performance-Based Compensation Rules Are Finalized
"In response to comments to the proposed regulations, the final version of Regs. Sec. 1.162-27(e)(2)(vi)(A) provides that a plan satisfies the per-employee limitation requirement if the plan specifies an aggregate maximum number of shares with respect to which stock options, stock appreciation rights, restricted stock, restricted stock units (RSU), and other equity-based awards can be granted to any individual employee during a specified period under a plan the shareholders approved as required by Regs. Sec. 1.162-27(e)(4). In the proposed regulations, this rule mentioned only stock options and stock appreciation rights." (Journal of Accountancy)  

Press Releases

Fiduciaries to Restore $485K to Bridgeport, Connecticut, Retirement Plan
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

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