Health & Welfare Plans Newsletter

April 29, 2015

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Employee Benefits Jobs

Pension Administrator
Retirement Strategies, Inc.
in GA

Benefits/HRIS Specialist
Arnold & Porter LLP
in DC

Participant Service Representative
PCS
in PA

401(k) Daily Valuation Administrator
Swerdlin & Company
in GA

Plan Compliance Specialist
Lincoln Financial Group
in ANY STATE

Account Manager
National Retirement Services, Inc.
in CA

Defined Contribution Pension Plan Administrator
The Angell Pension Group, Inc.
in ANY STATE

Managing Director, Retirement Services
General Board of Pension and Health Benefits
in IL

Executive Director
Legislative Commission on Pensions and Retirement, Minnesota State Legislature
in MN

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Webcasts and Conferences

A First Look at the EEOC's New Wellness Plan Guidance
May 19, 2015 WEBCAST
(ABA Joint Committee on Employee Benefits)

Affordable Care Act: Compliance Issues for Mid-Size Employers
May 26, 2015 WEBCAST
(Liebert Cassidy Whitmore)

401(k) Plan Workshop 2015 - Detroit
May 27, 2015 in MI
(SunGard Relius)

Form 5500 Workshop 2015 - Detroit
May 28, 2015 in MI
(SunGard Relius)

Overpayments, Underpayments, Fiduciary Duty and IRS Qualification
June 11, 2015 WEBCAST
(ABA Joint Committee on Employee Benefits)

View All Webcasts and Conferences



[Guidance Overview]

ACA Information Returns (AIR) Working Group Meeting: Draft Publication 5165 and Additional Topics for Review (PDF)
April 30, 2015; 52 presentation slides. "Important things to know about electronically filing ACA Information Returns: [1] Affordable Care Act Information Returns (Forms 1094-B, 1095-B, 1094-C and 1095-C) must be filed using 'AIR' (Affordable Care Act Information Return System) -- ACA Information Returns may not be filed using FIRE. [2] Acceptable Format for Transmission is XML (Returns will not be accepted electronically in any other format). [3] Each transmission is limited to 100MB, transmissions larger than 100MB must be split. [4] Testing for Tax Year 2014 returns (voluntary year) will begin July 2015 and Tax Year 2014 returns may be filed beginning October 2015. [5] Returns for Tax Year 2015 must be filed with the IRS by February 28, 2016 (paper) or March 31, 2016 (electronic)." (Internal Revenue Service [IRS])  


[Advert.]

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[Guidance Overview]

Important Changes to Minimum Value and Out-Of-Pocket Maximum Rules Embedded in Marketplace Guidance
"The [Notice of Benefit and Payment Parameters for 2016 (Final Rule)] establishes new standards by which employer-sponsored plans meet the minimum value requirement.... The Final Rule provides that an employer-sponsored plan must provide 'substantial' coverage of both inpatient hospital services and physician services in order to meet the new 'minimum standard of benefits' rule.... These changes to the minimum value rules under the Final Rule will generally apply to employer-sponsored plans, including plans that are in the middle of a plan year, immediately on the effective date of the final regulations, February 27, 2015." (Seyfarth Shaw LLP)  

[Guidance Overview]

EEOC's Proposed Wellness Regs Add Burdensome Notice Requirement, Still Prohibit Mandatory HRAs
"[In] contrast to the DOL regulations, which do not restrict the size of reward under a participatory wellness program, the proposed EEOC guidance seeks to extend the 30% maximum award to participatory wellness programs that require employees to answer a health questionnaire with disability-related inquiries or take medical examinations.... The EEOC's rationale for this proposal is that ... participatory programs rarely offer incentives in excess of 30%. However, this rule prohibits employers from requiring employees to complete [a health risk assessment (HRA)] in order to be eligible to participate in the plan, a practice that is permitted under DOL rules as long as the results of the HRA are not used to determine eligibility." (Proskauer's ERISA Practice Center)  

[Guidance Overview]

Montana and Wyoming Expand Data Breach Notice Requirements
"Montana HB 74, which goes into effect on October 1, 2015, specifically expands the list of 'additional identifiers' that constitute the definition of [personally identifiable information (PII)] to include: [1] Information that relates to an individual's physical or mental condition; and [2] Medical history, medical claims history, or medical treatment information obtained from a medical professional or medical care institution, from the individual, or from the individual's spouse, parent, or legal guardian.... [T]he Wyoming legislature has expanded the list of 'additional identifiers' to include ... Medical, biometric or health insurance information." (Wilson Elser)  

[Guidance Overview]

Massachusetts Attorney General Issues Proposed Regs on Implementation of New Earned Sick Time Law
"[T]he proposed regulations: [1] Broadly define 'employer' to include entities that have very small Massachusetts operations.... [2] Broadly define the types of employees entitled to sick leave.... [3] Outline how employers should take steps to comply in 2015 in light of the statute's mid-year effective date (July 1).... [4] Permit employers to define their own 'calendar year' for purposes of accrual and use of earned sick time, provided the employer gives written notice to employees as described in the regulations." (Ogletree Deakins)  


[Advert.]

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Text of Inspector General Report: Processes Have Been Implemented to Administer the Patient-Centered Outcomes Research Fee, But Controls Need Improvement to Ensure Filing Compliance (PDF)
"TIGTA found that 72,035 health insurance policy issuers/self-insured plan sponsors filed a Form 720, Quarterly Federal Excise Tax Return, with PCOR fees totaling $114 million for Tax Year 2012. Of these filers, 30,996 (43 percent) paid a PCOR fee of less than $4.25, which is the IRS's cost to process these returns.... TIGTA believes establishing a systemic error report that generates when the PCOR fee and/or tax payments do not match for Forms 720 with a PCOR fee will have minimal impact on IRS resources and allow the IRS to improve its monitoring of PCOR fee reporting and payment compliance." (Treasury Inspector General for Tax Administration [TIGTA])  

HHS Inspector General Early Alert: Without Clearer Guidance, Marketplaces Might Use Federal Funding Assistance for Operational Costs When Prohibited by Law (PDF)
"Starting in January 2015, establishment grant funds provided by [CMS] to the [State-based marketplaces (SBMs)] cannot be used for operational costs. We have concerns that, without more detailed guidance from CMS, SBMs might have used, and might continue to use, establishment grant funds for operating expenses after January 1, 2015, contrary to law. This issue is a significant matter and requires CMS's immediate attention." (Office of Inspector General [OIG], U.S. Department of Health and Human Services [HHS])  

Legislation Introduced to Repeal ACA Cadillac Tax
"Congressman Joe Courtney unveiled new legislation that would repeal the excise tax on high-cost health insurance plans scheduled to go into effect in 2018. Also known as the 'Cadillac tax,' the policy would apply a 40 percent tax on health insurance expenditures over $10,200 per person and $27,500 per family.... Studies of the policy have indicated that it will have a disproportionate and rapidly increasing impact on older workers, women, and workers in high-cost regions." (U.S. Congressman Joe Courtney [D-CT])  

Boeing May Have Considered FMLA-Protected Leave in Decision to Fire Employee
"Boeing was denied summary judgment against an employee's claim that it impermissibly terminated his employment in violation of the Washington Family Leave Act (WFLA).... [A] federal district court ... determined that there was evidence from which a reasonable jury could conclude that Boeing considered FMLA-protected leave as a negative factor when it made the decision to fire him. However, where the employee failed to show that his neck injury was a 'substantial factor' in Boeing's decision to terminate his employment, his discrimination and failure-to-accommodate claims under the Washington Law Against Discrimination (WLAD) failed to survive." [Jury v. Boeing, No. C13-1921RSL (W.D. Wash. Apr. 22, 2015)] (Wolters Kluwer Law & Business)  

Prescription Drug Prices Jump Another 3.8% in First Quarter of 2015
"Analyzed by category, branded drug prices jumped 5.7%, specialty drugs rose 2.5% and generic drugs increased 1.4% between January and March 2015. The increases follow those reported for calendar year 2014, in which branded, specialty and generic medications increased 14.8%, 9.7% and 4.9%, respectively, and 10.9% combined overall." (Truveris)  

[Opinion]

Employer Sponsored Insurance: Behind the Little Tree Is Obamacare's Forest
"[T]he most important question asked when discussing public views on Obamacare: 'Would you say the health care law has directly helped you and your family, directly hurt you and your family, or has it not had a direct impact?' It's not who has been helped (19%) or hurt (22%) by the law. It's the significant majority of respondents -- 56%!!! -- who have felt no direct impact. It's not a coincidence that the respondent percentage is almost identical to those with employer insurance." (InsureBlog)  

Benefits in General; Executive Compensation

Text of 3rd Quarter Update to the Treasury Department 2014-2015 Priority Guidance Plan (PDF)
47 pages; Employee benefit projects begin on page 5. "The 2014-2015 Priority Guidance Plan contained 317 projects that are priorities for allocation of the resources of our offices during the twelve-month period from July 2014 through June 2015 (the plan year).... This third quarter update to the 2014-2015 plan reflects 25 additional projects that have become priorities and guidance we have published during the period from January 1, 2015, through March 31, 2015." (Internal Revenue Service [IRS])  

Annual Statistical Supplement to the Social Security Bulletin, 2014
"The majority of the statistical tables present information about programs administered by the Social Security Administration -- the Old-Age, Survivors, and Disability Insurance program, known collectively as Social Security, and the Supplemental Security Income program. In addition, data are presented on the major health care programs -- Medicare and Medicaid -- and social insurance programs ... The Supplement also includes program summaries and legislative histories that help users of the data understand these programs.... The Supplement has been published annually since 1940." [Link is to web page where individual sections of the report can be viewed and downloaded; also available is the complete report as a single PDF file of 551 pages.] (U.S. Social Security Administration [SSA])  

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