Health & Welfare Plans Newsletter

May 7, 2015

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Employee Benefits Jobs

Part Time On Call Retirement Planning Consultant
Transamerica Retirement Solutions
in AR, CA, FL, GA, HI, IL, MI, MO, NJ, NY, TN, TX, UT

Sr. Financial Writer
DST Systems
in NY

401(k) Plan Consultant
Accounting & Consulting Group, LLP
in TX

Retirement Plan Administrator
PenSys, Inc.
in CA

Senior Project Manager/Business Analyst
National Rural Electric Cooperative Association [NRECA]
in VA

Defined Benefit Contribution Plan Consultant
SBC Benefit Consultants, Inc.
in NJ

Retirement Plan Administrator
BSP Consulting
in FL

Retirement Plan Analyst
Habif, Arogeti & Wynne, Wealth Management
in GA

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Webcasts and Conferences

Protecting Your ESOP Fiduciary
RECORDED
(National Center for Employee Ownership)

Affordable Care Act: Employer Shared Responsibility and Information Reporting
May 12, 2015 WEBCAST
(IRS [Internal Revenue Service])

Small Business Workshop
May 13, 2015 in IL
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

Ethics
May 14, 2015 in CA
(Western Pension & Benefits Council - San Diego Chapter)

Qualified Transportation Plans: Designing and Delivering Commuter Benefits
June 4, 2015 WEBCAST
(Thomson Reuters / EBIA)

Spring 15 Retirement, Annuity, and Life Insurance Benefit Planning
June 9, 2015 in NY
(New York State Bar Association)

401(k) Plan Workshop 2015 - Syracuse
June 23, 2015 in NY
(SunGard Relius)

Form 5500 Workshop 2015 - Syracuse
June 24, 2015 in NY
(SunGard Relius)

Mature ESOP: Making Sure Everyone's an Owner
September 23, 2015 WEBCAST
(Beyster Institute)

View All Webcasts and Conferences



CMS Webinar Slides: Best Practices for Service Area Change Requests, May 5, 2015 (PDF)
33 slides. Topics include: [1] What is a service area change request? [2] Required elements of a request; [3] Submitting requests; [4] Detailed description of changes; [5] Example justifications; [6] State approval: FFM; [7] State approval: States performing plan management functions; [8] State plan management systems. (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  


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HHS Observations: Cost Impact of Drug Manufacturer Tactics to Delay Generic Competition (PDF)
9 pages. "It is within this context -- a long history of various attempts by manufacturers to prolong market power in prescription drug markets -- that we offer our views on the recent actions of Actavis PLC and Forest Laboratories LLC concerning the product Namenda, a drug used to treat moderate-to-severe dementia from Alzheimer's disease. We understand Actavis seeks to remove its older product from the market and force patients to switch to its line extension product.... As the primary source of financing for dementia care, including Namenda, the federal government in particular has a stake in the dynamics of this market.... We are concerned that the measures taken by Actavis undermine competition and result in excess payments by consumers and taxpayers." (Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS])  

Newly-Insured Health Claims Data Show Pent-Up Demand for Preference-Sensitive Services (PDF)
12 pages. "State and federal health insurance exchanges began offering coverage to individuals in January 2014.... In the first quarter of 2014 the [newly insured] enrollees appear to have used preference-sensitive treatments at a level that exceeded the expectation of differences due to demographics alone, such as those used in actuarial rating calculations. The average cost of care for these treatments incurred by the new enrollees appears to be much higher than the average cost of care incurred by members with continuous coverage, due to a higher proportion of more expensive treatments. This paper would suggest that the overall increase in total cost of care due to these preference-sensitive services alone is less than 3 percent." (Society of Actuaries)  

ACA Violations by Health Plans: The Status of Birth Control Coverage (PDF)
"This research has uncovered three major trends in the ways insurance companies are not complying with the birth control benefit: [1] Insurance companies are still not providing coverage for all FDA-approved methods of birth control, or they impose out-of-pocket costs on them; [2] Insurance companies limit their coverage to generic birth control; and, [3] Insurance companies fail to cover the services associated with birth control without out-of-pocket costs, including counseling or follow-up visits.... [T]his report includes recommendations for various stakeholders." (National Women's Law Center)  

ACA Violations by Health Plans: The State of Women's Coverage (PDF)
"This report ... focuses on coverage options available to women on Marketplaces by studying issuers' coverage documents to determine whether or not Marketplace plans are covering women's preventive services, maternity care, and other services critical to women's health as required by the ACA. This analysis shows that the vast majority of health insurance issuers considered in this report offer coverage that violates specific requirements of the law.... In addition, this analysis finds ACA violations with at least one issuer in every state included in this report, across a wide range of women's health concerns." (National Women's Law Center)  

An Assessment of IRS Preparations to Ensure Compliance with Minimum Essential Coverage and Shared Responsibility Payment Requirements (PDF)
"The objective of this review was to evaluate the status of the IRS's preparations for determining whether taxpayers maintained [minimum essential coverage (MEC)] or met exemption requirements and assessing the [shared responsibility payment (SRP)] during the 2015 Filing Season.... To assist tax examiners, the IRS developed a tool to compute the SRP. TIGTA found this tool accurately computes the SRP. In addition, TIGTA believes the tool would be helpful to taxpayers and should be made available on IRS.gov.... The IRS agreed with this recommendation and plans to assess the feasibility and cost to provide an online SRP estimator tool." (Treasury Inspector General for Tax Administration [TIGTA]])  

Insurance Transitions Following the First ACA Open Enrollment Period
"The authors report the type of coverage people had before the law's major provisions took effect (September 2013) and at the end of the Marketplace enrollment year (November 2014). They estimate that 20.4 million nonelderly adults became newly insured and 7.4 million lost coverage, for a net increase of 12.9 million between September 2013 and November 2014. Among those previously uninsured, most (7.5 million) enrolled in Medicaid, followed by employer plans (7.3 million), the Marketplaces (3.1 million), and other insurance sources.... The majority of those insured at baseline (81 percent) experienced no change in source of coverage during the study period, suggesting that disruption from the law has been limited. The majority of Americans continue to be enrolled in employer coverage, and more gained coverage in employer plans than through the ACA's Marketplaces." (RAND Corporation)  

Trends in Health Insurance Enrollment, 2013-2015
"Among the 22.8 million people who gained insurance, most enrolled in employer-sponsored insurance, followed by Medicaid and the Marketplaces. Employer coverage is by far the largest source of insurance among Americans younger than age sixty-five, and the ACA creates new incentives for people to take up employer policies." (Health Affairs)  

Benefits in General; Executive Compensation

[Guidance Overview]

The SEC's Proposed Pay Versus Performance Rule
"[T]here may be no link at all between executive pay and [total shareholder return (TSR)].... Executive pay may well have increased because of improved financial metrics the compensation committee chose wisely to reward while the stock price declined because of general market conditions beyond the executives' control.... Turnover in the executive ranks will likely penalize the company in the pay versus performance table, even if it is for the benefit of the company.... Multi-year equity based performance awards which vest in the earliest of the reported period will be based on success metrics for prior years not reflected in TSR for the earliest period, perhaps skewing results." (Dodd-Frank.com, a blog by Stinson Leonard Street)  

[Guidance Overview]

Implications of Proposed SEC Pay-for-Performance Disclosure Rule
"The positive aspects of these rules are: [1] It will force companies to explain and demonstrate the link between pay and performance.... [2] Five years of data ultimately will need to be disclosed.... [3] The measures of performance are TSR and relative TSR. These are the measures that investors rely on for determining their performance.... [4] Options are valued at their fair market value, rather than intrinsic value, which puts them on equal footing with other equity vehicles.... [5] Pensions are valued without regards to uncontrollable events, like interest rates and mortality rates... On the negative side, a significant issue with the proposed rules is that the time horizon of the pay measured will not necessarily match the time horizon of the performance measured." (Farient Advisors)  

Pay Versus Performance
"SEC Chair Mary Jo White mentioned the issues in the reports in which she is most interested. They include: [1] whether TSR is the optimal measure of financial performance; [2] whether there are other measures that would provide useful information to shareholders that would be consistent with the statutory mandate to take into account changes in the stock value and any distributions; [3] whether shareholders are likely to use the information with respect to investments or voting decisions; [4] whether shareholders are likely to use this information to compare the companies in which they invest; and finally, [5] whether investors in smaller reporting companies will use this information and the costs to these companies of providing this information." (Winston & Strawn LLP)  

Retention Compensation Plans
"On its face, retention compensation strategies are another form of long-term deferred compensation; but it is different in that retention rewards are typically in place because of a specific event or set of circumstances triggering the need.... The most common use is where there is an anticipated transaction which requires leadership and key talent continuity in order to maintain the ongoing value of the enterprise.... [The authors] have seen growth in the use of retention arrangements within the health care industry as a result of the recent and expected future consolidation of hospitals and health systems." (Findley Davies)  

IRS Office of Chief Counsel Rejects Last Minute Corrections Under Section 409A
"A Section 409A document error generally can be corrected without penalty -- and without complying with the onerous correction procedures of IRS Notice 2010-6 -- if the arrangement is corrected before it vests (technically while it is still subject to a 'substantial risk of forfeiture).... Practitioners who work with those proposed regulations uniformly agree that the technique works so long as the correction is made prior to vesting and the arrangement remains unvested throughout the rest of the year. What has been less clear is whether the fix-before-vest technique also works when the arrangement subsequently vests within the same tax year. With the CCA, the IRS Chief Counsel's office offers its opinion and says the technique works only when the agreement remains unvested throughout the tax year." (Winston & Strawn LLP)  

Small Business Owners: Are You Helping Protect Your Employees' Financial Security?
"[M]ost employers and plan fiduciaries want to do the right thing for their workers, as demonstrated by their provision of health and retirement benefits. However, inadvertent mistakes can happen and create problems. [EBSA wants] to help you prevent this. We assist employers in complying with the law by increasing awareness and understanding of basic fiduciary responsibilities and protections for health and retirement benefits." (Phyllis Borzi, in U.S. Department of Labor [DOL] Blog)  

Press Releases

NCPERS Unveils Code of Conduct for Pension Service Providers
National Conference on Public Employee Retirement Systems

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