401K - DC Consultant
USI Consulting Group
in CT

Client Service Team Manager
Charles Schwab
in AZ

Product Manager
Charles Schwab
in AZ, TX

Retirement Technology Sr. Specialist
Charles Schwab
in NC

Retirement Technology Specialist
Charles Schwab
in NC

Retirement Business Services - Product Development Manager
Charles Schwab
in AZ

Sales Consultant-401(k) & Defined Benefit Administration
Farmer & Betts
in FL, IN, MN, MO, NC, TN, TX

401(k) Plan Administrator
CecilCo
in TX

Relationship Manager, Team Lead
The Guardian Life Insurance Company of America
in ANY STATE, CT, NJ, NY

Retirement Implementation Manager
Cuna Mutual Group
in WI

Compliance Manager
Cuna Mutual Group
in WI

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Affordable Care Act: Employer Shared Responsibility and Information Reporting
May 21, 2015 WEBCAST
(IRS [Internal Revenue Service])

Voluntary Fiduciary Correction Program and Abandoned Plan Workshop
May 21, 2015 in OH
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

Information Risk Management Essentials
May 28, 2015 WEBCAST
(Clearwater Compliance)

View All Webcasts and Conferences

[Official Guidance]

Text of IRS PLR 201519030: Computation of Medical Loss Ratio under Section 833(c)( (PDF)
"[If] the organization's Section 833(c)(5) MLR computed on an aggregate basis is at least 85 percent, the organization will satisfy the Section 833(c)(5) MLR for the taxable year. If the organization's Section 833(c)(5) MLR computed on an aggregate basis is not at least 85 percent, the organization will not satisfy the Section 833(c)(5) MLR for the taxable year.... [T]he Section 2718 medical loss ratio is computed by market segment, but the Section 833(c)(5) MLR is computed on an aggregate basis. As a result, it is possible for an organization to be required to issue Section 2718 medical loss ratio rebates to enrollees by market segment for a reporting year, but on an aggregate basis satisfy the Section 833(c)(5) MLR for that taxable year.... [W]hether for a given taxable year an organization can include rebates issued to enrollees under Section 2718(b) with respect to a prior reporting year as an expense in computing its Section 833(c)(5) MLR depends on the HHS guidance in effect for that year." (Internal Revenue Service [IRS])  

[Advert.]

Private & Public Exchange Summit, July 15-16

Join Payer and Exchange executives in July for the 6th Annual Private and Public Exchange Summit. The Summit will explore approaches for health plans and exchanges to improve market share, encourage engagement, and reduce the cost trend.

[Guidance Overview]

An Employee Moving from Full to Part-Time Status May Have to Stay on Your Health Plan for More Than a Year Under ACA Rules
"Most employers are using the IRS's 'look-back' method to determine which employees are full-time.... In some cases, an employer may have to keep a part-time employee on benefits for the remainder of their current stability period or the remainder of the current one and the subsequent one. This can be up to a year and a half in certain situations. One way for an employer to partially avoid this is to use the IRS's month-to-month method; at least with respect to salaried personnel." (Benefit Revolution)  

[Guidance Overview]

IRS Announces 2016 HSA and HDHP Limits (PDF)
"Under recent guidance from [HHS], a plan must apply the annual limitation on cost sharing for self-only coverage to OOP maximums for each individual in a family plan -- even if this amount is below the family OOP maximum. HHS initially posted an FAQ stating that this requirement applies similarly to deductibles for each individual in the plan, even if this amount is below the family deductible; however, HHS later removed that FAQ from its website without explanation. Thus, although it is not clear, a plan that applies a family deductible that exceeds the ACA self-only OOP limit (of $6,850 for 2016) may need to apply an embedded self-only deductible not exceeding that amount." (Buck Consultants at Xerox)  

FMLA Forms: Best Practices
"FMLA Employee Request Form... Deadlines... DOL Templates... GINA Safe Harbor Language... Complete Forms... Review Certifications Carefully... Recordkeeping." (Benefits Bryan Cave)  

Renegotiating Retiree Health Care Plans After New Supreme Court Guidance
"[This article] ... will explain the reasons why retiree health care plans have stayed under the radar screen and how that is changing; the magnitude of underfunding of retiree health care plans and the implications for state-city budgets; the principles of interpreting collective bargaining agreements recently enunciated by the US Supreme Court; and the various ways local governments are now trying to manage down their health care obligations over time and strategies that governments and public-sector unions can use to address this challenge." (The Brookings Institution)  

The ACA Cadillac Tax: A Primer for Employers (PDF)
"The taxable status of the insurer or administrator that the employer selects could cause the 40% excise tax to be subject to corporate income tax, leveraging the financial impact such that every $1.00 of provided healthcare benefit beyond the threshold may cost an employer $1.61, or more." (Milliman)  

CMS Presentation Slides: FF-SHOP Dental Issuer Website Review and Best Practices, May 5, 2015 (PDF)
69 slides. "Information that FF-SHOP dental issuers present on their websites may educate small employers visiting the website on the availability of Stand Alone Dental Plans (SADPs) through SHOP and thus play a role in an employer's decision to participate in the FF-SHOP.... CMS reviewed participating FF-SHOP dental issuer websites to understand the availability and quality of SHOP information that dental issuers displayed ... This presentation describes CMS's key findings ... and provides best practices and examples for providing accessible, complete, and accurate SHOP information that dental issuers may consider implementing to enhance their websites." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

Essential Health Benefits Prescription Drug Standard: The Exceptions Process
"HHS revised the exceptions process for prescription drugs in order to establish a more uniform process across plans and issuers. HHS clarified that the exceptions process is different from the internal claims and appeals process for enrollees receiving an adverse benefit determination. While the adverse benefit determination process is for a drug that is included in the plan's formulary drug list, the exceptions process is for nonformulary drugs." (National Health Law Program [NHeLP])  

Essential Health Benefits Prescription Drug Standard: Formulary Transparency
"[A]dvocates can review the 2015 QHP formularies to identify which plans are more transparent. In reviewing current formularies, advocates can document deficiencies to push for enhanced transparency requirements in future federal rulemaking. For example, while the 2016 Final Rule improves transparency in QHP formularies, it falls short in several key areas." (National Health Law Program [NHeLP])  

Diabetes Spending Soars in Employer-Sponsored Plans
"From 2009 to 2013, pre-65-year-old adult diabetics on employer-sponsored plans saw their healthcare spending increase $1,000 to about $15,000 per capita, according to the Institute, which uses data from Aetna, Humana, Kaiser Permanente and UnitedHealthcare. Those individuals with diabetes also pay more out-of-pocket than their non-diabetic peers, on the order of 2.5 times more." (Healthcare Payer News)  

Interactive Online Tool: The Health Spending Explorer
"This interactive tool provides up-to-date information on U.S. health spending by federal and local governments, private companies, and individuals. It was developed ... using data from the National Health Expenditure Account and will be updated annually with each data release." (Kaiser Family Foundation)  

Two Transit Parity Bills Languish in Congress
"Despite two transit parity bills introduced so far this year on Capitol Hill, Congress so far has made no indication it will extend the mostly non-controversial proposal to equalize the tax breaks for qualified parking and mass transportation and vanpool commuting expenses." (Thompson SmartHR Manager)  

San Bernardino to Slash Retiree Health Care in Bankruptcy Plan
"Steven Katzman, who represents a committee of retirees in talks with the bankrupt city, says a tentative deal has been struck under which retirees would sacrifice the city subsidies they currently receive for health care coverage in exchange for a guarantee that San Bernardino continues to fund and not cut current pension benefits. The deal would follow an approach taken in the recent bankruptcies of Detroit, Michigan and Stockton, California, where retiree health care was slashed or eliminated, while pensions emerged relatively unscathed." (Reuters)  

[Opinion]

Ten Things You May Not Know About Health Savings Accounts
"In the beginning, HSAs received almost no industry support.... In the beginning, HSAs received almost no support from conservative think tanks.... In the beginning, HSAs received no support from academic health economists.... HSAs were originally a bipartisan idea.... One of the earliest adopters of an HSA-type plan was a labor union.... HSAs are one of the earliest examples of behavioral economics applied in the workplace.... The companies that have profited the most from HSAs have contributed almost nothing to their legislative creation, their public promotion and their political defense.... The HSA that works best with the Obamacare tax credits is a Roth HSA.... The HSA Design that economists like is the one everyone else hates.... President Obama could create 35 million more spend-it-or-save-it accounts by executive order." (John C. Goodman, via Forbes)  

Dorsey Adds Experienced Employee Benefits Lawyer Elizabeth Deckman in Seattle
Dorsey & Whitney LLP

SOA CPD Tracker
Society of Actuaries

Power Kunkle Benefits Consulting Is the Latest Partner Firm to Join United Benefit Advisors
United Benefit Advisors

Labor Department Sues Alabama’s Law Partners LLC for Improper Use of Employee Retirement Contributions
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

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