ESOP and 401(k) Administrator
Primark Benefits
in CA

Retirement Compliance Senior Consultant
Buck Consultants a Xerox Company
in ANY STATE

Data and Benefits Analyst
NYC Multiemployer Pension Fund
in NY

Senior Account Manager
Ohio National Financial Services
in OH

Peer Reviewer and Technical Resource
The Angell Pension Group, Inc.
in ANY STATE

Post Your Job

View All Jobs

RSS Feed: All Jobs

2015 ASPPA Virtual Conference
May 14, 2015 WEBCAST
(ASPPA [American Society of Pension Professionals & Actuaries])

403(b) Plans: Brush up on the rules!
May 19, 2015 WEBCAST
(ASC Institute)

Mental Health Parity - Important Information About Your Health Coverage
May 28, 2015 WEBCAST
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

Retirement Plans Executive Summit
June 16, 2015 in MA
(Insured Retirement Institute [IRI])

2015 National Compliance Outreach Program for Broker-Dealers
July 14, 2015 in DC
(U.S. Securities and Exchange Commission)

6th Annual Private and Public Exchange Summit
July 15, 2015 in VA
(World Congress)

Retirement Plan Insights Seminar
August 11, 2015 in MA
(McKay Hochman Co., Inc.)

View All Webcasts and Conferences

[Official Guidance]

Text of CMS FAQs on Embedded Self-Only Cost Sharing Limitation (PDF)
"Q2: How can an issuer be in compliance with the requirement that the self-only annual limitation on cost sharing applies to each individual, regardless of whether the individual is enrolled in a self-only or in an other than self-only plan, and offer a family high deductible health plan (HDHP) with a $10,000 family deductible? A2: For 2016, the maximum annual limitation on cost sharing for self-only coverage is $6,850. Consequently, for 2016, an issuer can offer a family HDHP with a $10,000 family deductible, as long as it applies a maximum annual limitation on cost-sharing of $6,850 to each individual in the plan, even if the family $10,000 deductible has not yet been satisfied. This standard does not conflict with IRS rules on HDHPs." [Q1 covers reporting of plan cost sharing parameters by issuers.] (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Advert.]

Well-Being Bootcamp for HR, Wellness & Benefits Professionals

Through case studies and presentations by forward-thinking employers and leaders, this HRCI accredited meeting delivers a fresh look at the evolution of wellness and building programs founded on reconciling business goals with employee health accountability.

[Guidance Overview]

CMS Presentation: Understanding the Edge Server Reinsurance Payment Calculation, May 7, 2015 (PDF)
61 slides. "This training will provide a step-by-step explanation of the individual enrollee-level reinsurance calculations that will occur on the EDGE server including: [1] Claims and enrollee selection rules; and [2] Application of the Cost-sharing Reduction (CSR) Maximum Out-of-Pocket Adjustment (MOOP) calculation for individual and family policy. The training will also walk through examples of the reinsurance calculations." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

EEOC's Proposed Wellness Program Regs Offer Guidance on Confidentiality of Employee Medical Information
"The proposed rule states that a covered entity may only receive information collected by or through a wellness program in 'aggregate form' -- such that it does not disclose, and is not reasonably likely to disclose, the identity of specific individuals except as necessary to administer the plan. The proposed rule explains that both employers that sponsor wellness programs as well as administrators of wellness programs acting as agents of employers have obligations to ensure compliance with the confidentiality requirements." (Ogletree Deakins)  

[Guidance Overview]

The EEOC Proposed Regs on Employer Wellness Programs: Important Differences from HIPAA and ACA Rules
"[T]he EEOC does not address how to calculate the 30% limit when an employee's spouse and/or dependents are also eligible for the wellness program incentive. The EEOC rule appears to refer to 30% of the cost of employee-only coverage as 'the maximum allowable incentive available under HIPAA and the Affordable Care Act for health-contingent wellness programs.' Under HIPAA and the PPACA, however, the limit on incentives is up to 30% of the total cost of the employee's coverage, which might be for employee-plus-one or family coverage." (Towers Watson)  

[Guidance Overview]

Massachusetts Earned Sick Time Law Takes Effect July 1
"Employers must provide earned paid sick time to eligible employees if they maintained 11 or more employees on the payroll during 20 or more weeks (whether consecutive or not) or for 16 consecutive weeks over either the current or preceding calendar year.... All of an employer's employees, whether working in or outside Massachusetts, and regardless of their eligibility to accrue and use earned sick time, shall be counted for the purpose of determining employer size.... Employees must make good-faith efforts to alert their employers of their use of earned sick time; however, the employer can never require any documentation to explain the nature of the illness or the details of the domestic violence or other matter that required the employee to utilize his or her earned sick time." (Mintz Levin)  

Anti-Discrimination Litigation Under Section 1557 of the ACA
"Although the ACA has been in place for half a decade, HHS has yet to issue regulations implementing section 1557 (although proposed regulations are currently under review at the Office of Management and Budget). But section 1557 itself provides that the enforcement provisions provided by each of the statutes cited in section 1557 apply for violations of section 1557, and the courts are beginning to enforce it." (Health Affairs)  

New ACA Reporting Requirements Pose Challenges to Employers, Many Have Not Decided How They Will Comply (PDF)
"Only 10% of survey participants reported having already implemented an in-house or outsourced solution. 16% of survey participants reported that they have not yet even considered a solution, or do not know what solutions they should consider.... 65% of survey participants indicated that data quality was a concern. For many employers, multiple systems house the necessary data (these include payroll, HRIS, benefits administration, and leave of absence systems), and some of the data may be held by third parties." (PricewaterhouseCoopers)  

Do Individuals Make Sensible Health Insurance Decisions? Evidence from a Menu with Dominated Options
"[The authors] examine health-insurance decisions of employees at a large U.S. firm where a new plan menu included a large share of financially dominated options.... [A] majority of employees -- and in particular, older workers, women, and low earners -- chose dominated options, resulting in substantial excess spending. Most employees would have fared better had they instead been enrolled in the single actuarially-best plan.... [T]hese choices reflect a severe deficit in health insurance literacy ... rather than a sensible comparison of plan value. [These] results challenge the standard practice of inferring risk attitudes and assessing welfare from insurance choices, and raise doubts whether recent health reforms will deliver their promised benefits." (National Bureau of Economic Research [NBER])  

Employers Can Improve Health Plan Transparency Tool Usage
"Despite the availability of transparency tools, a new Kaiser Family Foundation poll shows consumers are not using the available data to make health care decisions.... There are a few things employers can do to increase utilization of transparency tools: Don't be afraid to over communicate.... Make sure it's easy to find cost information.... Educate and reeducate your employees about the costs associated with your health plan." (Mercer/Signal)  

Updated HHS Guide for Healthcare Providers Includes Practical Approaches for Safeguarding HIPAA Electronic PHI
"The guide goes beyond a description of the legal requirements to provide insights into the regulators' current views on operational practices -- for example, the emphasis on encryption comports with recent OCR enforcement activity even though HIPAA does not mandate encryption." (Thomson Reuters / EBIA)  

Antiquated Healthcare Billing Practices Are Alienating Consumers
"Patients and wealthy consumers are most dissatisfied with the healthcare billing and payment system. One in two Americans in poor or fair health -- the greatest users of the system -- rated hospitals poorly on price transparency and affordability. Millennials are more likely to judge healthcare organizations based on their billing practices. They also are more likely to challenge medical bills, search for better deals and make value-based decisions. Consumers and new entrants are beginning to circumvent the claims-based healthcare payment system, especially when seeking primary care and chronic disease management." (HealthLeaders Media)  

Insurers: The New Contraceptive Access Study That Politicians Are Citing Is Flawed
"[H]ealth insurers say [a recent study by the National Women's Law Center] is flawed and too strongly weighs a wider range of contraceptive options and brand-name contraceptives ... In response to the report, New York Attorney General Eric Schneiderman ... will introduce legislation that, if passed, will reinforce and expand on provisions in the [ACA] designed to increase access to contraceptive care for patients with no additional costs. The bill would, among other things, require health insurance policies in the state of New York to cover men's contraceptive treatment with no out-of-pocket costs, prohibit insurance companies from 'medical management' review of contraceptive coverage, and allow for the dispensation of a year's worth of a contraceptive at a time." (BuzzFeed News)  

White House Moves to Fix Two Key Consumer Complaints About Health Care Law
"Federal health officials said ... that they would require insurers to update and correct 'provider directories' at least once a month, with financial penalties for insurers that failed to do so. In addition, they hope to provide an 'out-of-pocket cost calculator' to estimate the total annual cost under a given health insurance plan. The calculator would take account of premiums, subsidies, co-payments, deductibles and other out-of-pocket costs, as well as a person's age and medical needs." (The New York Times; subscription may be required)  

The San Francisco Health Care Security Ordinance: A Refresher Course for Employers (PDF)
25 presentation slides. Topics include: [1] Covered employers; [2] Covered employees; [3] The HCSO voluntary waiver form; [4] Qualifying expenditures; [5] Calculating health insurance expenditures; [6] The City Option; [7] Irrevocable expenditures; [8] Employee notice requirement; [9] Recordkeeping requirements; [10] Reporting requirements; [11] Penalties. (ABD Insurance & Financial Services)  

[Opinion]

Court Case Showed How Health Insurers Overcharge Participants and Employers
"After suing and getting documentation from [Blue Cross Blue Shield of Michigan (BCBSM)], attorneys for Hi-Lex were able to show the court [in 2014] that BCBSM marked up hospital claims by as much as 22 percent. BCBSM didn't disclose the markups, however.... The hidden fees were listed in internal BCBSM documents under a variety of names: provider network fees, contingency/risk fees, retiree surcharges, and ... other-than-group subsidy fees.... One of the documents that came to light was a survey BCBSM conducted that found that 83 percent of its self-insured customers were completely unaware of the fees." [Hi-Lex Controls v. Blue Cross Blue Shield of Michigan, Nos. 13-1773/1859 (6th Cir. May 14, 2014; cert. denied Oct. 20, 2014)] (The Center for Public Integrity)  

[Opinion]

How Employers Can Spark a Health Care Revolution
"[T]hrough private exchanges, private sector employers are already taking control of health care costs, and workers and their families are already exercising greater control over their health care spending. Perhaps even more intriguing is how public sector employers will respond.... With massive purchasing power, state and local governments could demand high standards of transparency. For workers and their families, a vital component of a well-functioning private exchange is information on costs and quality of providers and services. A strong public sector demand for this information would reinforce the best efforts of privately financed patients." (The Daily Signal)  

Text of Third Circuit Opinion Delineating Threshold for Catalyst Theory Recovery of Attorney's Fees (PDF)
"To succeed under a catalyst theory of recovery, evidence that judicial activity encouraged the defendants to settle is not necessary. All that is necessary is that litigation activity pressured a defendant to settle or render to a plaintiff the requested relief.... [A] party is eligible for attorney's fees where his or her litigation efforts resulted in a voluntary, non-trivial, and more than procedural victory that is apparent to the court without the need to conduct a lengthy inquiry into whether that success was substantial or occurred on a central issue." [Templin v. Independence Blue Cross, No. 13-4493 (3d Cir. May 8, 2015)] (U.S. Court of Appeals for the Third Circuit)  

2015 Workplace Benefits Report: Helping Employees Live Their Best Financial Lives (PDF)
20 pages. "This report provides a clear picture of the data, trends and new ideas related to workplace benefits today. It uncovers new insights related to financial wellness, health care, incentives, the use of total rewards portals and employers' attempts to engage a multi-generational workforce. [Much of the analysis focuses] on trends and perceptions among larger firms, which serve as the incubators of benefits innovation, the trailblazers in implementing new ideas and the bellwethers for the future of benefits. [The report also highlights] where the pattern for the largest employers diverges from their smaller counterparts in order to gain insight into the direction of the benefits industry as a whole." (Bank of America Merrill Lynch)  

EEOC Memo Indicates Possible Focus on Benefits for Same-Sex Couples
"The instructions discussed in this EEOC post were distributed in February to field offices in an internal memorandum ... detailing how LGBT-related charges should be internally tracked and coordinated. Of particular note for employers, the memorandum lists insurance issues involving benefits for same-sex couples as an issue of particular interest to the EEOC. Employers should be aware that while certain older court decisions have concluded that Title VII does not provide a cause of action for sexual orientation discrimination, case law is evolving, especially in light of this EEOC position, which is not binding on courts but can carry significant weight in court." (Thomson Reuters / EBIA)  

Buyer's Guide for Recordkeeping and TPA Services Released
Fiduciary Supply Management Association [FSMA]

Former Target Lawyer Bob Seng Returns to Dorsey & Whitney in Minneapolis
Dorsey & Whitney LLP

Meridian Compensation Partners Announces the Opening of its San Francisco Office
Meridian Compensation Partners, LLC

Tackling America's Retirement Crisis Head-On: Retirement Income Certified Professional Becomes The American College's Top Designation Program
American College

View All Press Releases