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IRA Excess Contributions and Recharacterizations
June 11, 2015 WEBCAST
(Ascensus)

Trustees and Administrators Institutes
June 15, 2015 in CA
(International Foundation of Employee Benefit Plans [IFEBP])

Benefits Conference for Public Employees
June 16, 2015 in NY
(International Foundation of Employee Benefit Plans [IFEBP])

IRA Investments and Investment Issues
June 25, 2015 WEBCAST
(Ascensus)

View All Webcasts and Conferences

[Official Guidance]

Text of Instructions for CMS 2014 Risk Corridor Plan Level Data Form (PDF)
17 pages; May 29, 2015. "These are the filing instructions for the Risk Corridors Plan-level Data Form for the 2014 benefit year.... Each company with at least one health insurance issuer that offered a certified QHP through the Federal or State-based Marketplace during the 2014 benefit year will submit the Risk Corridors Plan Level Data Form with plan-specific premium data for each of its QHP issuers in the individual or small group markets. This form is only required to be submitted by companies with at least one issuer with at least one plan that is certified and offered through either the Federal or State-based Marketplace. The data included in the Risk Corridors Plan-level Data Form will be used to calculate risk corridors payments and charges[.]" [Also available: Risk Corridors 2014 Plan Level Data Form.] (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Advert.]

HSAs and Consumer-Driven Health Plans in a Post-Health Care Reform World

Attend this live webinar on June 17 and learn the steps needed to transition to the consumer-driven health plan that works best for your company. BenefitsLink discount.

[Official Guidance]

Text of Instructions for CMS Medical Loss Ratio (MLR) 2014 Annual Reporting Form (PDF)
May 29, 2015. "These are the filing instructions for the report to the Secretary required by ... the Public Health Service Act (PHSA), which includes elements that make up the medical loss ratio (MLR) and the calculation and provision of rebates to enrollees. The data included in the MLR Annual Reporting Form (MLR Form) are the exact data that will be used to calculate an issuer's MLR and rebates, if any, under section 2718 of the PHSA[.]" [Also available: MLR 2014 Annual Reporting Form and MLS 2014 Calculator and Formula Tool.] (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Official Guidance]

Text of Instructions for CMS Medical Loss Ratio (MLR) Rebate Notices (PDF)
8 pages; May 29, 2015. "Each issuer who must provide a rebate is also required to provide a notice containing information about its MLR and the rebate to policyholders and subscribers who are receiving a rebate, and also to subscribers in the group market whose policyholder is receiving a rebate (Notice).... Issuers must use ... standard Notices to provide the required Notice. These instructions provide directions as to who must be sent a Notice, the timing of the Notice, completing the attached standard Notices, and methods for providing Notice. Issuers may not deviate from the content of the forms provided, unless populating variable fields or adding the issuer's or plan's name/logo. There are three standard Notices, each one designed for policyholders and subscribers in different situations.... Notice to Subscribers in the Individual Market (Notice #1) ... Notice to Group Policyholders and Their Subscribers, Rebate Sent to the Policyholder (Notice #2) ... [and] Notice to Subscribers of Group Policyholders, Rebate Sent to the Subscribers (Notice #3)." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

New Agency FAQs May Require Changes to Health Plan Pharmacy Coverage of Preventive Care Services (PDF)
"A plan may use cost-sharing to encourage the use of generic pharmacy items rather than brand name items. But if a plan does impose cost-sharing or medical management techniques, it must have an accessible, transparent and expedient exceptions process. Also, if a provider recommends a particular contraceptive service or item based on medical necessity, the plan must defer to the provider's determination and cover it without cost sharing." (Buck Consultants at Xerox)  

[Guidance Overview]

Late to the Party: EEOC Proposes Wellness Program Regs
"Discussed [in this article] are some of the typical wellness program designs and the issues raised for those programs under the EEOC Wellness Rules. One key concern under these rules is whether the program is part of an employer-sponsored group health plan. Also, the rules primarily cover programs that ask questions about a disability or require a medical examination.... [T]he EEOC Wellness Rules often will require changes [in order for the plan] to remain compliant with the ADA." (McGuireWoods LLP)  

[Guidance Overview]

DOL Revises FMLA Forms
"Tucked away in the FMLA health care provider revised instructions is the following sentence: 'Do not provide information about genetic tests ... or the manifestation of disease or disorder in the employee's family members' ... This belated GINA insertion is not surprising. Since 2008, employers have been counseled to include GINA disclaimers in any written inquiry requesting medical information about an individual (e.g., FMLA, ADA, workers' compensation, drug test consent forms). What is surprising is the DOL's failure to use the GINA disclaimer specifically sanctioned by its government counterpart -- the EEOC." (Frost Brown Todd LLC)  

Doctor's Note Plus Knowledge of Workplace Incident May Have Been Sufficient Notice Under FMLA
"Disagreeing with a district court's determination that a police officer failed to provide sufficient notice of a serious condition qualifying him for intermittent FMLA leave, the Sixth Circuit ... found that a doctor's note limiting his workday to eight hours together with the employer's knowledge of a serious health-related incident at work (chest pains) provided evidence that his superiors were aware of his potential FMLA-qualifying condition. Further, because he provided sufficient evidence of the elements for a constructive discharge, the Sixth Circuit found that he established a fact issue as to whether he was denied a benefit under the FMLA. The grant of summary judgment on his FMLA retaliation claim was reversed as well because a reasonable jury could conclude he was targeted in such a way as to compel him to resign." [Festerman v. County of Wayne, No. 14-1950 (6th Cir. May 8, 2015; unpub.)] (Wolters Kluwer Law & Business)  

Texting Supervisor of Absence May Have Been Adequate Notice of FMLA Request
"[T]he employee asserted that he often texted with his supervisor, and that he had previously notified him, via text, of an absence. Observing that while his supervisor stated that employees were supposed to call in, the policy did not require calling a specific person, the court found that a trier of fact could infer that firing the employee for failing to call his supervisor, when other methods of communication were acceptable, was pretext." [Hudson v. Tyson Fresh Meats, Inc., No. 14-1852 (8th Cir. May 22, 2015)] (Wolters Kluwer Law & Business)  

CMS Webinar: Qualified Health Plan 2016 Plan Preview Overview (PDF)
May 21, 2015; 61 presentation slides. "The purpose of this presentation is to provide an overview of the 2016 Plan Preview Module of the CMS Health Insurance Oversight System (HIOS) and discuss best practices for its use. It is intended as a refresher for issuers already familiar with the system." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

Employers Plan to Expand Use of Onsite Health Centers
"Nearly four in 10 (38%) large U.S. employers with onsite health facilities plan to add new centers over the next two years ... A majority of the 120 responding employers that already have onsite or near-site health facilities, or are planning to implement them, share these objectives for their centers: increase productivity (75%), reduce health care costs (74%) and improve convenient employee access to health care services (66%). Nearly all centers also offer a similar range of primary care services. Immunizations (99%), care for acute conditions such as upper respiratory and urinary tract infections (99%), and blood draws (95%) top the list." (Towers Watson)  

'Insult to the Constitution': Judge Presses Administration Lawyer in Latest Obamacare Case
"The Obama administration faced a skeptical judge Thursday as it tried to get the latest Obamacare lawsuit tossed. Justice Department attorney Joel McElvain insisted the case shouldn't be allowed to move forward because the plaintiff, in this case the GOP-led House, lacks the standing to sue.... [D.C. District Court Judge Rosemary Collyer] told McElvain he didn't sufficiently address the GOP's charges that the administration overstepped its authority, and also pushed him to demonstrate when, if not in this circumstance, the legislative branch might ever be able to sue the executive branch." [U.S. House of Representatives v. Burwell and Lew, No. 14-cv-01967 (D.D.C. filed Nov. 21, 2014)] (Washington Examiner)  

Five Things You Need to Know About Medicare
"[1] Medicare is not a 'one size fits all' program.... [2] Medicare is not free! ... [3] Medicare does not cover all of your possible health care needs.... [4] You risk a possible penalty if you do not sign up for Medicare once you are eligible.... [5] There are special rules you need to know if you have health insurance through your employer at the time you are eligible for Medicare." (Women's Institute for a Secure Retirement [WISER])  

[Opinion]

Midwest Business Group on Health Comment Letter to IRS on 'Cadillac Tax' (IRS Notice 2015-16) (PDF)
"The Cadillac tax is a unique revenue generating mechanism that presumably targets excessively generous employer-sponsored health insurance packages, thereby increasing incentives for the prudent and efficient use of care. The tax is not intended to work at cross purposes with the general concept of employer-sponsored insurance, undermine the overall movement toward consumer directed care or hinder an employer's ability to offer cost effective strategies for improving the health and wellbeing of their workforce. The regulatory implementation of Section 4980I must serve these narrowly tailored objectives." (Midwest Business Group on Health [MBGH])  

Text of Ninth Circuit Opinion: Deadline for Appeal of Benefit Claim Denial Extended to Monday When It Falls on a Weekend (PDF)
"In a letter denying LeGras's application for continued long-term disability benefits, AETNA informed LeGras that he could file an internal appeal of the decision within 180 days. The 180-day period ended on a Saturday. Although LeGras mailed his appeal the following Monday, AETNA denied it as untimely ... We hold that because the last day of the appeal period fell on a Saturday, neither that day nor Sunday count in the computation of the 180 days. As LeGras mailed his notice of appeal on Monday, it was timely. This method of counting time is widely recognized and furthers the goals and purposes of [ERISA]. We therefore adopt it as part of ERISA's federal common law." [LeGras v. Aetna Life Ins. Co., No. 12-56541 (9th Cir. May 28, 2015)] (U.S. Court of Appeals for the Ninth Circuit)  

Economists Have Figured Out Who's Really to Blame for Increase in Income Inequality
"[I]f CEOs really are gobbling up a bigger and bigger slice of the profit pie, then inequality within society at large should have increased because inequality within companies increased. But that's not what happened.... [Researchers] were able to look at what had previously between private earnings data for every company between 1978 and 2012 -- the best data we have so far -- and found that the pay gap between executives and their own workers had barely changed during this time. What had changed, though, was the pay gap between every worker at the highest-paid firms and everyone else. In other words, inequality exploded because the top 1 percent of companies were making more and paying all their employees more. This was true across the country and across industries." (The Washington Post; subscription may be required)  

The Changing Landscape of Golden Parachutes in a Say-on-Pay World
"Facing pressure from shareholders, many companies have modified their parachute arrangements to require both a [change in control (CIC)] event and corresponding termination of employment by the company before payments are triggered. Such double-trigger requirements have continued to rise, with 95% of agreements now having them, a 10-percentage-point increase for CEOs and an 11-point increase for other [named executive officers (NEOs)] since 2010. The involuntary termination must take place within a specified length of time, called the 'protection period,' which is typically two years following the CIC event." (Towers Watson)  

LIMRA Secure Retirement Institute Study Finds Student Loan Debt a Growing Concern for Retirement Saving
LIMRA LOMA Secure Retirement Institute

U.S. Labor Department Secures Consent Judgment Against Fiduciaries in Lakewood, Washington, Who Took Money from Pension Plan for Personal Use
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

Court Appoints Independent Fiduciary to Distribute Assets of I.Q. Marketing Inc. 401(k) Plan in Minneapolis
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

New White Paper from United Benefit Advisors Provides Employer Road Map to Department of Labor Audit Process
United Benefit Advisors

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