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Employee Benefits Jobs
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Webcasts and Conferences
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[Guidance Overview]
Student Employees and the ACA, Part 1 of 4: Can We Exclude Student Workers from Our Health Plan?
"[C]ategorical or position-based exclusions from health care eligibility (such as exclusions of temps, co-ops, students, union, casual, students, interns and so on) no longer work.... Although there is no blanket exclusion for student employees, hours of service performed by students in positions subsidized through the federal work study program or a substantially similar state program need not be counted as 'hours of service.' ... Many student workers simply do not work 30 hours per week.... An employer may continue to exclude students as part of its overall compliance strategy, but may be required to pay a tax penalty if one or more of the students obtains subsidized coverage on an exchange."
(Mintz Levin)
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Third Circuit Requires a Stay from One Day to the Next to Be Considered Inpatient Care Under the FMLA
"The crux of this case is an interpretation of the regulation at 29 C.F.R. Section 825.114, which defines the terms 'inpatient care' for purposes of determining if a serious health condition exists ... The Third Circuit Court of Appeals concluded that 'an overnight stay' under this regulation means a stay in a hospital, hospice, or residential medical care facility for a substantial period of time from one calendar day to the next calendar day as measured by the individual's time of admission and his or her time of discharge.... [S]ince the plaintiff was admitted and discharged on the same calendar day, he did not have an overnight stay, and thus did not have a serious health condition." [Bonkowski v. Oberg Industries, Inc., No. 14-1239 (3rd
Cir. May 22, 2015)]
(Cary Kane ERISA Lawyer Blog)
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GM Not Obligated to Make $450 Million Contribution to Fund Union Retiree Health Benefits
"The district court granted summary judgment in favor of New GM, finding that the $450 million contribution obligation did not survive GM's reorganization.... [T]he Sixth Circuit [found] that the obligation did survive because the purchase agreement associated therewith passed on all liabilities arising under the UAW Collective Bargaining Agreement, which included the obligation to make the $450 million contribution. However, the Court nonetheless determined that New GM was not obligated to pay because a subsequent settlement agreement between GM and the UAW was properly construed as having extinguished GM's former obligation." [UAW v. Gen. Motors, LLC, No. 14-1019 (6th Cir. May 14, 2015; unpub.)]
(Proskauer's ERISA Practice Center)
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Improving Employees' Life and Disability Insurance Benefit Decisions: Results of an Employer Survey
"[V]ery little is known about how individuals select their insurance benefits packages, if their selections are optimal for their circumstances, or what employers can do to encourage them to select the optimal benefit package.... Survey results are used to describe the landscape of employer practices with respect to supplementary life and disability insurance and to investigate correlations between employer practices (such as cross-advertising group benefits with health insurance) and employee take-up."
(Center for Retirement Research at Boston College)
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The 2015 Aflac WorkForces Report (PDF)
"[J]ust 1 in 4 adults with incomes at or below 138 percent of the federal poverty level have access to employer-sponsored health insurance.... Higher-income workers are more likely to be satisfied with their benefits packages (58 percent vs. 46 percent for lower-income wage earners). They also devote more time to learning about their benefits: half of those earning less than $50,000 per year spent less than 30 minutes researching their benefits during their last open enrollment, compared to 41 percent of those at the $100,000-or-above mark."
(Aflac)
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Accounting Rule to Force U.S. Cities to Report Healthcare Bills
"As a result of rules approved Tuesday by the Governmental Accounting Standards Board, municipalities and states will have to record the cost of health insurance and other benefits besides pensions in financial statements ... Such costs are currently disclosed only in footnotes.... Similar requirements started taking effect for pensions last year.... States alone have $529.8 billion of unfunded liabilities for health care and other benefits besides retirement checks[.]"
(Bloomberg)
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Improving Care for Chronic Conditions: Current Practices and Future Trends in Health Plan Programs
"This report documents the current range of chronic care management services, identifies best practices and industry trends, and examines factors in the plans' operating environment that limit their ability to optimize chronic care programs.... Plans are making their existing programs more patient-centric and are integrating disease and case management, and sometimes lifestyle management and behavioral health, into a consolidated chronic care management program, believing that this will increase patient engagement and prevent duplication of services and missed opportunities."
(RAND Corporation)
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Getting to the ACO Tipping Point: What Else Might Be Needed?
"There are currently over 740 commercial, Medicare, and Medicaid accountable care organization (ACO) contracts operating in the U.S. This new health care contracting mechanism has grown rapidly over the last three years, and yet the future of the model is by no means secured. Across the U.S. there have been rumblings about the model's financial attractiveness, complexity, and impact."
(Health Affairs)
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Short-Term Health Insurance Plans in the Post-ACA Market (PDF)
7 pages. "[This report] provides an analysis of consumer shopping trends and premium costs in the individual and family short-term health insurance market on both a nationwide and state-by-state basis. The data presented is based solely on short-term health insurance plans selected by eHealth customers on eHealth's website during the 2013 and 2014 calendar years."
(eHealth)
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Survey of Non-Group Health Insurance Enrollees
"Most people in the non-group market do not have access to employer coverage. Over half are either not employed (29 percent) or self-employed (28 percent), and another 16 percent are employed part-time and likely do not have an offer of coverage. Of the one in four (26 percent) who work full-time for someone else, about four in ten, or just 10 percent of all non-group enrollees, say their employer or union offers a health plan to at least some of its employees. Among those whose employers offer a health plan, the largest share says that the main reason they don't participate in their employer's plan is because it is less expensive to buy their own coverage than to pay their portion of the cost for the plan at work."
(Henry J. Kaiser Family Foundation)
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Consumers Drawn to Low Prices of Temporary Health Plans Despite Risks
"Long seen as a stopgap for people between jobs, short-term policies that focus on catastrophic coverage can fill a niche for people ... looking for protection against unforeseen accidents, say some insurance brokers. In exchange for their lower premiums, the plans come with sharp limits, including no coverage for pre-existing medical conditions. Many consumer advocates hoped interest in such plans would decline after the [ACA] made broader coverage widely available, but short-term policies appear to be enjoying a resurgence, brokers say."
(Kaiser Health News)
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13% Left Health Care Rolls, U.S. Finds
"Nationwide, the administration said, the federal government is paying insurance subsidies in the form of tax credits to 8.7 million people, including 2.3 million in states that run their own exchanges. The average tax credit for those who qualified for financial assistance was $272 a month ... [T]he administration listed 11 states where more than 90 percent of consumers insured through the marketplace were receiving subsidies. Mississippi had the highest share, at 94.5 percent, followed in order by Florida, North Carolina, Wyoming, Louisiana, Arkansas, Georgia, Alabama, Wisconsin, Alaska and South Carolina."
(The New York Times; subscription may be required)
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Understanding the Rate Increases for Health Care Plans
"Some of the rate increases are substantial. But for several reasons, simply looking at the current numbers can be misleading.... These are just requests.... We're mostly seeing the really big ones.... Some increases matter more than others.... The budget effect is complex."
(The New York Times; subscription may be required)
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Benefits in General; Executive Compensation
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DOL Audit Quality Study and Recommendations for Improvement
"[T]he underlying problem is that many plan sponsors see no value in the audit and only see it as a compliance hurdle that needs to be overcome.... [T]here are pressures on accounting firms to reduce fees as plan sponsors may only hire accounting firms based on the lowest price.... It appears that there may be some changes coming very soon as the AICPA begins implementing [its] 6-point plan. Some of the eleven recommendations made by the DOL in its report may have more trouble being implemented, such as the recommended changes to ERISA needing congressional agreement. However, the increased focus on audits performed by firms in the lower strata is sure to be implemented more quickly."
(Belfint Lyons & Shuman, CPAs)
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Press Releases
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