Health & Welfare Plans Newsletter

June 5, 2015

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Employee Benefits Jobs

Software Product Manager
iraLogix, LLC
in FL

DC Third-Party Administration Management
Touchstone Retirement Group
in NY

401(k) & Retirement Sales
Chadler Solutions
in NJ

Team Lead, Operations
Verisight
in CA

Compliance Specialist
Verisight
in IL

Retirement Plan Administrator
Trust Point Inc.
in MN

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Webcasts and Conferences

Qualified Transportation Plans: Designing and Delivering Commuter Benefits
RECORDED
(Thomson Reuters / EBIA)

Big Data Breach: Lessons from Anthem
June 10, 2015 WEBCAST
(Employers Council on Flexible Compensation)

Ins and Outs of Plan Amendments
June 23, 2015 in FL
(ASPPA Benefits Council [ABC] of North Florida)

ACA Information Reporting: 1095-C and 1094-C Forms and Instructions
June 25, 2015 WEBCAST
(Thompson Information Services)

View All Webcasts and Conferences



[Guidance Overview]

Student Employees and the ACA, Part 2 of 4
"Self-funded student health plans were designated as [minimum essential coverage (MEC)] under [Internal Revenue Code section] 5000A(f)(1)(E) through 2014. After 2014, they will be MEC only if recognized as such through application to HHS via the process outlined in CFR Section 156.604. Note that, at this time, it is unclear if any educational institutions have availed (or will avail) themselves of this process; however, it seems likely that any such plans designated as MEC will fall under 5000A(f)(1)(E)." (Mintz Levin)  


[Advert.]

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[Guidance Overview]

IRS Issues Updated Guidance on ACA Reporting Requirements for Large Employers
"An [applicable large employer (ALE)] with no full-time employees for any month of the year is not obligated to report unless the ALE sponsors a self-insured health plan in which any employee, spouse, or dependent is actually enrolled. In that case, the ALE must still file Forms 1094-C and 1095-C even if it has no full-time employees.... The guidance provides examples demonstrating how reporting differs when an ALE reports for separate divisions and when ALEs are part of a controlled group.... The guidance confirms that ALEs may not use simplified statements for employees who actually enroll in the ALE's self-insured plan.... Forms 1095-C may be delivered to employees in any manner permitted for delivery of Forms W-2." (The Wagner Law Group)  

[Guidance Overview]

Final Rule on Limited Wraparound Coverage Under the ACA
"[L]imited 'wraparound' benefits are considered 'excepted benefits,' which means they are not be subject to the [ACA's] group health plan mandates, such as the prohibition on annual dollar limits. [Topics addressed in this article are:] [1] Limited wraparound coverage is a pilot project ... [2] Requirements for any limited wraparound coverage ... [3] Specific rules for limited wraparound coverage for part-time employees or retirees ... [4] Requirements for limited wraparound coverage for full-time employees ... [5] Implications for plan sponsors." (Segal Consulting)  

[Guidance Overview]

DOL Updates FMLA Notices and Certification Forms (PDF)
"Each of these FMLA forms has been modified to reflect the 2018 expiration date. Three of the forms -- the eligibility and designation notices (WH-381 and WH-382) and the qualifying exigency certification (WH-384) -- are otherwise unchanged (although the eligibility notice, previously a three-page form, has been compressed to two pages). The four remaining certification forms have been modified to reference expressly the Genetic Information Nondiscrimination Act (GINA) in instructions to employers and healthcare providers." (Buck Consultants at Xerox)  

Charts Show the Real Problem for American Health Spending
"Two charts in particular show that the United States doesn't have high costs because we use more health care. We have high costs because we pay way more for the care itself." (Vox)  

Republican Study Committee Reintroduces Health Reform Bill
"[The] American Health Care Reform Act, previously introduced in September 2013 ... eliminates the current exclusion from taxable income of employer-based benefits as well as Obamacare's tax credits paid through exchanges. Instead, it offers a standard deduction of $7,500 for individuals or $20,500 for a family that buys qualifying health insurance." (National Center for Policy Analysis Health Policy Blog)  

'New Rules' to Guide Health Care Redesign
"One of the [Leadership Alliance's] first steps was to propose 'new rules' to redesign the health care system ... [T]he rules can be applied to guide improvements for vulnerable patients, including those with low incomes, and those with complex needs who incur high costs ... The new rules also point to the dysfunction that underlies many of the unwritten rules governing health care today." (The Commonwealth Fund)  

The CFO's Expanding Role in Corporate Health Benefits
"The pace of change in the employee health care benefit environment is rapidly broadening and deepening the CFO's role. CFOs influence four areas: managing costs, financing the program and transferring risk, examining private insurance exchanges and investing in workforce health programs. A close collaboration among HR, Benefits and Finance leaders is the key to creating -- and sustaining -- an effective health benefit program." (Towers Watson)  

How Medicare Advantage Plans Can Thrive in a Winner-Take-All Market
"For the past few years, U.S. health plans that cover Medicare Advantage (MA) beneficiaries have been struggling to hold out against a string of reimbursement cuts. Now, as these rate cuts finally begin to stabilize, plans are faced with a new challenge: further improving the quality of the care they deliver." (Health Affairs)  

Benefits in General; Executive Compensation

Text of SEC Memo: Potential Effect on Pay Ratio Disclosure of Exclusion of Different Percentages of Employees at a Range of Thresholds (PDF)
"Excluding some employees from the determination of median employee compensation, which some commenters suggested, can affect the calculation of that median and thus change the ratio of the annual total compensation of the principal executive officer (PEO) to the median of the annual total compensation of employees (pay ratio).... Projections ... are based on evidence obtained from other studies, aggregate statistics, and other assumptions that may result in over- or underestimating the magnitude of the effect." (Staff of the Division of Economic and Risk Analysis of the U.S. Securities and Exchange Commission [SEC])  

The SEC Becomes Front Page News! More New Rules Coming Soon
"[T]he SEC seems poised to release proposed rules on Compensation Clawbacks under Dodd-Frank Act Section 954 and re-proposed rules on Incentive Compensation Reporting and Prohibitions for Financial Institutions under Dodd-Frank Act Section 956 (which also feature compensation clawbacks, not coincidentally)." (Winston & Strawn LLP)  

Press Releases

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