Pension Administrator
Actuaries Unlimited, Inc.
in CA

Client Executive EM
Transamerica
in IL, MN

Business Analyst
Charles Schwab
in TX

Employee Benefits Account Specialist
Chadler Solutions
in NJ

Benefits Analyst 3
University of California Office of the President
in CA

Senior Retirement Analyst
Vista Outdoor
in UT

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Cash Balance and Defined-Benefit Plan Designs
August 11, 2015 in NY
(ASPPA Benefits Council [ABC] of New York)

2016 Annual National Health Benefits Conference and Expo
January 25, 2016 in FL
(Health Benefits Conference & Expo)

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[Guidance Overview]

HRAs, FSAs and Employer Reimbursements for Health Insurance: Navigating the ACA
"By design, HRAs, Health FSAs and Employer Payment Plans, standing alone, cannot satisfy certain requirements of the ACA.... These arrangements may be structured, however, to be exempt from the ACA requirements. The following exceptions may apply. HRA Integrated with Group Health Plan.... Arrangement that Provides Excepted Benefits (Including an EAP and Limited Wraparound Coverage)... Health FSA.... Payroll Practice.... Retiree-Only or Single Employee Health Plan.... Medicare Premium Reimbursement Arrangement.... TRICARE-Related HRA." (von Briesen & Roper, s.c.)  

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[Guidance Overview]

GASB Adopts Two OPEB Statements (PDF)
"The changes in [Other Postemployment Benefit (OPEB)]-related financial reporting are sweeping in scope. For most employers, the result will be an increase in the balance sheet liability and a significant increase in the volatility of annual OPEB expense. There are several areas that are significant departures from current practice and may therefore cause concern for governmental employer." (Milliman)  

[Guidance Overview]

Massachusetts Attorney General Issues Required Notice, Clarifies 'Safe Harbor' Exemption Under New Earned Sick Leave Law
"First, the Notice states that the smallest increment of sick leave that can be used is one hour. Second, the Notice warns employees that sick leave cannot be used as an excuse to be late for work without advance notice of a proper use, and except in an emergency, employees must notify their employer before using sick leave. Third, the Notice addresses employer concerns that employees might fraudulently use sick time after submitting a resignation notice." (Littler)  

Sixth Circuit at It Again: Orders Make-Whole Relief in Disability Benefit Claim
"If the Plan provided for an increase in benefits, then plaintiff has a 502(a)(1)(B) claim against MetLife (and no breach of fiduciary duty claim against anyone). If the Plan did not provide for an increase in benefits, then International Steel may have violated its fiduciary duty by issuing a misleading SPD, but MetLife's determination accurately interpreted the Plan. Put simply, the court's ruling that International Steel 'breached its duty by issuing a summary plan description that did not accurately reflect the terms of the plan,' compels the conclusion that MetLife accurately interpreted the Plan and upheld its fiduciary duty." [Stiso v. Intl. Steel Group, No. 15-0430 (6th Cir. June 9, 2015)] (Begos Brown & Green LLP)  

If Your Employee Checks Into the Hospital After Midnight, Is It an 'Overnight Stay' Under the FMLA?
"[T]he trial court had determined that the employee had to stay at the hospital from 'sunset on one day to sunrise the next day.' That was not workable, according to the appellate court. After all, how could that principle work on a wintry December day in Fairbanks, Alaska, where those poor souls live in near darkness the entire day? Ultimately, the court determined that an 'overnight' stay had to constitute a 'substantial period of time' from one calendar day to the next calendar day 'as measured by the individual's time of admission and time of discharge.' ... Short of creating a bright line rule, the court suggested that 'a minimum of eight hours would seem to be an appropriate period of time.' But it left closer analysis of this eight-hour time frame to another day." [Bonkowski v. Oberg Ind., No. 14-1239 (3rd Cir. May 22, 2015)] (FMLA Insights)  

Participant Education is Critical in High Deductible Plan Management
"Patients must make informed decisions or financial motivation will move the dial the wrong way. In particular, the value of no-cost preventive services should be highlighted since this will identify needed care and aid in compliance with chronic disease treatment." (Frenkel Benefits)  

Are Smaller Companies Poised to Self-Fund Health Care?
"Historically, the cost savings haven't been enough to sway typical small or midsized companies, as their smaller work forces leave them exposed to potentially disastrous health-care costs in a year of excessive catastrophic claims. Although stop-loss insurance may significantly mitigate that risk, it doesn't eradicate it. But some factors are afoot now that may change the economic equation." (CFO)  

Insurers Push to Link Cost of Drugs to Performance
"Health insurers are pushing to link the cost of specialty medicines to how well they work to improve a patient's condition, a bid to contain prescription drug prices after decades in which pharmaceutical companies could charge whatever the market would bear. The shift is coming as insurers absorb mounting bills for drugs with eye-popping prices and brace for a slew of new therapies for diseases such as hepatitis C, cystic fibrosis, breast cancer, lung cancer, and leukemia. Those emerging treatments could cost US government-paid health programs such as Medicare nearly $50 billion over the next decade[.]" (The Boston Globe)  

New Evidence Health Spending Is Growing Faster Again
"[H]ealth spending was 7.3% higher in the first quarter of 2015 than in the first quarter of last year. Hospital spending increased 9.2%. Greater use of health services as well as more people covered by the ACA appear to be responsible for most of the increase.... Overall ... the increase was much larger in first quarter of 2015 than in the first quarters of 2014 or 2013." (The Wall Street Journal; subscription may be required)  

Supported State-Based Market Places: The Point of Convergence?
"[S]upported state-based health insurance marketplaces (SSBMs)....[which is the] after-the-fact-name of the hybrid operations that have emerged from well-documented exchange snafus in Oregon, New Mexico, and Nevada -- seem to offer the happy convergence of local control over insurance exchange functions and marketplace oversight, with an outsourcing to the federal government of the information technology (IT).... [In] the wake of a Supreme Court decision against the federal government in King v. Burwell at the end of June, would states embrace this option? Regardless of the outcome, is this where many states will end up in an evolved Obamacare world?" (Health Affairs)  

Cloud Tech Could Make a Supreme Court Decision Against Obamacare Irrelevant
"A state can get a health exchange that complies with the ACA in the same way that many businesses buy IT services... [in the form of] software as a service (SaaS).... States just getting started building an exchange right now have already lost federal subsidies to offset startup costs, but an SaaS exchange offers a low monthly operating expense compared to the large capital cost of building a custom state exchange. Rather than a big up-front capital investment in hardware and software, they simply pay to use a shared cloud computing service." (FierceHealthPayer)  

[Opinion]

2016 Health Insurance Premiums: The Reverse Bait-and-Switch
"[It's] important to look between the lines and see which plans are not requesting double-digit hikes for 2016.... The classic 'bait-and-switch' entices consumers to the store with the lure of bargains, but when they arrive they find those items sold out, or are pressured to buy up to a more expensive product.... The insurers requesting big rate increases for 2016 may be doing just the opposite: jacking up the costs of existing products so that narrow-network products, typically featuring care integration, look more attractive." (HealthLeaders-InterStudy)  

Third Circuit Opinion May Change the Way ERISA Plans Approach Settlement
"[T]he 3rd Circuit held that '[t]o succeed under a catalyst theory of recovery, evidence that judicial activity encouraged the defendant to settle is not necessary. All that is necessary is that litigation activity pressured a defendants to settle or render a plaintiff the requested relief.' ... ERISA plans may [now] become less likely to settle marginal claims out of concern that even a nuisance value settlement may open the doors to a fee award. While some ERISA plans routinely settle smaller cases because it makes business sense to do so, that may no longer be the case when attorney's fees are factored into the equation. In addition, ERISA plans may become less likely to increase early settlement offers in order to minimize the likelihood of being accused of having 'changed position.' " [Templin v. Independence Blue Cross, No. 13-4493 (3d Cir. May 8, 2015)] (InsideCounsel)  

Eleventh Circuit Finds Claimant Has 'Duty to Investigate' When Asserting Equitable Tolling of a Contractual Limitations Provision
"[W]hen does the court apply 'equitable tolling' to extend the time by which a claimant may file suit beyond the contractual limitations provision? Rarely. And, what happens if the claim denial letter fails to set out the date by which a claimant must file suit? The contractual limitations provision still may be enforceable." [Wilson v. Standard Ins. Co., No. 14-10825 (11th Cir. June 3, 2015; unpub.)] (Lane Powell PC)  

LifeLock Introduces 401k Theft Protection
LifeLock, Inc.

FedEx Corp. Adopts Mark-to-Market Pension Accounting
FedEx Corporation

Taxpayers with Foreign Assets May Have FBAR and FATCA Filing Requirements in June
IRS [Internal Revenue Service]

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