Health & Welfare Plans Newsletter

June 25, 2015

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Webcasts and Conferences

Webcast: Understanding the MPRA 2014 Regulations
July 1, 2015 WEBCAST
(International Foundation of Employee Benefit Plans [IFEBP])

FYI on RIFs: Guidance for Early Retirements and Voluntary Reductions in Force
July 8, 2015 WEBCAST
(Ogletree Deakins)

SCOTUS On Employee Benefits: What the Supreme Court Decisions in King and Obergefell will Mean for Employers and Plan Sponsors
July 8, 2015 WEBCAST
(Seyfarth Shaw LLP)

Webcast: ACA Update: King v. Burwell—Now What?
July 9, 2015 WEBCAST
(International Foundation of Employee Benefit Plans [IFEBP])

Health Benefits Laws Compliance Assistance Seminar
July 21, 2015 in NE
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

Health Benefits Laws Compliance Assistance Seminar
September 2, 2015 in SC
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

Changes to Cafeteria Plans: What You Need to Know to Prepare
September 15, 2015 WEBCAST
(Lorman Education Services)

ACOPA LA Advanced Pension Conference
January 22, 2016 in CA
(ASPPA College of Pension Actuaries [ACOPA])

View All Webcasts and Conferences



[Guidance Overview]

IRS Transition Relief for Small Companies Offering Employer Payment Plans Ends on June 30
"[E]mployers are no longer allowed to reimburse employees for individually purchased health insurance policies, because they violate the ACA's market reforms. However, the IRS had issued transition relief for small employers that offered this type of arrangement to provide them with additional time to obtain group health coverage. Small employers should be aware that this transition relief is ending on June 30, 2015. Any small employer that still offers this type of arrangement after June 30 could be subject to an excise tax of $100 per employee per day until the violation is corrected." (Wolters Kluwer Law & Business)  


[Advert.]

Well-Being Bootcamp for HR, Wellness & Benefits Professionals

Sponsored by World Congress

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]

Massachusetts Earned Sick Time Law Takes Effect July 1
"Employers must provide all employees, including part-time, seasonal, and temporary employees, one hour of sick time for every 30 hours worked, up to a maximum of 40 hours per year. Employers with 11 or more employees must provide paid sick time; employers with fewer than 11 employees must provide unpaid sick time.... The use of earned sick time is job-protected leave. Employers may not interfere with, restrain, or deny the exercise of an employee's rights under the law. Employers may not retaliate against employees for exercising their rights under the law." (Mintz Levin)  

ACA Survives Supreme Court Challenge
"By a 6-3 vote, a divided court affirmed an Internal Revenue Service ruling that subsidies should be available not only in states that have set up their own health insurance exchanges, but also in those where consumers rely on the federal government exchange.... While there are more challenges to come, an adverse ruling in this case would have been close to a mortal blow to the act that continues to divide the nation and its political conversation." (The Washington Post; subscription may be required)  

Supreme Court Upholds ACA Subsidies
"The different path the Court took ... will not impact the implementation of the ACA or affected health plans. While this decision maintains the status quo, it is significant because it supports the ACA's current infrastructure and avoids a number of problems that could have been created had the Supreme Court ruled another way.... Now that this question has been resolved, the IRS and other regulatory agencies are free to focus their efforts on the remaining outstanding ACA issues, including implementing the new reporting requirements, developing nondiscrimination rules for insured health plans, issuing guidance on automatic enrollment requirements for large employers, and promulgating regulations on the Cadillac Tax." (Thompson Hine)  

Paying Employee Full Salary to Work Part-Time in Lieu of Taking FMLA Leave May Be Interference
"Though an employer appeared generous in setting up a plan where, in lieu of FMLA leave, an employee would be paid her full salary to work as often as she could while her son was treated for cancer, a federal court in North Carolina found triable questions on whether this constituted FMLA interference because a jury could find the employer discouraged her from exercising rights under the Act. There was also a question whether she was prejudiced because the communication issues for which she was fired might not have arisen had she been on protected leave." [Alexander v. Carolina Fire Control, Inc., No. 1:14CV74 (M.D.N.C. June 18, 2015)] (Wolters Kluwer Law & Business)  


[Advert.]

Join us at IHC Private Exchange FORUM Baltimore Sept. 1-2, 2015!

Sponsored by Institute for Healthcare Consumerism [IHC]

Come to the ONLY national event 100% dedicated to private exchanges and defined contribution! We'll provide a 360-degree perspective on the massive growth and transition to the Private Exchange delivery model. Sign up today for the lowest rates!



Third Circuit Instructs Employers to Allow Employees Submitting Insufficient FMLA Medical Certifications Opportunities to Cure Their Paperwork
"The court's message is clear: an employer must strictly comply with the regulations, which provide an opportunity for an employee to receive notice of and to cure defects in a medical certification. When Human Resources properly identifies insufficiencies in FMLA paperwork, the employee must be notified of and provided with an opportunity to cure. In general, failure to conform to the regulations puts an employer in peril." [Hansler v. Lehigh Valley Hospital Network, No. 14-1662 (3d. Cir. June 22, 2015)] (Fox Rothschild LLP)  

Paid Sick Time Law Developments: State of California; Emeryville, California; Eugene, Oregon; and Bloomfield, New Jersey
"The wave of new sick leave legislation continues across the country. At the same time, state and local governments continue to refine existing laws to address new laws passed, as well as the complexities that surround providing for and administering paid sick leave benefits." (Littler)  

Are We on the Path to Paid Sick Leave?
"President Obama has urged Congress to pass federal legislation giving U.S. workers seven days of paid sick leave. But the consensus remains that such a bill would be unlikely to gain the necessary Congressional support in the near future.... Some companies, of course, aren't waiting for a federal paid sick leave law to become reality." (HRE Daily)  

40% of Physician Networks Could Be Considered Narrow
"The results of the study found that 41% of networks on the marketplaces are considered small or x-small. Only 11% are considered x-large and include more than 60% of office-based practicing physicians in the area. The majority of the networks on the marketplace are either health maintenance organizations (HMOs) or preferred provider organizations (PPOs), and there is a sharp distinction between the size of their networks. More than half (55%) of HMOs have x-small or small networks compared with only 25% of PPOs." (American Journal of Managed Care)  

The Skinny on Narrow Networks in Health Insurance Marketplace Plans
"The 'narrowness' or size of a network can be quantified, and 41 percent of silver plan physician networks in the ACA marketplace are small or extra small. While consumers are likely to select plans with low premiums, they are not fully aware of the characteristics of narrow networks. Well-functioning narrow networks will survive only if their characteristics are communicated more clearly to consumers and they are regulated to ensure adequacy." (Robert Wood Johnson Foundation)  

Multiemployer Plans: Current ACA Issues (PDF)
"The study found some regional differences in the implementation of cost-management strategies: Implementation of reference-based pricing was highest in the West. Implementation of both onsite clinics and wellness with incentives was highest in the Midwest. Implementation of narrow networks was highest in the Northeast... A large majority of plans in the study have not changed coverage for spouses.... Similarly, most plans in the study have maintained coverage for retirees." (Segal Consulting)  

Analysis of 2016 Premium Changes and Insurer Participation in the ACA's Health Insurance Marketplaces
"This brief presents an early analysis of changes in the premiums for the lowest- and second-lowest cost silver marketplace plans in major cities in 10 states plus the District of Columbia ... In most of these 11 major cities, we find that the costs for the lowest and second-lowest cost silver plans -- where the bulk of enrollees tend to migrate -- are changing relatively modestly in 2016, although increases are generally bigger than in 2015. The cost of a benchmark silver plan in these cities is on average 4.4% higher in 2016 than in 2015." (Henry J. Kaiser Family Foundation)  

[Opinion]

Now That the Supreme Court Has Issued Its Health Care Decision, Let's Fix the Underlying Law
"[T]he country's largest employers were providing health coverage to employees long before the Affordable Care Act. 'With the legal case settled, Congress should use this opportunity to repeal the burdensome and unnecessary taxes, mandates and reporting requirements imposed by the ACA,' says Annette Guarisco Fildes, president and CEO of ERIC. 'Specifically, we want Congress to repeal the 40 percent health care excise tax, the employer mandate and all the related reporting requirements.' " (The ERISA Industry Committee [ERIC])  

[Opinion]

Business Leaders Respond to King v. Burwell Decision
"Moving forward, we believe Congress and the Administration should address the problems that still accompany the Affordable Care Act, such as the medical device tax, insurance tax, pharmaceutical tax and the complexity of complying with the regulatory requirements. Business Roundtable will also aggressively pursue regulatory or legislative changes to the 40 percent tax on many employer and government health care plans." (Business Roundtable [BRT])  

[Opinion]

Actuaries Say Supreme Court Decision Upholding Subsidies Averts Significant Health Insurance Market Disruptions
" 'The ACA's premium subsidies work together with the individual mandate as incentives for even individuals in good health to obtain coverage,' said Academy Senior Health Fellow Cori Uccello. 'Had the court's majority decided differently, the federal-marketplace states would be facing significant disenrollment of those who cannot afford insurance without the subsidies, and the consequences of that could have threatened the viability of those markets. In the loss-of-subsidy scenario, adverse selection would have been a serious concern, as relatively higher-cost individuals would have retained coverage, increasing average costs and premiums.' " (American Academy of Actuaries)  

[Opinion]

Six Problems with the ACA That Aren't Going Away
"There is an urgent need to make major changes in the law regardless of how the Supreme Court rules. These are changes that will require bi-partisan cooperation -- something that is rare in health policy. The changes are needed because there are at least six major problems that aren't going away. [1] An impossible mandate ... [2] Unworkable subsidies ... [3] Perverse incentives for insurers ... [4] Other perverse incentives for buyers ... [5] Lack of access to care ... [6] Impossible burden for the elderly and the disabled." (John Goodman, in Health Affairs)  

[Opinion]

ERIC Letter to Congressional Leaders Urging Repeal of 'Cadillac' Tax and Employer Mandate
"[We] urge Congress to move forward with legislation to repeal the mandates, taxes and reporting requirements imposed by the ACA. Specifically, we ask that Congress repeal the 40 percent health care excise tax, the employer mandate and all the related reporting requirements. These measures cause employers to devote costly resources to unnecessary compliance burdens and taxes, funds that are better spent on benefits for employees and other critical business needs." (The ERISA Industry Committee [ERIC])  

Benefits in General; Executive Compensation

FASB Proposes Changes to Accounting for Stock Compensation (PDF)
"Some of the more significant amendments address: [1] accounting for income taxes at settlement (a.k.a., windfalls, shortfalls, and the APIC Pool); [2] accounting for forfeitures; [3] net settlements to cover withholding taxes; [4] classification of awards with repurchase features; [5] expected term assumption for non-public entities." (PricewaterhouseCoopers)  

SEC Proposes Rules for Pay-for-Performance Disclosures (PDF)
"The Proposed Rules generally would require that executive compensation disclosures in many proxy or information statements include: [1] a tabular presentation of compensation actually paid to named executive officers (NEOs) and the cumulative total shareholder return (TSR) of the company and its peers for each of the last five fiscal years; and [2] a clear description of the relationship between compensation actually paid and the company's TSR as well as the relationship between the company's TSR and that of its peers." (PricewaterhouseCoopers)  

Press Releases

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