Health & Welfare Plans Newsletter

July 1, 2015

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Employee Benefits Jobs

Senior Pension Consultant
PenServ, Inc.
in NY

Senior Defined Benefit Data Analyst
Transamerica Retirement Solutions
in MA

Plan Consultant
Transamerica Retirement Solutions
in MA

Lead Mgr, RPS Product Management, Non-Qualified Business
T. Rowe Price
in MD

Lead Manager, RPS Business Development
T. Rowe Price
in MD

Employee Benefits Administrator
Keystone Benefits Group
in PA

Benefits Department Manager
IUPAT Industry Pension Fund
in MD

Benefits Attorney
Ogletree, Deakins, Nash, Smoak & Stewart, P.C.
in OR

Vice President - Financial Services
MAGIS Financial Partners, Inc.
in PA

Retirement Plan Sales
Retirement LLC
in OK

Regional Marketing Director
John Hancock Retirement Plan Services
in CO

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Webcasts and Conferences

Understanding the Paid Sick Leave Law
July 8, 2015 in MA
(Massachusetts Staffing Association)

Fundamentals of 401(k) and Other Qualified Plans - Kansas City
July 28, 2015 in KS
(SunGard Relius)

Safe Harbor 401(k) - Cincinnati
July 28, 2015 in OH
(SunGard Relius)

IRA Distributions
November 5, 2015 WEBCAST
(Ascensus)

View All Webcasts and Conferences


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[Official Guidance]

Text of GASB Statement No. 75, Accounting and Financial Reporting for Postemployment Benefits Other Than Pensions
310 pages. "This Statement establishes standards for recognizing and measuring liabilities, deferred outflows of resources, deferred inflows of resources, and expense/expenditures. For defined benefit OPEB, this Statement identifies the methods and assumptions that are required to be used to project benefit payments, discount projected benefit payments to their actuarial present value, and attribute that present value to periods of employee service.... In addition, this Statement details the recognition and disclosure requirements for employers with payables to defined benefit OPEB plans that are administered through trusts that meet the specified criteria and for employers whose employees are provided with defined contribution OPEB." (Governmental Accounting Standards Board [GASB])  


[Advert.]

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[Official Guidance]

Text of GASB Statement No. 74, Financial Reporting for Postemployment Benefit Plans Other Than Pension Plans
122 pages. "The scope of this Statement includes OPEB plans -- defined benefit and defined contribution -- administered through trusts that meet the following criteria: [1] Contributions from employers and nonemployer contributing entities to the OPEB plan and earnings on those contributions are irrevocable. [2] OPEB plan assets are dedicated to providing OPEB to plan members in accordance with the benefit terms. [3] OPEB plan assets are legally protected from the creditors of employers, nonemployer contributing entities, and the OPEB plan administrator. If the plan is a defined benefit OPEB plan, plan assets also are legally protected from creditors of the plan members." (Governmental Accounting Standards Board [GASB])  

[Official Guidance]

CMS Publication: Explanation of Data Elements in the Issuer Risk Adjustment Transfer Report (PDF)
Dated June 30, 2015. "This document provides a description of each data element provided in the Issuer Risk Adjustment (RA) Transfer Report. Data included in this report reflect amounts calculated based on the risk adjustment formulas outlined in regulation and is provided for informational purposes (78 FR 15410 and 45 CFR Part 153). They do not constitute specific obligations of Federal funds to any particular plan or issuer." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Official Guidance]

Text of CMS Reinsurance Payment Report Job Aid (PDF)
Dated June 30, 2015. "This document provides a description of each data element provided in the Issuer Reinsurance (RI) Report. Data included in this report reflect amounts calculated based on the risk adjustment formulas outlined in regulation and is provided for informational purposes ... They do not constitute specific obligations of Federal funds to any particular plan or issuer." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

Text of GASB Fact Sheet on Statement No. 74, Financial Reporting for Postemployment Benefit Plans Other Than Pension Plans, and Statement No. 75, Accounting and Financial Reporting for Postemployment Benefits Other Than Pensions (PDF)
3 pages. Topics include: [1] What types of OPEB are covered by the Statements? [2] What are the main provisions of the Statements? [3] What makes OPEB a liability? [4] Does the GASB require governments to fund OPEB? [5] When do the new OPEB Statements take effect? (Governmental Accounting Standards Board [GASB])  

[Guidance Overview]

Text of CMS Quick Start Guide: Request for Reconsideration Form for Risk Adjustment and Reinsurance (PDF)
Dated June 30, 2015; version 1.6. "There is a three-level Administrative Appeals process for Risk Adjustment (RA) and Reinsurance (RI): [1] Request for Reconsideration; [2] Informal Hearing before the [CMS] Hearing Officer; [3] Review by CMS Administrator (or delegate)." [Available online: Request for Reconsideration (Risk Adjustment and Reinsurance).] (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

Updated PCORI Fees Due by July 31
"This fee will continue to be adjusted in the future until it is no longer payable. For self-insured plans, the return must be filed by July 31 of the calendar year immediately following the last day of the plan year. For plan years ending on and after January 1, 2014 and before October 1, 2014, the fee, payable by July 31, 2015 is $2.00 multiplied by the average number of covered lives. For plan years ending on and after October 1, 2014 and before January 1, 2015, the fee, payable by July 31, 2015, is $2.08 multiplied by the average number of covered lives. The $2.08 fee amount also applies for plan years ending on and after January 1, 2015 and before October 1, 2015, payable by July 31, 2016." (Cheiron)  

Supreme Court to Consider ERISA Preemption of State Health Care Reporting Requirements
"This issue is important to the business community because of its potential to subject plan administrators to a multiplicity of burdensome state reporting requirements ... Even on its own, Vermont's reporting scheme imposes a litany of complex requirements on ERISA plans, including rules governing the content, timing, coding, and encryption of the reports. And as explained in the petition for certiorari, a ruling in this case could potentially impact the reporting requirements of at least sixteen states -- plus others that are considering similar legislation." [Gobeille v. Liberty Mutual Ins. Co. (2d Cir. Feb. 4, 2014, cert. pet. granted June 29, 2015)] (Mayer Brown LLP via Lexology)  

What All Employers Need to Know About the Upcoming 'Cadillac' Excise Tax
"While most employers have not focused on the Excise Tax, a few have been forward looking and creative in seeking to reduce its potential impact on them.... [P]opulation health strategies look to bend the cost curve by making employees healthier.... Some employer plans are changing the paradigm and contracting directly with the providers who are willing to go at risk for the cost and quality of services they provide or provide flat fee pricing for a suite of services needed to treat a particular condition." (InsideCounsel)  

First-Year Results from Reinsurance and Risk Adjustment Programs
"Nationally, many of the new cooperative plans received risk adjustment programs, but others paid into the risk adjustment program. The Blue plans, traditionally the insurer of last resort in many states, generally did well in the reinsurance programs but had mixed results in the risk adjustment program. Certainly insurers that have to pay in to the program will not be pleased, and we can expect to hear from them. There may also be mistakes in the data. Insurers can appeal results they believe to be incorrect." (Health Affairs)  

CMS Summary Report on Transitional Reinsurance Payments and Permanent Risk Adjustment Transfers for the 2014 Benefit Year (PDF)
49 pages. "99.7 percent of issuers who set up EDGE servers successfully submitted the data necessary to calculate reinsurance payments and risk adjustment transfer.... [F]or the 2014 benefit year, reinsurance contributions exceeded the requests for reinsurance payments; therefore we have increased the coinsurance rate to 100 percent. For the 2014 benefit year, over $7.9 billion in reinsurance payments will be made to 437 issuers nationwide." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

CMS Posts Full Year of 2014 'Open Payments' Financial Data
"[CMS has] published 2014 Open Payments data about transfers of value by drug and medical device makers to health care providers. The data includes information about 11.4 million financial transactions attributed to over 600,000 physicians and more than 1,100 teaching hospitals, totaling $6.49 billion.... The Open Payments program, created by the [ACA], requires drug and device manufacturers to report transfers of value (i.e., payments, honoraria or research grants) to health care providers, as well as other industry-related investments providers may have. The program relies on voluntary participation by physicians and teaching hospitals to review the information submitted by these companies." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

Description of Health Benefits for Members of Congress and Designated Congressional Staff (PDF)
"[B]eginning January 1, 2014, Members and designated congressional staff are no longer able to purchase FEHB plans as active employees; however, if they enroll in a health plan offered through a small business health options program (SHOP) exchange, they remain eligible for an employer contribution toward coverage ... This report summarizes the provisions of the final rule and describes how it affects current and retired Members and congressional staff. OPM has indicated that Members and congressional staff are still eligible for other health benefits related to federal employment, and these additional health benefits are outlined in this report." [Report No. R43194, dated June 17, 2015] (Congressional Research Service [CRS])  

[Opinion]

CBO: Because of Our Massive Uncertainty on the ACA's Myriad of Impacts, We Have No Clue What a Repeal Would to Do the Deficit
"[T]he government's report concludes that it cannot accurately project whether a repeal of PPACA would increase, reduce or have no impact on federal deficits. But, when compelled to give one answer, their best guess is that it would increase the deficit by 1.9%. Stated alternatively it would increase our national debt by 0.75% -- well within their margin of error.... A reading of [recent] headlines leads one to believe that a repeal would clearly and decisively be a horror.... [In] reality the actual impact is not something the CBO was nearly so certain of[.]" (Benefit Revolution)  

Benefits in General; Executive Compensation

Text of SEC Memo: Extended Analysis of Potential Effect on Pay Ratio Disclosure of the Exclusion of Different Percentages of Employees (PDF)
"In [Table 1 of] the original analysis, Staff considered the exclusion of different percentages of employees.... [This report extends that analysis] to show the effects of excluding percentages greater than 20%, and up to 95% (in 5% increments).... In the original analysis, Staff considered the exclusion of different percentages of employees under two scenarios: Scenario I (all excluded observations are below the median) and Scenario II (all excluded observations are above the median). [This report extends] Table 1 to show the effects of excluding percentages of employees under three intermediate scenarios[.]" (Division of Economic and Risk Analysis, U.S. Securities and Exchange Commission [SEC])  

Supreme Court Decision Provides New Financial Planning Opportunities
"The Supreme Court's decision creates several immediate new planning opportunities for same-sex married couples, particularly those who were previously married in another state but have been recently living in a state that did not recognize (or one of the 13 that outright banned) their marriage. Those couples will now be able to do everything from filing joint income tax returns, to benefit from the marital deduction for state estate and inheritance tax purposes, to get divorced if the couple decides to separate. In fact, for many such couples, a major planning issue will simply be unwinding the strategies previously in place to handle the fact that their marriage wasn't recognized, but are no longer necessary!" (Michael Kitces in Nerd's Eye View)  

Part-Time Private Industry Workers Less Likely to Have Access to Benefits in 2013
"In March 2013, nearly three-fourths (74 percent) of full-time private industry workers had access to retirement benefits, compared with just 37 percent of part-time workers. Similarly, 85 percent of full-time workers had access to health insurance through their employers, compared with only 24 percent of part-time workers. Full-time workers were also much more likely than part-time workers to have access to paid holidays, sick leave, and vacations." (U.S. Bureau of Labor Statistics [BLS])  

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