Health & Welfare Plans Newsletter

July 6, 2015

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Senior Relationship Manager
Verisight
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Verisight
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Relationship Manager
Verisight
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Brown Smith Wallace
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DailyAccess
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Account Service Representative
DailyAccess
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Employee Benefits Consulting Manager
Plante Moran
in IL, MI

Employee Benefits Sr. Consultant
Plante Moran
in MI

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Milliman
in TX

Junior Pension Administrator
AKT Retirement Plan Services
in OR

Internal Marketing Representative, Retirement Plans
Ohio National Financial Services
in OH

Pension Administrator
AKT Retirement Plan Services
in OR

DB Pension Analyst
Milliman
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Associate Consultant / Retirement Plan Administration Specialist
Spectrum Pension Consultants, Inc.
in ANY STATE, HI, IA, WA

401(k) Representative
Slavic401k
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Client Services Manager - Retirement Plans
Charles Schwab
in OH, TX

Defined Benefits Actuary
Charles Schwab
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Client Relationship Manager
Acropolis Investment Management, LLC
in MO

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[Guidance Overview]

New Trade Bill Escalates ACA Reporting Penalties, Resuscitates Health Coverage Tax Credit
"The general penalty for failure to file a required information return with the IRS ... will increase from $100 per return to $250 per return. The cap on the total amount of penalties for such failures during a calendar year will increase from $1,500,000 to $3,000,000. If a failure relates to both an information return (e.g., a Form 1095-C required to be filed with the IRS) and a payee statement (e.g., that same Form 1095-C required to be furnished to the individual), these penalties are doubled. If a failure is caused by intentional disregard, the new $250 penalty ... is doubled to $500 for each failure, and no cap applies[.]" (Lockton)  


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[Guidance Overview]

Trade Legislation Restores Health Coverage Tax Credit
"In addition to extending the [health care tax credit (HCTC)], the legislation makes clear that in the future, an individual will not be able to claim both the HCTC and a premium tax credit for the same months. Employers covering potentially eligible individuals may wish to revise their COBRA election notices and other plan communications to include HCTC information -- references to the HCTC were removed in previous updates to the DOL's model election notice" (Thomson Reuters / EBIA)  

[Guidance Overview]

CMS Webinar: Plan Design Certification Reviews and Common Corrections (PDF)
38 presentation slides; June 30, 2015. Topics include: [1] Plan design reviews for QHP certification: Nondiscrimination, Out-of-pocket cost outliers for specific medical conditions using standard treatment protocols, Formulary outliers, Clinical appropriateness, and Cost sharing outlier; [2] Exclusions and explanations language review; [3] Cost sharing reduction plan variation reviews; [4] Supporting informed consumer choice/meaningful difference; and [5] Plan ID crosswalk. (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

CMS Webinar: Qualified Health Plan and Stand-Alone Dental Plan 2016 Data Integrity Tool, Plan Crosswalk, Correction and Certification Notices
33 presentation slides; June 23, 2015. "For PY2016, CMS will be conducting three types of reviews on issuer's application data: [1] Data integrity reviews ... [2] Certification reviews ... [3] Plan crosswalk reviews ... CMS will report review results to issuers for each of these three areas via Excel attachments in the issuer's official notices." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

ERISA Preemption Back on the Docket: Supreme Court Agrees to Review Application of Vermont Data Reporting Law to Self-Insured Health Plans
"The Supreme Court's decision to hear the Vermont case may have been based in part on the divergent result in the Sixth Circuit. Although data reporting and taxation are different in nature, both [the Second and Sixth] circuits looked to the Supreme Court's 1995 Travelers decision for guidance on ERISA preemption.... If not preempted, the additional costs of complying with these types of state laws ultimately will be borne by plan sponsors -- either directly or through their TPA contracts." [Gobeille v. Liberty Mutual Ins. Co. (2d Cir. Feb. 4, 2014, cert. pet. granted June 29, 2015)] (Thomson Reuters / EBIA)  

Recent Studies Challenge Conventional Wisdom on Health Plan Design
"If all the savings of HDHPs can be achieved without price consciousness, imagine how effective they could be if price enters the equation as well. What needs to be done to get members focused on price? Is it to stay with my own recommended doctor at all costs? Or could heavy promotion of the cost side of the shopping equation and extensive availability of price shopping tools with high quality alternative providers offered, add further fuel to a HDHPs business case?" (Frenkel Benefits)  

Obamacare Is About to Sucker-Punch Ohio Employees
"A [recent] survey shows that the end of transitional relief plans -- often referred to as grandmothered health-insurance plans -- will bring significant rate increases to small businesses when they renew in 2016. Their analysis found Obamacare-compliant plans will cost employers an additional $2,434.67 per employee per year.... A whopping 563 -- more than 90 percent -- will see an average increase in premiums of 37.9 percent." (The Federalist)  

[Opinion]

Willis Acquires Towers Watson -- Is There More to This Story?
"Back in 2011 Aetna CEO Mark Bertolini made the comment, 'Not too far away from now -- in the next 6-7 years -- 75 million Americans will be retail buyers of healthcare. And they'll come to the marketplace with their own money and either a subsidy from their employer or a subsidy from their government. And it doesn't much matter -- they'll be spending their money.' Since then Aetna has been acquiring technology companies including bswift that has built 'exchange' capabilities. Bertolini thinks healthcare will be individually purchased. Aetna buys exchange technology. Towers Watson buys exchange technology. Willis buys Towers Watson. Are these events part of the same story?" (Joe Markland)  

Benefits in General; Executive Compensation

[Guidance Overview]

Key Issues in the SEC's Proposed Compensation Clawback Rules
"[H]ow do the proposed rules apply to incentive-based compensation based on stock price or total shareholder return, which generally are not items of financial information required to be reported under the securities laws? ... The SEC seems to be reaching beyond the language of the statute to cover the full intent of Congress.... Are time-based restricted stock or RSUs considered 'incentive-based compensation' that is subject to clawback? Once you have thrown overboard the plain language of the statute, one could read the definition [of compensation] include time-based RSUs and restricted stock because their value is based on the stock price." (Winston & Strawn LLP)  

[Guidance Overview]

SEC Proposes Broadened Executive Compensation 'Clawback' Rules
"[C]ompanies that do not have clawback policies in place face the choice of whether to adopt a policy now that reflects the requirements of the proposed rules, or alternatively to wait until the SEC proposal and the exchange standards have been finalized. While the answer to this will depend on each company's individual situation, consideration should be given to the fact that the rules are only proposed, are likely to receive substantial comment and may undergo substantial changes before being finalized." (McGuireWoods LLP)  

[Guidance Overview]

SEC Proposes Clawback Rules: A Comprehensive Summary
"[T]he proposed rules require recovery of excess incentive-based compensation received by an individual who served as an executive officer of the listed issuer at any time during the performance period for that incentive-based compensation. This would include incentive-based compensation derived from an award authorized before the individual becomes an executive officer, and inducement awards granted in new hire situations, as long as the individual served as an executive officer of the listed issuer at any time during the award's performance period." (Dodd-Frank.com, a blog by Stinson Leonard Street)  

[Guidance Overview]

Putting Executive Pay at Risk: SEC Proposes Rules on Mandatory Clawback Policies
"The proposed rules define 'incentive-based' compensation as any compensation that is granted, earned or vests based wholly or in part upon the attainment of any financial reporting measure.... [A table] provides illustrative examples of covered and not-covered items of compensation[.]" (Ropes & Gray LLP)  

Same-Sex Marriage: Effect on Benefits
"Changes are now likely to be needed for state law benefits, such as leave laws, state health care continuation requirements and the like. Employers should also consider providing same sex spouses with all of the spousal benefits provided to opposite sex spouses, no matter if the spousal benefit is mandated by law." (Stinson Leonard Street)  

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