Health & Welfare Plans Newsletter

July 7, 2015

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Retirement Plan Administrator
Mann Associates
in IL

Client Services & Retirement Plan Associate
Leading Retirement Solutions
in WA

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Tycor Benefit Administrators, Inc.
in PA

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Webcasts and Conferences

Same-Sex Spousal Benefits After the Supreme Court Decision
July 16, 2015 WEBCAST
(International Foundation of Employee Benefit Plans [IFEBP])

Effect of Death on Retirement Plans
July 24, 2015 WEBCAST
(SunGard Relius)

Safe Harbor 401(k) - Chicago
July 30, 2015 in IL
(SunGard Relius)

Fundamentals of 401(k) and Other Qualified Plans - Norfolk
August 4, 2015 in VA
(SunGard Relius)

2015 SPARK Forum
November 8, 2015 in FL
(SPARK Institute)

10 Steps to Successful ESOP Administration
November 18, 2015 WEBCAST
(Beyster Institute)

View All Webcasts and Conferences


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[Official Guidance]

IRS Information About the ACA Assurance Testing System (AATS)
"The ACA AATS will open for testing [in] July 2015 for Information Returns that will be processed in 2015. The README file provides an explanation of the character-by-character comparison used in AATS. [Software developers:] Please review the README file before programming the AATS scenarios." (Internal Revenue Service [IRS])  


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[Guidance Overview]

IRS Issues Interim Guidance on New Expatriate Law, Invites Comments
"[I]nsurers and employers will be given more time to bring their expat plans into compliance with the new law.... [T]he agencies will allow insurers and employers to use a reasonable good faith interpretation of the law.... [T]he reasonable good faith standard does not apply to ACA tax reporting requirements ... IRS tax forms [may] be supplied electronically to the enrollee (expat) without consent, unless the enrollee explicitly refuses electronic delivery.... [T]he PCORI fee won't apply if the plan or policy is designed and issued specifically to cover primarily employees [1] who are working and residing outside the United States, or [2] who are not citizens or residents of the United States but who are assigned to work in the United States for a specific and temporary purpose or who work in the United States for no more than six months of the policy year or plan year." (Lockton)  

Health Plan Can't Seek Reimbursement from Injured Participant's Attorney
"After plan participant Carolyn Avera obtained a $50,000 settlement for her injuries, the health plan filed suit against Avera, her attorneys and the other driver involved in the accident, seeking to recoup the benefits it paid out on Avera's behalf.... The lawyers argued that they couldn't be liable to the health plan under [ERISA] because they weren't a party to the plan in question. The judge agreed ... The judge also rejected the health plan's attempt to bring state law conversion and tortious interference claims against the attorneys, finding that they failed under North Carolina law. However, the judge allowed the health plan to bring an ERISA-based subrogation claim against Avera based on language allegedly contained in the plan document." (Bloomberg BNA)  

Appropriate Use of Reference Pricing Can Increase Healthcare Value
"Reference pricing strategies encourage patients to use high-volume hospitals and surgeons who benefit from experience to obtain good outcomes as well as lower costs.... Well-constructed reference pricing offers meaningful choices to consumers and savings to purchasers, with no sacrifice of quality. It helps move health care from a provider-dominated to a consumer-engaged system." (Health Affairs)  

OPEB Funding Policy Opportunities
"[E]mployers should consider that ANY funding policy [for OPEB (Other Postemployment Benefits, usually retiree medical)] is better than nothing -- and even a modest level of pre-funding will improve the plan's funded status and balance sheet impact.... To the extent that investment returns can help fund future benefit costs, an OPEB trust with higher expected returns can help reduce your calculated OPEB liability.... Employers should harness this increased scrutiny to compel stakeholders (e.g., employers, employees, and taxpayers) to collaboratively review OPEB terms and create a strategy to prudently prefund these promises." (Van Iwaarden Associates)  


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Current ACA Issues for Multiemployer Plans
"More than half of plans in the study ... remain grandfathered under the ACA, meaning they do not have to comply with some parts of the law. A large majority of plans in the study have not changed coverage for spouses. Most plans in the study have maintained coverage for retirees. The three most popular cost-management strategies that plans have implemented are [1] soliciting competitive bids from carriers/vendors, [2] implementing more intensive pharmacy management programs, and [3] increasing copayments." (Segal Consulting)  

Mayo Makes Case for Medicare Reimbursement for Telemedicine
"[To] Mayo and other health care innovators across the country, telemedicine will play an increasingly major role in the future of effective and affordable health care. They think federal policies which recognize that fact make more sense than forcing care providers to overcome licensing restrictions as well as payment restrictions as they remotely treat ICU patients, remotely diagnose strokes, remotely direct the delivery of babies and remotely monitor patients in real time in their homes." (Altarum Institute)  

Private Exchanges Leading to Increased Voluntary Benefit Purchasing
"Employees are buying a greater number of voluntary benefits to supplement the traditional lines of insurance that have historically been offered; they're also buying more voluntary benefits when given more options for such benefits than had previously been offered. Based on an analysis of the Willis book of business available ... voluntary benefit purchasing more than doubled when employees purchased in a private exchange." (The Institute for HealthCare Consumerism [IHCC])  

International Wellness Initiatives (PDF)
10 pages. "[This issue brief explores] the potential effects of wellness initiatives based on four international case studies: the public sector of Japan; the tiered health sector of Israel; the private insurance company Discovery of South Africa; and global employer American Express' programs in the U.S., India, U.K., and Mexico." (Health Practice International Committee, American Academy of Actuaries)  

Fitch Places Aetna on Rating Watch Negative
"Fitch Ratings has placed the ratings of Aetna Inc. (Aetna) on Rating Watch Negative. The rating action follows Aetna's recent announcement that it has reached an agreement to acquire Humana Inc. (Humana) in a cash and stock transaction valued at approximately $37 billion.... The rating action reflects Fitch's concern about Aetna's expected financial leverage metrics following the close of the transaction, as well as potential operational and/or earnings disruptions that could arise as these two very large and complex organizations are integrated." (InsuranceNewsNet.com)  

[Opinion]

Projected Health Insurance Premium Increases: What Do They Mean to Consumers?
"The Affordable Care Act appears to have failed on delivering its promise of controlling global health care costs. The primary reason given by the insurers when submitting requests for much higher premiums for 2016 is that health care costs were much higher than their actuaries anticipated.... Respected institutions such as Geisinger in Pennsylvania and Scott and White in Texas are asking staggering premium increases, indicating that the supposed cost containment features of ACA are having a negligible impact on legitimate spending." (Physicians for a National Health Program [PNHP])  

Benefits in General; Executive Compensation

[Guidance Overview]

SEC's Proposed Clawback Rule Raises Section 409A and Other Tax Issues (PDF)
"Section 409A's general prohibition on accelerations means a company should not satisfy its clawback obligation under the proposed rule by deducting the amount to be recovered from an executive's nonqualified plan account (or any other amount subject to Section 409A), as such a practice would expose the executive to Section 409A's tax penalties. There is also a potential problem if the documentation for an arrangement subject to Section 409A provides for recouping amounts owed by the employee, even if recoupment is to occur at the originally scheduled payment date." (Groom Law Group)  

[Guidance Overview]

SEC Proposes Sweeping Rule on Incentive Pay Clawbacks
"Few classes of listed issuers would be exempt under the proposed rule. Exempt companies include clearing agencies for security futures products or standardized options and registered management investment companies that do not pay incentive compensation to executive officers. More notable are those issuers not proposed for exemption: emerging growth companies, smaller reporting companies, foreign private issuers, controlled companies, and issuers of only listed debt or preferred securities. The proposed rule would not give exchanges discretion to exempt categories of issuers not expressly exempted under the proposed rule." (Jenner & Block)  

[Guidance Overview]

SEC Proposes Executive Compensation Clawback Rules
"Incentive-based compensation would be deemed received for purposes of the proposed rules in the period in which the applicable financial reporting measure is attained, even if the payment or grant occurs after the end of that period.... Recovery would not be required if the compensation committee ... of the listed issuer determines that (i) it would be impracticable to seek recovery because the direct costs of enforcing recovery would exceed the recoverable amounts or (ii) recovery would violate the issuer's home country law." (Vorys, Sater, Seymour and Pease LLP)  

Snapshot Survey: Financial Services Executive Compensation
"78% of companies are making changes to their executive pay programs as a result of difficult market conditions. The most popular changes planned are the strengthening of bonus-malus and clawback conditions (47%), strengthening the link between performance management and compensation (44%) and increasing the use of non-financial measures (31%) in reviewing performance." (Mercer)  

Press Releases

US Labor Department Solicits Nominations for 2016 ERISA Advisory Council
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

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