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[Official Guidance]
Text of CMS Guidance on Federal Standard Notices of Product Discontinuation and Renewal in Connection with the Open Enrollment (PDF)
3 pages. "For the 2016 coverage year, the deadline for finalizing QHP offerings is in October 2015 and open enrollment period will begin on November 1, 2015 -- after a 90-day discontinuation notice would be required to be sent with respect to a product discontinuation effective December 31, 2015.... Accordingly, in connection with the open enrollment period for coverage in benefit year 2016, CMS will not take enforcement action against an issuer that fails to provide a discontinuance notice related to individual market coverage at least 90 days prior to the discontinuation, as long as the issuer provides such notice consistent with the timeframes applicable to renewal notices, which for non-grandfathered, non-transitional plans is before the first day of the next annual open enrollment period, and for grandfathered and transitional plans is at least 60 days before the date
of renewal. CMS encourages states to take a similar approach."
(Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])
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[Advert.]
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[Guidance Overview]
Election of Federal External Review Process by Self-Insured, Non-Federal Governmental Group Health Plans (PDF)
"Non-grandfathered, self-insured, non-federal governmental [group health] plans electing to comply with either the HHS-administered external review process or the private accredited independent review organization (IRO) process must now make that election through [the Health Information Oversight System (HIOS)], rather than by email. Unless changes are required, plans that previously made this election need not do anything further at this time."
(Buck Consultants at Xerox)
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[Guidance Overview]
New Oregon Law Mandates Sick Leave Policy for Most Employers
"The mandatory sick leave law applies to all state government and private sector full- and part-time workers regardless of whether they are paid on an hourly, salaried, commissioned or piece-rate basis. Those excluded from the law's application include independent contractors, workers who receive paid sick leave under federal law, participants in work training programs administered under state or federal assistance programs, participants in secondary and post-secondary work-study programs, children employed by their parents, employers covered by a collective bargaining agreement and certain railroad workers.... [E]ffective on Jan. 1, 2016, existing employees will begin to accrue one hour of sick time for every 30 hours worked."
(Holland & Knight)
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[Guidance Overview]
In Maryland, Montgomery County Joins the Jurisdictions Requiring Paid Sick Leave
"Beginning October 1, 2016, employers in Montgomery County will have to provide most employees in the County with up to 56 hours of paid sick and safe leave. All private businesses and individuals (as well as the County government) who employ one or more persons to work within the County are covered by this amendment."
(Littler)
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Federal Lawmakers Introduce Bill to Undo Tax Penalties on Health Insurance Reimbursement Arrangements
"A group of lawmakers has introduced legislation to roll back guidance from the Treasury Department that prohibits employers from using stand-alone health reimbursement arrangements to reimburse employees for health care-related expenses.... The bill would also allow employees to use HRA funds to purchase health coverage on the individual market, as well as for qualified out-of-pocket medical expenses if the employee has qualified health coverage. In addition, the bill would protect employers from being financially penalized for providing this cost-sharing option to employees."
(Employee Benefit News)
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Cadillac Tax Hurricane Preparation: After-Tax HSA Contributions
"While [IRS Notice 2015-16] isn't guidance or even proposed guidance, if its forecast rings true, it's not difficult to predict the impact to most employer-sponsored plans, beginning in 2018. For example, it's likely that: [1] Flexible spending accounts and health reimbursement arrangements will go away. [2] Employer and pretax employee contributions to health savings accounts will end. [3] Most employers will eventually need to drop all health plans except for qualified high deductible health plans."
(Employee Benefit News)
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Employer-Sponsored Insurance Spending for Children's Health Care Rising Faster Than for Total Population
"Spending on health care for children (ages 0-18) covered by employer-sponsored insurance (ESI) grew an annual average of 5.7 percent per year between 2010 and 2013, compared to 3.9 percent for the total population (ages 0-64) with ESI ... Per capita spending on children reached $2,574 by 2013, a $391 increase from 2010. The rise in children's spending in 2013 occurred despite a drop in the use of prescription drugs and visits to the emergency room, demonstrating that rising health care prices were an important driver behind the spending increase. The report also showed growth in spending on children's inpatient services, which contributed to the overall increase in spending."
(Health Care Cost Institute)
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[Opinion]
The Coming Shock in Health Care Costs
"While many reforms are being tested, the administration's main focus has been on creating 'accountable care organizations.' ... The results so far are less than encouraging. Several studies found that ACOs achieved minimal savings after two years.... Experts from across the ideological spectrum agree that the key to long-term cost control is to pay doctors and hospitals in a way that rewards cost savings and quality.... Scaling bundles offers significant advantages over the current strategy.... [T]his reform is not just for big health systems that think they will do better financially by participating. It can work in rural areas and for smaller hospitals and practices and become the standard method of payment nationwide."
(Ezekiel Emanuel and Topher Spiro, in The Wall Street Journal; subscription may be required)
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Benefits in General; Executive Compensation
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[Guidance Overview]
Dodd-Frank Clawback Proposal
"Some executives may not have had anything to do with the misstatement, but would still be required to pay back incentives which were previously thought to be earned.... Will executives want to shift more of their pay from incentive to salary to reduce the risk of future clawbacks? This would be a reverse from the general movement of the market to more performance-based compensation. Will executives expect a larger amount of pay since their compensation is at risk even after it is paid? When the new rule is adopted, virtually every existing clawback policy will need to be rewritten."
(Findley Davies)
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[Guidance Overview]
SEC Proposes Compensation Clawback Rules (PDF)
7 pages. "Registrants should immediately consider amending their incentive compensation plans so that the new recovery rules are applicable.... [To] take an extreme case, if the SEC finalizes its rule in 2015 and the rule is effective upon finalization, a calendar year registrant must be able to recover IBC in the event the 12/31/15 financials are restated and the restatement affects currently outstanding IBC awards, including long-term incentives granted in prior years in which payment is affected by results in 2015. This contractual right of recovery will be particularly important with respect to executive officers who are no longer employed by the registrant -- absent a rule requiring repayment, the registrant may be unable to collect, which could lead to delisting."
(Frederic W. Cook & Co., Inc.)
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Participant Data and Fiduciary Responsibility in the Information/Innovation Age
"Recognizing that ERISA plan fiduciaries are charged with meeting a prudence standard when discharging their duties solely in the interest of plan participants and beneficiaries, fiduciaries must not only act prudently in responding to a breach of their plan participants' [personal health information (PHI)], but should also consider developing prudent policies and procedures with respect to the handling and transmission of all [personally idenfifiable information], participant data, and PHI, in the regular course, as well as notification and remediation measures for breaches of same."
(Epstein Becker Green via Confero magazine)
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Applying Heimeshoff to Contractual Limitations in Benefit Plan Provisions
"To apply the Heimeshoff holding, the reasonableness analysis includes four possible questions: [1] Is the total time for a participant to file suit reasonable? [2] Is the time after the final claim denial reasonable for a typical participant to file suit? [3] Is the information about the limitations provision given to the participant enough to make enforcing it against him or her reasonable? And [4] is the time otherwise reasonable, under the circumstances, for the particular participant to file suit? Answering the first and second questions should be simple; one only needs a rule for how many days are sufficient for a typical plaintiff to file suit. The third question should be simple, yet is the subject of a circuit split.
The fourth question cannot be answered with a simple rule, because what might be equitable would depend on the particular participant and his or her circumstances, and thus could vary case by case."
(Bradley Arant Boult Cummings LLP)
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Compensation Inequality: Evidence from the National Compensation Survey
"Using data from the National Compensation Survey, this article examines compensation inequality measures and trends over the 2007-2014 period. The analysis suggests that inequality measures based on total compensation (i.e., wages plus costs of employer-provided benefits) are higher than measures based solely on wages. It also points to an increase in inequality over the study period -- an increase largely driven by a growing compensation gap between high- and low-earning occupations-- and considerable intraoccupational inequality."
(U.S. Bureau of Labor Statistics [BLS])
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[Opinion]
Steven Hall and Partners Comment Letter to SEC on the Proposed Pay Versus Performance Disclosure (PDF)
6 pages. "[T]he approach suggested ... is overly prescriptive, and represents a troubling move away from the principles-based approach of many of the Commission's other recent compensation disclosure proposals, including, notably, the rule-making that led to the current CD&A format. We believe that a principles-based approach to the pay versus performance disclosure would provide companies with the flexibility necessary to communicate their pay for performance story more fulsomely, and beyond the use of one metric, and would enhance the benefit to shareholders of the proposed disclosure."
(Steven Hall & Partners)
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[Opinion]
TIAA-CREF Comment Letter to SEC on Pay Versus Performance Proposed Rule (PDF)
4 pages. "[T]he Proposed Rule could be strengthened by requiring separate disclosures for each PEO that held the position during the required time period. Combining compensation paid to multiple PEOs in a single year, as currently proposed, may obfuscate the board's decisions related to leadership change. This could result in inaccurate representations of information and cause confusion."
(TIAA-CREF)
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[Opinion]
Meridian Compensation Partners Comment Letter to SEC Recommending Changes to Pay Versus Performance Proposed Rule (PDF)
9 pages. "[Meridian recommends these] changes to the Proposed Rule ... [1] Eliminate the required tabular disclosure in favor of a graphical disclosure depicting registrant total shareholder return (TSR) and compensation actually paid over the covered period. [2] Limit the scope of the required disclosure to a registrant's principal executive officer (PEO) and Principal Financial Officer (PFO). [3] Base the amount 'actually paid' under a stock option grant on the option's in-the-money value on the date of vesting. [4] Eliminate (or modify) the disclosure of peer group TSR."
(Meridian Compensation Partners)
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[Opinion]
Business Roundtable Comment Letter to SEC Opposing Its Proposed Pay Versus Performance Rule
"[T]he prescriptive nature of the proposed rules would add to investor information overload and would lead to a result inconsistent with the objectives set forth by the Senate Banking Committee.... [A] principles-based approach would best serve investors and meet the Committee's and Commission's objectives, and we outline recommendations for taking such an approach [in this letter]."
(Business Roundtable [BRT])
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