Client Relationship Manager (Retirement Services)
Marsh & McLennan Agency
in NJ

Retirement Plan Specialists
Arista Wealth Management
in NV

Benefits Analyst
Directors Guild of America - Producer Pension and Health Plans
in CA

Benefits Manager - Retirement
BNY Mellon
in PA

Retirement Plans Account Manager
Ohio National Financial Services
in OH

Insurance/Benefits Account Coordinator
RFSI - Raffa Financial Services, Inc.
in MD

Account Manager - Retirement Plans
Keller Benefit Services, Inc.
in MD

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Top Ten ACA Compliance Issues Organizations Face
July 23, 2015 WEBCAST
(Employee Benefit Adviser)

Affordable Care Act: Employer Shared Responsibility Provisions and Information Reporting
July 28, 2015 WEBCAST
(IRS [Internal Revenue Service])

New EEOC Rules for Wellness Plans
July 30, 2015 WEBCAST
(Frenkel Benefits, LLC)

Safe Harbor 401(k) - Kansas City
August 13, 2015 in KS
(SunGard Relius)

Advanced Cross-Tested Plans: Adding More Tools - Kansas City
August 14, 2015 in KS
(SunGard Relius)

Transparency in Healthcare Audio/Webcast
December 16, 2015 WEBCAST
(Conference of Consulting Actuaries)

View All Webcasts and Conferences

[Guidance Overview]

Trade Act Reinstates Expired Health Coverage Tax Credit (HCTC)
"[E]mployers should consider adding information about the HCTC back to COBRA notices (particularly for terminations of employment that are related to international trade) and descriptions of COBRA in summary plan descriptions and other communications with employees.... Before 2014, the DOL model COBRA notice included specific information concerning the HCTC. It is likely that the DOL will re-issue COBRA notices with similar model language for employers and plan administrators to use." (Proskauer's ERISA Practice Center)  

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[Guidance Overview]

Agencies Issue Final Regs on Preventive Services Mandate, Including Contraceptive Coverage Accommodation
"The guidance about what constitutes a closely held business should help employers that object to providing contraceptive services under their health plans determine if they are eligible for the accommodation. Before eliminating any coverage, however, they should remember to address any administrative issues, such as providing notice of the modification ... And there may be more to come -- the preamble indicates that the agencies are continuing to explore options for funding contraceptive services where an accommodation is requested." (Thomson Reuters / EBIA)  

Trade Legislation Increases Penalties for Information Return Failures, Including IRS Forms 1094 and 1095
"The IRS previously announced limited relief from penalties for Forms 1094 and 1095 filed and furnished in 2016, for ALEs able to show a good faith effort to comply with the new requirements. Although these penalty increases do not seem to affect that relief, they provide additional incentives for ALEs to at least satisfy the good faith standard for the fast-approaching 2016 deadlines." (Thomson Reuters / EBIA)  

Need To Investigate Employee Misconduct While the Employee is on FMLA Leave? Follow This Employer's Lead
"Employers often are gun shy about conducting workplace investigations or taking disciplinary action against an employee while the employee is on FMLA leave.... [C]arry on with your internal investigations and disciplinary measures so long as you can show that you would have done the same absent any request for FMLA leave. In fact, employers arguably have a duty to conduct a prompt investigation into allegations of this kind.... You can indeed ask an employee during his FMLA leave to report to work to participate in an internal investigation. Within reason, of course." [Adams v. Anne Arundel County Public Schools, No. 14-1608 (4th Cir. June 15, 2015)] (FMLA Insights)  

Satisfaction With Health Coverage and Care: Findings from the 2014 Consumer Engagement in Health Care Survey
"The overall satisfaction rate among consumer-driven health plan (CDHP) enrollees increased in most years ... while it decreased in most years among enrollees in traditional health care plans. Differences in out-of-pocket costs may have explained some of the differences in overall satisfaction rates.... Satisfaction with out-of-pocket health care costs has been trending upward among CDHP enrollees. CDHP and HDHP enrollees were found to be less likely than those in a traditional plan both to recommend their health plan to friends or co-workers and to stay with their current health plan if they had the opportunity to switch plans." (Employee Benefit Research Institute [EBRI])  

Physician Payments, Patient Out-of-Pocket Payments Up a Little in 2014
"Despite rising deductibles, the actual change in direct patient responsibility for payment verged on trivial. For example, an established patient in a primary care practice paid $26.38 per visit (on average) in 2013 and $28.73 in 2014. The third-party payer paid $91.70 in 2013 and $94.84 in 2014. The total physician payment was $118.08 (2013) and $122.13 (2014)." (National Center for Policy Analysis Health Policy Blog)  

Wal-Mart Sued for Retroactive Availability of Spousal Benefits for Same-Sex Spouses
"The lawsuit seeks compensation for medical expenses for the years in which Dee was denied spousal coverage.... The suit argues that because Wal-Mart would have provided Jackie with coverage for her wife [Dee] if she had been a man, failing to provide it because she is a woman constitutes sex discrimination.... The EEOC's Strategic Enforcement Plan (SEP) ... lists 'coverage of lesbian, gay, bisexual and transgender individuals under Title VII's sex discrimination provisions, as they may apply' as an enforcement priority for FY2013-2016. In Jackie's case, the EEOC issued a final determination on January 29, 2015 that Wal-Mart's failure to provide spousal coverage of Dee constituted sex discrimination." (Calhoun Law Group, P.C.)  

Federal District Court Grants Class Certification Against Blue Shield for Possible ERISA Violation
"On July 14, 2015 a federal judge certified a class of members suing California Physician's Service dba Blue Shield of CA (BSCA) for alleged improper medical claim denials in violation of ERISA. The court found that because members are seeking 'declaratory and injunctive relief, allowing a class action to be brought would be in the interests of judicial economy'." [Escalante v. California Physicians' Service dba Blue Shield of CA, No. 14-cv-03021 (C.D. Cal. July 14, 2015)] (AVYM Healthcare Revenue Consultants)  

GAO Observations on 18 Undercover Tests of Enrollment Controls for ACA Coverage and Subsidies
"GAO was asked to examine controls for application and enrollment for coverage through the federal Marketplace. This testimony describes [1] the results of GAO's undercover testing of the Marketplace's eligibility and enrollment controls, including opportunities for potential enrollment fraud, for the act's first open-enrollment period; and [2] additional undercover testing in which GAO sought in-person application assistance." (U.S. Government Accountability Office [GAO])  

Fake Enrollees Keep Getting Obamacare Subsidies
"The [GAO] last summer announced that it had created 12 fake identities and 11 were able to sign up for coverage, qualifying for a total of $2,500 a month in subsidies.... An update to the probe found that all 11 enrollees had their coverage automatically extended for 2015.... Six policyholders had their coverage terminated a few months later because they did not submit the necessary documentation. But GAO investigators were able to get five enrollees reinstated after talking to Healthcare.gov phone representatives. The representatives also increased the enrollees' subsidies by a total of $1,000 for the year. The application of the sixth policyholder is still pending." (CNNMoney.com)  

Exchange Plans Include 34 Percent Fewer Providers Than the Average for Commercial Plans
"[E]xchange plan networks include 42 percent fewer oncology and cardiology specialists; 32 percent fewer mental health and primary care providers; and 24 percent fewer hospitals. Importantly, care provided by out-of-network providers does not count toward the out-of-pocket limits put in place by the ACA." (Avalere Health)  

Six Million Pay ACA Fine Rather Than Buy Health Insurance
"About 6.6 million people filed federal tax returns with an individual shared responsibility payment ... That's about 10 percent more than the Obama Administration predicted ... While the IRS report did not disclose how much the fines raised in total, the average penalty ... was $190, being as much as much as 1 percent of income. The IRS also found that 300,000 citizens overpaid by an average of $110 and with a collective $35 million." (Healthcare Payer News)  

Head of Obamacare Rollout to Lobby for Insurers
"As the new voice for insurers, Ms. Tavenner will lead the industry in a time of tumultuous changes and challenges, including delicate negotiations with Congress over the future of the Affordable Care Act.... Her selection as chief lobbyist for the industry highlights how federal health programs have become a priority for insurers, which increasingly depend on revenues from Medicare and Medicaid and the new public insurance marketplaces." (The New York Times; subscription may be required)  

[Official Guidance]

Text of IRS Proposed Regs: Property Transferred in Connection with the Performance of Services
"[M]any taxpayers who wish to electronically file (e-file) their annual income tax return have been unable to do so because of the requirement in Section 1.83-2(c) that they submit a copy of their section 83(b) election with their income tax return. Commercial software ... does not consistently provide a mechanism for submitting a section 83(b) election with an individual's e-filed return. As a result, an individual who has made a section 83(b) election ... would be required to paper file his or her income tax return ... The proposed regulations would remove the second sentence in Section 1.83-2(c) of the existing regulations. This would eliminate the requirement that taxpayers submit a copy of a section 83(b) election with their tax return for the year in which the property subject to the election was transferred.... These regulations under section 83 are proposed to apply as of January 1, 2016, and would apply to property transferred on or after that date. Taxpayers may rely on these proposed regulations for property transferred on or after January 1, 2015." (Internal Revenue Service [IRS])  

[Guidance Overview]

SEC Proposes Clawback Rules Mandated Under Dodd-Frank
"What type of restatement will trigger a clawback? ... What kinds of compensation are subject to the clawback policy? ... How is 'excess compensation' determined? ... Does the board have discretion regarding the means of recovery? ... Can a company protect an executive officer from personal liability associated with clawbacks?" (Steven Hall & Partners)  

[Guidance Overview]

SEC Issues Proposed Rules for Pay Versus Performance
"Registrants may consider modeling how their [cumulative total shareholder return (TSR)] may compare to the compensation 'actually paid' to their CEO and other NEOs and to the TSR of their peers. Companies should also consider whether supplemental disclosure measures ... may prove useful to address any perceived disconnect between pay and performance that might result from the Proposed Rules." (Haynes and Boone, LLP)  

US Labor Department and Kentucky Labor Cabinet Sign Three-Year Agreement to Protect Misclassified Workers
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

AHIP's Board of Directors Unanimously Elects Marilyn Tavenner as President and CEO
America’s Health Insurance Plans [AHIP]

Alex Assaley & Daniel Haverkos Named as Delegates to NAPA DC Fly-In Forum
AFS 401[k] Retirement Services

The Segal Group Announces Officer Promotions
The Segal Group

Health Care Service Corporation’s Blue Directions Private Exchange Now Offers Employers Increased Plan Options, Member Support and Transparency Tools
Health Care Service Corporation

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