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UNITE HERE HEALTH
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ERISA Services, Inc.
in TN

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ERP Actuaries & Consultants
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DF Pensions, Inc.
in FL

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Legacy Retirement Solutions, LLC.
in PA

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Randall & Hurley
in ANY STATE, ID, OR, WA

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Learn about the IRS Updated EPCRS Plan Correction Procedures
August 6, 2015 WEBCAST
(ASC Institute)

Global Pensions: Where We Are, How We Got There, and Where We Are Going
August 18, 2015 in GA
(ASPPA Benefits Council [ABC] of Atlanta)

Half-Day Defined Benefit Plan Workshop
August 20, 2015 in OH
(ASPPA Benefits Council [ABC] of Cleveland)

Affordable Care Act: Employer Shared Responsibility Provisions and Information Reporting
September 16, 2015 WEBCAST
(IRS [Internal Revenue Service])

Retirement Readiness Seminar
October 14, 2015 in NY
(The Conference Board)

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[Official Guidance]

CMS CO-OP Program Guidance Manual (PDF)
59 pages; version 1, dated July 29, 2015. "This manual contains guidance on ... [1] Core contract requirements including the review of employment agreements and executive compensation; [2] Risk-based capital (RBC) requirements; [3] Start-up Loan disbursements; and [4] Semi-annual and quarterly reporting requirements." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

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[Guidance Overview]

CMS Webinar: FF-SHOP Issuer Testing for Plan Year 2016
32 presentation slides; July 28, 2015. Topics include: [1] Issuer Testing Schedule -- DRAFT (Subject to Change); [2] New Issuer Testing Scope; [3] Alpha Issuer Testing Scope; and [4] All Issuer Testing Scope. (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

Competition and Choice in the Health Insurance Marketplaces, 2014-2015: Impact on Premiums (PDF)
"Prior studies found that the Marketplaces offered a variety of affordable plans in 2014. In addition, Marketplaces with a greater number of plans demonstrated significantly enhanced consumer choice and lower premiums. [This report examines] states that used the federal HealthCare.gov platform in both 2014 and 2015 and [provides] a detailed analysis of how the supply of issuers changed from 2014 to 2015, the level of competition achieved in 2015, and how changes in the supply of issuers affected premium growth between 2014 and 2015." (Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

The Health Coverage Tax Credit Retroactively Reincarnated (PDF)
"The Act is not simply a reinstatement of prior law. Instead, it contains several new provisions, including the following: [1] Certified individuals may claim retroactive payments for 'qualified health insurance' from January 1, 2014 through July 6, 2015 on an amended tax return any time before the expiration of the 3-year statute of limitations with respect to the applicable taxable year. [2] By July 6, 2016, the Secretary of Treasury must establish a program for making payments on behalf of certified individuals to providers of qualified health insurance. [3] The term 'qualified health insurance' is revised, effective January 1, 2016, to specifically exclude individual coverage through an exchange established under the [ACA]." (Groom Law Group)  

[Guidance Overview]

Oregon Now Requires All Employers to Provide Sick Leave to Employees
"Oregon is now the fourth state, after Connecticut, California, and Massachusetts, to mandate that employers provide their employees with sick leave benefits. Oregon's new sick leave law goes into effect on January 1, 2016, applies to all private- and public-sector employees, and, in most cases, requires that the sick leave be paid. The law imposes posting and notification requirements on employers to ensure that employees are aware of their rights under the law and the amount of sick leave that they have accrued." (Vorys, Sater, Seymour and Pease LLP)  

[Advert.]

Last Chance to Receive Discounted Rates at IHC Private Exchange FORUM Baltimore!

As a benefit to our partnership with IHC, BenefitsLink would like to extend to you a complimentary registration FREE of charge to Private Exchange FORUM. Use Promo Code: BENEFITSLINKVIP Hurry, Offer expires July 31, 2015

HIPAA Audits Are On the Way
"OCR will select about 350 covered entities for desk audits, and at most that number of business associates ... The agency will seek to include a wide variety of entities based on type, location and affiliation with other covered entities.... The major challenge of the upcoming desk audits will be the very short turnaround time -- likely two weeks, with no opportunity to get clarification of OCR's data request[.]" (Thompson SmartHR Manager)  

Checklist: Filing for an ACA Transmitter Control Code
"In order to e-file ACA information returns with the IRS, you need to obtain a Transmitter Control Code (TCC). Gather and check off the items you need to complete required fields on the ACA Application for TCC.... E-filing is required for providers of minimum essential coverage that file 250 or more information returns during the calendar year. The purpose of the TCC application is to receive a TCC to become authorized to e-file Forms 1094B, 1095-B, 1094-C and 1095-C." (International Foundation of Employee Benefit Plans [IFEBP])  

CO-OP Enrollment and Profitability Lower Than Projected, Might Affect Ability to Repay Loans (PDF)
"Most of the 23 CO-OPs we reviewed had not met their initial program enrollment and profitability projections as of December 31, 2014 ... [M]ember enrollment for 13 of the 23 CO-OPs that provided health insurance in 2014 was considerably lower than the CO-OPs' initial annual projections, and 21 of the 23 CO-OPs had incurred net losses as of December 31, 2014 ... The low enrollments and net losses might limit the ability of some CO-OPs to repay startup and solvency loans and to remain viable and sustainable." (Office of Inspector General [OIG], U.S. Department of Health and Human Services [HHS])  

Analyzing the Justification for Expanding the Pioneer ACO Program
"The $384 million figure is based on an econometric estimate of gross Medicare savings compared with the cost of caring for all Medicare beneficiaries in the markets where the Pioneers operate. But this estimate does not reflect shared savings payments made by CMS to the successful ACOs, or shared loss payments by ACOs to CMS. When these amounts are included, the net program savings is actually $249 million -- still a positive result, but 35 percent lower than claimed." (John Valiente, for the Healthcare Financial Management Association [HFMA])  

GAO Report: IRS Needs to Strengthen Oversight of ACA Tax Provisions for Individuals
"Incomplete and delayed marketplace data limited IRS's ability to match taxpayer PTC claims to marketplace data at the time of return filing.... IRS does not know whether these challenges are a single year or an ongoing problem.... IRS does not know the total amount of advance PTC payments made to insurers for 2014 marketplace policies because marketplace data are incomplete.... [S]everal external stakeholders ... reported challenges with IRS collaboration efforts, such as not receiving certain IRS guidance in time for stakeholders to have complete information at the beginning of the filing season." (U.S. Government Accountability Office [GAO])  

Should Exchanges Require, Recommend, or Nudge Enrollees to Claim Less Than the Full Advance Premium Tax Credit?
"[R]oughly half of those who enrolled in the ACA's exchanges and received [Advance Premium Tax Credits (APTC)] ended up owing money to the federal government, because their income ended up higher than they had anticipated.... One solution is for enrollees to wait until tax filing to receive their credit as a lump sum. For most people, however, that would diminish their ability to afford monthly premiums. Another is to claim a partial amount of what they are eligible for at the time of application. This would build in a financial cushion[.] ... All [but one of the] exchanges set the default amount of tax credits that applicants receive at 100 percent of what the exchange determines them qualified for, based on previous tax data and the applicant's prediction for the coming year.... DC opted to take a different approach, lowering the default to 85 percent." (Health Affairs)  

Medicare Prescription Drug Premiums Projected to Remain Stable
"[T]he average premium for a basic Medicare Part D prescription drug plan in 2016 will remain stable, at an estimated $32.50 per month ... despite the fact that total Part D costs per capita grew by almost 11 percent in 2014, driven largely by high cost specialty drugs and their effect on spending in the catastrophic benefit phase.... [T]otal Medicare payments to plans for reinsurance have grown by more than three times the pace of premium growth. However, growth in per-Medicare enrollee spending continues to be historically low, averaging 1.3 percent over the last five years." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

Would Expanding Medicare Coverage for Telemedicine Increase or Decrease Federal Spending?
"Considerable uncertainty surrounds estimates of the likely utilization rates for covered telemedicine services themselves and of the downstream effects on other services that might be induced or avoided. In its analysis, CBO examines whether use of telemedicine as proposed would prevent the use of more expensive services, such as emergency room visits or hospital admissions, or would instead increase the use of other services to provide follow-up care." (Congressional Budget Office [CBO])  

As Medicare and Medicaid Turn 50, Use of Private Health Plans Surges
"More than 30 percent of the 55 million Medicare beneficiaries and well over half of the 66 million Medicaid beneficiaries are now in private health plans run by insurance companies like the UnitedHealth Group, Humana, Anthem and Centene. Enrollment has soared as the government, in an effort to control costs and improve care, pays private insurers to provide and coordinate medical services for more and more beneficiaries." (The New York Times; subscription may be required)  

New AHA Solutions/Clearwater Compliance White Paper Explores Fast-Changing Data Security Issues
Clearwater Compliance

Company Owner Restores More Than $59K to Approved Products Inc. 401(k) Savings Retirement Plan in Fairfield, Ohio, Following Fiduciary Breach
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

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