Plan Administration Department Manager
MidAmerica Administrative & Retirement Solutions, Inc.
in FL

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Measuring the Value of Investment in Wellness
August 19, 2015 WEBCAST
(Business Insurance)

Intermediate IRA Training Part 2
August 20, 2015 WEBCAST
(Wolters Kluwer)

Employee Plans Compliance Unit (EPCU) Updates
August 27, 2015 WEBCAST
(IRS [Internal Revenue Service])

SEC's Pay Ratio Rule: What Companies Need to do to Prepare
October 15, 2015 WEBCAST
(Practising Law Institute)

Pension Administration Business Managers and Owners Conference
March 20, 2016 in IL
(ASPPA [American Society of Pension Professionals & Actuaries])

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[Official Guidance]

Text of Draft 2015 IRS Instructions for Forms 1094-C and 1095-C (PDF)
18 pages; revised August 6, 2015. "All Applicable Large Employer Members (ALE Members) are required to file Forms 1094-C and 1095-C for 2015.... For 2015, Form 1094-C was revised to move line 19 (Is this the Authoritative Transmittal for this ALE Member?) into Part I of the form and to allow for an entry in the 'All 12 Months field' in Part III, Line 23, column (b) Full-Time Employee Count for ALE Member. Form 1095-C was revised to include a first month of the plan year indicator (plan start month) in Part II and a Part III Covered Individuals Continuation Sheet." [Also see August 6, 2015, revision of Draft 2015 Form 1095-C.] (Internal Revenue Service [IRS])  

[Advert.]

Mercer Select's Guide to ACA Employer Shared Responsibility

Fortify your compliance efforts with the Guide to ACA Employer Shared Responsibility. This 300-page resource will help you understand your obligations, identify compliance steps, and set a play-or-pay strategy. Contact us at select@mercer.com.

[Official Guidance]

Text of Draft 2015 IRS Instructions for Forms 1094-B and 1095-B (PDF)
8 pages; revised August 6, 2015. "Providers of minimum essential coverage are required to file Forms 1094-B and 1095-B for 2015 in accordance with the forms and these instructions to report coverage in 2015. For 2015, Form 1095-B, Part III, was revised to include Covered Individuals Continuation Sheet(s) used when there are more than six covered individuals." [Also see August 6, 2015 revision of Draft 2015 Form 1095-B.] (Internal Revenue Service [IRS])  

[Official Guidance]

CMS Interface Control Document: Risk Adjustment and Reinsurance Addendum (PDF)
162 pages, version 4.01.00, dated June 2015. "This is an addendum to the existing ICD, which describes the relationship between CMS and the issuer's EDGE server. This document serves to define additional reports that will be produced by the issuer's EDGE servers as a supplement to the ICD currently published on the Registration for Technical Assistance Portal (REGTAP). These reports include the risk adjustment and reinsurance calculation reports that are used for payment processing, as well as additional analytic reports. The CMS-EDGE server interface is only necessary when CMS is operating the Risk Adjustment and/or Reinsurance programs on behalf of a state." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

FF-SHOP Enrollment/Reconciliation Issuer Testing Overview (PDF)
52 presentation slides, Aug. 4, 2015. Topics include: [1] Federal Data Services Hub (Federal DSH) Enterprise File Transfer (EFT) Password Policy Implementation; [2] Issuer Contacts for Enrollment Data Reconciliation; [3] Generation of FF-SHOP Annual Election Notices; [4] Update on FF-SHOP Switch Files for Non-renewals; and [5] Enrollment/Reconciliation Issuer Testing Overview: 2015 Reconciliation Issuer Timeline, Issuer Inbound File Validations; File Naming Convention, and Test File Transmission. (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

Federal Parity Law Associated with Increased Probability of Using Out-of-Network Substance Use Disorder Treatment Services
"[The authors] conducted an interrupted time-series analysis using insurance claims from large self-insured employers to evaluate whether federal parity was associated with changes in out-of-network treatment for 525,620 users of substance use disorder services. Federal parity was associated with an increased probability of using out-of-network services, an increased average number of out-of-network outpatient visits, and increased average total spending on out-of-network services among users of those services." (Health Affairs)  

[Advert.]

Is Your Wellness Plan a Lawsuit Waiting to Happen?

August 26 -- Attend this live webinar and make sure you are up to speed and fully compliant on the latest issues surrounding wellness plans. BenefitsLink discount.

Sixth Circuit: Benefit Denial Based on Medical File Review Was Arbitrary and Capricious
"You already know that you do not have to give special deference to the opinions of treating physicians. But you need to explain why the treating physician's opinions are being rejected. Overusing the same independent medical reviewers can adversely affect the weight given to your record reviews. And, what about independent medical exams: Are they required?" [Shaw v. AT&T Umbrella Benefit Plan No. 1, No. 14-2224 (6th Cir. July 29, 2015)] (Lane Powell PC)  

Obama Administration Considering Executive Order Requiring Federal Contractors to Provide Employees Paid Sick Leave
"Under the draft proposal, covered employees would accrue paid sick leave at a rate of 1 hour for every 30 hours worked. No contractor would be permitted to cap accrual at less than 56 hours per year, which equates to 7 days of leave. Moreover, covered employees would have to be allowed to carryover all accrued unused sick time." (Proskauer Rose LLP)  

U.S. Hospitals Urge DOJ Antitrust Probe of Anthem-Cigna Deal
"In a letter to the Department of Justice, the hospital industry's largest lobbying group said combining the No. 1 and No. 5 health insurers threatens to reduce competition in 817 geographic markets serving 45 million consumers. In many of those markets, the American Hospital Association said, there are no strong competitors to buy assets that Anthem or Cigna might want to sell to pass muster with federal authorities. State insurance regulators will also look at the deal." (Reuters)  

CVS Discontinuing Coverage of Some Popular Prescription Drugs
"CVS is dropping more than two dozen prescription drugs from its list of covered medicines for 2016, including Viagra. The drugs will still be sold at CVS/pharmacy stores, but customers who carry prescription benefit insurance with CVS/Caremark will no longer receive coverage for them. CVS said the medicines dropped from the list of drugs the company covers all have cheaper equivalents that are still covered by its insurance plan." (CNNMoney.com)  

Some Federal Employee Life Insurance Rates to Rise; Others to See Decrease
"On the heels of an immediate premium hike in the long-term care insurance program for federal employees, some rates are going to increase in 2016 in their much more widely used life insurance program -- although others will hold steady and still others will decrease ... For the retiree basic coverage, premiums will rise upwards of 10 percent. The picture is mixed for the additional forms of insurance, though, generally with decreases at younger ages but increases at older ages." (The Washington Post; subscription may be required)  

Blue Cross Now Seeking 34.6% Rate Hike in North Carolina for ACA Plans
"Blue Cross and Blue Shield, North Carolina's largest health insurer, is scrapping its June request for a 25.7 percent rate increase in favor of a larger rate hike: 34.6 percent.... As the state's dominant health insurer and the only ACA insurer in several dozen counties, Blue Cross is seen as a barometer of North Carolina's health insurance market for pricing and access. The company's request ... would affect about 380,000 people Blue Cross covers in North Carolina on individual policies under the [ACA]. It does not apply to the majority of the 3.9 million Blue Cross covers in the state under employer plans, state plans and other policies." (The News and Observer)  

[Official Guidance]

Text of Draft IRS Instructions for Form 2848: Power of Attorney and Declaration of Representative (PDF)
Draft is dated August 6, 2015 but indicates a December 2015 revision date. "What's New: Updated the description and representation requirements for unenrolled return preparers (designation h). Removed registered tax return preparer (designation i). The unenrolled return preparer designation includes individuals who passed the IRS registered tax return preparer competency test that was offered between November 2011 and January 2013." (Internal Revenue Service [IRS])  

[Guidance Overview]

To-Do List for Implementing Final Rules on the CEO Pay Ratio Disclosure
"[1] Brief the board and/or compensation committee as to the final rules and the action steps.... [2] Each company may select a methodology to identify its median employee based on the company's facts and circumstances ... [3] Assess your ability to calculate precisely all items of compensation or whether reasonable estimates may be appropriate for some elements.... [4] Begin to evaluate possible testing dates.... Consider work-force restructuring ... [5] Determine whether any of your non-U.S. employees are employed in a jurisdiction with data privacy laws that make the company unable to comply with the rule without violating those laws." (Winston & Strawn LLP)  

[Guidance Overview]

SEC Adopts CEO Pay Ratio Disclosure Requirements
"Despite much public debate and significant negative feedback on the proposed rules, the SEC adopted final requirements that are generally consistent with its initial proposal and largely without compromise on what were perceived as the most controversial issues.... Certain non-U.S. employees may be excluded pursuant to a foreign data privacy law exemption and/or a 5 percent de minimis exemption; reliance on either exemption requires additional disclosure. Compensation of employees may be adjusted to the cost of living in the jurisdiction where the CEO resides." (Skadden, Arps, Slate, Meagher & Flom LLP)  

[Guidance Overview]

Final CEO Pay Ratio Rules Provide More Flexibility for Compliance
"[S]ome data-gathering activities have been simplified: [1] Once companies determine their median employee, they can continue to use that person as the median employee for two more years, as long as their circumstances remain the same. [2] Companies that have business combinations can exclude newly acquired employees for that fiscal year's disclosure. [3] Two exclusions for non-U.S. workers were provided.... [4] Companies can apply a cost-of-living adjustment when identifying the median employee and in calculating the median employee's compensation, although the unadjusted ratio would also need to be disclosed to provide context." (Towers Watson)  

[Guidance Overview]

SEC Proposes Executive Compensation Clawback Rules
"[T]he issuer's annual determination of its Section 16 officers takes on an added importance.... This is an opportune time for an issuer to review its existing policy to determine if the provisions of the policy should be supplemented or amended in view of the SEC's proposed rules. For issuers without a clawback policy, the issuer should examine the necessity of such a policy.... [L]isted issuers should be aware that, the two largest proxy advisory firms, ISS and Glass Lewis, consider the presence of a clawback policy as a factor in making certain corporate governance recommendations." (Holland & Knight)  

Five Predictions about the CEO Pay Ratio Rule in Practice
"[1] The media will be the most voracious consumers of this data.... [2] CEOs and Boards will use historically low ratios as an argument for raising CEO Pay.... [3] Compensation professionals will be tasked with explaining why 'pay ratio' at their company is not directly comparable to their peers.... [4] Companies with high ratios will work to explain how this benefits their shareholders.... [5] Some companies will find themselves stuck between hiring, or keeping, the right person and staying within the guidelines to receive positive Say on Pay recommendations from proxy advisory firms." (Performensation)  

Could CEO Pay Ratio Disclosure Lead to Employee Misunderstanding and Lost Productivity?
"[F]or organizations that don't proactively manage employee expectations, there may be employee misunderstanding that could have a negative impact on employee engagement, productivity and, potentially, turnover. This concern should not be ignored and could be addressed as part of a holistic CEO pay ratio implementation and communications strategy." (Towers Watson)  

Changes to Federal Tax Return Filing Deadlines
"Pursuant to recently enacted legislation, filing deadlines for federal partnership information returns (Form 1065), S corporation information returns (Form 1120S) and C corporation income tax returns (Form 1120) have been changed.... For taxable years beginning after December 31, 2015, the IRS must modify its regulations to provide for the following maximum filing deadline extensions: ...Form 5500, Annual Return/Report of Employee Benefit Plan: 3-1/2 months." (Vorys, Sater, Seymour and Pease LLP)  

Guide to Society of Actuaries Written Exams: How to Be Successful (PDF)
35 pages. "The purpose of this document is to provide useful information for candidates taking written-answer examinations. In addition, we have included examples that illustrate many of the concepts.... This is the second version of the document.... [1] The fellowship exams were restructured and renamed. This document reflects those changes. However, the examples continue to be from the prior structure as the principles they illustrate are still valid. [2] The preliminary examination on life contingencies (MLC) added a written-answer component in 2014. Some specific advice for this exam has been added." (Society of Actuaries)  

Ascensus Appoints New Regional Vice President
Ascensus

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