ESOP Administrator
Blue Ridge ESOP Associates
in ANY STATE

DC Valuations Specialist
PenSys, Inc.
in CA, NC

Benefits Program Strategy Analyst 3
University of California Office of the President
in CA

Benefits Program Strategy Analyst 4
University of California Office of the President
in CA

Transition Manager- National Accounts
Transamerica
in CO, IA, NY

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Voluntary Fiduciary Correction Program
September 3, 2015 in MO
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

Avoid the ACA New Shared Responsibility Payment to the IRS
September 9, 2015 WEBCAST
(First Advantage)

Voluntary Fiduciary Correction Program
September 9, 2015 WEBCAST
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

9th Annual Executive Forum on On-Site and Near-Site Employee Health Clinics
September 17, 2015 in IL
(World Congress)

Employee Plans Programs - Summer 2015 Updates
September 17, 2015 WEBCAST
(IRS [Internal Revenue Service])

Pension De-Risking – Where Do We Stand Now?
September 22, 2015 WEBCAST
(Western Pension & Benefits Council)

2015 Fall Conference - Be Informed, Be Strategic, and Be Connected
September 23, 2015 in CA
(Western Pension & Benefits Council - Los Angeles Chapter)

Summary of Benefits and Coverage: Reviewing the SBC Content and Distribution Rules (Plus 2016 Updates!)
September 24, 2015 WEBCAST
(ABD Insurance & Financial Services)

2015 Fall Fly-In Conference
September 28, 2015 in GA
(Southern Employee Benefits Conference)

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[Official Guidance]

2014 Risk Corridors Validation Instructions (PDF)
37 pages. "While conducting reviews of MLR and risk corridors submissions, CMS identified a number of material differences from data that issuers submitted for other programs, including reinsurance and risk adjustment. CMS also identified a number of errors that could lead to submissions that do not comply with CMS regulations or guidance. In order to resolve these differences ... CMS needs additional information to explain the data in issuers' MLR and risk corridors submission. Without this additional information, CMS will be unable to verify the accuracy of the submission and validate the data needed to operate the MLR and risk corridors programs." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[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.

State Law Claim for Invasion of Privacy Escapes ERISA Preemption
"A federal court recently held that the plaintiff's claims under state law survived ERISA preemption, and remanded the case to state court to determine the plaintiff's claims for invasion of privacy and unfair business practices arising from the administrator's disclosure of her medical records to her employer.... While each of the federal circuits will have its own case precedents interpreting the Supreme Court's Davila holding, the ruling in Rose is representative of the preemption analysis." [Rose v. HealthComp, Inc., No. 15- 619 (E.D. Cal. Aug. 10, 2015)] (Williams Mullen)  

Sixth Circuit: In Subrogation Dispute, SPD Was Enforceable in Absence of Plan Document
"This case is a reminder that, notwithstanding Amara, there are circumstances when the parties to a litigated ERISA dispute should expect a court to enforce an SPD's terms over other purported plan documents.... As the court appears to acknowledge, it is not uncommon (particularly in the health plan context) for a plan to be established and maintained without both a formal plan document and an SPD. If, as in this case, the plan's administrators intend for the same document to serve as both the plan and SPD (an arrangement that would seem to be disfavored under Amara), that document should satisfy ERISA's requirements for both plan documents and SPDs." [Nat. Elevator Inc. Health Benefit Plan v. Moore, No.14-04048 (6th Cir. Aug. 25, 2015)] (Practical Law Company)  

Told 'You Can't Take Time Off' After Taking Leave to Care for Son, Teacher Has FMLA Claims Revived
"[T]he appeals court found that [the teacher] never requested an accommodation, was not a qualified individual, and failed to provide adequate comparator evidence. However, his FMLA interference and reprisal claims were supported by his principal's alleged comments suggesting he would suffer repercussions if he took any more time off to care for his son[.] [Preddie v. Bartholomew Consolidated School Corp., No. 14-3125 (7th Cir. Aug. 24, 2015)]" (Wolters Kluwer Law & Business)  

Many Employees Unaware of Workplace Wellness Programs
"Only 34 percent of U.S. workers said they have a health and wellness program at work, even though 70 percent of employers say they offer this type of program, according to recent research ... Nearly half (45 percent) of employee respondents said that if their company did offer a workplace wellness program, they would participate. However, these respondents all believe that a program is unavailable at their job." (Wolters Kluwer Law & Business)  

[Advert.]

Now is a great time to join Worldwide Employee Benefits Network (WEB)

WEB members represent more than 25 professions and 30 areas of expertise within the pension and benefits industry-including administrators, consultants, attorneys, accountants, investment managers, communications experts and benefits managers. Join today.

Few Health Savings Accounts Owners Choose to Invest That Money
"About two-thirds of health savings accounts offer individuals the ability to use an investment option ... Yet few consumers are taking advantage of the investment options. The EBRI study found that 6.4 percent of people with HSAs invested their health savings account contributions in mutual funds or other financial vehicles. The remainder left the contributions in savings accounts, where their money isn't at risk from market fluctuations." (Kaiser Health News)  

Larger Issuers, Larger Premium Increases: Health Insurance Issuer Competition Post-ACA
"[T]he largest issuer in each marketplace had a 75% higher premium increase from 2014 to 2015 compared to other same-state issuers ... On average, the largest issuers raised rates by 23.9%, while the other issuers only raised rates by 13.7%. Moreover, the largest issuers' premium increase affects a larger proportion of plans ... and [does] not seem justified from the standpoint of incurred claims-to-premium ratio[.]" (Technology Science)  

[Opinion]

Re-evaluating Value in Health Plan Management (PDF)
"One [pharmacy benefit manager] recently estimated plan sponsors are wasting $4.9 billion annually as a result of inadequate management of specialty medications in the medical benefit. Most of this waste could be avoided by applying the utilization and trend-management programs that are traditionally found in the pharmacy benefit to the medical benefit.... [T]he results of [these] efforts will be more limited unless they are coupled with a new resolve regarding something most benefit managers have not considered: namely, providing different levels of plan coverage for the same specialty drug when it is used for different conditions." (Chelko Consulting Group)  

[Guidance Overview]

Dodd-Frank and Executive Compensation: Where Are We Now?
"[T]he SEC has adopted final rules requiring pay ratio disclosures, as well as proposing rules mandating 'clawbacks' of incentive compensation from executives at exchange listed companies in the event of a restatement in certain circumstances. The purpose of this [article] is to provide a summary of these final and proposed rules and the steps that companies should consider taking to prepare to comply with the new rules. Additionally, because Dodd-Frank was enacted more than five years ago and implementation has been slow, we include a summary of the Dodd-Frank provisions relating to executive compensation and their current status[.]" (Seyfarth Shaw LLP)  

Third Circuit Rules That Plan Must Give Notice of Limitations Period
"The Court of Appeals ruled that the regulation [under ERISA Section 503] should be construed broadly and in favor of [the plan participant making a claim for benefits] because ERISA is a remedial statute and noted that both Courts of Appeals to have addressed the issue (the Sixth Circuit in 2014 and the First Circuit in 2011) have required disclosure of the plan-imposed time limit. In addition, practical considerations supported such an interpretation of the regulation, as imposing a requirement on plan administrators to inform claimants of deadlines for judicial review in documents that they are likely to actually read (i.e., adverse benefit determinations) results in only a trivial burden." [Mirza v. Ins. Admin. of America, Inc., No. 13-3535 (3d Cir. Aug. 26, 2015)] (Duane Morris LLP)  

Second Circuit Provides Test for Whether Severance Pay Policy Is an ERISA Plan
"The Second Circuit concluded that the employer's policy represented a multi-decade commitment to provide severance benefits to a broad class of employees under a wide variety of circumstances and required individualized review whenever potentially eligible employees were terminated. This review requires managerial discretion and individualized evaluation. As a result, the Second Circuit found that the employer assumed the obligation to pay severance benefits on a regular basis, and, therefore, faced periodic demands on its assets that required long-term administration and control." [Okun v. Montefiore Medical Center, No. 13-3928 (2d Cir. July 17, 2015)] (The Wagner Law Group)  

Summary of Recent ERISA Appellate Court Decisions, August 27, 2015
"The Second Circuit held that a Section 502(a)(1)(B) claim may be brought against the claims administrator who has discretion to make final benefit determinations, Section 502(a)(3) may impose a fiduciary duty arising indirectly from the [Mental Health Parity Act], and simultaneous claims under Section 502(a)(1)(B) and 502(a)(3) may proceed. The Third Circuit ... held that court orders remanding benefit claims to the administrator do not constitute final and appealable decisions under 29 U.S.C. Section 1291 ... and that a denial letter's failure to include the plan's time limitation to file a civil action renders it unenforceable. The Sixth Circuit held that a Summary Plan Description may be a controlling plan document (because apparently Amara is so 2011)." (Springer & Roberts LLP)  

How Can Employee Benefits Play a Role in Corporate Branding?
"[E]mployees who are very satisfied with their benefits are almost four times more likely to be very satisfied with their jobs. Further, almost 70% of employees with a comprehensive benefits program would recommend their place of employment (versus 46% with less benefits).... '[B]enefits that are perceived as fair and competitive will motivate employees to be more committed because the organization is signaling its own commitment to them.' " (Grooms Benefit Solutions)  

Sabrina Bailey Named Global Head of Defined Contribution
Northern Trust

New Business Development Roles at RMS
Retirement Management Services, LLC

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