Executive Benefits Client Associate
Wells Fargo
in NC

Relationship Manager
The Retirement Plan Company
in ID, OR, WA

Account Manager I/II - Retirement Plans
The Standard
in OH

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Living to 100: Keys to Longevity
September 3, 2015 WEBCAST
(International Foundation of Employee Benefit Plans [IFEBP])

Obtaining Actionable Data From Your Carriers and Vendors
September 10, 2015 WEBCAST
(International Foundation of Employee Benefit Plans [IFEBP])

Implementing Your Wellness Program
September 17, 2015 WEBCAST
(International Foundation of Employee Benefit Plans [IFEBP])

Investment Boot Camp for Pension Actuaries
October 14, 2015 in TX
(Society of Actuaries)

Winning with Self-Directed IRAs Conference
October 22, 2015 in NV
(Retirement Industry Trust Association [RITA])

View All Webcasts and Conferences

[Official Guidance]

Text of CMS Instructions for 2014 Risk Corridors Discrepancy Worksheet (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 needs additional information to explain the data in issuers' MLR and risk corridors submission.... Each company that submitted risk corridors data for the 2014 benefit year will be required to complete and attest to a checklist which identifies critical components of the risk corridors and MLR submission.... Companies will complete the Discrepancy Worksheet only if they have been instructed to do so by CMS in a letter dated August 31, 2015 and have been provided with a unique web link to access the form." [Also available: 6-page Supporting Statement.] (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.

[Official Guidance]

CMS National List and Description of Current and Proposed EHB Benchmark Plans
"For plan years 2014-2016, two documents are provided for each [Essential Health Benefits (EHB)] benchmark plan in the 50 states and D.C.: [1] a summary of the plan's benefit coverage and limits, including a list of covered prescription drug categories and classes; and [2] a list of state-required benefits. The list of each state's required benefits has been compiled to help states and issuers determine which state-required benefits must be included in plan designs. For 2017, two documents are provided for each proposed EHB benchmark plan: [1] a summary of the plan's coverage of certain benefits that appear on the Plans & Benefits Template, including a list of covered prescription drug categories and classes; and [2] supporting plan documents that provide detail regarding all plan coverage, limits, and exclusions.... [W]hen designing plans that are substantially equal to the EHB benchmark plan issuers may need to conform plan benefits, including coverage and limitations, to comply with [recent federal] requirements and limitations." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

IRS Revisits 'Minimum Value Lite' Plans; Transition Relief Expiring
"The [IRS] has revisited its fascination with so-called Minimum Value (MV) Lite plans that, as originally designed, claimed to satisfy the [ACA's] minimum value health plan standard without covering inpatient hospitalization or physician services.... Under new proposed rulemaking, plans that relied on transition relief for 2015 won't meet the minimum value standard for 2016 unless the coverage is 'substantial' for both inpatient hospitalization and physician services. The IRS has yet to define 'substantial,' but has asked for comments on this issue." (Lockton)  

[Guidance Overview]

ACA Reporting Requirements for Carriers and Employers (Part 7 of 24): Mergers and Acquisitions
"When it comes to mergers and acquisitions involving at least one applicable large employer (ALE), the substantive rules governing employer shared responsibility ... and the corresponding reporting rules ... share at least one thing in common: we don't yet know how they work. This leaves parties to corporate deals with some challenging questions: How should acquired employees be treated? Does the form of the transaction matter? Do 'successor employer' rules of the sort found in the COBRA final regulations apply? Are the parties free to apportion exposure? What presumptions might be invoked if the matter of [ACA] compliance is not addressed?" (Mintz Levin)  

[Guidance Overview]

Report of Essential Health Benefits under the ACA (PDF)
"Because each state selected its own [essential health benefit (EHB)]-benchmark plan under the 2014-2016 approach to the EHB, there is considerable variation in EHB coverage from state to state. This variation occurs in terms of specific covered services as well as in terms of amount, duration, and scope.... Furthermore, because states can allow non-group and small-group plans to substitute certain services within the categories, coverage in plans within a state also may vary by benefit amount, duration, and scope." [Report No. R44163, dated Aug. 27, 2015.] (Congressional Research Service [CRS])  

[Advert.]

Executive Forum on On-Site & Near-Site Employee Health Clinics – Chicago

Executive Forum on On-Site & Near-Site Employee Health Clinics – Chicago – Sep 17-18 – HR/Benefits Staff: Attend for $195* – use code BLINK1 – (*valid only for HR/Benefits Staff as defined on event website. Please visit for qualifications)

[Guidance Overview]

IRS Proposes Modification to Minimum Value Rule; CMS Proposes 2017 EHB Benchmark Plans
"While the actuarial value standard would apply as of December 31, 2013, the additional requirement for covering substantial physician and hospital services would apply for plan years beginning on or after November 3, 2014 for purposes of determining premium tax credit eligibility.... Along with the 2017 [Essential Health Benefits (EHB)] benchmark plans, CMS also published each state's 2014-2016 benchmark plan and a list of each state's current mandated benefits. An updated list of state mandated benefits will be published later, although coverage benefits enacted after 2011 are presumably not part of the EHB unless the state is prepared to cover their cost for qualified health plans." (Timothy Jost, in Health Affairs)  

2017 Commissioner's Standard Ordinary (CSO) Tables
"The Valuation Table Team has completed their work on the 2017 Commissioner's Standard Ordinary (CSO) Tables. These include male / female, smoker / nonsmoker and age-nearest birthday (ANB) / age-last birthday (ALB)." (Society of Actuaries)  

The Haze of Medical Marijuana and Benefits
"[A] health plan doesn't have to cover medical marijuana. What's not clear is whether a health plan even can cover it. If coverage is provided, the benefit would be taxable. [A recent articles notes] that VEBAs are tax-exempt trusts, and there's an argument that if a VEBA covers the cost of medical marijuana, it could lose its tax exemption. However, they write, if less than 3% of the VEBA's total expenditures are for nonpermitted purposes, its tax-exempt status should be safe." (International Foundation of Employee Benefit Plans [IFEBP])  

Telehealth Commercial Coverage and Parity Laws: Trends, Challenges and Opportunities
"Many, but not all, of the 29 states with telehealth commercial insurance laws have equal coverage (some impose restrictions and limits resulting in less than coverage parity). Payment parity exists in a smaller subset of those states, which means that not only must the services be covered, but the rate the health plan pays the provider for telehealth services must be equal or equivalent to the rate the health plan pays that same provider for the in-person service.... In states that lack payment parity, many hospitals and providers receive less than the in-person payment rate for the same service. That creates a disincentive for providers to utilize telehealth service[.]" (Foley & Lardner LLP)  

Action Steps for Reviewing Your State's 2017 EHB Benchmark Plan
"HHS has set forth a short 30-day public comment period regarding the proposed [Essential Health Benefits (EHB)] benchmark plans with comments due by ... September 30, 2015.... This EHB Step Guide is designed to help state advocates review and analyze their state's benchmark plan, and raise any concerns to HHS before there is final federal approval." (National Health Law Program [NHeLP])  

Interim Report on the IRS' Verification of ACA Premium Tax Credit Claims (PDF)
26 pages. "Because of incomplete and unreported data from the Exchanges, the IRS is unable to ensure that taxpayers claiming the PTC purchased insurance through an Exchange and properly reconciled APTCs received. However, the IRS has developed processes to identify erroneous PTC claims. Our review of these processes identified that 79 of the 80 reject code conditions and 16 of the 20 PTC error codes were working as intended. Computer programming errors always identifying tax returns with the particular error condition. The IRS plans to make programming corrections." [Dated May 29, 2015; released online Sept. 1, 2015.] (Treasury Inspector General for Tax Administration [TIGTA])  

Health Care Premiums Rise, More Increases Coming
"Group health care premiums continue to outpace inflation ... The increases may be more difficult for smaller employers to control, as they are 'really dependent on the insurer,' whereas larger firms can create the health plans they offer by working directly with insurers, [said Steve Wojcik, NBGH vice president of public policy]. He added that historically, smaller employers have typically faced higher premium rates than large employers." (Business Insurance; free registration required)  

What Constitutes 'Retaliation' under ERISA?
"[A] viable cause of action under ERISA for retaliation requires, to succeed, a strong linkage between a job action or other harmful decision and the participant's request for benefits or effort to protect those benefits. Most of the typical disputes that go on day after day between participants and plan administrators don't rise to this level, no matter how it feels to the particular participant trapped in the dispute. Instead, a viable ERISA claim for retaliation looks much more like the facts of [Perez v. Brain], in which the [DOL recently] recovered several hundred thousand dollars in back pay and other damages for a trio of employees and plan participants who blew the whistle on malfeasance by a plan fiduciary and cooperated with a federal criminal investigation." (Stephen Rosenberg, The Wagner Law Group)  

International Employers Challenged by National Benefit Plan Mandates
"Employers need to understand which benefits are automatically provided by a foreign government and which are required to be provided by employers for their employees working in that country. For example, paid time off benefits, such as vacation, holidays, maternity and paternity leave, and medical leave, may not be required for employers in the US but are common government-mandated benefits in other countries." (Moss Adams LLP)  

PBGC to Pay Benefits at Standard Register
PBGC [Pension Benefit Guaranty Corporation]

Jiff and Mercer Launch New Product Health Pathfinder by Mercer
Mercer

Conrad Siegel Investment Advisors Launches Check Mate for Retirement Income Planning
Conrad Siegel Investment Advisors, Inc.

Richard McHugh Joins PSCA as Vice President of Washington Affairs
PSCA [Plan Sponsor Council of America]

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