Health & Welfare Plans Newsletter

September 9, 2015

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Employee Benefits Jobs

Senior Account Manager
Cammack Health LLC
in NY

ERISA and ESOP Attorney
Krieg DeVault LLP
in IN

Pension Administrator
Karel-Gordon & Associates
in IL

Benefits Claims Specialist
Smithfield Farmland, a Smithfield Company
in MO

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Webcasts and Conferences

Integrity 101: What Every Pension Professional Should Know
RECORDED
(ASPPA [American Society of Pension Professionals & Actuaries])

Update on Recent IRS Guidance
September 24, 2015 in OH
(ASPPA Benefits Council [ABC] of Central Ohio)

Current Trends in ERISA Litigation and Best Practices to Avoid the Courtroom
September 24, 2015 in FL
(ASPPA Benefits Council [ABC] of North Florida)

Employer 1095 and 1094 Reporting
September 24, 2015 WEBCAST
(Frenkel Benefits, LLC)

ERISA Workshop
October 8, 2015 in KS
(SunGard Relius)

Advanced Plan Design Workshop
October 9, 2015 in KS
(SunGard Relius)

Don't Do That with Your ESOP: Financial and Administrative Issues
October 13, 2015 WEBCAST
(National Center for Employee Ownership [NCEO])

Affordable Care Act: Where Are We Now? Where Are We Going?
October 15, 2015 WEBCAST
(Worldwide Employee Benefits Network [WEB])

Ethics
December 2, 2015 WEBCAST
(Conference of Consulting Actuaries)

Responsibilities of Internal ESOP Fiduciaries
January 6, 2016 WEBCAST
(Beyster Institute)

View All Webcasts and Conferences


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[Official Guidance]

Text of Executive Order Establishing Paid Sick Leave for Federal Contractors
"Executive departments and agencies shall ... ensure that new contracts ... include a clause, which the contractor and any subcontractors shall incorporate into lower-tier subcontracts, specifying, as a condition of payment, that all employees, in the performance of the contract or any subcontract thereunder, shall earn not less than 1 hour of paid sick leave for every 30 hours worked.... A contractor may not set a limit on the total accrual of paid sick leave per year, or at any point in time, at less than 56 hours.... Paid sick leave accrued under this order shall carry over from 1 year to the next and shall be reinstated for employees rehired by a covered contractor within 12 months after a job separation.... The paid sick leave required by this order is in addition to a contractor's obligations under [the Service Contract Act and the Davis-Bacon Act] ... A contractor may only require certification issued by a health care provider for paid sick leave ... for employee absences of 3 or more consecutive workdays, to be provided no later than 30 days from the first day of the leave." (The White House Blog)  


[Advert.]

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Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

Co-sponsored by the International Foundation of Employee Benefit Plans and the Wharton School of the University of Pennsylvania, the CEBS designation gives you the knowledge and confidence to succeed in today's business environment. Learn More!



[Official Guidance]

Text of CMS FAQs: SBC Online Posting of Policy and Certificate of Coverage Documents (PDF)
"To the extent an issuer is unable to meet this requirement by the applicability dates listed [in this FAQ], HHS will not take enforcement action against an issuer that makes the individual coverage policy or group certificate of coverage documents accessible online no later than November 1, 2015 ... [If] a group health insurance issuer is required, in accordance with the June 12, 2015 SBC final rule, to provide the internet web address on the SBC before October 31, 2015, HHS will not take enforcement action against that issuer if it provides an internet web address for group certificate of coverage documents no later than November 1, 2015.... Closed blocks of business that do not meet the conditions for enforcement relief must continue to comply with the SBC requirements, including providing the SBC to plan sponsors and individuals at the required timeframes in the SBC final rules." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

Executive Order Requires Paid Sick Leave for Employees of Government Contractors
"The requirement will take effect for covered contracts entered into after January 1, 2017.... [An] employee may use the leave for his or her own physical or mental illness, injury, medical condition, treatment or diagnosis as well as that of a spouse, child, parent, 'or any other individual related by blood or affinity whose close association with the employee is the equivalent of a family relationship.' An employee may also use the leave for absences from work resulting from domestic violence, sexual assault, or stalking ... or to obtain additional counseling, seek relocation, seek assistance from a victim services organization or to take related legal action. The leave for domestic violence, sexual assault or stalking is available for the employee and for the employee to assist a related individual[.]" (Ford & Harrison LLP)  

[Guidance Overview]

ACA Nondiscrimination Rules Would Impact Health Plan Insurers Acting as TPAs
"Health plan insurers may be surprised by the seemingly broad reach of the Section 1557 proposed regulations' nondiscrimination rules.... According to HHS, an insurer that participates in the exchanges and thereby 'receives' federal financial assistance also is covered under the proposed regulations: [1] For all its other health plans. [2] In its role as a TPA for employer-sponsored health plans.... [T]hese regulations may impact a broad range of insurers and plans, particularly because the nondiscrimination rules would apply well beyond an insurer's exchange-based offerings." (Practical Law Company)  

House Subcommittee Holds Hearing on Protecting Affordable Coverage for Employees
From the Background Memo: "Historically, an employer with 50 or fewer employees was considered a 'small employer' and could purchase health insurance coverage in the small-group market. The [ACA] revised this historical threshold upward, redefining a small employer as those employers with 100 or fewer employees. Now, States must implement the expanded definition for plan years beginning in 2016. H.R. 1624, Protecting Affordable Coverage for Employees Act of 2015, would amend the Public Health Service Act to redefine small employer as one with 50 or fewer employees and give States the option to expand the definition to include employers with up to 100 employees.... [An actuarial] analysis estimated that the effect of expanding the definition of small employer to 51 to 100 employees would result in roughly two-thirds (64%) of members in groups with 51-100 employees receiving a premium increase in 2016, with these groups receiving an 18% increase on average." (Subcommittee on Health, Energy & Commerce Committee, U.S. House of Representatives)  


[Advert.]

American Conference Institute's Employee Benefit Plans Conference

Sponsored by American Conference Institute

Our faculty of leading in-house counsel & top law firms will break down the latest concerns impacting employee benefit plans & illustrate the steps you can take to remain compliant. Join us on November 17-18, 2015 in New York, NY.



Employees of Federal Contractors to Get Paid Sick Leave
" 'Contractors should take note that this requirement does not take effect immediately and is not self-implementing. It takes effect in 2017 and only after the Department of Labor issues rules,' [said Shlomo Katz, a government contracts lawyer at Brown Rudnick].... 'The executive order requires covered contractors to provide sick leave in addition to vacation and other fringe benefits already required by the Service Contract Act and Davis Bacon Act,' Katz added. 'Some will argue that the President is exceeding his authority by mandating sick leave because Congress has already legislated via those two laws (SCA and Davis-Bacon) that government contractors provide 'prevailing' fringe benefits to workers, and there is no indication that the President has done any studies to determine that sick leave is a "prevailing" fringe benefit.' " (Bloomberg BNA)  

How Mobile Health Can Mend Your Bottom Line
"As individuals make greater use of telemedicine and health apps, they are more likely to increase their knowledge and discover viable alternatives to costly emergency room and physician office visits. As health apps become more integral to individuals' lives, employers can leverage these services to drive positive changes in employee health, reinforcing the directives of their overall wellness initiative -- cutting costs and improving productivity." (Benefitfocus)  

Time for a HIPAA Security Check-Up!
"While we wait for additional HIPAA guidance ranging from breach notification to cloud security guidance, OCR promised its audit program is moving forward with a contractor selected to help staff the next round of audits. OCR confirmed it remains in the address verification phase -- meaning your organization still could be in the running.... Deputy Director McGraw is reported to have announced that OCR will submit its audit plans for public comment later this year or early next year before moving forward with additional audits. This means the next round of HIPAA audits will begin in 2016 at the earliest." (Davis Wright Tremaine LLP)  

What Are a Hospital's Costs? Utah System Is Trying to Learn
"Hospitals know what they are paid by insurers, but it bears little relationship to their costs.... The [University of Utah] hospital has been able to calculate ... the cost per minute in the emergency room (82 cents), in the surgical intensive care unit ($1.43), and in the operating room for an orthopedic surgery case ($12). With such information, as well as data on the cost of labor, supplies and labs, the hospital has pared excess expenses and revised numerous practices for more efficient and effective care." (The New York Times; subscription may be required)  

Benefits in General; Executive Compensation

Employer Costs for Employee Compensation, June 2015
"In June 2015, average costs in private industry for retirement and savings benefits were $1.24 per hour worked, or 4.0 percent of total compensation. The average cost per hour worked for defined benefit plans ... was 55 cents or 1.8 percent of total compensation. The average cost for defined contribution plans ... was 69 cents or 2.2 percent of total compensation.... Private industry employer costs for paid leave averaged $2.15 per hour worked or 6.9 percent of total compensation, supplemental pay averaged $1.10 or 3.5 percent, insurance benefits averaged $2.57 or 8.2 percent, and legally required benefits averaged $2.50 per hour worked or 8.0 percent." (U.S. Bureau of Labor Statistics [BLS])  

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