Health & Welfare Plans Newsletter

September 17, 2015

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401(k)/Pension Sales Consultant
Farmer & Betts
in FL, NC, TN

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Aspire Financial Services LLC
in FL

Account Manager 403(b)-457 Markets
Aspire Financial Services LLC
in FL

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Aspire Financial Services LLC
in FL

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Transamerica
in VA

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Webcasts and Conferences

Cadillac Tax Round Two: IRS Notice 2015-52 Addresses More Issues
RECORDED
(Thomson Reuters / EBIA)

2015 Reinsurance Contributions: Form Completion, Submission, and Payment
September 23, 2015 WEBCAST
(Centers for Medicare & Medicaid Services [CMS])

2015 Reinsurance Contributions: Form Completion, Submission, and Payment
September 28, 2015 WEBCAST
(Centers for Medicare & Medicaid Services [CMS])

ACA Information Returns (AIR)
September 29, 2015 WEBCAST
(IRS [Internal Revenue Service])

2015 Reinsurance Contributions: Form Completion, Submission, and Payment
September 30, 2015 WEBCAST
(Centers for Medicare & Medicaid Services [CMS])

Recognizing and Addressing COBRA
November 11, 2015 WEBCAST
(Lorman Education Services)

IRA Basics
November 17, 2015 WEBCAST
(Ascensus)

Understanding Your Summary Plan Descriptions
December 3, 2015 WEBCAST
(Lorman Education Services)

2016 NTSA 403(b) Masters Summit
January 21, 2016 in AZ
(National Tax-Deferred Savings Association [NTSA])

View All Webcasts and Conferences


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[Official Guidance]

Text of 2015 Instructions for IRS Forms 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, and 1095-C, Employer-Provided Health Insurance Offer and Coverage (PDF)
17 pages. "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 available: 2015 Form 1094-C and 2015 Form 1095-C.] (Internal Revenue Service [IRS])  


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[Official Guidance]

Text of 2015 Instructions for IRS Forms 1094-B, Transmittal of Health Coverage Information Returns, and 1095-B, Health Coverage (PDF)
7 pages. "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 available: 2015 Form 1094-B and 2015 Form 1095-B.] (Internal Revenue Service [IRS])  

[Guidance Overview]

October 15 Deadline Nears for Medicare Part D Creditable Coverage Notices
"There have been no revisions to the 2015 model notices provided by [CMS] and [employers] should continue to use the 2011 model notices.... Notices do not have to be sent as a separate mailing; they can be provided as part of enrollment/renewal or other plan information materials." (Marsh Consulting Group)  

[Guidance Overview]

City of Tacoma Issues Rules Interpreting Paid Leave Ordinance
"Which employers and employees are covered? ... Does the ordinance apply to telecommuting? ... Can employers frontload paid leave? ... May employers estimate hours worked within the city? ... May employers require employees to provide documentation when using paid leave? ... May employees donate paid leave to one another? ... What must be included in a 'premium pay' program? ... What recordkeeping requirements does the ordinance impose? ... How must employers that do not engage in business in Tacoma certify compliance with the ordinance? ... Must employers cash out unused paid leave upon separation of employment? ... What pay rate applies when employees use paid leave?" (Littler)  

Attitudes Shift on Paid Leave: Dads Sue, Too
"The cases come against the backdrop of a societal shift in which many fathers are working less and spending more time with their children. A recent Pew Research Center analysis reported that from 1965 to 2011, fathers reduced the number of hours they devoted to paid work to about 37 from 42 each week on average and increased the number of hours they devoted to child care each week to about seven from 2.5." (The New York Times; subscription may be required)  


[Advert.]

Register for NBCH's 20th Annual Conference, Nov. 16-18 in Dallas

Sponsored by National Business Coalition on Health [NBCH]

This must-attend event convenes employers, health plans, providers, business health coalitions and other key stakeholders focused on the future of health care and benefits. Free admission for employers that are members of an NBCH coalition. Join us.



Doubts Surround Effectiveness of Wellness Plans Aimed at Weight Loss
"[A recent study finds] no company has been able to demonstrate sustained weight loss across a large population for two years or more.... Wellness programs that focus on weight loss may in fact have negative effects, [the study] says, arguing that overscreening and crash dieting can impact employees' morale and even harm their health. Despite these concerns, some employers are raising the bar for employees to qualify for program incentives[.]" (FierceHealthPayer)  

Google Backs Startup Oscar Health Insurance
"Insurance startup Oscar Health Insurance Corp. has a powerful new ally in its uphill battle to win customers from entrenched insurance giants ... Google Capital, the Internet company's growth-equity fund, has invested $32.5 million in Oscar ... Oscar has amassed a war chest of more than $350 million in its bid to use data and technology to make the insurance business work more like an Internet service, drawing on things such as telemedicine." (The Wall Street Journal; subscription may be required)  

3D-Printed Prescription Drugs a Huge Stride Forward for Personalized Medicine
"In addition to tailoring the form of drugs to the needs of particular classes of patients, 3DP opens the possibility of tailoring each individual tablet to the needs of a specific patient, regardless of the physical location of the printer. This is something that has simply not been financially feasible with mass-produced medications." (Wilson Elser)  

GAO Report on State Health Insurance Marketplaces: CMS Should Improve Oversight of State Information Technology Projects
"CMS tasked various offices with responsibilities for overseeing states' marketplace IT projects. However, the agency did not always clearly document, define, or communicate its oversight roles and responsibilities to states as called for by best practices for project management.... [W]hile CMS established a process that required the testing of state marketplace systems to determine whether they were ready to be made operational, these systems were not always fully tested, increasing the risk that they would not operate as intended." (U.S. Government Accountability Office [GAO])  

[Opinion]

Four Ways Obamacare Has Affected Health Insurance
"The employer health insurance market still looks strong.... The middle class took less advantage of Obamacare than the poor.... Medicaid expansion really mattered.... A model of the uninsured was pretty accurate, but not perfect." (The New York Times; subscription may be required)  

[Opinion]

Merge Away!
"The health insurance market is consolidating due to the fact that being bigger gives insurers more leverage to negotiate prices with hospitals, health care providers and pharmaceutical companies. It also gives insurers greater administrative efficiencies. In fact, that is exactly why not-for-profit Medicare has administrative costs of about two percent while private insurers average seventeen percent. Medicare is tens of billions of dollars cheaper then private insurance in terms of cost for the same services." (The Health Care Blog)  

Benefits in General; Executive Compensation

[Official Guidance]

Text of IRS Notice 2015-63: 2015-2016 Special Per Diem Rates (PDF)
"This annual notice provides the 2015-2016 special per diem rates for taxpayers to use in substantiating the amount of ordinary and necessary business expenses incurred while traveling away from home, specifically [1] the special transportation industry meal and incidental expenses (M&IE) rates, [2] the rate for the incidental expenses only deduction, and [3] the rates and list of high-cost localities for purposes of the high-low substantiation method." (Internal Revenue Service [IRS])  

Social Security and Medicare Lifetime Benefits and Taxes
"Benefits from government retirement programs -- Social Security and Medicare -- vary over time, but the trend has been toward higher lifetime benefits for each successive cohort. Expansion derives mainly from increases in real annual benefits, more years of benefits through longer lifespans, and better and more expensive health care. In 1960, a couple where each spouse earned constant 'average' wages over a career beginning at age 22 and retired on his or her 65th birthday would receive about $300,000 in health and retirement benefits; today, that figure is over $1 million in health and retirement benefits. The expected benefits for couples turning 65 in 2050 -- age 30 today -- are scheduled to rise under current law to almost $2 million." (Urban Institute)  

Pay vs. Performance Disclosure Issues for Your Upcoming Proxy
"Companies/Committees that don't currently use relative TSR as a metric in executive pay will have two options. One is to switch to TSR as a performance measure, despite its many flaws. The other is to explain in the Compensation Disclosure & Analysis section why the performance metric the Committee uses to determine executive pay is better.... [It] may be a challenge to get proxy statement readers to continue reading the Committee's explanation of the unique performance measures it actually uses. (Charts will be preferable to text.)" (Winston & Strawn LLP)  

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