Senior Benefits Analyst
Horizon Agency, Inc.
in MN

Investment Advisor - Retirement Plan Services
The PrivateBank
in IL

Implementation Analyst
T. Rowe Price
in CO, MD

Senior Benefits Analyst (Health)
The Segal Group
in AZ

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Milliman
in TX

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Ethics for Actuaries: Don't Get Caught in the Middle!
December 3, 2015 WEBCAST
(ASPPA College of Pension Actuaries [ACOPA])

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[Official Guidance]

Text of CMS FAQs on the Federally-Facilitated Marketplace's 2016 Employer Notice Program (PDF)
3 pages. Unnumbered and undated. "What is the employer notice program? ... How is the FFM implementing the employer notice program in 2015? ... Will employers be liable for the employer shared responsibility payment for 2015 if a full-time employee receives a premium tax credit for coverage received through a Marketplace in that year? ... Which employers will be notified through the employer notice program in 2016? ... When can employers expect to receive notices? ... Can employers receive notices by email or to a designated address? ... How does an employer submit an appeal of an employer notice to the FFM? ... When will CMS implement the process for all employers?" (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Advert.]

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

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.

[Official Guidance]

Text of CMS FAQs for Agents and Brokers Operating in the SHOP Marketplace (PDF)
3 pages. Unnumbered; dated September 2015. "This document is intended for agents and brokers interested in participating in the SHOP Marketplace; this document generally does not apply to agents and brokers participating in State-based SHOP Marketplaces.... What do agents and brokers need to assist clients in the SHOP Marketplace? ... What is the SHOP Marketplace Agent/Broker Portal? ... How can agents and brokers who have completed SHOP Marketplace registration begin assisting clients in the SHOP Marketplace? ... Where do agents and brokers registered with the SHOP Marketplace add their National Producer Number (NPN) on the SHOP Marketplace application? ... Does it cost employers more to work with an agent or broker in the SHOP Marketplace? ... Do agents and brokers need to be re-authorized on client's accounts upon renewal? ... Can an employer change the agent or broker associated with their account in the SHOP Marketplace?" (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Official Guidance]

Text of IRS Q&As on Information Reporting by Employers on Form 1094-C and Form 1095-C
18 Q&As, covering: [1] Basics of Employer Reporting: Questions 1-5; [2] Reporting Offers of Coverage and other Enrollment Information: Questions 6-13; [3] Reporting for Governmental Units: Questions 14-15; and [4] Reporting Offers of COBRA Coverage: Questions 16-18. Updated September 18, 2015. (Internal Revenue Service [IRS])  

[Guidance Overview]

IRS Releases Final Forms 1094/1095 and Instructions for 2015, with Relief for HRA Reporting and Other Modifications
"[C]larification is provided regarding truncation of EINs on statements provided to individuals and how to handle missing taxpayer IDs. Reporting entities will also want to read Notice 2015-68 for its further elaboration of reporting issues, including limited penalty relief related to soliciting taxpayer IDs from covered individuals." (Thomson Reuters / EBIA)  

HSA Growth Concentrated Among High-Income Households And Large Employers
"Between 2005 and 2012, the share of employers whose employees had health savings accounts (HSAs) and the share of employees working at these employers grew more than tenfold. High-income and older tax filers both established HSAs and fully funded their HSAs at least four times as often as did low-income and younger filers." (Health Affairs)  

[Advert.]

FORUM West Can Help You Navigate the Changes in Health & Benefits

IHC FORUM West in Las Vegas is part of the ONLY conference series 100% dedicated to health care consumerism. Where all health & benefits stakeholders gather under one roof to share best practices, innovation and expert insights.

Fitbit Agrees to Sign Business Associate Agreements and Take on HIPAA Compliance
"For a number of years, Fitbit avoided HIPAA compliance by not engaging in data sharing with health plans or healthcare providers. In a turn of events this week, Fitbit announced it will enter into HIPAA business associate agreements with covered entity health plans and self-insured employers that will offer Fitbit's wellness platform to employees and insured individuals. This means that Fitbit will have to implement the security controls required by the HIPAA Security Rule, but only with respect to data it is receiving from or collecting on behalf of covered entity health plans or healthcare providers." (Faegre Baker Daniels LLP)  

IRS Announces Special Per Diem Rates for Travel Away From Home on or After October 1, 2015
"The per diem rules can greatly simplify the process of substantiating business travel expense amounts. Per diem allowances that are deemed substantiated may be retained by the employee, even if they exceed what the employee actually spent. But if an employer pays more generous allowances (exceeding what will be deemed substantiated), the employer must require substantiation, require return of the excess, or treat the excess as taxable wages." (Thomson Reuters / EBIA)  

Insurers Use Lobbying Muscle, Campaign Cash to Push Mergers
"Executives of the firms involved in the proposed deals have insisted that consumers will benefit in the form of lower premiums, despite historical evidence that insurance industry mergers have actually resulted in just the opposite: higher premiums. While it's true the companies that emerged from previous acquisitions were able to force doctors and hospitals to accept lower reimbursement, the insurers pocketed the savings instead of passing them along to their customers." (The Center for Public Integrity)  

[Opinion]

Wellness Programs: Skip the Bad Press by Using a Softer Touch
"Ultimately, the mere existence of wellness programs shows insurers are serious about the imperative to get their members healthier. So it's a shame that a concept so promising has in some cases gotten so off-track, with employers taking on the mentality that the best way to encourage people to participate is to strong-arm them." (FierceHealthPayer)  

Judicial Do's and Don'ts of ERISA Benefit Claim Administration (PDF)
"[T]he growing list of plan administrative rules that impact benefit plans -- including broadening fiduciary rules for retirement plans and increasing compliance challenges with the myriad new rules under the Affordable Care Act -- adds potential risk for plan administrators with government audits and with benefit challenges by participants and beneficiaries.... This article analyzes court cases that discuss how plan administrators should properly decide and administer ERISA benefit claims and what liability should attach to poor claims administration. Based on this case review, this article then suggests best practices to avoid mishandling the ERISA claims review process." (McDermott Will & Emery, via Bloomberg Pension & Benefits Daily)  

SunGard Launches Investor Financial Planning Apps through Windows Store
SunGard

DOL Secures Judgment Ordering Fiduciaries of Connecticut, SIMPLE IRA Plan to Restore Nearly $21k in Withheld Contribution
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

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