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[Guidance Overview]
IRS Health Care Tax Tip 2015-5: How Coverage You Offer (Or Don't Offer) May Mean an Employer Shared Responsibility Payment for Your Organization
"[Y]ou may need to make an employer shared responsibility payment to the IRS if you are an applicable large employer and either of these circumstances applies for 2015: [1] You offered minimum essential coverage to fewer than 70 percent of your full-time employees and their dependents, and at least one full-time employee enrolled in coverage through the Health Insurance Marketplace and received the premium tax credit. [2] You offered minimum essential coverage to at least 70 percent of your full-time employees and their dependents, but at least one full-time employee enrolled in coverage through the Health Insurance Marketplace and received the premium tax credit.... For both of these circumstances, the 70 percent threshold changes to 95 percent after 2015."
(Internal Revenue Service [IRS])
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Trends in Open Enrollment
"[Employees] expect more decision-making tools and support (89 percent at least somewhat agree) because they are more responsible for their health care costs than in years past.... 'Amount of the monthly premium' is the top factor they consider when choosing their major medical/health insurance plan each year (30 percent).... Despite growing expectations and increased desire to be involved, most employees (90 percent) say they choose the same benefits year over year, and many admit they do not spend a whole lot of time researching their benefits options. In fact, 79 percent spent less than an hour, and more than half (56 percent) spend fewer than 30 minutes researching benefits options during their last open enrollment."
(Aflac)
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ACA Compliance: What's Ahead for Employers?
"Phased implementation of the ACA requirements has kept employers consistently busy over the last few years, but there is still more to come. Throughout the end of 2015 and into the first half of 2016, employers will continue to focus on the employer shared responsibility provisions of the ACA, tackle the new reporting requirements (not an easy feat, to say the least), and begin planning for the 'Cadillac' plan tax. Here is [a] 'simplified' cheat sheet and some tips for what's ahead."
(Ogletree Deakins)
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Treasury Inspector General Report: Improvements Are Needed by IRS to Ensure Accuracy of Allocation of the Health Insurance Provider Fee (PDF)
"The IRS used third-party data to the extent that the data were available to identify the covered entities required to file Form 8963, Report of Health Insurance Provider Information. However, third-party data were not available for all covered entities that are required to file.... 665 (53.9 percent) of the 1,233 providers that were listed on Forms 8963 were not included in premium information from third-party sources.... [R]egulations do not provide a process for the IRS to correct the health insurance provider fee for all covered entities once the final fee letters are distributed.... TIGTA recommended that the Commissioner, Large Business and International Division, work with the Department of the Treasury to amend the regulations to provide for a reconciliation process to ensure that the fee is accurately allocated among covered entities. The IRS disagreed with this
recommendation[.]"
(Treasury Inspector General for Tax Administration [TIGTA])
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Text of Federal District Court Opinion Awarding Statutory Penalties for Failure to Furnish Plan Document for Life Insurance Plan Even Though Terms Were Identical to SPD (PDF)
"Defendant Board of Trustees argues that its failure to provide Plaintiff with the Plan Document is excused because the Plan Document contains no terms that specifically address the life insurance benefit, and because there are no conflicting terms between the SPD and the Plan Document regarding same.... [T]he terms of the SPD specifically state that in the event of any inconsistency between the SPD and the Plan Document, the Plan Document will control. Ergo, armed only with access to the SPD and not the Plan Document, Plaintiff could not have known the unequivocal terms of the life insurance policy because she did not have the opportunity to discover any inconsistencies, or lack thereof, between the SPD and the Plan Document.... Defendant Board of Trustees will be assessed a penalty of $61,380.00 for its failure to furnish a copy of the Plan Document ... in addition to the $12,760.00
for Defendant Board of Trustees' failure to provide a copy of the Policy." [Harris-Frye v. United of Omaha Life Ins. Co., No. 1:14-cv-72 (E.D. Tenn. Sept. 21, 2015)]
(U.S. District Court for the Eastern District of Tennessee)
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Tips for Maximizing Your Health Benefits During Annual Enrollment
"Participate in the enrollment process.... Determine the best source of coverage for your dependents.... Reassess your and your dependents' health care needs.... Don't buy on price alone.... Explore other health plan choices offered by your employer.... Evaluate your plan's provider network ... Take advantage of opportunities to improve your health and lower your health costs.... Take an additional step if you are enrolled in COBRA.... Take a 'health and wealth' view to spend your dollars wisely."
(Aon Hewitt)
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Oscar and the Changing Health Insurance Landscape
"One indicator regulators use to determine whether a business combination will reduce competition is whether there are significant barriers to entry in the industry. If there are, new competitors will not exploit openings created by incumbents' consolidation. During the hearing, the CEOs of Anthem and Aetna each (independently) pointed to Oscar, a new health insurer with highly pedigreed investors, as evidence that health insurance is an easy business to enter."
(National Center for Policy Analysis Health Policy Blog)
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[Opinion]
This Is Your Brain on Wellness
"There are three reasons I hope my competitors undertake these programs. First, their healthcare expenses will rise.... Second, their productivity will decline.... And that raises the third point ... Their corporate morale will suffer."
(The Health Care Blog)
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Benefits in General; Executive Compensation
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[Official Guidance]
Text of IRS Tax Relief for Victims of Valley and Butte Fires in California
"Victims of the Valley and Butte fires that took place beginning on September 12, 2015 in parts of California may qualify for tax relief from the Internal Revenue Service.... [C]ertain deadlines falling on or after Sept. 12, and on or before January 15, 2016 have been postponed to January 15, 2016. This includes the Sept. 15 estimated tax deadline, the 2014 corporate and partnership returns on extension thru Sept. 15, and the Oct. 15 deadline for those who received an extension to file their 2014 return.... This relief also includes the filing of Form 5500 series returns, in the manner described in section 8 of Rev. Proc. 2007-56."
(Internal Revenue Service [IRS])
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What Causes Workers to Retire Before They Plan?
"Workers in poor initial health and workers who experience worsening health prior to their planned retirement date are significantly more likely to retire early than others. Workers with retiree health insurance are slightly more likely to respond to health shocks by retiring early ... more research is needed to establish whether the Affordable Care Act (ACA) will induce workers with deteriorating health to retire earlier.... Job-to-job mobility makes workers more likely to reach their retirement plans ... Health is the most important driver of early retirement... To the extent health improves in the future, workers may be better able to realize their retirement plans, leading to later retirement dates. The ACA is unlikely to significantly increase early retirement."
(Center for Retirement Research at Boston College)
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[Opinion]
ERISA Industry Committee Comment Letter to DOL on Fiduciary Hearing (PDF)
"The investment education carve-out should not prohibit references to specific plan investment options.... The regulation should make clear that discussions among co-workers should not constitute fiduciary investment advice.... The regulation should narrow the definition of the term 'recommendation'.... Employers with limited involvement in a Health Savings Account (HSA) (as under current guidance) should not be deemed fiduciaries under the rule."
(The ERISA Industry Committee [ERIC])
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