Health & Welfare Plans Newsletter

September 25, 2015

BenefitsLink.com logo EmployeeBenefitsJobs.com logo LinkedIn logo Twitter logo Facebook logo
Get Retirement News  |  Advertise  |  Previous Issues  |  Search

Employee Benefits Jobs

Client Service Manager
The Newport Group
in FL, NC, WI

Employee Benefits / ERISA Attorney
Fennemore Craig, P.C.
in AZ

Retirement Planning Consultant
Transamerica
in AZ

Assistant Retirement Plan Administrator
Law Offices of R. David Danziger, P.C.
in PA

Sr Pension Administrator
Growing TPA firm
in ANY STATE, NH

Assistant Fund Administrator
The Chicago Laborers' Pension and Welfare Funds
in IL

Retirement Plan Education Specialist
Verisight
in ANY STATE

Group Compliance Consultant
The National Rural Electric Cooperative Association [NRECA]
in VA

Post Your Job

View All Jobs

RSS feed for jobs RSS Feed: All Jobs


Webcasts and Conferences


Subscribe Now to This Newsletter (free)

We also publish the BenefitsLink Retirement Plans Newsletter (free): Subscribe Now


[Official Guidance]

ACA Information Returns (AIR) Composition and Reference Guide (PDF)
105 pages. Version 0.18, dated Sept. 22, 2015. "The purpose of this document is to provide guidance to all types of external transmitters about composing and successfully transmitting compliant submissions to IRS.... This document covers details on composing and submitting Form 1094/1095-Bs and Form 1094/1095-Cs by transmitters to IRS." (Internal Revenue Service [IRS])  


[Advert.]

Telehealth & Remote Patient Monitoring Summit – Jan 27-28, 2016 – Atlanta

Sponsored by World Congress

Incorporating Telehealth and Remote Patient Monitoring practices has been shown to increase access to care, improve outcomes, and decrease health delivery costs. Take $200 off registration -- promo code BLINK2 (not valid on Webcast or Government Rate).



[Guidance Overview]

CMS Announces 2015 Transitional Reinsurance Fee Submission Process (PDF)
"The deadlines for the 2015 transitional reinsurance fee are approaching ... The process is largely unchanged from 2014. Enrollment counts for purposes of determining the 2015 reinsurance fee must be submitted by November 16. Also, the second contribution for the 2014 reinsurance fee must be made by November 15." (Buck Consultants at Xerox)  

[Guidance Overview]

Reviewing the SBC Content and Distribution Rules (PDF)
29 presentation slides. Topics include: [1] Covered plans; [2] Required SBC content; [3] New SBC template for next year; [4] When to provide the SBC; [5] What to provide; [6] How to provide; [7] Who must receive SBCs; [8] Who must provide SBCs; [9] Mid-year material modifications; and [10] SBC language requirement; and $1,000/failure penalties ... but when? (ABD Insurance & Financial Services)  

[Guidance Overview]

IRS Grants Reporting Relief for Many Integrated HRAs
"Under the revised final instructions for the Forms, an employer that sponsors an integrated HRA paired with a group health plan that provides [minimum essential coverage] need only report the major medical coverage. In other words, employers sponsoring such arrangements are no longer required to report the integrated HRA coverage. However, where an employee is covered by an HRA sponsored by one employer and a group health plan sponsored by another employer (e.g., spousal coverage), both employers must report the coverage that each provides[.]" (The Wagner Law Group)  

[Guidance Overview]

Detail Required in ACA Health Coverage Reporting
"Employers face trouble because they have to figure out which employees require an offer; they may face uncertainty over who was covered and the duration. Large employers must report on full-time employees. Companies with a lot of part-time and variable hour workers and companies in high-turnover industries could have trouble meeting the employer mandate, and these filings will be tests of their success in complying with the ACA duties." (Thompson SmartHR Manager)  


[Advert.]

Open-Enrollment Season: Tips for Employers Educating Employees

Sponsored by Lorman and BenefitsLink

October 20 -- Learn how to design a benefits package that is attractive to employees and combats rising costs, and learn strategies for communicating those benefits to employees to make them more knowledgeable consumers of health care. BenefitsLink discount.



[Guidance Overview]

Executive Order Extends Paid Sick Leave to Federal Contractors
"[U]nlike many of the existing state and municipal paid sick leave laws, there is no express cap on the amount of accrued, unused time that employees can carry over to the subsequent year.... As a result, the Order's carryover provision currently can be interpreted as requiring employers with a paid sick leave policy that provides more than 56 hours of leave per year to allow employees to carryover any accrued, unused time, not just up to 56 hours of accrued, unused time." (Seyfarth Shaw LLP)  

After-Tax HSAs: A Strategy for Avoiding the Cadillac Tax
"Most employers do not facilitate after-tax contributions to health savings accounts (HSAs), but they should consider it as a potential strategy to avoid the ACA excise tax on high-cost health plans." (PLANSPONSOR)  

Cadillac Tax Is Hated, But It Might Be Working
"[The UAW recently] proposed an unusual level of labor-management collaboration to tackle rising health costs. The draft agreement calls for labor and the Big Three domestic automakers to pool resources in a co-op 'to explore innovative ways of improving the delivery of negotiated health care benefits in a manner that increases quality, lowers cost, produces less waste and provides better patient care.' If the new contract is ratified by Chrysler workers, the UAW will take the same proposal into contract negotiations with Ford and General Motors. Does that mean the Cadillac tax is working as intended? Perhaps. It's definitely bringing new urgency to efforts to control costs." (Real Clear Politics)  

Onslaught of Bills to Repeal Cadillac Tax Continues
"The American Worker Health Care Tax Relief Act of 2015 (no bill number available), introduced Sept. 24 by Sen. Sherrod Brown (D-Ohio), joins several other bills that have been introduced this year by both Democrats and Republicans to fully repeal the unpopular tax that many call the Cadillac tax. Brown's bill has nine co-sponsors, including Democratic presidential candidate Sen. Bernie Sanders (I-Vt.)." (Bloomberg BNA)  

Prescription Drug Trends Projected to Reach Double Digits in 2016
"Trend rates for health maintenance organizations (HMOs) and open-access preferred provider organization (PPO)/point-of-service (POS) plans -- the two most common medical plan types offered -- are projected to differ by 1 percentage point: 6.8 percent for HMOs and 7.8 percent for PPO/POS plans. Trend rates for prescription drug coverage are expected to be significantly higher in 2016: 11.3 percent for carve-out coverage for actives and retirees under age 65 and 10.9 percent for retirees age 65 and over. Both projections are roughly 3 percentage points greater than projections for 2015." (Segal Consulting)  

Top 11 Health Plans in 2015
"The National Committee for Quality Assurance has released its newest rankings for health plans in the United States based on clinical and satisfaction scores. The organization used combined HEDIS, CAHPS and NCQA Accreditation standards scores as of June 30, 2015. [An] infographic shows the top 11 health plans, based on the scores." (Healthcare Payer News)  

High Deductibles More Common in Exchanges Than in Employer Plans
"Roughly half of all workers in employer plans have an annual deductible of at least $1,000, and the average deductible has grown at almost seven times faster than wages.... Roughly 60% of those with ACA plans either paid no monthly premium or less than $125, compared with 55% of people with employer plans. Employers subsidize the vast majority of their workers' health insurance premiums, and the government offers subsidies for the millions of Americans now enrolled in coverage through the exchanges." (Modern Healthcare)  

Premium Costs for Lower-Income Enrollees Similar to Those with Employer Coverage
"Six in 10 marketplace enrollees and 55 percent of those with employer plans reported they pay either nothing or less than $125 a month for individual coverage ... most marketplace enrollees are eligible for a premium subsidy and do not pay the full premium amount out of their own pockets, similar to how most employers pay part of their employees' premiums. The effect of subsidies is seen most clearly among people earning less than 250 percent of the federal poverty level ($29,175 for a single person), 72 percent of whom paid nothing or less than $125 a month in premiums." (The Commonwealth Fund)  

Blue Cross Blue Shield Association Launches Nationwide Database on Healthcare Quality and Cost
"The database provides two primary advantages, BCBSA CIO Doug Porter [said] ... For consumers, they are better informed with this data at their fingertips. And for health plan account decision-makers, 'they now have fuller visibility and transparency' to guide employees to seek out the best point of service for their care ... [P]roviders can benefit by using the data to benchmark care delivery patterns, which allows them to drive more coordinated, patient-centered care[.]" (FierceHealthPayer)  

Working Individuals Make Up the Largest Group Who Benefit from Ohio Medicaid Expansion
"More than 300,000 Ohioans benefiting from the state's decision to accept Medicaid expansion work in industries that are the foundation of the state's economy, with jobs ranging from sales and food service to construction and health care ... This projected group of working Ohioans represents an estimated 55 percent of the state's residents who benefit from Ohio's Medicaid expansion, which went into effect last year." (Families USA)  

A Framework for Understanding Health Insurance Consolidations (PDF)
"The consolidation of two insurers results in one fewer competitor, but the incremental change in market concentration may not be sufficient to affect competition. In contrast, an insurer may use its market power, due to a substantial increase in market concentration post-merger, to reduce provider payments.... Insofar as insurers operate in a more heavily regulated industry, the ACA may be playing a role in the continuing trend in M&A. However, the history of insurer consolidations long precedes ACA enactment." [CRS Insight No. IN10362, Sept. 22, 2015] (Congressional Research Service [CRS])  

Senators Ask Anthem and Aetna CEOs to Commit to Pass Along Savings to Consumers If Their Mergers Are Approved [Video]
"[N]ever in the history of health insurance mergers have prices gone down for consumers when there were less health insurance companies to compete. Sen. Al Franken did his best to pin down Mark T. Bertolini, the chief executive of Aetna, and Joseph R. Swedish, the chief executive of Anthem, to commit that their companies would pass on any promised merger savings to consumers. Their answers were high comedy." (Consumer Watchdog)  

Benefits in General; Executive Compensation

[Guidance Overview]

Section 409A Audits: Observations and Workplan (PDF)
31 presentation slides. Topics include: [1] High-Level Review of Section 409A; [2] Update on IRS Audit Activity and 409A Guidance: Introducing the REAL Audit Enemy (It's Not the IRS); and [3] Preparing for an Audit: Preliminary Questions, Building the Catalog, Zoological Taxonomy, Common Pressure Points, and Handling Risk and Errors. (Winston & Strawn, for American Benefits Council)  

Section 409A Corrections to Employment Agreements: Time for an Ounce of Protection in 2015
"[IRS Chief Council Memorandum 201518013] supports the correction of defective severance provisions if that occurs in the year before a termination of employment occurs. The IRS memo was actually unfavorable to the taxpayer, because it rejected a 409A correction that took place in the year severance occurred. While time remains this year, it is worth reviewing any agreements, plans, or releases that provide for severance." (Paul Hastings LLP)  

Recommended Steps to Successful Equity Plan Approval, Part 2
"Consider imposing a meaningful limit on the number of shares that may be granted to non-employee directors under the plan ... Give the compensation committee and board of directors sufficient time ... to review the proposed share authorization, the plan changes, and the rationale for the share increase and plan changes.... Include in the proxy a detailed discussion of the reasons for the share authorization and the board's analysis ... Include information in the proxy about share overhang and burn rates[.]" (Morgan Lewis)  

CEO Contractual Protection and Managerial Short-Termism (PDF)
37 pages. "[F]irms with CEO contractual protection are less likely to cut R&D expenditures to avoid earnings decreases and are less likely to engage in real earnings management.... [T]his effect increases with the duration and monetary strength of CEO contractual protection.... [T]he effect is stronger for firms in more homogeneous industries and for firms with higher transient institutional ownership, as protection is particularly important for CEOs in these firms, and is stronger when there are weaker alternative monitoring mechanisms." (The Accounting Review)  

Questions for IRS, PBGC, and DOL Sought for Gray, Blue, and Green Books
"The Gray Book Committee is accepting questions in preparation for their meetings with the [IRS, PBGC and DOL] for the 2015 editions. They are seeking relevant questions [to be submitted by Dec. 1] covering such areas as funding, nondiscrimination, benefit restrictions, qualification issues, PBGC-related issues, and other areas that are of interest to enrolled actuaries." (Conference of Consulting Actuaries, Public Plans Community)  

National Compensation Survey: Employee Benefits in the U.S., March 2015 (PDF)
572 pages. "The National Compensation Survey (NCS) provides comprehensive measures of compensation cost trends, the incidence of benefits, and detailed benefit provisions. This bulletin presents estimates of the incidence and key provisions of selected employee benefit plans. Estimates presented are on benefits for civilian workers -- workers in private industry and in state and local government -- by various employee and employer characteristics. For the purposes of the NCS, the Federal Government, agricultural, and household workers, and workers who are self-employed, are excluded." [Bulletin 2782, Sept. 2015] (U.S. Bureau of Labor Statistics [BLS])  

Press Releases

Connect   LinkedIn logo   Twitter logo   Facebook logo

Additional useful links:

BenefitsLink.com, Inc.
1298 Minnesota Avenue, Suite H
Winter Park, Florida 32789
Phone (407) 644-4146
Fax (407) 644-2151

Lois Baker, J.D., President
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager

Copyright 2015 BenefitsLink.com, Inc. — but feel free to forward this newsletter without further permission from us, if you do not modify the newsletter in any way (including this lower portion).

All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of that content. You may not alter or remove any trademark, copyright or other notice from copies of the content.

Links to websites other than those owned by BenefitsLink.com, Inc. are offered as a service to readers. The editorial staff of BenefitsLink.com, Inc. was not involved in their production and is not responsible for their content.

We are proud of our Privacy Policy.

Thanks for reading this newsletter!