Conversion Project Manager
LT Trust
in CO

Employee Benefits Attorney
Ice Miller LLP
in IN

Client Relations Manager
Benefit Consultants Group
in NJ

Retirement Plan Sales Manager
Benefit Consultants Group
in NJ

Plan Administrator - Junior or Trainee
QBI, LLC
in CA

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Telehealth Summit
October 15, 2015 in DC
(ERIC [ERISA Industry Committee])

What the New Proposed ‘Conflict of Interest’ Rule Means for Retirement Plans
October 15, 2015 WEBCAST
(International Foundation of Employee Benefit Plans [IFEBP])

Managing Your Withdrawal Liability Risks: What's Next for Employers Participating in Troubled Multiemployer Pension Funds?
October 21, 2015 WEBCAST
(Polsinelli)

Behavioral Economics—Reduce Health Care Costs and Increase Participation
October 22, 2015 WEBCAST
(International Foundation of Employee Benefit Plans [IFEBP])

ACA Reporting Requirements: Is Your Company Ready for 2016 and 2017?
October 28, 2015 WEBCAST
(Midwest Business Group on Health)

ERISA Workshop
November 3, 2015 in NY
(SunGard Relius)

ERISA Workshop
November 5, 2015 in OH
(SunGard Relius)

Retirement Exchange
November 6, 2015 in IN
(ProCourse Fiduciary Advisors, LLC)

View All Webcasts and Conferences

[Official Guidance]

Text of CMS Federally-Facilitated Marketplace and Federally-Facilitated Small Business Health Options Program Enrollment Manual (PDF)
144 pages, dated Sept. 30, 2015. "This document provides operational policy and guidance on key topics related to eligibility and enrollment activities within FFMs and FF-SHOPs, as well as within individual market Marketplaces and SHOPs that rely on the federal FFMs' or FF-SHOPs' eligibility and enrollment platforms (the SBM-FPs).... The information provided in this document applies to organizations and entities that may be involved in enrolling a QI or SHOP enrollee into a QHP or QDP using the FFMs' or FF-SHOPs' eligibility and enrollment functions." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Advert.]

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Explore the advantages of a Self-Funded Health Plan! By bringing together cutting edge cost containment strategies, excellent service and outstanding resources, IPMG's EBS division can help you make a difference for your plan.

[Guidance Overview]

CMS FAQ Ignores Requirement of 4980H Penalties -- Are 1411 Notices No Longer Required?
"CMS announced the 1411 notices would be provided to 'certain employers' whose employees enrolled in an Exchange with advance premium tax credits. Furthermore, these 'certain employers' would only be receiving the 1411 notice if the Exchange has the address of the employer.... Despite the notices only going to 'certain employers' the FAQ makes it clear that the IRS will independently determine any liability for an employer under 4980H without regard to whether a 1411 notice was issued or whether the employer engaged in any appeals procedure. This goes directly against the plain language of 4980H." (Health Care Attorneys P.C.)  

[Guidance Overview]

Determining a Controlled Group Under the ACA
"An employer could own several small companies ... with each having fewer than 50 full-time equivalent employees, but under the controlled group rules, the common ownership could add up to more than 50 full-time employees and an employer could become an Applicable Large Employer. The controlled group rules apply to Brother-Sister companies, Parent-Subsidiary companies, Affiliated Service companies, or any combination of the above." (Schneider Downs)  

[Guidance Overview]

Health and Welfare Benefits Monthly Update (PDF)
55 presentation slides covering: [1] 6056 Reporting and Disclosure Rules: Practical Applications, and [2] Forms 1095-C Examples. (Alston & Bird LLP)  

[Guidance Overview]

Reporting for ACA Mandates: IRS Issues Final Forms and Additional Guidance
"The new forms and instructions closely adhere to drafts published earlier this year with a few clarifications.... [1] If an employer offers a health reimbursement account to employees who enroll in its insured health plan, the employer is no longer required to report on coverage under the HRA ... [2] An offer of COBRA coverage on termination of employment is no longer to be reported as an offer of coverage on Form 1095-C ... [3] A new option for reporting the total number of employees on Form 1094-C ... allows employers to take a snapshot on the 12th day of each month." (Ballard Spahr LLP)  

[Guidance Overview]

Hawaii Posts Nation's First State Innovation Waiver Proposal
"On September 9 Hawaii became the first state to post a draft 1332 waiver proposal for public comment. While Hawaii's waiver proposal is focused on the state's unique 40-year-old employer mandate, the 40-page proposal illuminates the procedural and substantive issues that other states will have to address in moving forward with 1332 waiver proposals. Section 1332 of the [ACA] authorizes states to request waivers from the [HHS] and Treasury of key components of the ACA's coverage provisions, including those related to benefits and subsidies, the Marketplaces, and the individual and employer mandates." (Manatt, Phelps & Phillips)  

Text of District Court Order in CNH Industrial America Case, Denying Lifetime Retiree Health Benefits Under Collective Bargaining Agreement
"In concluding that the parties intended to confer lifetime benefits to the retirees ... the Court relied heavily on contract language tying eligibility for contribution-free healthcare benefits to eligibility for pension benefits.... However ... [M&G Polymers v. Tackett] forecloses reliance on this rationale ... Tackett suggests that courts should not rely on language 'tying.... eligibility for health care benefits to receipt of pension benefits.' ... It does not suggest that courts cannot rely on language tying the duration of retiree healthcare benefits to the receipt of benefits. There is a difference.... [T]he tying language used here no longer supports the Court's determination that the parties intended to confer lifetime benefits." [Reese v. CNH Industrial N.V., No. 04-CV-7059 2 (E.D. Mich. Sept. 28, 2015)] (U.S. District Court for the Eastern District of Michigan)  

Applying M&G Polymers Supreme Court Decision, District Court Decides Retirees Are Not Entitled to Lifetime Health Benefit
"Relying on a recent U.S. Supreme Court decision that upended a long stretch of retiree-friendly precedent, [M&G Polymers USA, LLC v. Tackett,] Judge Patrick J. Duggan ruled Sept. 28 that the CNH retirees' right to employer-paid health-care benefits lasted only as long as each collective bargaining agreement. Duggan had ruled eight years earlier that the retirees' benefits were vested for their lifetimes. The ruling is significant because it represents one of the first times a federal court within the jurisdiction of the U.S. Court of Appeals for the Sixth Circuit has had the opportunity to apply the U.S. Supreme Court's ruling[.]" (Bloomberg BNA)  

When a Manager Makes Even One Stupid Comment After an FMLA Request, the Employer Pays the Price
"[W]hat was his supervisor's response to Jim about his FMLA request? A one-liner: The Company 'paid for [Jim's] insurance and thus expected him to be at work.' That's it. That's all the boss said. Oh yeah, the boss also allegedly 'appeared frustrated and aggravated' when Jim turned in his FMLA paperwork. Whatever that means. One ill-advised comment. That's all it took, since the court reviewing Jim's FMLA claim found that this one remark (along with the 'frustrated and aggravated' look, of course) was enough to allow a jury to consider whether the Company violated the law." [Hefti v. Brunk Ind. Inc., No. 14-C-729 (E.D. Wis. Sept. 23, 2015)] (FMLA Insights)  

Charges Billed by Out-of-Network Providers: Implications for Affordability
"[This] study identified a pattern of average billed charges submitted by out-of-network providers that far exceeded Medicare reimbursement for the same service performed in the same geographic area.... There was wide variation in out-of-network charges from different providers for the same procedure.... For many procedures, [the authors] found regional patterns in the ratio of out-of-network charges to average Medicare fee at the state level." (America's Health Insurance Plans [AHIP])  

Privacy Advocates Urge Stronger Protection of Employee Health Data
" 'A $40 a month penalty is not enough for me to want to tell my employer what I'm doing with my health,' said [one employee].... Advocates [say the EEOC] proposal includes a large loophole: It allows employers to get individual data provided to the wellness programs if needed to administer their health plans.... [P]rivacy advocates [also] say HIPAA's rules don't apply directly to employers. In addition, wellness programs run entirely by the employer, rather than as part of the employer's group health insurance plan, are also outside of HIPAA's purview." (Kaiser Health News)  

Provider Groups Come Out Swinging Against Insurance Company Mergers
"[Tom Nickels, executive vice president of the American Hospital Association (AHA), criticized the insurance companies'] oft-cited argument that all healthcare is local, noting that in their arguments for the deals 'they cite national statistics on the number of competitors instead of the actual competition in local markets.' ... [Andrew W. Gurman, M.D., president-elect of the American Medical Association,] argued that consolidation in the health insurance industry also compromises the ability of physicians to advocate for their patients, especially when doctors are forced to negotiate with a 'mega-merged conglomerate.' " (FierceHealthPayer)  

60% of Employers Say Their Plans Are Likely Trigger the Cadillac Tax -- and Soon
"[N]early nine in ten employers have calculated whether their health plan will trigger the Cadillac tax, and 60% say that without any future changes, their plan will face the tax.... Of those that are on track to trigger the tax, 62% say they will likely face the tax right away in 2018. An additional 10% say they will hit the tax in 2019, 12% in 2020, and 11% in 2021 or later." (International Foundation of Employee Benefit Plans [IFEBP])  

[Opinion]

Excise Tax on High-Cost Plans Will Help to Control Rising Costs
"The Cadillac tax will help curtail the growth of private health insurance premiums by encouraging employers to limit the costs of plans to the tax-free amount. The excise tax will discourage the provision of insurance that covers such a large proportion of health care spending that consumers have little incentive to insist on cost-effective care and providers have little incentive to provide it." (101 health policy experts, via Center on Budget and Policy Priorities)  

[Opinion]

ERISA Industry Committee Comment Letter to IRS on Notice 2015-52, ACA 40% Excise Tax (PDF)
12 pages. "[E]mployers and their administrators and their insurance carriers need to assess and avoid the risk of Code section 4980I excise taxes in advance, and the entire excise tax process should be designed to support these advance determinations. Plan sponsors need to know the excise tax threshold amounts and the value of their health plan coverage before the applicable taxable period, not after. Plan sponsors need to have time to adjust their plan designs, and to reduce extraneous excise tax 'costs' before the applicable taxable period, not after. If a plan sponsor has excise tax risk exposure, the amount of that risk should be known with reasonable accuracy before the applicable taxable period, not after." (The ERISA Industry Committee [ERIC])  

[Opinion]

NHeLP Comment Letter to CMS on Proposed 2017 Essential Health Benefits Benchmark Plans
13 pages. "There is a clear directive in the [ACA] requiring the Secretary of HHS to define the [essential health benefits (EHBs)], and as a legal matter, HHS has no authority to delegate defining the EHBs to states or issuers.... HHS should clarify in written guidance to states that they may supplement when there is insufficient or inadequate coverage of an EHB category.... We urge HHS to eliminate any provision allowing issuer flexibility to substitute benefits." (National Health Law Program [NHeLP])  

[Guidance Overview]

SEC Issues Proposed Clawback Regulations
"The new standards require listed companies to adopt and comply with policies that require the recovery, or 'clawback,' of erroneously paid incentive-based compensation to an executive officer where the benchmark to receive such compensation is based on financial information." (Reid and Riege, P.C.)  

Updated IRS Stock Compensation Audit Guide Provides Compliance Checklist
"[T]he IRS tells its auditors to determine whether: [1] stock was actually transferred; [2] stock options were transferred to a related person; [3] the purchase price was reduced for a note used to acquire employer stock; [4] elections were punctually made under IRC Section 83(b) and records verify these timely elections; [5] a substantial risk of forfeiture exists to delay vesting according to the facts and circumstances; and [6] dividends were paid on restricted stock." (myStockOptions.com)  

DOL Obtains Default Judgments Restoring Losses to Employee Retirement Plan of Madison-based IDS Sales & Engineering Inc.
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

DOL Sues Defunct Corporation in Wayne, Pennsylvania, to Distribute Nearly $1 Million in Assets from 401(k) Plan
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

OneAmerica Closes Acquisition of BMO’s U.S. Retirement Services Business
OneAmerica Financial Partners

View All Press Releases