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HRA Compliance Drilldown: Health Care Reform, Code, and Other Rules
RECORDED
(Thomson Reuters / EBIA)

Current Developments & “What’s New” in Pensions, Ethics and Professionalism Related to Employee Benefits Practice
October 27, 2015 in CT
(NIPA - CT Chapter)

Conducting a Vendor Search
October 28, 2015 WEBCAST
(Multnomah Group)

Administrative Service Agreements for Health and Welfare Plans: Anticipating and Addressing Potential Pitfalls
November 12, 2015 WEBCAST
(Thomson Reuters / EBIA)

Where ADA and FMLA Overlap: Leaves, Accommodations and Headaches, Oh My!
November 12, 2015 WEBCAST
(Franczek Radelet PC)

Interaction of Employer-Provided Group Health Plans with Marketplace Coverage, COBRA, and Medicare
November 19, 2015 WEBCAST
(ABA Joint Committee on Employee Benefits)

Ascend 2016 Conference
November 14, 2016 in NV
(Ascensus)

View All Webcasts and Conferences

[Official Guidance]

2015 ACA Transitional Reinsurance Program: Annual Enrollment and Contributions Submission Form Manual (PDF)
59 pages. "This document assists a Contributing Entity, or a TPA or ASO contractor on behalf of the Contributing Entity, to perform the required steps for completing the 2015 reinsurance contribution submission process." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Advert.]

DATAIR! More Choices – Better Guidance – Less Cost

FSA, DCAP, Full-Flex, HRA, HSA, 132(f)
Documents, SPDs, Amendments, Administrative Forms
(888) 328-2474   Sales@DATAIR.com   www.DATAIR.com

[Official Guidance]

Text of IRS Publication 5164: Test Package for Electronic Filers of ACA Information Returns for Tax Year 2015 (PDF)
21 pages. 'Early Look' Version 1.0, dated October 2015. "[This publication] contains general and program specific testing information for use with ACA Assurance Testing System (AATS) ... [which is] the process and the system used to test software and electronic transmissions prior to accepting Software Developers, Transmitters and Issuers into the AIR System. Software Developers are required annually to pass pre-defined AATS submissions and test scenarios for the forms that they will support. Transmitters and Issuers are required to pass communication tests for the forms they will file." (Internal Revenue Service [IRS])  

[Guidance Overview]

Now's the Time to Prepare for Filing Forms 1094-C and 1095-C (PDF)
80 presentation slides. Topics: [1] Overview of reporting requirements; [2] Refresher of some of the basic rules; [3] Forms in general; and [4] Examples. (Trucker Huss)  

[Guidance Overview]

IRS Issues Final ACA Reporting Instructions and Forms for Employers and Providers of Minimum Essential Coverage
"While the final instructions for the most part track the requirements of the draft instructions ... they include the following significant changes: [1] Simpler reporting of coverage offered under a multiemployer plan in 2015 ... [2] COBRA elected by terminated employees need not be reported ... [3] HRA coverage need not be reported if employee is also covered by employer's medical plan ... [4] Filing extension ... [5] Waiver from electronic filing requirement ... [6] Corrected returns." (Trucker Huss)  

[Guidance Overview]

HHS Releases Far-Reaching Proposed Rule to Prohibit Discrimination by 'Covered Entities' Pursuant to Section 1557 of the ACA
"This rule would be the first law to explicitly prohibit discrimination in health care programs on the basis of sex. These discrimination prohibitions generally apply to 'Covered Entities' ... and include Covered Entities' operations as health insurance issuers in Federally Facilitated Marketplaces (FFMs) and State-Based Marketplaces (SBMs)... [and] health insurance issuers acting in their capacity as third-party administrators for self-insured group health plans." (Epstein Becker Green)  

[Advert.]

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

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 Presentation: FF-SHOP Updates, October 13, 2015 (PDF)
33 presentation slides. Topics include: [1] Updates and Announcements (1-50 small group definition, employee choice, renewal notices, and enrollment/reconciliation); [2] Overview of 834 Companion Guide Changes; and [3] All Issuer testing tips. (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

CMS Webinar: 2015 Reinsurance Contributions -- Updating Contributions Filings (PDF)
42 presentation slides. Topics include: [1] Review common filing discrepancies; [2] How to discover a discrepancy; [3] How to review and duplicate the 2015 form; [4] Completing a two-part contribution payment; [5] Refiling versus resubmitting the 2015 form; [6] Correcting Automated Clearing House (ACH) debit transaction failure; [7] Form and supporting documentation mismatch; [8] Correcting annual enrollment count; and [9] Re-submitting supporting documentation. (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

Recent Study Causing Some Economists to Rethink High-Deductible Health Insurance
"The new paper shows that when faced with a higher deductible, patients did not price shop for a better deal. Instead, both healthy and sick patients simply used way less health care.... This raises a scary possibility: Perhaps higher deductibles don't lead to smarter shoppers but rather, in the long run, sicker patients." (Vox)  

Cadillac Tax Initially Will Have Limited Impact
"Only 4 percent of people with employer-sponsored coverage will be enrolled in plans whose projected costs exceed the thresholds in 2018, the Treasury's Office of Tax Analysis estimates. Even this figure overstates the tax's effect, however, since the tax applies only to the portion of plan costs over the thresholds. That's just 1 percent of plan costs in 2018, Treasury finds.... These estimates are smaller than those at the time when Congress was considering the excise tax in 2009 and 2010.... The enacted version of the tax raised the thresholds and adjusted them to reflect the age and gender composition of a firm's workforce. Also, health costs have grown less rapidly than previously projected." (Center on Budget and Policy Priorities)  

[Advert.]

Now is a great time to join Worldwide Employee Benefits Network (WEB)

WEB members represent more than 25 professions and 30 areas of expertise within the pension and benefits industry-including administrators, consultants, attorneys, accountants, investment managers, communications experts and benefits managers. Join today.

Employers Offer Cash for Health Care Shopping
"Companies for years have raised deductibles, or the amount employees pay before most of their coverage begins. They've also given workers online tools to help them shop for the best deals on things like imaging exams and bloodwork. Now, some are using cash to nudge employees toward those deals." (The Salt Lake Tribune)  

Four Reasons Drugs Are Expensive, of Which Two Are False
"A recent uptick in commercial drug discovery in diseases such as cancer, hepatitis C, and multiple sclerosis means that the price of drugs is firmly a First World Problem; not merely something that troubles poor people in faraway countries. This article focuses on the economics of the problem. The aim is to explain why many drugs are so expensive that even First World health systems struggle to pay for them. After all, to the uninitiated, drug pricing does not make obvious sense." (Jack Scannell, in Forbes)  

Six Reasons Why Organizations Should Embrace HSAs
"A triple threat -- savings, savings and more savings ... A smart and easy way to manage today's healthcare costs ... To build a health nest egg ... Low investment thresholds and solid returns ... It's like a 401(k) for healthcare (but better) ... Employers save too." (Benefitfocus)  

20 Questions to Pinpoint the Perfect Wellness Vendor
"Use [these] questions as a checklist or guide when shopping for your next wellness vendor in order to find the best fit to positively impact your organization.... Fit ... Experience ... Expertise/Risk ... Communication/Technology ... Customization ... Support ... Data ... Costs." (International Foundation of Employee Benefit Plans [IFEBP])  

DC Bill Would Provide Most Generous Paid Leave Benefits in the Nation
"The Act would entitle an eligible individual to receive up to 16 weeks of paid family and medical leave benefits in a 12-month period. The paid leave amount would equal 100% of the eligible individual's average weekly wages up to $1,000 per week plus 50% of the average weekly wages over $1,000, up to a maximum weekly benefit of $3,000. Covered employees could also be paid while taking leave on a reduced leave or intermittent leave schedule." (Littler)  

Medicare Open Enrollment Starts Today, Oct. 15
"The average basic Medicare PDP premium in 2016 will remain stable at $32.50 per month while the average MA premium will decrease to an average of $32.91. In addition, approximately 49 percent of 2016 MA plans and 41 percent of PDPs earned 4 stars or higher in their 2016 overall star rating." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

Medicare Premiums May Soar as Social Security Payments Stay Flat
"About 70 percent of Medicare beneficiaries will be protected against higher premiums in 2016. But Medicare actuaries predicted in July that the standard premium for other beneficiaries would rise next year to $159 a month. The premium for most beneficiaries is now just under $105 a month, the same as in 2013 and 2014." (The New York Times; subscription may be required)  

Where Might Premiums Be Heading? 2014 Medical Loss Ratios Suggest Rate Changes May Vary Widely Across States
"MLRs in the individual market have risen dramatically since the adoption of the ACA, with insurers spending an average of 92 percent of individual health plan premiums on patient care or quality improvement in 2014, leaving 8 percent for administrative costs and profits.... In 10 states and the District of Columbia last year, the average MLR was more than 100 percent -- meaning that insurers spent more on medical care, on average, than they brought in from premiums." (Robert Wood Johnson Foundation)  

Health Insurance Marketplace: Uninsured Populations Eligible to Enroll for 2016
"[This brief uses] recently released data from the National Health Interview Survey (NHIS) to examine the composition of people that remained uninsured though the first quarter of 2015 and may be eligible to purchase insurance coverage from a Qualified Health Plan (QHP) through the Marketplaces (QHP-eligible uninsured).... Nearly half (48 percent) of QHP-eligible uninsured individuals have family incomes between 100% and 250% of the Federal Poverty Level (FPL) and may qualify for the advance payments of the premium tax credit (APTC) and cost-sharing reductions (CSR). About 30 percent have incomes between 250% and 400% FPL and may qualify for APTC. The remaining 22 percent have family incomes above 400% FPL." (Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS])  

How Many Individuals Might Have Marketplace Coverage at the End of 2016?
"ASPE's projection ... yielded an estimated range of 9.4 to 11.4 million effectuated enrollees in the Marketplace at the end of 2016.... ASPE modeled 2016 enrollment as coming via three channels: [1] Continued enrollment by 2015 Marketplace enrollees ... [2] Shifts from off-Marketplace individual coverage into coverage through the Marketplaces ... and [3] Enrollment of the uninsured through the Marketplaces[.]" (Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS])  

[Opinion]

Corporate Wellness Programs Lose Money
"Evidence that wellness programs lose money has been accumulating ... even from members of the wellness industry. In total, the evidence is compelling enough that companies planning or currently running their own programs may want to reconsider their commitment to these programs, or at a minimum, recalculate savings using the available calculator. This is especially true for companies where these programs are proving unpopular enough that significant savings would be required to justify the negative morale impact that these programs often involve." (Harvard Business Review)  

[Opinion]

Why the Ruckus Over the Cadillac Tax?
"The tax would no doubt encourage insurers and employers to find efficiencies and negotiate more aggressively with hospitals and clinicians. But market incentives to do that already exist, even if they are somewhat muted by the tax subsidy for employer-provided insurance. It is fanciful to think that premiums can be reduced substantially, and that growth over time can be kept in line with general inflation, without reducing the amount of health benefits provided to workers." (JAMA Forum)  

What Osberg vs. Foot Locker Teaches About Equitable Remedies Under ERISA
"Enforcing equitable remedies under ERISA by focusing on whether the evidence supports the charge, as Osberg shows, is all that is necessary to separate the wheat from the chaff when participants come to court challenging plan decisions based on equitable remedies. So is Osberg a tipping point that may lead the way to a less grudging view by the courts of equitable relief claims under ERISA where allegedly misleading plan communications are at issue? Time will tell, but it has all the indicia that past tipping points in other areas of ERISA litigation, such as excessive fee disputes, have had: a well-reasoned decision by a well-respected court, well-founded in the evidence." [Osberg v. Foot Locker, Inc., No. 07-cv-1358 (S.D.N.Y. Sept. 29, 2015)] (Stephen Rosenberg, The Wagner Law Group)  

IRS Scrutinizes Public Employer PTO Plans
"The constructive receipt doctrine is taking on renewed significance as public employers have created new conversion options for 'extended leave,' retirement accounts, health insurance continuation, and the like, some of which have at least a limited 'cash out' option. But even in situations where the cash option is limited or capped, the IRS is clear that the 'constructive receipt' rule will continue to apply. The IRS is currently conducting an initiative focusing on benefits, and accordingly is increasing its scrutiny of public employer PTO and benefit plans." (von Briesen & Roper, s.c.)  

CEOs Beware: Your Astronomical Salaries May Soon Cost You Customers
"Most [Americans] still think the CEO pay ratio at large national corporations is around 30-to-1, when it is really closer to 300-to-1. The misunderstandings will soon fade: In August, the [SEC] ordered companies to begin reporting their CEO pay ratios by 2017. When that information begins to circulate widely, companies may find themselves running afoul of the old-fashioned norms on Main Street -- and losing customers as a result. Recent evidence from researchers at Harvard Business School suggests that customers punish companies that offer lavish CEO salaries." (The Washington Post; subscription may be required)  

Schwab Retirement Plan Services Introduces Advisor Managed Accounts to Help More 401(k) Participants Receive Retirement Plan Advice
Charles Schwab Corporation

W. Thomas Reeder Jr. Sworn in as PBGC Director
PBGC [Pension Benefit Guaranty Corporation]

Frontier Announces New Senior Appointment
Frontier Advisors

Mercer Marketplace Private Exchange Continues Growth in Individual Participants and Clients
Mercer

Eddie Ahmed Joins MassMutual as Chief Human Resources Officer
MassMutual

LIMRA Appoints New International Research Director
LIMRA

OneAmerica Rolls Out Road Show to Promote Financial Wellness
OneAmerica Financial Partners

NAPA Announces Top Women Advisors
National Association of Plan Advisors [NAPA]

John Hancock Retirement Plan Services Declares October 16 First "National TPA Day"
John Hancock Retirement Plan Services

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