Health & Welfare Plans Newsletter

October 21, 2015

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Webcasts and Conferences

Participant Restrictions Under IRC §436 AFTAP Rules
RECORDED
(ASPPA College of Pension Actuaries [ACOPA])

Aging Securely: An Actuarial Forum on Financial and Health Care Retirement Challenges
October 23, 2015 in DC
(American Academy of Actuaries)

HIPAA and Group Health Plans: 8 Things Employers Need to Know
October 28, 2015 in NC
(Hill, Chesson & Woody)

ASPPA Annual Conference Recap
November 10, 2015 WEBCAST
(ASPPA Benefits Council [ABC] of Greater Twin Cities)

Stay Up to Date on ERISA's Latest Developments!
November 12, 2015 WEBCAST
(ASC Institute)

Effective ESOP Administrative Committees
November 17, 2015 WEBCAST
(National Center for Employee Ownership [NCEO])

Changes, Challenges & Choices – Corporate Health & Wealth Benefit Plans
November 18, 2015 in IL
(James M. Moyna. CPA, PC)

ECFC Annual Conference - Advocacy, Advancement & Action
March 16, 2016 in DC
(ECFC [Employers Council on Flexible Compensation])

NAPA 401(k) Summit - Many Voices, One Vision
April 17, 2016 in TN
(National Association of Plan Advisors [NAPA])

View All Webcasts and Conferences


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[Official Guidance]

Text of IRS AIR Submission Composition and Reference Guide for Tax Year 2015 ('Early Look') (PDF)
107 pages; version 1.0, Oct. 20, 2015. Designed to accompany IRS Publications 5164 and 5165.. "The purpose of this document is to provide guidance to all types of external transmitters about composing and successfully transmitting compliant submissions to IRS. The audience of this document is: [1] Issuer -- A business filing their own ACA Information Returns regardless of whether they are required to file electronically (transmit 250 or more of the same type of information return) or volunteer to file electronically.... [2] Transmitter -- A third-party sending the electronic information return data directly to the IRS on behalf of any business required to file. [3] Software Developer -- An organization writing either origination or transmission software according to IRS specifications." (Internal Revenue Service [IRS])  


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[Official Guidance]

Text of CMS Proposed Methodology: Basic Health Program -- Federal Funding Methodology for Program Years 2017 and 2018
"This document provides the methodology and data sources necessary to determine federal payment amounts made in program years 2017 and 2018 to states that elect to establish a Basic Health Program under the Affordable Care Act to offer health benefits coverage to low-income individuals otherwise eligible to purchase coverage through Affordable Insurance Marketplaces." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

CMS Provides FAQ About New Law Allowing States to Keep Original ACA Small-Employer Definition
"States may elect to extend the definition of small employer to cover employers with up to 100 employees by any means that is legally binding under state law, as long as the definition applies to all insurers, including those in the Small Business Health Options Program (SHOP) program. States that elect to expand the definition as of January 1, 2016 are requested to notify CMS by October 30, 2015. States may allow their insurers to modify their rate filings for 2016 considering the change in definition." (Health Affairs)  

[Guidance Overview]

Colorado Issues New Guidance on 'Use-It-or-Lose-It' Vacation Policies, But Questions Remain
"The [Colorado Department of Labor and Employment's Division of Labor's] new position, issued in the form of Frequently Asked Questions, starts out with what appears to be a solid endorsement of use-it-or-lose-it vacation policies ... The FAQ then narrowed the scope of permissible policies ... Many use-it-or-lose-it policies, as currently written, may run afoul of this enforcement position." (Littler)  

CalPERS Dependent Eligibility Audit Saves System Millions in Health Care Costs
"[The recently-completed CalPERS] Dependent Eligibility Verification (DEV) project ... will achieve savings and cost avoidance close to $122 million.... [T]he project resulted in more than 18,000 ineligible dependents being removed from employer-sponsored health care provided by CalPERS to state agencies, public agencies, and school districts contracted with CalPERS for health coverage. The projected savings will be in reduced employer health premium contributions as well as avoiding the cost of health care claims for ineligible dependents." (CalPERS)  

Educational Assistance Programs: Why They Work
"Respondents overwhelmingly offer educational assistance to their full-time salaried and hourly workers. More than one in three respondents also provide these benefits to their part-time salaried and hourly workers. The most common type of coursework covered is undergraduate-level courses (88%), followed by master's degree-level courses (87%) and associate degree courses (69%)." (International Foundation of Employee Benefit Plans [IFEBP])  

Even If Wellness Could Save Money, It Doesn't
"[T]he dramatic increase over the 13 years in the number of people whose employers push wellness should produce an equally dramatic decrease in wellness-sensitive medical events [WSMEs].... Instead ... these WSME admissions have trended essentially flat over the period, as a percentage of all admissions. In other words, there is no difference between the decline in admissions for WSMEs -- despite $7-billion/year being spent on vendors to prevent them -- and the declines in every other category of hospitalization." (Al Lewis and Vik Khanna)  

Baby Steps: Will Boomers Buy Into Mobile Health? (PDF)
7 pages. "Boomers often have a youthful attitude, but they may not be as physically adaptable or interested in new, newer, and newest gadgets and apps. Too often devices are designed with small, unlabeled or nearly invisible buttons and user interfaces that they may not perceive as intuitive. As they age, boomers are also impacted by physical changes in: Hearing.... Eyesight.... Dexterity." (California HealthCare Foundation)  

Sources of Health Insurance Coverage: A Look at Changes Between 2013 and 2014 (PDF)
56 pages. "There was no change in the percentage of the nonelderly population with coverage through an employment-based health plan. More people were covered by employment-based coverage in 2014 than in 2013 because of population growth, but the percentage with employment-based health coverage was unchanged at 62 per cent. The percentage of workers with employment-based health coverage increased slightly between 2013 and 2014, rising from 70.5 percent to 70.8 percent." (Employee Benefit Research Institute [EBRI])  

[Opinion]

Amicus Brief of IBEW-NECA Southwestern Health and Benefit Fund and the U.S. Chamber of Commerce to Supreme Court on Tracing Requirement for ERISA Benefit Overpayments (PDF)
22 pages. "Plans recover over $1 billion from reimbursement every year.... Even with rigorous and costly enforcement efforts, plans will not be able to keep up with the speed at which beneficiaries can secure and spend their tort recoveries. Each time a plan loses that race, more dollars will flow out of the plan and into the hands of a double-recovering beneficiary. To make matters worse, the expenses of these enforcement efforts will further erode a plan's financial ability to provide the same level of benefits without increasing the required contributions. Crippling plans' ability to recover reimbursements will harm the participants themselves the most." [Bd. of Trustees of the National Elevator Industry Health Benefit Plan v. Montanile, No. 14-11678 (11th Cir. Nov. 25, 2014; cert. pet. granted Mar. 30, 2015)] (Joint Committee on Employee Benefits [JCEB], American Bar Association)  

Benefits in General; Executive Compensation

[Guidance Overview]

A Look at the Additional Disclosures Required to Take Advantage of Optional Provisions in the CEO Pay Ratio Rule (PDF)
"[C]omplying with the rule will require companies to take the following steps: [1] Inventory their global workforce. [2] Identify the median employee. [3] Calculate the CEO's and median employee's annual total compensation for purposes of the disclosure. [4] Disclose the ratio and supporting information in the company's annual proxy.... As companies prepare for the new disclosure requirements, they will likely consider whether to take advantage of some of these options and will need to weigh the benefits of doing so against the potential disadvantages associated with the additional disclosures that would be required." (Towers Watson)  

Obergefell Decision Creates Unexpected (and Perhaps Unintended) Consequences
"Given that same-sex marriage is now a fundamental right, there is a less compelling argument (some might argue no compelling argument) for employers to provide benefits for relationships that are less formal than marriage. Employers are now re-thinking whether their health insurance plans should provide coverage to domestic partnerships. Employers also are re-thinking whether they should allow employees to use their sick leave benefits to care for persons in relationships that have not been formalized in marriage. Since marriage now is available for same-sex relationships, some employers are narrowing the reach of these benefit plans and sick leave policies to only 'spouses' and omitting less formally defined relationships." (InsideCounsel)  

Press Releases

NAGDCA Celebrates Annual National Retirement Security Week, October 18-24, 2015
NAGDCA [National Association of Government Defined Contribution Administrators, Inc.]

Congratulations to the 2015 Recipients of DCIIA’s and Pensions & Investments’ Innovator Award
Defined Contribution Institutional Investment Association [DCIIA]

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