Health & Welfare Plans Newsletter

November 12, 2015

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2015 Employment Tax Year in Review
December 3, 2015 WEBCAST
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Employer Forum on Worksite Wellness
January 27, 2016 in IL
(Midwest Business Group on Health)

Becoming an S Corporation ESOP
May 24, 2016 WEBCAST
(National Center for Employee Ownership [NCEO])

Don't Do That With Your ESOP
June 7, 2016 WEBCAST
(National Center for Employee Ownership [NCEO])

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[Guidance Overview]

Answers to Some Common Questions About ACA Reporting and Form 1095-C
"Q: Which form(s) do I need to complete: the 1095-C or the 1095-B? ... How do I know whether I am an ALE for 2015? ... How do I count my full-time equivalent employees for purposes of determining whether I am an ALE in 2015? ... How do I count my seasonal workers for purposes of determining whether I am an ALE in 2015? ... I thought I did not have to comply with the ACA employer mandate in 2015 if I had fewer than 100 employees! What is the rule? ... How do I report for new hires? ... What do I report if someone's employment is terminated during the year? ... How do I report for employees who have elected COBRA coverage? ... Must I report for my union employees? ... How do I report multiemployer plan coverage for my union employees?" (Ogletree Deakins)  


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[Guidance Overview]

ACA Reporting Requirements for Carriers and Employers (Part 17 of 24): Reporting for Offers of Coverage and Auto-Enrollment
"Despite that auto-enrollment is no longer required under the ACA, some carriers are insisting on it as a precondition to offering their products. This approach lends itself to boosting enrollment in instances where coverage was not previously widely offered -- e.g., industries with large cohorts of variable and contingent workers -- and in which anticipated take-up rates are low and the expectation of adverse selection is high. This post explores the impact of carrier-required auto-enrollment on reporting." (Mintz Levin)  

[Guidance Overview]

New Health Plan FAQs Address Preventive Services, Wellness Programs and Mental Health Parity
"The Departments provided a reminder that a reward may be financial, non-financial or in-kind. Consequently non-financial (or in-kind) incentives (e.g., gift cards, water bottles and sports gear) provided by a group health plan to participants satisfying a standard related to a health factor are rewards subject to the 2013 regulations.... The reason for any denial of reimbursement or payment for services with respect to mental health and substance use disorder benefits also must be made available to participants and beneficiaries.... [T]he Departments clarified that a health plan cannot refuse to disclose such information on the grounds that it is 'proprietary' or has 'commercial value.' " (Benefits Bryan Cave)  

[Guidance Overview]

EEOC Regs Provide Clarity But Complexity for Wellness Programs
"Employers may offer, as part of their health plans, an incentive when a spouse (a) is covered under the employee's health plan; (b) receives health or genetic services offered by the employer, including as part of a wellness program; and (c) provides information about his or her current or past health status as part of an HRA.... Employers may request genetic information as part of a wellness program only when the wellness program is reasonably designed to promote health or prevent disease." (Calfee, Halter & Griswold LLP)  

Top Three ACA Reporting Challenges and How to Tackle Them
"Coordinating data is a challenge that can be made even more challenging by various data issues that are likely to come up in the process. Gathering employment history data from payroll systems can be difficult, and even if you're able to get it -- possibly by paying a hefty fee to your payroll-services provider -- you may find it doesn't provide the detail about employment history that ACA reporting demands. Also, if you haven't been tracking employee leave (and why would you since there was no reason to before ACA?), you'll have to sift through the data manually to calculate leave earned and leave taken as ACA requires." (The Institute for HealthCare Consumerism [IHCC])  


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Growth in HSA Enrollment Continues
"The number of enrollees with HSAs/HDHPs rose to nearly 19.7 million in January 2015, up from 17.4 million in January 2014. Most enrollment gains in the HSA/HDHP market were in large group plans. The share of HSA/HDHP lives enrolled in large group plans jumped from 68 percent in January 2013 to 74 percent in January 2014 and to 78 percent in January 2015. The gender distribution of people covered by HSAs/HDHPs in the individual market was evenly split -- 50 percent male and 50 percent female." (America's Health Insurance Plans [AHIP])  

2015 Records Lowest Rate of Increase in U.S. Health Care Costs in Nearly 20 Years
"After plan design changes and vendor negotiations, a recent analysis ... shows the average health care rate increase for mid-size and large companies was 3.2 percent in 2015, marking the lowest rate increase since Aon began tracking the data in 1996. Aon projects average premium increases will jump to 4.1 percent in 2016.... Despite the low rate of increase, the average amount that employees need to contribute toward their health care has increased more than 134 percent over the past decade.... [L]ow rate increases are prompting most employers to take a traditional 'managed trend' approach to mitigating health costs in the short term, though some non-traditional approaches are emerging." (Aon Hewitt)  

HHS Office of Inspector General Calls for Increased Oversight and Enforcement of HIPAA
"The anticipated launch of the Phase 2 Audits, as well as OCR's public statements that it intends to step up its enforcement activities, should be an impetus for covered entities and business associates to assess their privacy, security and breach notification practices for compliance with the HIPAA standards and to mitigate the risks, threats and vulnerabilities to protected health information (PHI) that lead to breaches.... Covered entities and business associates should take [listed] steps to ensure that they are prepared for the possibility of a Phase 2 Audit and minimize the risk of civil money penalties in the event of a security breach or complaint by an individual patient or health plan member[.]" (McDermott Will & Emery)  

Employer Disability Compliance Adoption Lags Behind Recognition of Importance
"Virtually all employers, large and small, consider it important to have FMLA and ADA service capabilities in their organizations. The gap between employers' importance ratings for these service capabilities and adoption rates suggests they need help in implementing their programs.... [A]lmost half of employers report outsourcing some or all of their FMLA and ADA services. About 40 percent of employers expect the importance of outsourcing these services to increase[.]" (Prudential)  

Why 43% of Employees Are Distracted 75% of the Day
"A decided 70 percent of respondents say their health habits have a noticeable impact on their ability to focus at work, according to the survey. Whether your workforce is diligently working away or struggling to stay on task, you can help by investing in employees' well-being -- support everyone will welcome with open arms. [An infographic explains] more about what's distracting employees at work and how healthy habits help keep them focused." (Employee Benefit News)  

86% of Canadians Say Employers Are Responsible for Employee Health
"Health needs of employees are important for maintaining the employer-employee relationship, so the survey findings suggest that employers can no longer view such matters are optional. According to the survey, 84 percent think their employer is responsible for supporting physical health and 86 percent think employers should support psychological health. The results seem to vary between age groups." (Bel Marra Health)  

Benefits in General; Executive Compensation

Supreme Court Ponders Scope of ERISA Plan Recovery Rights
"Some of the Justices seemed to agree that plans really need to track participant litigation and join lawsuits in their early stages even if that clashes with ERISA's goal of streamlining health and retirement plan administration. But Chief Justice John Roberts noted that plans may have a difficult time even knowing there's been a settlement, and they may be facing an opponent determined to dissipate, commingle and hide funds." (Thompson SmartHR Manager)  

Supreme Court Justices Seem Dubious of ERISA Plan's Right to Recover Medical Costs
"The biggest problem [the Plan's attorney Neal Katyal] faced was that the Court's earlier cases had explained that the limitation of the ERISA regime to 'traditional' equitable remedies excluded a group of 'ancillary' damage-like remedies that were available in equity. So pretty much every time he tried to argue that equity had permitted some particular remedy that looks like the remedy he seeks here, one of the Justices would break in to suggest it was only ancillary." [Bd. of Trustees of the National Elevator Industry Health Benefit Plan v. Montanile, No. 14-11678 (11th Cir. Nov. 25, 2014; oral arg. Nov. 9, 2015)] (SCOTUSblog)  

Nonqualified Deferred Compensation Plan Guidance from the IRS Appears to Be on the Horizon
"In a notice published in 2007, the IRS announced its intent to issue new regulations under Code Section 457(f) in an attempt to harmonize Code Sections 457(f) and 409A. Over eight years later, we are still waiting for that guidance. The wait may soon be over, however, because IRS officials informally have indicated that this guidance is 'very, very close' to be released, probably by the end of this year or early in 2016. The two pieces of guidance presumably will not be issued at the same time." (Porter Wright Morris & Arthur LLP)  

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