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[Guidance Overview]
Recent EEOC Activity on Wellness Programs
48 presentation slides. Topics: [1] Brief overview of wellness program regulation to date, including history of EEOC activity; [2] Refresher on EEOC's proposed ADA regulations regarding wellness programs generally; and [3] Overview of EEOC's proposed GINA Title II regulation regarding spousal HRAs.
(Groom Law Group, for American Benefits Council)
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Views on the Value of Voluntary Workplace Benefits: Findings from the 2015 Health and Voluntary Workplace Benefits Survey (PDF)
13 pages. "Three-quarters of workers state that the benefits package an employer offers prospective workers is extremely (36 percent) or very (41 percent) important in their decision to accept or reject a job. Nevertheless, 30 percent are only somewhat satisfied with the benefits offered by their current employer, and 20 percent are not satisfied. Eighty-eight percent of workers report that employment-based health insurance is extremely or very important, far more than for any other workplace benefit. Workers identify lower cost (compared with purchasing benefits on their own) and choice as strong advantages of voluntary employment-based benefits. However, they are split with respect to their comfort in having their employer choose their benefits providers, and think the possibility that they may have to pay the full cost of any voluntary benefits is a disadvantage."
(Employee Benefit Research Institute [EBRI])
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The ACA, Medicare Costs, and Retirement Security
"The 2010 Affordable Care Act (ACA) included roughly 165 provisions to improve Medicare's finances. The Medicare Trustees Report, which reflects the ACA provisions, shows dramatically lower costs. The Medicare actuaries also produce alternative projections assuming that the legislated restraints on growth in payments to health providers are not feasible. A review of both sets of projections over the past six years shows that the gap between them is narrowing due to declines in the alternative cost projections. However, a significant gap still remains, which underscores the inherent uncertainty involved in long-range projections."
(Center for Retirement Research at Boston College)
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ACA: What Employers Need to Do Now
"Some of the required information may be compiled by your payroll service. But your payroll service probably will not track the following: [1] The date when coverage (as opposed to premium payments) begins and ends; [2] Evidence of your offer of group health coverage to eligible employees; [3] Any employee waivers of coverage; [4] The out-of-pocket employee cost of the lowest cost employee-only coverage.... [It's] going to be an employer responsibility to come up with required historic data and undertake a 'good faith' effort to comply in order to avoid IRS fines for submitting incomplete or inaccurate data."
(Golan & Christie LLP)
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New Health Plans Offer Discounts for Diabetes Care
"Offered by Aetna in four regions next year, the gold-level plans are tailored for the needs of people with diabetes. They feature $10 copays for the specialists diabetics need such as endocrinologists, ophthalmologists and podiatrists, and offer free blood sugar test strips, glucose monitors and other diabetic supplies. A care management program with online tools and coaching helps people manage their condition day-to-day. The plans also offer financial incentives, including a $50 gift card for getting an A1c blood test twice a year to measure blood sugar levels and a $25 card for hooking up a glucometer or biometric tracker to the Aetna site."
(Kaiser Health News)
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Concerns Regarding the Pharmacy Benefit Management Industry (PDF)
13 pages. "The purpose of this report is to provide an overview of three legislative and regulatory concerns that legislators, policymakers, customers, and pharmacies have raised regarding the pharmacy benefit management (PBM) industry: [1] The importance of accuracy and transparency in PBM revenue streams; [2] Potential conflicts of interest with PBM-owned mail-order and specialty pharmacies; and [3] Unclear generic drug pricing and maximum allowable cost payment calculations. These issues are critical for policymakers and legislators to understand as they consider whether additional oversight of the PBM industry is warranted."
(Applied Policy)
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State Efforts to Reduce Consumers' Cost-Sharing for Prescription Drugs
"[At] least seven states ... have taken recent legislative action to lower the burden of high-price prescription drugs, both inside and outside the insurance marketplaces ... And seven state-based marketplaces require insurers to offer standardized benefit designs that also place limits on pharmaceutical cost-sharing."
(The Commonwealth Fund)
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DOJ Antitrust Head Remains Focused on Health Care in Era of Consolidation
"When reviewing a potential merger, [Assistant Attorney General Bill Baer] stated that the government will look at the future of the market -- not at how the markets appear today -- and will evaluate how local companies may increasingly compete regionally or nationally. In addition, Baer noted ... [t]he 'countervailing market power' justification may not be effective moving forward.... The government will investigate to ensure that mergers are not designed simply to take advantage of higher reimbursement rates even when there is no change in care provided."
(Faegre Baker Daniels LLP)
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Is the U.S. Healthcare System Trustworthy? Most Think Not
"Only 37% of the U.S. adult population has confidence in the U.S. medical system. From 1999 to 2006, America's least trusted institutions were health maintenance organizations (ranging from 15-18%) ... Only 8% of consumers trust their health insurers as a source for health and wellness and just 10% trust their employers.... 22% of the public is optimistic about its future of the U.S. health system but 53% are pessimistic."
(Paul Keckley)
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[Opinion]
Obamacare's Cadillac Tax Must Be Repealed
"As a former tax counsel to the Senate Finance Committee who helped develop provisions of the Affordable Care Act, I can say this unequivocally: the law's so-called 'Cadillac Tax' should be repealed. It was bad tax policy then, and it remains bad tax policy now. If it remains in place, it will eventually undermine employer-based health insurance, as almost all companies will sooner or later become subject to it and as a result may be likely to drop employee health benefits."
(Christopher Condeluci, in CFO)
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[Opinion]
The Pre-existing Condition: Innovative Solutions to America's Thorniest Healthcare Challenge
"The ACA expands access to care by particular groups of individuals and for particular medical services. But the act does little to expand the supply of healthcare resources or, despite lip service in that direction, to improve the efficiency of delivery.... With the public and policymakers focused almost exclusively on the distribution of care, healthcare technology policy has meandered counterproductively in the shadows."
(Altarum Institute)
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Benefits in General; Executive Compensation
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[Guidance Overview]
Dodd-Frank's Executive Compensation Provisions: A Progress Report
"[A chart] summarizes the status of some of the more recent SEC rulemaking actions pertaining to Dodd-Frank's executive compensation provisions. It also includes links to [Towers Watson] articles and blog postings discussing these provisions."
(Towers Watson)
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Acceleration of Benefits Following Nonqualified Benefit Plan Termination Did Not Give Rise to ERISA Claim
"[T]he 11th Circuit held that the termination of a nonqualified deferred compensation plan and acceleration of the participant's annuity benefits to a present value lump sum does not 'adversely affect' the participant's benefit.... The court dismissed [the participant's] claims finding that: ... [t]he tax impact is not an ERISA protected benefit; and [u]sing a discount rate to calculate the present value of a future benefit is not a reduction of benefits and therefore, does not 'adversely affect ... accrued benefits' in violation of the plan documents." [Taylor v. NCR Corp., No. 1:14-cv-2217-WSD (N.D. Ga. Sept. 23, 2015)]
(Fulcrum Partners, LLC)
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Decision Time for Nonqualified Deferred Compensation: Top Issues in Choosing Salary Deferrals for the Year Ahead
"In the analysis for deferrals to make in 2016, one ongoing issue stems from the tax increases that took effect in 2013, including the additional Medicare taxes for high earners. Other points to consider include the following. [1] Maximizing the amount you can contribute to your 401(k) plans.... [2] Cash needs for the year ahead and multi-year projections for your income.... [3] The financial security of your company, and your job security.... [4] Company match.... [5] The thresholds for higher taxes and rates."
(myStockOptions.com)
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