Employee Benefits Jobs
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Webcasts and Conferences
Excess Contributions Three-Part Series - Session 1: IRA Excesses
December 1, 2015 WEBCAST
(PenSys, Inc.)
How to Calculate the Cost of a Data Breach and How to Get the Budget for Your HIPAA-HITECH Compliance Program
December 3, 2015 WEBCAST
(Clearwater Compliance)
Excess Contributions Three-Part Series - Session 2: SEP and SIMPLE Excesses
December 3, 2015 WEBCAST
(PenSys, Inc.)
Employee Plans - Examinations Update – Fall 2015
December 8, 2015 WEBCAST
(IRS [Internal Revenue Service])
How to Mature Your Information Risk Management Program
December 8, 2015 WEBCAST
(Clearwater Compliance)
Excess Contributions Three-Part Series - Session 3: QP and 403(b) Excesses
December 9, 2015 WEBCAST
(PenSys, Inc.)
How to Implement a Strong, Proactive HIPAA Business Associate Risk Management Plan
December 10, 2015 WEBCAST
(Clearwater Compliance)
How to Develop Your HIPAA HITECH Policies and Procedures
December 17, 2015 WEBCAST
(Clearwater Compliance)
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Discussions
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[Guidance Overview]
Tax Implications for Non-Discriminatory Employer-Paid Life Insurance Coverage That Exceeds $50,000 (PDF)
"Your employees may have to pay taxes on the value of the following types of employer-sponsored group term life insurance: [1] Employer-paid group term life benefits that exceed $50,000; [2] Discriminatory employer-paid term life plans; [3] Employer-sponsored voluntary life coverage; [and] [4] Employer-sponsored voluntary life insurance paid for with pre-tax dollars under a Section 125 plan. This [article] clarifies the key Section 79 areas to review at the end of each calendar year. Each section details potential tax consequences ... [and] how to calculate tax liability."
(Marsh & McLennan Agency LLC)
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[Guidance Overview]
DOL Proposed Rules for Disability Claims Include Changes for Denial Notices
"The proposed rules would expand the requirements for disability denial notices to include: [1] A discussion of the plan's decision, including the basis for disagreeing with any disability determination by the Social Security Administration (SSA), treating physician, or other third party payor, to the extent that the plan did not follow the determinations presented by the claimant. [2] The plan's internal rules, guidelines, protocols, standards, or other similar criteria used in denying the claims (or a statement that they do not exist). [3] A statement that the claimant is entitled to receive relevant documents upon request at the claims stage (as opposed to providing that information for the first time in a denial notice at the appeal level)."
(Practical Law Company)
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[Guidance Overview]
EEOC Issues Proposed Rule on GINA and Wellness Programs
"While inducements in exchange for information about a spouse's health status are permitted, the proposed rule does not permit inducements in exchange for current or past health status information about an employee's children, either biological or adopted. According to the EEOC, the possibility that an employee may be discriminated against based on genetic information is greater when the employer has access to information about the health status of the employee's children versus the employee's spouse. However, employers may offer health or genetic services, including participation in a wellness program, to an employee's children on a voluntary basis and may ask questions about a child's current or past health status as part of providing such services."
(Littler)
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[Guidance Overview]
Grandfathered Plan and Patient Protection Guidance Finalized
"According to a 2014 survey, 37 percent of plans are grandfathered plans and 26 percent of employees in ERISA-covered plans are in a grandfathered plan ... In its prohibition of pre-existing condition exclusions, the rule finalizes guidance that was in ACA FAQs Part V to clarify this is not the same as excluding a category of benefits. If the exclusion does not depend on when a beneficiary developed the condition, it is a permissible exclusion of a category."
(Thompson SmartHR Manager)
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Should I Report My Full-Time Interns on Form 1095-C?
"If the intern does not complete your plan's waiting period, you would not have to report them because an individual is not considered a 'full-time employee' when in a limited non-assessment period (which is a fancy term for a waiting period that is 90 days or less). If the intern works past the waiting period, you will need to report the intern if the intern was working a full-time schedule. If the intern does not receive an offer of coverage, you have to report it as such and risk incurring a penalty under the ACA if the intern receives a subsidy from an Exchange plan during that month."
(Graydon Head & Ritchey LLP)
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Lawmakers Press Obama for Meeting on Cadillac Tax
"Sens. Dean Heller (R-Nev.), Sherrod Brown (D-Ohio), Martin Heinrich (D-N.M.) and Reps. Joe Courtney (D-Conn.) and Frank Guinta (R-N.H.) wrote to President Obama on Tuesday requesting a meeting 'as soon as possible.' 'Finding a path forward on the repeal of this provision is a bipartisan and bicameral end-of-year priority for each of us and a large number of our colleagues on both sides of the aisle,' the lawmakers write. 'As we continue to negotiate the repeal of this tax in pending, must-pass legislative packages in Congress, we respectfully request a meeting with you to discuss a plan to eliminate this tax.' ... The lawmakers indicate in the letter that they are looking to include repeal of the tax in a larger package."
(The Hill)
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Federal District Court Determines that Employer's Use of Employee Health Insurance Premium Payments Was Breach of Fiduciary Duty
"Judge Nelson ruled that the employee payroll deduction health insurance contributions became ERISA plan assets on the dates that the employees' wages were otherwise paid. She further found that the President and CEO, as plan fiduciary, breached his duty of loyalty by failing to remit the plan assets to the plan and using the assets to pay other corporate creditors and personal expenses. The president ... was found to be a fiduciary (and ultimately responsible for the breach) as he controlled the finances of the Company and directed the finance department with respect to the payment of creditors." [Perez v. Harris, No. 12-3136 (D. Minn. Nov. 9, 2015)]
(Stinson Leonard Street)
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Supreme Court Will Hear Seven Challenges to Contraceptive Mandate
"The challenges seek a decision from the Supreme Court overturning the ACA requirement that non-profit groups take action to opt out of the mandate, allowing them to benefit from the blanket exclusion granted to churches and other religious institutions."
(Wolters Kluwer Law & Business)
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Out-of-Network Coverage by ACA Marketplace Plans in 2016
"Across the states using healthcare.gov, 59 percent of 2016 ACA plans do not have out-of-network coverage, except when the enrollee has a medical emergency or obtains prior authorization from the plan before receiving out-of-network healthcare. In three states (New Jersey, New Mexico, and South Dakota), every 2016 ACA plan lacks out-of-network coverage."
(HealthPocket)
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New Jersey Lawmakers Tackle Those Surprise 'Out of Network' Medical Bills
"Doctors and hospitals would be required to disclose whether their services are not covered by a person's insurance network before treatment occurs under the latest version of a proposed bill aimed at curbing 'surprise' bills.... Hospital officials and physician office administrators would be legally obligated to explain up front who is covered and not covered, and how much more would a person pay for an out-of-network provider, according to the legislation."
(NJ.com)
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Study: Health Plan Buyers Will Save Money If They Shop
"Millions of consumers who are enrolled this year could pay higher rates if they stay in the same health plan next year ... The KFF analysis found that in nearly three-quarters of counties in 36 states served by healthcare.gov, the lowest-priced silver plan this year will not be the lowest priced next year. People in those plans could save money on premiums by switching to a different silver plan in 2016.... If they don't switch, their premium would increase an average of 15 percent before any tax credit is included."
(Kaiser Health News)
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[Opinion]
NCPA President Testifies at Congressional Hearing on PBM Corporations
"[1] The concentrated PBM marketplace has three corporations ... covering approximately 78 percent of patients who have their benefits managed by PBMs; [2] When it comes to large-scale prescription drug plans, such as those provided through the federal government, the three largest PBM corporations are currently the only practicable option, so choice is severely limited; ... [3] PBM corporations have inherent conflicts of interest through their ownership of mail order and specialty pharmacies, ... and [4] While there are industry-wide regulations for commercial health insurers, PBM corporations have largely escaped federal regulations[.]"
(National Community Pharmacists Association [NCPA])
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Benefits in General; Executive Compensation
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Evidence on Defined Contribution Health and Retirement Benefits: The Road Ahead (PDF)
"For more than a quarter-century now, most private-sector American workers who have a retirement plan at work have funded it primarily through their own contributions -- and do not have a traditional pension funded exclusively by the employer.... While the majority of private-sector health benefit costs historically have been paid by employers, that may be starting to change with the advent of 'defined contribution' health plans that cap employers' health costs. These trends have major implications for the American work force, the U.S. health care system, and even economic security in the nation."
(Employee Benefit Research Institute [EBRI])
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Reporting Requirements for Executive Benefit Plans (PDF)
"Sponsors of unfunded top-hat plans meeting IRS requirements must report only: [1] Name, address, and employer identification number (EIN). [2] That the employer's plan primarily provides nonqualified deferred compensation to a select group of management or highly compensated employees. [3] The number of plans and the number of employees in each. This statement must be filed within 120 days after the plan becomes subject to ERISA. Once the statement is filed, no other reporting is required unless the DOL requests plan documents. However, if the statement misses the deadline, the plan is subject to an annual filing requirement. A plan that fails to satisfy top-hat plan requirements will also be subject to ERISA in its entirety."
(Lockton)
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[Opinion]
American Benefits Council Comment Letter to IRS on Changes to Annual Return/Report of Employee Benefit Plans -- Form 5500 Series (PDF)
"[M]any of the changes described in the Notice and subsequent release of the draft Form 5500-EZ involve new or significantly changed questions and our members find many of them to be ambiguous. This ambiguity will require additional guidance before companies can implement the changes. Changes of this nature will need significant systems changes so it will be very difficult to implement them properly if required for the 2015 plan year. In fact, our members have indicated these thousands of forms will require development of a manual process after the additional guidance is issued, which will greatly increase the likelihood of mistakes as well as increase the costs."
(American Benefits Council)
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Press Releases
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David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager
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