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[Guidance Overview]
IRS Health Care Tax Tip 2015-78: Tax Considerations for Employers with Fewer than 50 Employees
"If an employer has 50 or fewer employees, it can purchase health insurance coverage for its employees through the Small Business Health Options Program. Employers that have fewer than 25 full-time equivalent employees with average annual wages of less than $50,000 may be eligible for the small business health care tax credit. These employers are eligible for this credit if they cover at least 50 percent of their full-time employees' premium costs, and the coverage is purchased through the SHOP."
(Internal Revenue Service [IRS])
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[Guidance Overview]
ACA Penalty Risk When Dropping Coverage for Unpaid Premiums During Leave of Absence
"The IRS treats an employer as having made an offer of coverage to a full-time employee if coverage terminates because the employee fails to timely pay the premiums. Effectively, you can terminate the employee's coverage without fear that the employee will go to the exchanges, receive a subsidy, and trigger the penalties. However, just like COBRA, the IRS treats a premium payment as timely if paid within a 30-day grace period, and it is considered paid on the date the employee mails the check."
(Graydon Head & Ritchey LLP)
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Questions and Answers About Federal Employee Health Insurance
"If I do not want to change my health insurance during the Open Season, what do I need to do? ... How much money will self-plus-one save? ... Does Blue Cross Basic have the same Medicare waiver as Blue Cross Standard for federal retirees? ... For individuals that have not made an Open Season election where can they enroll or change their enrollment? ... I am currently enrolled in a self-and-family enrollment and only have one eligible family member (either a spouse or an eligible child). Should I switch to self-plus-one?"
(The Washington Post; subscription may be required)
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Health Insurance: State-to-State 2015
56 pages. "This report catalogues specific contributions of health insurance plans to each state's economy including: [1] Access to health insurance coverage; [2] Number of direct and indirect jobs generated; and [3] Tax revenues paid."
(America's Health Insurance Plans [AHIP])
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$3.5 Million HIPAA Settlement Highlights Need for Training
"For HIPAA covered entities in general, the enforcement action highlights the importance of: [1] Compliant business associate agreements with third-party administrators, other service providers, and vendors; [2] Risk analyses that include all IT equipment, applications, and data systems that use electronic PHI; [3] Procedures for terminating access to electronic PHI when employees and other workforce members stop working for an employer; [and] [4] Ongoing training for all workforce members."
(Practical Law Company)
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Puerto Rico Health Insurer to Pay Record $3.5 Million HIPAA Settlement
"Since 2010, these companies have reported five major breaches and two minor ones. Five of the reported breaches involved mailing errors.... Former employees of Triple-S and its business associates also were a recurring problem ... The $3.5 million resolution amount is the highest OCR has levied on a single entity by settlement."
(Thompson SmartHR Manager)
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How an $84,000 Drug Got Its Price: 'Let's Hold Our Position ... Whatever the Headlines'
"Gilead gained federal approval for its drug Sovaldi in late 2013 and ultimately settled on the price of $84,000 for a 12-week course of treatment. To the company, that price seemed to deliver the right balance: value to shareholders while also not so high that insurers would 'hinder patient access to uncomfortable levels' ... But they also got more than they bargained for: an outpouring of outrage from the public, a backlash from government and private payers, and political scrutiny."
(The Washington Post; subscription may be required)
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Paying for Better Health and Well-being in Diabetes Care
"Globally, over 380 million people are estimated to have Type 2 diabetes, and nearly half are undiagnosed. One approach to changing this trend is to better align health care payments with prevention and chronic disease management.... [M]aking feasible changes to the way health care is paid for can better support the needed workforce structures, care management systems, and care coordination tools to assist patients and their clinicians in managing diabetes and diabetes risk factors."
(The Brookings Institution)
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Benefits in General; Executive Compensation
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[Guidance Overview]
DOL Issues Proposed Rule That Would Significantly Alter Claims Procedures (PDF)
"The Proposed Rule would almost certainly increase the administrative costs and burdens of administering disability plans, and would encourage claimants to pursue their claims in court.... Changes of concern include: [1] Disclosure of the basis for disagreeing with a third party ... [2] Strict compliance and possible de novo review ... [3] Right to review and respond to new information before final decision."
(Groom Law Group)
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Managing Nonqualified Deferred Compensation Distributions: What Employers Need to Know (PDF)
"Know when to take out Federal Insurance Contributions Act (FICA) and Federal Unemployment Tax Act (FUTA) taxes.... Keep NQDC participants in your payroll system even after they've left the company.... Remember other sources of income when calculating taxes on distribution.... Be aware of differences in state income tax requirements.... Report distributions on the proper tax documents."
(Bank of America Merrill Lynch)
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New York State Court Invalidates Executive Compensation 'Soft Cap' Regulation
"On Nov. 13, 2015, the Albany County Supreme Court upheld New York Governor Cuomo's Executive Order regarding executive compensation and administrative expenses of certain service providers (EO 38) ... but struck down those provisions of the [Department of Health] regulation that prevented Covered Providers from using non-State dollars to pay Covered Executives more than $199,000. The Albany court is the third New York State trial court to rule on the validity of EO 38 and the DOH regulations promulgated pursuant to that executive order. Significantly, the Albany Supreme Court took a different approach than the two other courts which previously ruled on this issue."
(Greenberg Traurig)
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Press Releases
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