Compliance Analyst
National Retirement Services, Inc.
in NC

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High Deductible Health Plans (HDHPs) and Health Savings Accounts (HSAs)
December 16, 2015 WEBCAST
(Trucker Huss)

Pension Protection Act (PPA) Webinar
December 16, 2015 WEBCAST
(Benefit Resources, Inc.)

Advanced HSAs
July 26, 2016 WEBCAST
(Ascensus)

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Today's Discussions on the BenefitsLink Message Boards

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[Official Guidance]

AIR Submission Composition and Reference Guide (PDF)
107 pages; version 2.0, dated Nov. 2015. "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])  

[Advert.]

Talent Management & Employee Retention Strategies Forum – Feb 2-3

Employers share strategies on acquiring the best talent and engaging their workforce; ensuring top talent remain in the organization. HR/Benefits Staff: Use code BLINK2 to attend for $95.

[Official Guidance]

Text of EEOC Extension of Comment Period on Proposed Regs for GINA and Employer Wellness Programs
"On October 30, 2015, the EEOC published [a proposed regulation on GINA and employer wellness programs ... The previous comment deadline was December 29, 2015. The EEOC has received a request for an extension of the comment deadline for this proposed rule. This action extends the comment period until January 28, 2016." (U.S. Equal Employment Opportunity Commission [EEOC])  

[Guidance Overview]

The Cadillac Tax: Fight the Future (PDF)
39 presentation slides, with audio. Topics: [1] What is the Cadillac tax and when does it apply? [2] What guidance do we have so far, and when can we expect regulations? [3] How does the Cadillac tax threaten account-based health plans (FSAs, HRAs, HSAs)? [4] What percentage of plans are likely to be subject to the Cadillac tax? [5] What are the early strategies that are developing to avoid the Cadillac tax? [6] Are there any proposals to eliminate or modify the Cadillac tax? Does the President support it? [7] How does the excise tax apply if your plan is subject to the Cadillac tax? (ABD Insurance & Financial Services)  

[Guidance Overview]

Proposed 2017 Benefit Payment and Parameters Rule Released
"The proposed rule would set cost sharing for the 2017 calendar year for self-only coverage at $7,150 and $14,300 for other than self-only coverage.... The proposed rule suggests amending the regulatory definitions of 'large' and 'small' employers to match the definition set by the Protecting Affordable Coverage for Employees Act (PACE Act).... The rule would also provide that, for an employer not in existence the preceding calendar year, its size should be determined by its reasonable expectation of the average number of employees during the year." (Cowden Associates, Inc.)  

[Guidance Overview]

Agencies Issue Final Rule on Grandfathered Health Plans and Other ACA Initiatives
"Carriers and group health plans are prohibited from imposing lifetime and annual limits on coverage. Because health reimbursement arrangements (HRAs) cannot meet this requirement and are a group health plan, HRAs must be integrated with a group health plan in order to meet the requirements of the ACA. HRAs are still prohibited from being used to purchase individual plan premiums. There are two sets of requirements for HRA and other account-based plan integration." (Cowden Associates, Inc.)  

Does ERISA Preempt State Health Database Laws?
"No matter how the case comes out, Gobeille will have important ramifications for the field of health policy. If the Court holds that ERISA preempts individual state [all-payer claims database (APCD)] laws, there will likely be calls for a uniform federal healthcare data reporting regulation. A ruling in favor of Vermont, on the other hand, would give other states the green light to adopt APCD laws of their own.... If the Court reframes the preemption test broadly, it will inhibit future state regulation of ERISA plans in other areas beyond health policy. And if the Court narrows the test, it will become easier for states to impose reporting requirements on both ERISA welfare and pension plans." [Gobeille v. Liberty Mutual Ins. Co., (2d Cir. Feb. 4, 2014, argued Dec. 2, 2015)] (Mayer Brown via Employee Benefit News)  

The Impact of the Cadillac Tax on the Energy Industry (PDF)
10 pages. "Exploration and production and midstream have rich medical plan designs and coverage levels in their plans, a high average age and gender mix in their employee populations. These factors contribute to higher plan costs that will reach the Cadillac tax thresholds sooner than later.... In 2018, 42 of the 96 energy companies will pay $17.9 million in penalties; by 2022, 85 of the 96 companies will pay $178.4 million." (Ascende)  

HSAs Underused: Workers, Facing Behavioral Barriers, Don't Take Full Advantage of Benefits
"[V]ery few account holders invest their HSA funds, allowing their health-care buying power to be eroded by inflation and missing an opportunity to grow their savings tax-free via market returns.... [V]ery few account holders contributed the statutory maximum to their HSAs, hampering their abilities to accrue large health savings balances and increasing the risk that they will have to cover large medical expenditures that bump up against their plan's out-of-pocket maximum." (Morningstar Advisor)  

Technology and ICD-10 Give Health Plans New Recovery Powers
"The ICD-10 (the coding system health care providers use to report diagnoses, symptoms and procedures) is of tremendous utility to subrogation/reimbursement efforts ... New levels of detail in ICD-10 codes give plans important new abilities to see whether an injury can be associated with a recovery opportunity.... ICD-10 codes also tell the plan about services performed: when the member first presented with providers; continuing treatment he or she needed to repair the injuries; and treatment for complications directly connected to the injury. ICD-10 even gives plans a better chance of separating out pre-existing chronic conditions from treatment directly relating to the injury." (Thompson SmartHR Manager)  

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Practice Note on Actuarial Practices Relating to Preparing, Reviewing, and Commenting on Rate Filings Prepared in Accordance with the ACA (PDF)
25 pages. "This document is intended to provide information to actuaries preparing, reviewing, or commenting on rate filings in accordance with Section 2794 of the Public Health Service Act. Specific changes from one year to the next are not considered in this practice note. Rather, it is meant to provide information on the main issues related to filing ACA-compliant plan rates, reflecting the requirements under the ACA." (Premium Review Work Group of the American Academy of Actuaries)  

Ten Potential Drivers of ACA Premium Rates in 2017
[1] Trend [in healthcare costs and utilization] ... [2] Changes to essential health benefits and the CMS Actuarial Value Calculator ... [3] Additional data ... [4] Continued migrations ... [5] Carrier shuffling ... [6] Ongoing political uncertainty: court cases and elections ... [7] Transitional reinsurance ... [8] Risk corridors ... [9] Risk adjustment ... [10] Changes in fees and taxes." (Milliman)  

Illinois Judge Keeps Chicago Retiree Healthcare Challenge Alive
"A lawsuit challenging Chicago's move to save money by phasing out lifetime subsidized healthcare for its retired workers can move forward in part.... The ruling cited a 2014 Illinois Supreme Court decision that public sector workers' healthcare benefits are protected by the state constitution's pension clause. The retirees are seeking refunds for rising health insurance premiums because of a phase-out of a city subsidy.... [T]he refunds would date back to 2013 and total about $110 million[.]" (The New York Times; subscription may be required)  

CMS Ramps up Data to Support Value-Based Payments
"Over the next few years, [CMS] will adopt a value-based payment policy as part of an unprecedented attempt at industry-wide delivery system reform. Yet, according to CMS Acting Administrator Andy Slavitt, none of it matters unless healthcare data helps providers deliver better care to patients.... Slavitt noted that ... some health plans don't provide them access to their data, or if data is provided it is through individual reports or portals that don't integrate with data on the rest of a provider's practice ... CMS is requiring commercial health plans that do business in the marketplace and in Medicare to make data that is valuable to providers or patients available in machine-readable form." (HealthData Management)  

[Opinion]

Senate Budget Bill Would Reverse Almost All of Health Reform's Coverage Gains
"The bill leaves in place health reform's market reforms, including those that bar insurers from denying coverage to people with pre-existing health conditions or charging them higher premiums in the individual market. But without the individual mandate and the subsidies to make coverage more affordable, healthier people would likely drop or otherwise go without coverage. Losing most of the healthy people from the risk pool would substantially push up individual market premiums for everyone else, by making those still enrolled sicker and costlier to cover, on average. Higher premiums, in turn, would push even more healthy people out of the pool over time, driving up premiums still further." (Center on Budget and Policy Priorities)  

[Official Guidance]

Congress Repeals Automatic 3-1/2 Month Extension for Form 5500
"The conference agreement repeals the provision in the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 that provides for an automatic 3-1/2 month extension of the due date for filing Form 5500 [which would have applied to plan years beginning in 2016]. Thus, the extended due date for Form 5500 is determined under DOL and IRS rules as in effect before enactment of the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015." [The Form 5500 provision is discussed at pp. 536-38 of the 555-page conference report. The conference report was agreed upon on December 3, 2015. It has not yet been signed into law by President Obama.] (114th Congress)  

[Official Guidance]

Text of 2015 Form 5500: Annual Return/Report of Employee Benefit Plan (PDF)
"This form is required to be filed for employee benefit plans under sections 104 and 4065 of [ERISA] and sections 6047(e), 6057(b), and 6058(a) of the Internal Revenue Code. Complete all entries in accordance with the instructions to the Form 5500." (Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]; Internal Revenue Service [IRS]; and Pension Benefit Guaranty Corporation [PBGC])  

[Official Guidance]

Text of Instructions for 2015 Form 5500 Annual Return/Report of Employee Benefit Plan (PDF)
82 pages. "Under the computerized ERISA Filing Acceptance System (EFAST2), you must electronically file your 2015 Form 5500.... Changes to Note: [1] IRS Electronic Filing Requirements.... [2] IRS Compliance Questions (optional for the 2015 plan year) ... [3] Schedule MB.... [4] Schedule SB.... [5] Form 5500 Final Return/Report for Plans Trusteed by PBGC." (Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]; Internal Revenue Service [IRS]; and Pension Benefit Guaranty Corporation [PBGC])  

[Guidance Overview]

DOL Releases Advance Copies of 2015 Form 5500 Annual Return/report
"The 'Changes to Note' section of the 2015 instructions highlight important modifications to the Form 5500 and Form 5500-SF: New IRS Compliance Questions were added to Schedules H and I.... The Schedule SB instructions are modified to simplify the alternative age/service scatters that cash balance plans with 1,000 or more active participants have an option to report on an attachment to line 26. The instructions for 'Final Return/Report' are modified to add a statement that a filer for a terminated defined benefit plan for which PBGC has been appointed trustee may contact DOL at PBGCTrusteedPlan@dol.gov for further information." (Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL])  

[Guidance Overview]

DOL Proposes Update to Regs for Disability Benefit Claims (PDF)
"DOL has ... expressly requested comments on two specific topics.... [1] [W]hether it should modify the existing timing rules for deciding disability benefit claims to allow claimants and plans sufficient time to engage in a dialogue regarding new evidence and rationales prior to the determination of the claim or appeal.... [2] [W]hether the regulations should require plans to provide, in the final notice of adverse benefit determination on appeal, a statement of the plan's applicable contractual limitations period and the period's expiration date." (Trucker Huss)  

[Guidance Overview]

DOL Issues Proposed Regs Implementing ACA Protections for Disability Claims
"Claims and appeals must be adjudicated in a manner designed to ensure the independence and impartiality of the person involved in making the decision. Benefit denial notices must contain a full discussion of why the plan denied the claim and the standards behind the decision. Claimants must have access to their entire claim file and be allowed to present evidence and testimony during the review process.... Claimants are deemed to have exhausted administrative remedies if the plan does not adhere to all claims processing rules.... Notices must be written in a culturally and linguistically appropriate manner." (The Wagner Law Group)  

ASPPA Advocacy Effort Succeeds -- IRS Delays New Form 5500 Questions
"The final version of the 2015 Form 5500 was released on Dec. 3 and, in a victory for [the ASPPA Government Affairs Committee (GAC)], the new IRS compliance questions were made optional (at least for the 2015 plan year).... [T]he IRS had proposed a number of new questions be added to the Form 5500 for the 2015 filing year.... [After filing comment letters with both IRS and OMB,] a face to face meeting was held with OMB on July 14 in which ASPPA GAC once again requested a delay in the effective date to reduce the costs of compliance by giving service providers more time to update systems.... [T]he assumption is that OMB considered ASPPA GAC's comments and ultimately came to the conclusion that we were right; that is, there was no pressing reason to add these new questions in such a rushed fashion." (American Society of Pension Professionals & Actuaries [ASPPA])  

Keeping Your Compensation Committee on Track During the Busy Winter Season
"The fourth quarter is the start of many critical and often scrutinized committee activities: reviewing performance, approving 2015 incentive awards and developing 2016 performance incentive plans. This article provides a sample full year committee calendar and a checklist of activities and actions compensation committees should be focusing on during Q4 2015 and Q1 2016." (Meridian Compensation Partners, LLC)  

Pacific Resources Names Nate Free as Vice President, Client Services
Pacific Resources

Genstar Capital and Aquiline Capital Partners Complete Acquisition of Ascensus
Ascensus

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