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HIPAA Compliance Audits: New Protocols and Requirements
December 15, 2015 WEBCAST
(MentorHealth)

Implications of Longevity Risk
February 3, 2016 WEBCAST
(Society of Actuaries)

Form 5500 Reporting Update
February 24, 2016 WEBCAST
(Lorman Education Services)

2016 Mid-Sized Retirement & Healthcare Plan Management Conference: Lifting the Fog: Clarity for Your Employee Benefit Plans
March 20, 2016 in CA
(University Conference Services)

HIPAA Compliance Program BootCamp
April 21, 2016 in FL
(Clearwater Compliance)

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Today's Discussions on the BenefitsLink Message Boards

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[Official Guidance]

IRS 2015 Form 8941: Credit for Small Employer Health Insurance Premiums (PDF)
To be filed by employers who paid premiums during their tax year for employee health insurance coverage provided by the employer through a Small Business Health Options Program (SHOP) Marketplace. (Internal Revenue Service [IRS])  

[Advert.]

Executive Forum on Rewarding Healthy Behaviors – Feb 2-3 - Las Vegas

Learn how innovative workplace wellness strategies, preventive health management initiatives, and evidence-based success impact workforce productivity and increase ROI. HR/Benefits Staff: Use code BLINK2 to attend for $195.

[Official Guidance]

Text of Agency Guidance: Waivers for State Innovation
"State Innovation Waivers are available for effective dates beginning on or after January 1, 2017. They may be approved for periods up to 5 years and can be renewed.... This document provides additional information about the requirements that must be met, the Secretaries' application review procedures, the amount of pass-through funding, certain analytical requirements, and operational considerations." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS], and U.S. Department of the Treasury)  

[Guidance Overview]

ACA Reporting Requirements for Carriers and Employers (Part 21 of 24): Reporting for 'MEC' Plans
"The lingering reporting-related questions appear to cluster around full-time employee determinations, offers of coverage, and eligibility, participation and coverage. This post examines issues relating to coverage, both under the rules governing the reporting of minimum essential coverage and under the employer shared responsibility rules, with a particular emphasis on 'MEC plans.' " (Mintz Levin)  

[Guidance Overview]

Don't Forget Year-End Amendment to Cafeteria Plans Allowing Revocation for Marketplace Coverage
"Notice 2014-55 was effective as of September 18, 2014, and it allowed participants to revoke a cafeteria plan election for group health coverage, that is not a health FSA and provides minimum essential coverage, for two specific situations.... The first ... was that employees experiencing a change in employment status where they no longer expect to average 30 hours of service per week, but remain eligible for employer-provided coverage, may revoke a cafeteria plan election and elect other minimum essential coverage.... The second scenario arises when participants who made a cafeteria plan election for group health coverage intend to enroll in Marketplace coverage during either a special enrollment period or the Marketplace's annual enrollment period (for non-calendar year plans)." (Jackson Lewis P.C.)  

[Guidance Overview]

EEOC's Proposed Rules for Wellness Programs Under the Genetic Information Nondiscrimination Act (GINA) (PDF)
"These Proposed Rules clarify that GINA does not prohibit employers from offering limited inducements (either rewards or penalties) if covered spouses provide information about their current or past health status, as long as certain requirements are met. Among other things, the Proposed Rules require that the provision of information must be voluntary and that the individual provide prior, knowing, voluntary and written (including electronic) authorization." (Alston & Bird LLP)  

[Guidance Overview]

HHS and Treasury Release Substantive Guidance on ACA State Innovation Waivers
"The guidance ... clarifies that proposals will be evaluated specifically as they affect the vulnerable and low-income populations on whom the ACA's protections are focused and on their access to affordable and comprehensive care. The guidance also discusses the limited capacity of the federally facilitated marketplace (FFM) and the Internal Revenue Service (IRS) to administer state waiver programs, basically stating that states that want to design their own premium subsidy programs are on their own." (Timothy Jost, in Health Affairs)  

[Guidance Overview]

Text of HHS Fact Sheet: HHS and Treasury Issue Additional Guidance on ACA Section 1332 Waivers
"In 2012, the Departments published regulations that set forth the process for states to submit applications and describe what an application from a state must contain. These waivers may take effect as early as January 1, 2017.... Coverage ... Affordability ... Comprehensiveness ... Deficit Neutrality ... Impact of Other Program Changes ... Funding Available to States ... The Departments welcome comments on this guidance and will consider issuing additional guidance in the future if additional clarifications are necessary." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

Health Reform 2.0: Provider-Sponsored Health Plans Become Key
"[E]mployers saw a 6.3% increase this year as the slowdown in health spending growth dating to 2002 seemed to come to an end.... In households, average spending for those with private coverage increased 4.7% from 2013 as employers pushed higher premiums and co-payments through, and as employees opted for HSAs as a mechanism to lower their risk.... For those who deliver services to patients ... the stark realities are these: ... The burden to reduce costs will ultimately fall on providers.... The major purchasers of healthcare services -- Medicare, Medicaid, large employers and private insurers -- are shifting the financial (insurance) risk to them.... Relationships with insurers are changing." (Paul Keckley, Ph.D., Navigant Healthcare)  

Welfare Benefit Plans: More Than Just the ACA
"ERISA generally allows the plan sponsor to decide whether to offer a plan and allows flexibility in the plan's benefit design. But if an employer does decide to sponsor a plan, there are mandated benefits. Here is [a] list of those mandated benefits complete with initials and acronyms." (The Retirement Plan Blog)  

OCR Announces Two HIPAA Resolution Agreements, Including Highest-Ever Settlement Payment
"Some of the violations alleged by OCR -- such as failure to have business associate contracts -- suggest that the insurer was unaware of its HIPAA obligations. Others, such as the ID card mistakes and the extraneous information on the backs of letters, suggest inadvertent failures that might have been avoided with tighter controls.... The [second] resolution agreement is less sweeping but underscores the importance of being able to track the physical location of hardware and storage media, as well as who is accessing PHI and for what purpose." (Thomson Reuters / EBIA)  

Crunch Time Again for ACA Enrollment
"Rising premiums and shaken faith among insurers have cast a cloud over sign-up season for President Barack Obama's health care law ... 'Medical costs of enrollees have been higher than expected and total enrollment remains low,' said Caroline Pearson [of] Avalere Health. 'If participation is leveling off, then plans may be stuck with a risk pool that is not particularly balanced.' ... The fines for people who remain uninsured in 2016 have gone up substantially[.]" (InsuranceNewsNet.com)  

The Legal Fate of Obamacare: Round 4
"[T]he Supreme Court turns next to the plea of religious non-profit schools, colleges, hospitals and charities to be exempted from any role in carrying out the law's promise of free contraceptives to working women and some students. It is a high-stakes sequel to the 2014 ruling giving some for-profit companies an exemption from that mandate, and it probably will further clarify church-state relationships in America." (SCOTUSblog)  

Gov. Christie Signs Bill Updating New Jersey's Multiple-Employer Health Plan Rules
"Gov. Chris Christie signed a bill to loosen state regulations for multiple-employer welfare arrangements, a self-funded insurance option for small businesses, and allow larger employers the opportunity to seek an insurance alternative.... The MEWAs use pooled contributions from employers to purchase health insurance plans for their employees and help support the cost of claims." (NJBiz)  

[Guidance Overview]

IRS Issues Guidance on Application of Obergefell Decision to Benefit Plans
"The IRS indicates in [Notice 2015-86] that in light of Windsor and the guidance issued thereafter, it does not anticipate any significant impact from Obergefell on the application of federal tax law to employee benefit plans. However, in a series of questions and answers in [this] Notice, the IRS does address certain issues relating to the amendment or administration of plans in response to Obergefell." (McGuireWoods LLP)  

[Guidance Overview]

IRS Notice on Obergefell Includes Permitted Cafeteria Plan Election Change and Guidance on Qualified Retirement Plans
"Notice 2015-86 confirms that Obergefell does not require changes to the terms of qualified retirement plans, and health and welfare plans. However, for calendar-year cafeteria plans that do not allow election changes due to significant improvements in coverage, but now wish to do so by the applicable deadlines, this guidance is arriving fairly late in the year and doesn't allow much time for plan amendments and election changes." (Practical Law Company)  

New Consumer Decision Support Features now Available at HealthCare.gov
Centers for Medicare & Medicaid Services [CMS]

Murphy & Sylvest is Certified for Fiduciary Excellence
Centre for Fiduciary Excellence [CEFEX]

Cowden Associates, Inc. Promotes Lesa Votovich to Vice President of Health and Benefits and Amy Crouse to Senior Analyst
Cowden Associates, Inc.

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