Pension Plan Administrator
Growing Retirement Plan Administration Firm
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Retirement Plan Administrator
Delaware Valley Retirement, Inc
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[Guidance Overview]

Staying on the Compliance Track: The 2015 Health Benefits Year in Review (PDF)
9 pages. Topics include: Final health insurance reform regulations; Proposed disability plan claims procedures; EEOC proposed wellness program rules under the ADA and GINA; U.S. Supreme Court cases; ACA reporting; Section 4980I (so-called 'Cadillac Tax') guidance; and 2016 COLA adjusted amounts. (Alston & Bird LLP)  

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[Guidance Overview]

IRS Issues New HRA Integration Rules
"Notice 2015-87 reaffirms that HRAs limited to retirees may reimburse individual market insurance premiums (including Medicare supplement plans) and other medical-related costs.... Unless the retiree-only exception applies, unused amounts in an HRA cannot be used to reimburse premiums paid by former employees for individual market coverage even if the amounts were originally earned in the HRA when the HRA was properly integrated with a group health plan.... An HRA that reimburses medical expenses for an employee and the employee's spouse and dependents cannot be integrated with self-only group health plan coverage provided by the employer. However, the IRS will not enforce this requirement until 2017." (Proskauer's ERISA Practice Center)  

[Guidance Overview]

Final Regs Issued on ACA Market Reforms (PDF)
10 pages. Topics include: [1] Grandfathered health plans; [2] Prohibition of preexisting condition exclusions; [3] Prohibition on lifetime and annual limits; [4] Prohibition on rescissions; [5] Coverage of dependents to age 26; [6] Internal claims and appeals and external review; and [7] Patient protections. (McDermott Will & Emery)  

[Guidance Overview]

Transit Pass Parity with Parking Benefit Starting in 2016
"[T]he IRS had already announced that the 2016 limits for transit passes was to be the same as it was in 2015, no more than $130 per month. The 2016 limit for a qualified parking benefit was to have been $255 in 2016, a slight increase from 2015's $250. Now, and presumably forever more (until Congress changes its mind yet again), both benefits will be set at the higher amount." (Kushner & Company)  

'Tis The Season For Moonlighting: FMLA Leave and Secondary Employment
"[W]orking at a second job is not necessarily inconsistent with being on FMLA leave. For example, an employee's serious health condition may prevent them from being able to perform manual labor at one job, but not from performing clerical work at another. Moreover, neither the FMLA statute nor its regulations prohibit outside employment by an employee on FMLA leave, except where an employer has an established policy against moonlighting which applies to all employees on any type of equivalent leave of absence." (McDermott Will & Emery)  

CMS Announces Medicare Drug Spending Dashboard
"CMS is releasing a new online dashboard to provide information on Medicare spending on prescription drugs, for both Part B ... and Part D ... The dashboard includes information on each prescription drug, including cost trend analysis, brand names, generics, and the name of the manufacturer, and provides easily searchable, detailed information and data. The 80 prescription drugs included in the dashboard represent 33 percent of all Part D spending and 71 percent of Part B drug spending in 2014, or $55 billion of the more than $143 billion in Medicare prescription drug spending in 2014. Prescription drug spending in Parts B and D was 14 percent of total Medicare spending in 2014, up from 11 percent in 2010 -- just five years ago." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

ACA and Drug Prices Drive U.S. Healthcare Spending Surge
"Although prescription drugs constitute about 10% of healthcare spending overall, prescription drug spending grew by more than 12% last year to nearly $300 billion overall. That increase represents the largest annual growth rate in more than 10 years. According to CMS, a sizable chunk of that growth can be attributed to new high-priced hepatitis C drugs, along with price increases on brand name drugs and a reduction in savings on drugs whose patents expired." (Sheppard Mullin)  

Consumer Cost-Sharing in Marketplace vs. Employer Health Insurance Plans, 2015
"56 percent of enrollees in marketplace plans attained cost-sharing reductions in 2015. However, for people without cost-sharing reductions, average copayments, deductibles, and out-of-pocket limits under catastrophic, bronze, and silver plans are considerably higher than under employer-based plans on average, while cost-sharing under gold plans is similar employer-based plans on average. Marketplace plans are far more likely than employer-based plans to require enrollees to meet deductibles before they receive coverage for prescription drugs." (The Commonwealth Fund)  

How Much Do Marketplace and Other Nongroup Enrollees Spend on Health Care, Relative to Their Incomes?
"[The authors] examine premiums and out-of-pocket costs, as well as total financial burdens for individuals with different characteristics enrolled in ACA-compliant nongroup coverage.... [D]espite the financial assistance available, individuals across the income distribution who are ineligible for Medicaid can still face very high expenditures." (Urban Institute)  

Antidote Needed for the COBRA Trap
"For working seniors with employer-sponsored plans, it may make sense to delay enrollment in Parts B and D to avoid paying premiums for coverage they don't yet need.... Medicare allows seniors to delay enrollment without penalty if they have coverage through work. But once they retire and coverage ends, they have an eight-month window ... to enroll in Medicare Parts B and D without incurring fines. If they miss that window, they could face late enrollment penalties of up to 10 percent for every year late -- and have to pay higher premiums for the rest of their lives. They could even have to go without insurance while they wait for the next sign-up period." (Morning Consult)  

[Guidance Overview]

Year-End Tax and Spending Legislation Includes Employee Benefits Provisions (PDF)
"The PATH Act extends numerous tax provisions that expired at the end of 2014, with extensions varying from two years (2015 and 2016) to permanent extensions. The combined 2,000+ page legislation contains a miscellany of employee benefits provisions. Highlights include a permanent extension of transit and parking benefit parity, retroactive to the beginning of 2015. In addition, the 40 percent excise tax on so-called 'Cadillac health plans' is delayed for two years and is also made deductible." (Alston & Bird LLP)  

SCOTUS Revisits ERISA Reimbursement
"One of the more interesting developments during the oral argument was the plan's concession that disability and pension plans would not be affected by the rule it is advocating. Katyal explained that Social Security disability benefits are protected from garnishment under Section 207 of the Social Security Act ... He added that pension plan participants who receive an overpayment often don't know that they are overspending until after the fact; thus, they lack the requisite knowledge. That concession is significant because several of the circuit court cases involved in the circuit split, for which certiorari was granted, are disability cases." [Bd. of Trustees of the National Elevator Industry Health Benefit Plan v. Montanile, No. 14-11678 (11th Cir. Nov. 25, 2014; oral arg. Nov. 9, 2015)] (DeBofsky & Associates, via Employee Benefits Committee Newsletter, ABA Section of Labor and Employment Law)  

2015 Was a Wild Ride for Employee Benefits
"Employers dipped their collective toe into new models for employee benefits, employees took on more responsibility, and a couple of new players came swashbuckling in declaring they were going to completely revamp the business. All this action occurred against a backdrop of complexity that occupies most of the HR department's time.... Big trends we saw in 2015: ... Rise of the benefits tech companies ... More compliance requirements ... Consumers continue to take the reins ... Healthcare gets more expensive ... Tracking wellness." (Corporate Synergies)  

Section 409A: Reflections on Its 11th Anniversary (PDF)
"If your company will be sold, have your counsel review all of your agreements before the due diligence process begins. Many times, Section 409A issues are discovered during due diligence. The penalties for violating Section 409A are severe and imposed on the employee or independent contractor rather than the employer. There are no penalty exceptions for inadvertent errors no matter how small.... The IRS has initiated a Section 409A audit project to assess compliance with the law." (Wilkins Finston Friedman Law Group LLP)  

FASB Directs Staff to Draft a Final Accounting Standards Update on Employee Share-Based Payment Accounting Improvements (PDF)
"The final ASU would amend Topic 718 in the following eight areas: ... [1] Stock-for-tax withholding ... [2] Presentation of stock-for-tax withholding on statement of cash flows ... [3] Accounting for award forfeiture ... [4] Accounting for excess tax benefits and deficiencies ... [5] Presentation of excess tax benefits and deficiencies on statement of cash flows ... [6] Classification of awards with contingent repurchase features ... [7] Estimating expected term of stock option award for nonpublic companies ... [8] Using intrinsic value rather than fair value for liability awards for nonpublic companies." (Frederic W. Cook & Co., Inc.)