Plan Administrator for Retirement Plans
Dana Consulting Group, Ltd.
in ANY STATE

Post Your Job

View All Jobs

RSS Feed: All Jobs

Pension Plan Investment Products and Service Provider Contracts: the Good the Bad and the Ugly
January 13, 2016 WEBCAST
(American Bar Association [ABA])

Top 5 Employee Benefit Trends for 2016
March 3, 2016 WEBCAST
(Lorman Education Services)

View All Webcasts and Conferences

Today's Discussions on the BenefitsLink Message Boards

View All Discussions

[Official Guidance]

Text of CMS Draft 2017 Letter to Issuers in the Federally-Facilitated Marketplaces (PDF)
85 pages. "This Letter provides issuers seeking to offer qualified health plans (QHPs), including stand-alone dental plans (SADPs), in the Federally-facilitated Marketplaces (FFMs) or the Federally-facilitated Small Business Health Options Programs (FF-SHOPs) with operational and technical guidance to help them successfully participate in those Marketplaces in 2017.... Throughout this Letter, CMS identifies the areas in which States performing plan management functions in the FFMs have flexibility to follow an approach different from that articulated in this guidance. CMS also describes how parts of this Letter apply to issuers in State-based Marketplaces on the Federal Platform (SBM-FPs). CMS notes that the policies articulated in this Letter apply to the certification process for plan years beginning in 2017." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Advert.]

Weight Loss at the Workplace: Legal Issues in Reducing Health Care Costs and Promoting Wellness

January 28 webinar - Learn about issues to identify and address when formulating and implementing a corporate wellness program that is aimed at weight loss. BenefitsLink discount.

[Official Guidance]

Text of CMS Draft Bulletin: Timing of Submission and Posting of Rate Filing Justifications for the 2016 Filing Year for Single Risk Pool Coverage Effective On or After January 1, 2017 (PDF)
"[T]his bulletin proposes guidance for purposes of establishing the uniform deadline ... for health insurance issuers to submit the Unified Rate Review Template for proposed rates in the individual and small group markets. It also proposes guidance for purposes of establishing the uniform posting deadline ... for a state with an effective rate review program to provide public access to information regarding proposed rate increases that are subject to review. The bulletin also identifies the deadline for posting of final rate increases (including those not subject to review) and the CMS web address to be used by states with an effective rate review program that elect to provide public access from their website through a link to the rate information made available on the CMS website. The timelines specified in this bulletin would apply to rates filed in 2016 (2016 filing year) for single risk pool coverage (including both qualified health plans (QHPs) and non-QHPs) effective on or after January 1, 2017." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Official Guidance]

Text of CMS Proposed Key Dates for Calendar Year 2016: QHP Certification in the Federally-Facilitated Marketplace; Rate Review; Risk Adjustment and Reinsurance (PDF)
"This document summarizes key dates for calendar year 2016 regarding some activities and policies that are outlined in other documents that have not yet been finalized and are open to comment by interested parties, such as the [1] Draft 2017 Letter to Issuers in the Federally-facilitated Marketplaces (December 23, 2015) ... [2] HHS Notice of Benefit and Payment Parameters for 2017 (December 2, 2015) ... and [3] the Draft Bulletin: Timing of Submission and Posting of Rate Filing Justifications for the 2016 Filing Year for Single Risk Pool Coverage Effective on or after January 1, 2017 (December 23, 2015). CMS is not soliciting additional comments on the substance of the underlying policies or the proposed key dates through release of this document." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Official Guidance]

Text of IRS Notice 2016-2: Claiming the Health Coverage Tax Credit for 2014 and 2015 (PDF)
14 pages. "This notice provides guidance regarding the health coverage tax credit (HCTC) under Section 35 of the Internal Revenue Code, as modified by the Trade Preferences Extension Act of 2015 ... This notice provides information on who may claim the HCTC, the amount of the HCTC, and the procedures to claim the HCTC for tax years 2014 and 2015. This notice also provides guidance for taxpayers eligible to claim the HCTC who enrolled in a qualified health plan (QHP) offered through a Health Insurance Marketplace ... in tax years 2014 or 2015, and who claimed or are eligible to claim the premium tax credit (PTC) under Section 36B (including taxpayers who received the benefit of advance payments of the PTC (APTC))." (Internal Revenue Service [IRS])  

[Guidance Overview]

IRS Confirms That Opt-Out or Cash-In-Lieu Payments Must Be Added to Employee Contributions in Determining ACA Affordability
"In the IRS's judgment, an opt-out payment has the effect of increasing an employee's contribution for health coverage beyond the amount of any salary reduction contribution. Foregoing that opt-out, concludes the IRS [in Notice 2015-87], compels an employer to add the cash-in-lieu amount to the employee contribution in calculating PPACA affordability.... [An] employer may continue opt-out payments without having to include those opt-out amounts in the employee contributions so long as that employer had a published opt-out policy in place prior to December 16, 2015." (Benefit Revolution)  

Cadillac Tax Delayed Until 2020, Payments Become Deductible
"[H]ealth insurers and third party administrators are often required to pay the tax, and it is expected that these third parties will generally demand reimbursement from employers. Reimbursements for the non-deductible Cadillac tax would have constituted taxable income to the health insurers. Insurers had already indicated that they expected employers to reimburse them for these additional taxes on the Cadillac tax reimbursements, ultimately costing employers 50 to 60 percent, rather than 40 percent, of the value of excess benefits provided. Now that the Cadillac tax is deductible, the tax's burden on employers should actually approximate the size of the tax." (Ice Miller LLP)  

CMS Proposed Insurance Reforms Incite Industry Backlash
"CMS faces a daunting task in finalizing its rule for the 2017 health insurance market. The agency received more than 500 comments this week, many of which demand the rollback of provisions intended to help consumers.... Insurance companies and business groups slammed the CMS' proposals to regulate provider networks and standardize plan options, saying it would choke their ability to keep healthcare premiums low." (Modern Healthcare Online; free registration required)  

Why Your Wellness Program Isn't Working
"Maybe it's just a matter of time before you'll see an impact from your wellness program, or maybe you need more communication with employees so they understand its value. Or maybe there's a bigger issue: Your workplace culture doesn't support it." (Buck Consultants)  

Trial Court Finds Pittsburgh's Paid Sick Days Ordinance to Be Invalid and Unenforceable
"The challenge was based on the fact that under the laws of the Commonwealth of Pennsylvania ... 'a municipality which adopts a home rule charter shall not determine duties, responsibilities or requirements placed upon businesses, occupations and employers ... except as expressly provided by the statutes which are applicable in every part of this Commonwealth or which are applicable to all municipalities or to a class or classes of municipalities.' Citing an earlier Pennsylvania Supreme Court ruling, the trial court found that the Paid Sick Days Ordinance imposed a requirement on employers and therefore was invalid and unenforceable." (Littler)  

Increased Transparency and Consumer Protections for 2016 Marketplace Plans
"This issue brief investigates several key changes to the qualified health plans, with a focus on increased transparency and consumer protections. A new out-of-pocket costs calculator, requirements regarding provider networks, and prescription drug cost-sharing requirements should serve to better inform and improve consumer selection. In addition, several policy changes will help individuals with more severe health needs." (The Commonwealth Fund)  

Consumers Still Confused About Health Plans' Coverage of Prescription Drugs
"It's fairly straightforward to check online formularies for pharmacy-covered medications, such as cholesterol treatments or blood pressure medications. But checking for medical-benefit drugs is much more complicated for consumers and can involve clicking through layers of websites. Even finding out if a drug is part of the medical benefit coverage instead of the pharmacy formulary isn't easy." (Healthcare Payer News)  

Health Insurance CO-OPs Sunk by Sick Newcomers, Low Risk-Corridor Payments
"Twelve of the Affordable Care Act's 23 co-ops have either closed or will cease to exist by the end of this year. Many of those closures occurred after the federal government announced it would be paying only a sliver of the promised payments under the law's risk-corridor program, which was intended to help plans cover losses in the first years of the insurance exchanges. Industry insiders say the co-op collapse could have been avoided had Congress not stymied those payments." (Modern Healthcare Online; free registration required)  

ACA Rate Stabilization Program Results Should Guide Strategy for 2016
"From a technical perspective, the first year of the reinsurance and risk adjustment programs was a resounding success.... The risk adjustment transfers, however, were an unpleasant surprise for most issuers. The few companies that received risk adjustment transfers collected much less than predicted and the many issuers that paid were charged far more than estimated." (Healthcare Payer News)  

[Guidance Overview]

Year-End Spending and Tax Deal Affects Health Retirement and Fringe Benefit Plans (PDF)
"The key provisions of H.R. 2029 affecting health, retirement and fringe benefit plans [include]: [1] High cost employer-sponsored health coverage excise tax.... [2] Health insurer fee moratorium.... [3] Medical device tax moratorium.... [3] Mass transit and parking benefits.... [4] Governmental accident or health benefits.... [5] Charitable distributions from IRAs.... [6] Rollovers to simple IRAs.... [7] Church plans.... [8] Foreign investment in real property tax act (FIRPTA).... [9] Airline employee IRA rollovers.... [9] Public safety officers." (Groom Law Group)  

Benefitfocus Announces CFO, Milt Alpern, to Retire in March 2016
Benefitfocus

View All Press Releases