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[Guidance Overview]
2015 Ends With a Flurry of ACA Activity
"The guidance in [Notice 2015-87] regarding health coverage affordability determinations for applicable large employers who maintain opt-out arrangements, flex credits, or HRAs should help employers assess how to complete line 15 of Form 1095-C and understand their potential exposure under the ESR rules. Also welcome was an indication in the Notice that the IRS will not impose penalties for ACA reporting failures, provided that the employer can show that it has made good faith efforts to comply with the information reporting requirements."
(Bond, Schoeneck & King)
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[Guidance Overview]
Identity Protection Services Provided Before a Breach Will Not Be Treated as Taxable Income
"The IRS's previous guidance effectively created an exclusion for identity protection services, but only after a breach and only for individuals whose personal information might have been compromised. [Announcement 2016-02] eliminates the breach condition, and requires only that the services be provided by an entity that received personal information. (Whether an employer might have other reasons to provide the services, such as a compensatory motive, is apparently irrelevant.)"
(Thomson Reuters / EBIA)
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Prescription Drug Prices Jumped More Than 10 Percent in 2015
"[O]ver the past year, the price of branded drugs -- those still on patent -- rose 14.77 percent. Specialty drugs, which often are used to treat complex or rare conditions and tend to carry high price tags, rose 9.21 percent. Even generic drugs, which historically have tended to get cheaper over time, rose 2.93 percent."
(The Washington Post; subscription may be required)
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Prior Layoffs of Clerks Outside Protected Class Doom Laid-Off Law Clerk's FMLA Claims
"A law firm processing clerk who was told she had been selected for layoff in the days before she was set to return from surgery-related FMLA leave will not be able to take her FMLA and state law disability claims to a jury, a federal district court in Ohio ruled. The employee was selected as part of a successive wave of lay-offs over the course of 2013 and employees laid off from her department in previous waves had not taken FMLA leave." [Partin v. Weltman Weinberg & Reis Co., LPA, No. 1-14-cv-216 (S.D. Ohio Jan. 5, 2016)]
(Wolters Kluwer Law & Business)
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The Evolving Paid Sick Leave Patchwork: 2016 Update
"[T]he patchwork challenge has nothing to do with the social question of whether there should or should not be paid sick days. The practical challenge is the proliferation of leave and attendance laws and how they interact with each other. National and multi-jurisdiction employers are struggling to develop paid sick leave policies that meet all of the requirements of all of these laws."
(Jackson Lewis P.C.)
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Managing FMLA Fraud: Using Your Policy to Your Advantage
"It's always helpful with employment disputes, including those involving FMLA retaliation claims, to be able to point to specific policy language that the employee violated. In [one recent] case, the express requirement for the employee to notify the employer of a change in her need for leave won the day.... [O]ther helpful policy language could include a statement that the submission of false information in support of a request for FMLA leave, or the abuse or misuse of approved FMLA leave, may result in discipline, up to and including immediate termination."
(Benefits Bryan Cave)
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The Wellness Program Awakens: District Court Rejects EEOC Challenge
"Wellness programs ... received a shot in the arm at the end of 2015 when a federal district court in Wisconsin ruled that an employer may require compliance with a wellness program as a condition for participation in its group health plan, without violating the [ADA]. In the arduous struggle for effective wellness programs as part of a well-designed group health plan, the EEOC's recent challenges to such programs as violating the ADA and [GINA] have been particularly daunting." [EEOC v. Flambeau, Inc., No. 14-cv-638 (W.D. Wis. Dec. 30, 2015)]
(Littler)
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Should Your Employer Do More for Your Health?
"86 percent of U.S. employees are above normal weight or have a chronic health condition, and ... they miss an estimated 450 million extra days of work a year compared with healthy workers. This costs American businesses from $150 billion to a little more than $225 billion in lost productivity ... A chief health officer would be an uncomplicated solution ... to not only help keep workers healthy, but improve the company's bottom line."
(CBS MoneyWatch)
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[Opinion]
What's Behind the Out-of-Pocket Cost Problem
"A decade ago, most middle-class Americans felt pretty good about their health insurance, and politically supported extending coverage to the uninsured. Now, more than a quarter of those folks are paying $1,000 or more before their coverage kicks in.... Given employers' decision to make high-deductible plans a centerpiece of their strategy for avoiding rising healthcare costs, and the fact that they are affecting people across the income spectrum, policymakers need to come up with more creative solutions than making more subsidies available to more people ... Making insurers and self-insured employers exclude an expanded set of high-value services from the deductible would be a good place to start."
(Modern Healthcare; free registration required)
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Benefits in General; Executive Compensation
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[Official Guidance]
IRS Notice of Hearing on Definitions of Terms Relating to Marital Status
"This document provides notice of public hearing on proposed regulations relating to the holdings of Obergefell v. Hodges, 2015, Windsor v. United States, 2013, and a revenue ruling that define terms in the Internal Revenue Code describing the marital status of taxpayers. The public hearing is being held on Wednesday, January 27, 2016, at 10:00 a.m. The IRS must receive outlines of the topics to be discussed at the public hearing by Friday, January 15, 2016."
(Internal Revenue Service [IRS])
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If You Have a Top Hat Plan, This Court Case Is Worth Watching (PDF)
"The Maryland federal district court in Bond v. Marriott International Inc. ... found the plan in question was a top hat plan and that the statute of limitations didn't apply to the suit, even though the complaint was filed 20 years after the participant left employment. The case is now being appealed by Marriott, and the [DOL] recently filed a friend-of-the-court brief on behalf of the former employees....
Little guidance exists on what constitutes a select group of management or highly compensated employees. It's generally beneficial for plan sponsors to limit these plans as much as possible, to help ensure they have top hat status."
(ERISAdiagnostics, Inc.)
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Press Releases
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BenefitsLink.com, Inc.
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Lois Baker, J.D., President
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager
BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2016 BenefitsLink.com, Inc. All materials
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