Health & Welfare Plans Newsletter

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Employee Benefits Jobs

Group Benefits - Health and Welfare Compliance
NRECA [National Rural Electric Cooperative Association]
in VA

Regional Retirement Plan Sales Consultant
Brighton Jones
in WA

Compliance Analyst
National Retirement Services, Inc.
in NC

Senior Vice President - Regional Sales
Pension Consultants, Inc.

Retirement Plan Sales Consultant
John Hancock Retirement Plan Services
in MA

Regional Sales Consultant
The Retirement Advantage
in IL

Client Relationship Manager
The Retirement Advantage

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Webcasts and Conferences

Risk Transfer Trends
January 13, 2016 WEBCAST
(Conference of Consulting Actuaries)

2015 Employee Benefits Year in Review...and What’s Coming for 2016!
January 21, 2016 WEBCAST
(ABD Insurance & Financial Services)

Look into the Crystal Ball: How Retirement Plans and Financial Well-Being Programs will Evolve in 2016
January 26, 2016 WEBCAST
(Aon Corporation)

Future of Group Benefits: Are You Prepared?
January 27, 2016 WEBCAST

Mastering the HIPAA Privacy, Security, and Breach Notification Rules
February 4, 2016 in MD

Affordable Care Act - Just the Basics
February 9, 2016 WEBCAST
(Liebert Cassidy Whitmore)

IRA Excess Contributions & Recharacterizations
February 23, 2016 WEBCAST

East Coast Defined Contribution Conference
March 6, 2016 in FL
(Pensions & Investments)

View All Webcasts and Conferences


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[Guidance Overview]

New Puerto Rico Law Allows Employees to Use Accrued Paid Sick Leave to Care for Qualified Family Members
"Law No. 251 allows employees who work for employers covered under Act 180 to use up to five days of accrued sick leave per year to care for qualified family members who are ill. Qualified family members are the employee's sick children, spouse, or parents. Sick minors, persons of advanced age (those 60 years of age or older), or individuals who are disabled who are under the employee's legal custody or guardianship also are considered qualified family members under this law. This leave, commonly referred to as caregiver's leave, is required to be offered only by employers with 15 or more employees." (Littler)  


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[Guidance Overview]

ACA Reporting Requirements for Carriers and Employers (PDF)
48 pages. "In this volume, [the authors] have collected the 24 weekly blog posts that comprise the series entitled, 'The Affordable Care Act's Reporting Requirements for Carriers and Employers.' ... Each of the posts addressed compliance issues affecting employers and state-licensed insurance carriers, with a particular though not exclusive focus on the law's reporting requirements. The issues discussed week-to-week were generally gleaned from newly issued guidance or developing client problems, questions or concerns." (Mintz Levin)  

[Guidance Overview]

Questions and Answers about Health Care Information Forms for Individuals (Forms 1095-A, 1095-B, and 1095-C)
16 Q&As for individual taxpayers; updated Jan. 11, 2016. Topics include: Can I file my tax return if I have not received any or all of these forms? ... My employer or health coverage provider has suggested that I opt to receive these forms electronically rather than on paper. Are they allowed to ask me that? ... Will I get a Form 1095-C from each of my employers? ... What do I need to do with these forms? ... Am I required to file a tax return if I receive one of these forms? ... Should I attach Form 1095-A, 1095-B or 1095-C to my tax return? (Internal Revenue Service [IRS])  

[Guidance Overview]

CMS Writes Draft Letters to FFM Issuers for 2017
"While the 2017 letter retains much of the content from information set out in prior years, it places renewed focus on issues including network adequacy, discriminatory benefit design, and formulary review. CMS is accepting comments on its proposed guidance until January 17, 2016[.]" (Wolters Kluwer Law & Business)  

Trouble Paying Medical Bills: 2015 vs. 2005
"Despite a large decrease in the proportion of working-age people categorized as 'uninsured' ... one quarter of us still have trouble paying medical bills. In 2015, 15 percent spent 'all or most' of their savings on medical bills. In 2005, it was 12 percent. In 2015, 10 percent 'borrowed money from friends or family' and nine percent 'increased credit card debt.' In 2005, eight percent reported 'borrowing money or taking out another mortgage.' In 2015, 32 percent 'put off/postponed getting health care you needed.' In 2005, 29 percent of adults report 'they or someone in their household skipped medical treatment, cut pills, or did not fill a prescription in the past year because of the cost.' " (National Center for Policy Analysis Health Policy Blog)  


You are invited to Private Exchange FORUM Dallas Feb 23-24, 2016

Sponsored by Institute for Healthcare Consumerism [IHC]

Join us in Dallas Feb. 23-24 at Private Exchange FORUM, the leading event on private exchanges! Learn next steps and best practices in health care consumerism and plan design, as well as ACA compliance and reporting issues for 2016 and beyond!

A Broker's Role Is Not About Pricing Anymore
"There will be plenty of headaches as employers go through the first year of the Affordable Care Act reporting requirements. But there is also opportunity for employee benefit brokers. Helping clients navigate this process can increase a broker's value and secure those clients for the long-term.... Determining eligibility is one challenge ... Finding data, such as eligible employees, employer and employee contributions and the number of times a health plan was offered, is not easy[.]" (Employee Benefit News)  

Turning to Medicaid to Insure Lowest-Paid Employees
"Companies must offer affordable coverage to all employees and will be subject to a penalty if their workers instead turn to the health exchange to buy subsidized coverage. There's no penalty for companies, it turns out, if workers qualify for Medicaid ...[A] startup called BeneStream... facilitates enrollment in the government program.... CEO Benjamin Geyerhahn said moving workers from private insurance to Medicaid helps firms shift their costs to the government." (Kaiser Health News)  

Health-Related Tax Expenditures: Overview and Analysis (PDF)
18 pages. "From FY1974 to FY2014, real health-related tax expenditures have increased, on average, at an annual rate of 7.5%. Looking forward, the nominal value of health tax expenditures is estimated to increase from $210.4 billion in FY2015 to $296.2 billion in FY2019.... [H]ealth-related tax expenditures have generally increased at a rate greater than the growth of total revenue collections.... This report analyzes these provisions at the level of a budget function, rather than focusing any single provision." [Report No. R44333, dated Jan. 8, 2016.] (Congressional Research Service [CRS])  

Democrats Want NIH Action to Prevent 'Drug Price Gouging'
"Fifty-one lawmakers said the NIH has the statutory authority 'to alleviate health and safety needs which are not being reasonably satisfied,' and it wants the agency to issue guidelines for when it would take such action.... Under a 1980 law ... federal agencies that fund private research retain certain rights on patents when the 'benefits of the patented product are not "available to the public on reasonable terms," ' the lawmakers wrote[.]" (Morning Consult)  

Modifying the ACA's Family Subsidy Rules to Help Ensure Affordability
"[A]ll members of a family are ineligible for subsidies if at least one member has access to employer-provided insurance in which his or her contribution for a single premium is less than 9.56 percent of household income.... Sen. Al Franken (D-Minn.) proposed a modification ... that would allow dependents to receive subsidies -- but not the worker -- when the family employer premium contribution exceeds 9.56 percent of the worker's household income.... If the Franken proposal were implemented ... 2.3 million individuals who are not currently eligible for subsidies ... would become eligible and enroll in subsidized coverage in the individual marketplaces." (The Commonwealth Fund)  

Health Law Enrollment Periods to Be Tightened
"The Obama administration will tighten the rules for people who enroll in insurance through outside of official enrollment periods ... Insurers say that the rules are so broad that people can wait until they get ill to buy insurance. That raises health-care spending and overall premiums because people who are sicker generally cost more to cover." (The Wall Street Journal; subscription may be required)  

Kentucky Moves Ahead with Plans to Dismantle Health Exchange
"Gov. Matt Bevin notified federal officials in a letter dated Dec. 30 that the state exchange will cease operations 'as soon as is practicable.' That will be at least a year from now, according to federal law. It will not affect health plans sold for 2016.... More than 100,000 people have used Kentucky's exchange, dubbed kynect, to purchase private health insurance plans with the help of a federal subsidy since it was implemented in 2013." (The Washington Post; subscription may be required)  

U.S. State Attorneys General Joining Probe of Health Insurer Mergers
"About 15 state attorneys general have joined the Justice Department's probe of two big insurance mergers, ... increasing the scrutiny on proposed deals that would reduce the number of nationwide health insurers to three from five. The formation of a large group to scrutinize Aetna Inc.'s plan to buy Humana Inc. and Anthem Inc.'s bid for Cigna Corporation complicates what is already expected to be a tough and lengthy review by federal antitrust enforcers." (Reuters)  

Benefits in General; Executive Compensation

[Guidance Overview]

2016 Deadlines Approach to Furnish Incentive Stock Option and Employee Stock Purchase Plan Information Statements and Returns
"Section 6039 of the Internal Revenue Code requires a corporation to furnish a written statement to any employee or former employee who either [1] exercised an incentive stock option within the meaning of Section 422 of the Code (ISO) during 2015 or [2] during 2015 first transferred legal title to shares acquired under the corporation's employee stock purchase plan.... The corporation must furnish these statements on Forms 3921 and 3922 no later than February 1, 2016.... [C]orporations must [also] file returns with the Internal Revenue Service on Forms 3921 and 3922 no later than February 29, 2016, if filed on paper, or March 31, 2016, if filed electronically." (DLA Piper)  

New 'Digest of EEO Law' Issued by EEOC
"The [EEOC] today announced the latest edition of its federal sector Digest of Equal Employment Opportunity Law, which is available online. The Digest now includes hyperlinks so that stakeholders can easily access the full decisions which have been summarized. This quarterly publication, prepared by EEOC's Office of Federal Operations, features a wide variety of recent Commission decisions and federal court cases of interest. The current edition also includes a special year-end selection of notable EEOC decisions for fiscal year 2015 (which ended Sept. 30, 2015)." (U.S. Equal Employment Opportunity Commission [EEOC])  

Press Releases

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2016, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of, Inc., or in the case of third party materials, the owner of that content. You may not alter or remove any trademark, copyright or other notice from copies of the content.

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