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[Official Guidance]
AIR Production for Tax Year 2015 will open on January 21, 2016
"The IRS will begin accepting ACA Information Returns for Tax Year 2015, at 9:00 a.m. EST, on January 21, 2016. Although transmitters are not required to pass Phase 2 AATS if Phase 1 AATS was successfully passed, we recommend transmitters submit to the Phase 2 AATS environment to identify potential obstacles due to recent Schema changes."
(Internal Revenue Service [IRS])
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[Official Guidance]
CMS Announcement Clarifying, Eliminating and Enforcing Special Enrollment Periods
"The action we are taking today announces the elimination of several unnecessary special enrollment periods, clarifies the definitions of other special enrollment periods, and provides stronger enforcement so that special enrollment periods serve the purpose for which they are intended and do not provide unintended loopholes.... While there will continue to be special enrollment periods for people who lose coverage mid-year or experience other life changes, this channel for enrollment will not be available for the vast majority of consumers."
(Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])
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[Guidance Overview]
Text of IRS Publication 969: Health Savings Accounts and Other Tax-Favored Health Plans (PDF)
21 pages, dated Jan. 13, 2016. "An HSA may receive contributions from an eligible individual or any other person, including an employer or a family member, on behalf of an eligible individual.... An Archer MSA may receive contributions from an eligible individual and his or her employer, but not both in the same year.... A health FSA may receive contributions from an eligible individual. Employers may also contribute.... An HRA must receive contributions from the employer only. Employees may not contribute."
(Internal Revenue Service [IRS])
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[Guidance Overview]
Completing Form 1095-C: Coding Line 14 May Not Be as Intuitive as It Appears
"Without a doubt the most challenging parts of the Form 1095-C to complete are lines 14, 15, and 16. These lines provide critical information to the government regarding an individual's eligibility for a premium tax credit, the individual mandate, and the employer mandate. Line 14 dictates how line 15 and line 16 should be completed. Therefore, correctly completing line 14 is critical to accurately completing line 15 and line 16."
(Health Care Attorneys P.C.)
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[Guidance Overview]
IRS Clarifies Several Health Care Reform Compliance Issues
"[T]he IRS recently released Notice 2015-87 which -- in 31 pages -- provides additional guidance on a number of issues related to the [ACA] and other, more general, health and welfare plan compliance issues. But, as the old saying goes, 'be careful what you wish for.' Not all of the additional guidance contained in IRS Notice 2015-87 is favorable to employers."
(Miller Johnson)
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[Guidance Overview]
After Insurer Complaints, Small Steps to Toughen Special Enrollment Period Eligibility
"Insurers have claimed that the [special enrollment periods (SEPs)] are being abused. They claim that individuals are in fact waiting until they encounter health problems to sign up for coverage through SEPs and then dropping coverage once their problems are resolved. Insurers claim that individuals who enroll through SEPs cost more and enroll for shorter periods of time.... [Six] current SEPs will be eliminated in the federally facilitated marketplaces and state-based marketplaces that use HealthCare.gov, effective January 1, 2016."
(Health Affairs)
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Cadillac Tax Delayed Two Years: Five Things You Need to Know
"[1] The tax is still part of the law.... [2] The delay doesn't modify the Cadillac tax inflation-rate cap.... [3] There are concrete steps employers can take to reduce potential Cadillac tax exposure ... [4] Emerging strategies can reduce inefficiencies, in addition to costs.... [5] Helping employees help themselves has the longest shelf life and arguably the best outcomes."
(bswift)
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Private Exchange Enrollment Tied to Employer-Sponsored Plans Jumps 35 Percent
" 'While adoption is substantial, it does represent a bit of a deceleration from previous growth rates, and a little bit lower than in previous forecasts,' said Scott Brown, managing director at Accenture Health and one of the authors of the report. 'We're also beginning to see larger employers taking a wait-and-see approach,' Brown added, explaining that these employers continue to look for ways to contain their costs."
(Healthcare Payer News)
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Retirement Health Savings Account and Medicare: Using an HSA for Supplemental Retiree Medical Expenses
"[F]or any retiree that is saving for both medical expenses in retirement and also all of their other retirement goals, using a combination of an IRA (for most retirement expenses) supplemented by an HSA as a 'retirement health savings account' may be the most tax-preferenced way to save holistically for retirement.... [C]ontributing the maximum to an HSA every year has the potential for more beneficial tax treatment than any other type of tax-preferenced account. Which makes accumulating in an HSA so desirable that it may even be preferable to pay current medical expenses out of pocket, just to preserve (and keep contributing to) the HSA account balance to be used as a future health retirement account!"
(Michael Kitces in Nerd's Eye View)
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Even With 'Skin In The Game,' Health Care Shoppers Are Not More Savvy
"[E]ven when people were responsible for more of their health costs, they weren't more likely to consider cost or shop around for the best deal on medical treatments. A majority of people across the board knew that some doctors cost more than others. Even so, only about 10 percent of consumers in each group considered other doctors the last time they bought medical care; and only about 4 percent compared costs."
(Kaiser Health News)
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Feds Targeting Three Common FMLA Mistakes
"[1] Not recognizing workers' need for leave and disciplining those employees for absences that should've been covered by FMLA; [2] Failing to meet the notice deadlines under the FMLA regs, and [3] Failing to properly administer medical certification -- including recertification requests that are made more frequently than the law allows."
(HR Benefits Alert)
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Will 2016 Be the Costliest Year in ACA History?
"What will the increase in individual mandate penalties mean for employers? ... for insurance carriers? ... What will the expansion of the employer mandate mean for employers? ... for insurance carriers? ... What will the rising premiums in ACA policies mean for employers? ... for insurance carriers? ... What does the reporting requirements mean for employers?"
(Benefitfocus)
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Early Assessment of Competition in the Health Insurance Marketplace
"The purpose of the study was to focus on a few states that had one or more potential indicators of 'insufficient competition' -- such as few insurers offering plans, low enrollment, high premiums, inadequately informed consumers, or sparsely populated rural areas -- and try to understand how competition was working in these markets and what might be done to make it work better. The report describes the findings for each selected state, discusses common themes across the states, and provides some potential remedies to improve competition."
(The Brookings Institution)
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[Opinion]
District of Columbia Proposal Shows the Wrong Way to Provide Paid Leave
"Given the economic and social benefits [paid leave] provides and given that the private market will not generate as much as needed, public policies should ensure that such leave is available to all. But it is important to do so efficiently, so as not to burden employers with high costs that could lead them to substantially lower wages or create fewer jobs.... [Analysis of the proposed D.C. legislation] suggests that this level of leave would be badly underfunded by the proposed tax, perhaps by as much as two-thirds."
(The Brookings Institution)
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[Opinion]
American Employees Still Need Relief from the Cadillac Tax
"Since the Cadillac tax includes individuals' contributions to their flexible benefits accounts, more and more employers will (and many already have begun to) cease offering FSAs and HSAs in order to avoid triggering the tax threshold. In effect, workers will lose a useful, tax-effective tool to pay for these high costs. For this reason, it is crucial that we find a way to fully repeal the Cadillac tax before 2020, or, at the very least, exempt employee contributions to their health savings and flexible health care accounts from the tax calculation."
(The Hill)
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Benefits in General; Executive Compensation
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[Guidance Overview]
Effects of SEC's Proposed Clawback Rules on Incentive Based Compensation (PDF)
"While well-accepted compensation theories advocate tying compensation to a company's financial performance, given the SEC's proposed rules and the current market trend, issuers may wish to reduce the amount of compensation that is contingent upon the satisfaction of financial reporting measures, so as to reduce their executive officers' exposure to clawback. To the extent that compensation will be based on the achievement of financial reporting measures, per the proposed rules, the compensation awards should include explicit language to facilitate clawback, if required."
(Fulcrum Partners, LLC)
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New York State Appellate Court Upholds Executive Compensation Order and Regs: What Happens Next?
"The EO 38 regulations ... were drafted to limit the amount that Covered Providers, as well as certain subcontractors and agents of Covered Providers, could pay to executives, and the amount of administrative expenses that these Covered Providers could incur.... Although the Second Department has ruled that EO 38 and the implementing regulations are valid, there remain many open issues. Most critical is what aspects of the regulations are currently enforceable."
(Greenberg Traurig)
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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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