Health & Welfare Plans Newsletter

February 29, 2016 logo logo LinkedIn logo Twitter logo Facebook logo
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Employee Benefits Jobs

Senior Counsel - Benefits Counsel 4 (0201)
University of California Office of the President
in CA

Senior Retirement Plan Consultant
TWG Benefits, Inc.

Account Executive
Aspire Financial Services LLC
in FL

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Webcasts and Conferences

Retirement Realities–LIVE STREAM from the NIRS Seventh Annual Policy Conference
March 1, 2016 WEBCAST
(International Foundation of Employee Benefit Plans [IFEBP])

M&A Transactions on the Rise -- Bringing With Them Benefits and Compensation Issues
March 16, 2016 in NY
(Worldwide Employee Benefits Network [WEB] - New York Chapter)

Voluntary Fiduciary Correction Program & Abandoned Plan Workshop
April 20, 2016 in MI
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

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[Guidance Overview]

ACA Reporting for Large Employers (PDF)
19 presentation slides. "[1] Get the large employer headcount right. [2] Understand who must receive a Form 1095-C. [3] Calendar extended deadlines (paper vs. electronic). [4] Know the streamlined reporting options and what they offer. [5] Know the types of transition relief and when they apply. [6] Get the Form 1095-C Series 1 and Series 2 codes down cold. [7] Understand the interaction of lines 14, 15 and 16 on 1095-C. [8] Know when 1094-B/1095-B reporting might apply to an employer plan. [9] Know how to report for self-insured plans, when applicable. [10] Understand your options for penalty relief." (E is for ERISA)  


The ACA reporting extension will be over before you know it!

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[Guidance Overview]

DOL Proposes Rule Implementing Paid Sick Leave Executive Order
"[T]he proposed rule covers not only employees performing services directly under covered contracts, but also employees who spend at least 20% of their workweeks performing services 'necessary to the performance' of covered contracts.... Further, the proposed rule covers employees exempt from the [FLSA] overtime and minimum-wage requirements. This coverage means that bona fide administrative, executive, and professional employees also must accrue sick leave even if they are not entitled to other compensation required by the FLSA, [the Service Contract Act], and [the Davis-Bacon Act]." (Wiley Rein LLP)  

[Guidance Overview]

DOL Issues Proposed Rule Implementing Paid Sick Leave for Federal Contractors
"The DOL estimates the rule would extend paid sick leave to nearly 437,000 workers.... [T]he proposed rule would impose substantial new obligations on many employers already facing compliance challenges with the growing number of state and local mandates." (Littler)  

DOL Issues Notice of Proposed Rulemaking to Implement Executive Order Requiring Federal Contractors to Provide Paid Sick Leave
"The requirements of EO 13706 apply only to certain categories of contracts with the federal government, and only to contracts that are 'new' on or after January 1, 2017.... The Notice proposes a narrow exemption from coverage for employees who perform work duties necessary to the performance of a covered contract but who are not directly engaged in performing the specific work called for by the contract, and who spend less than 20 percent of their hours worked in a particular workweek performing work in connection with such contracts." (Ballard Spahr LLP)  

HHS Proposed Rule Would Prohibit Gender Discrimination in Health Care
"The proposed rule applies to any health program or activity, any part of which receives funding from HHS, such as hospitals that accept Medicare patients or doctors who treat Medicaid patients... [If] a self-funded plan has an administrative-services-only contract with an insurer for benefits administration, if that insurer receives any federal funding, such as Medicare payments, that insurer is subject to Section 1557 and so is the plan[.]" (Bloomberg BNA)  

Recovering Third-Party Payments After Montanile (PDF)
"[W]hat can plan sponsors and plan administrators do to decrease the likelihood that they will end up in the same position as the board in Montanile? ... [1] Review plan subrogation and reimbursement provisions -- What does your plan say about its right to recover from third-party settlements? ... [2] Review plan procedures for pursuing reimbursement -- How does your plan respond when a participant receives a third-party settlement? ... [3] Consider adding plan language that provides a basis to seek relief under ERISA Section 502(a)(2)." (Drinker Biddle, via Bloomberg BNA Health Law Reporter)  

Igniting Worksite Wellness with Strategic Communications
"Employees can't just think about their health occasionally -- they need to consider their health year-round.... Here's what works: [1] Creating communication wellness boards ... that include information about the employee health program, wellness tips and healthy recipes. [2] Posting a one-page Stall Street Journal in company bathroom stalls with health tips. [3] Delivering leadership speaking points to managers so they can share during team meetings.... [4] Sending mailings to employees' homes four times a year to remind employees (and, in some instances, their spouses) to schedule an annual health exam or take a health assessment." (HealthFitness)  

Workplace Wellness: No Good Deed Goes Unpunished
"More employers than ever are using [workplace wellness] programs to identify, evaluate and treat health risks posed by employees, and in some cases to incentivize lifestyle changes to promote improved wellbeing and productivity. Federal policy seems to support these efforts but ... different agencies serving different interests view the landscape differently.... [E]mployers, to provide even the most basic form of wellness program, must navigate an increasingly patchworked and inconsistent array of rules, leaving them vexed and frustrated." (Ingram's Magazine)  

To Encourage Fitness: Carrots, Sticks -- or Active Design?
" 'Active design' is the process of structuring the workplace to inherently promote movement.... Some active design solutions involve extensive workspace reconstruction, but other options are simpler and less costly. [1] Taking the stairs ... [2] Provide access to natural light.... [3]Encourage face-to-face communications.... [4] Incorporate height-adjustable work surfaces." (Society for Human Resource Management [SHRM])  

The Evolution of Private Health Insurance Exchanges
"As more private exchanges have entered the employer-provided health care marketplace in recent years ... the workforce has also undergone a generational shift. These trends have shined a bigger light on creating a consumer-grade shopping experience with more choice for active employees who have limited compensation dollars to spend and want to meet their families' needs at the right price and acceptable risk levels." (Willis Towers Watson)  

Failed CO-OP Sues Feds Over Risk Corridor Shortfall
"[CMS] announced last fall that it would be able to pay insurers only 12.6 percent of what they were owed through the risk corridor program, as payments into the program from insurers came up short.... The shortfall hits smaller insurers and CO-OPS especially hard, including Health Republic in Oregon, which took a $20 million hit ... [W]hile it has ceased operating, Health Republic wants to use its experience to help other insurers recoup what they're owed through the risk corridor program ... Thus, it is trying to make its complaint into a class-action suit." (FierceHealthPayer)  

Benefits in General

ERISA Attorney Robert E. "Rob" Hoskins Dies
Prominent attorney Robert E. "Rob" Hoskins, 50, died on February 27. A partner in the Greenville, South Carolina office of Foster Law Firm, LLC, Rob handled ERISA and insurance claims involving long term disability, health insurance, life insurance, accidental death and dismemberment insurance, and pension/retirement matters before various courts including the U.S. Supreme Court. He wrote and lectured extensively on ERISA. His peers rated him as an "AV" lawyer in Martindale-Hubble. Rob was a co-administrator of, a popular forum for ERISA attorneys, where he contributed over 4,300 posts. His complete biography is online. Services in Greenville are on March 3. He will be greatly missed. (Legacy)  

Executive Compensation and Nonqualified Plans

409A's Documentation Decree: Put It in Writing
"[C]hances are, if the employer does not know an arrangement is subject to 409A, the arrangement most likely is not supported by a '409A-compliant document.' So just what constitutes a 409A-compliant document?" (Milliman Retirement Town Hall)  

Press Releases

SALGBA Challenge Winners Announced
State and Local Government Benefits Association [SALGBA]

Connect   LinkedIn logo   Twitter logo   Facebook logo, Inc.
1298 Minnesota Avenue, Suite H
Winter Park, Florida 32789
(407) 644-4146

Lois Baker, J.D., President <>
David Rhett Baker, J.D., Editor and Publisher <>
Holly Horton, Business Manager <>

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