Health & Welfare Plans Newsletter

March 7, 2016

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Webcasts and Conferences

Navigating the Pitfalls of PBM Contract Negotiation
April 12, 2016 WEBCAST
(ABA Joint Committee on Employee Benefits [JCEB])

Audit Trilogy Part II: Preparing For and Surviving a Health and Welfare Audit
April 19, 2016 WEBCAST
(ABA Joint Committee on Employee Benefits [JCEB])

NAGDCA 2016 Annual Conference
September 18, 2016 in CO
(National Association of Government Defined Contribution Administrators [NAGDCA])

View All Webcasts and Conferences


Discussions


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[Official Guidance]

Text of IRS Q&A: Employer Health Care Arrangements
Dated Mar. 4, 2016. "Q1. What are the consequences to the employer if the employer does not establish a health insurance plan for its own employees, but reimburses those employees for premiums they pay for health insurance (either through a qualified health plan in the Marketplace or outside the Marketplace)? ... Q2. Is there transition relief available from the excise tax under Section 4980D for certain employers who offered their employees health coverage through arrangements that would constitute an employer payment plan as described in Notice 2013-54? ... Q3. Where can I get more information?" (Internal Revenue Service [IRS])  


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[Guidance Overview]

From the IRS: Return Preparer Best Practices -- Resolving Information Form 1095 Conflicts (PDF)
Dated Mar. 4, 2016. "There are no special or specific due diligence requirements related to [ACA] issues or specifically to Form 1095 information returns. This document represents best practices for practitioners to gather necessary information to prepare 2015 tax returns for their clients, including information that may be helpful to demonstrate compliance with the ACA health coverage provision. General requirements on filing a complete and accurate tax return continue to apply. Preparers are expected to resolve conflicting or contradictory statements from their clients during the return preparation process, as they do today." (Internal Revenue Service [IRS])  

[Guidance Overview]

Health Care Law: Are You an Applicable Large Employer? (Video)
"If you're an employer, you need to know if you're an applicable large employer under the health care law. Learn how to determine the size of your work force and why it matters." (Internal Revenue Service [IRS])  

Form 1095-C: Why and How to Educate Your Employees
"You can think of the 1095-C as essentially a 'W-2 of benefits.' Given its impact on the health care employees and their families receive, it's vital that you educate your workers about the new tax form before it arrives (in the mail or electronically) -- and before you receive a flood of questions." (Benefitfocus)  

ERISA Shadows 'Big Time Fun' at Dave and Buster's
"Direct evidence of an employer's specific intention to interfere with benefits is generally lacking. However, D&B's numerous public statements (in addition to other evidence that may be uncovered on discovery), tying the reduction in the hours of its workforce to its anticipated costs under ACA, may constitute evidence sufficient to establish the prerequisite specific intent.... In order to counter such allegations, D&B could introduce evidence that it implemented the national reduction in hours for reasons other than health benefit costs. As noted, a collateral effect on ERISA protected benefits is permissible, as long as the sole intention of the employer's actions was not to interfere with benefits. A nationwide reduction in hours, even if made in order to manage costs, can be upheld as a fundamental business decision." [Marin v. Dave & Buster's, Inc., No. 15-3608 (S.D.N.Y. Feb. 9, 2016)] (Wolters Kluwer Law & Business)  


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Forum on Employer Health Care Reform Strategies April 10-12

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Big Win for Self-Insured ERISA Plans at Supreme Court
"New York, in an amicus curiae brief in support of the law, contended that it had already expended considerable resources towards creating its own [all payer claims database (APCD)], and was 'about a year away from launching' the database. This decision calls into question whether any future data collection/reporting laws enacted in conjunction with the creation of these APCDs by New York or other states would also be preempted by ERISA." [Gobeille v. Liberty Mutual Ins. Co., No. 14-181 (U.S. Mar. 1, 2016)] (Bond, Schoeneck & King)  

When is a Voluntary Plan Truly a Voluntary Benefit Plan?
"Voluntary benefits have been available for decades, but the whirlwind of changes in how health insurance is purchased and delivered since the implementation of the [ACA] has forced employers and employees to seek solutions to address increasing gaps in traditional health insurance plans that have created larger out-of-pocket costs. Increasingly, voluntary benefits are evolving into a meaningful option that more employers are offering to employees. Many plan sponsors might be surprised to learn that their 'voluntary plans' are not truly voluntary under [ERISA], and that, consequently, the sponsors have not met their ERISA compliance obligations." (Ascende)  

DOL Goes to Work on Federal Contractor Sick Leave
"DOL's proposed rule for federal contractors ... is applicable to new or renewed contracts beginning in 2017.... While several of the key provisions were already defined by the president in the executive order, the regulation now clarifies that the leave mandate would apply to an expansive list of contractors." (Bloomberg BNA)  

Health Insurance Plans to be Rated by Network Size
"The Obama administration, responding to consumer complaints, says it will begin rating health insurance plans based on how many doctors and hospitals they include in their networks.... [I]nsurers will still be allowed to sell health plans with narrow networks of providers. But consumers will know in advance what they are getting because the government will attach a label indicating the breadth of the network for each plan sold on HealthCare.gov." (The New York Times; subscription may be required)  

Benefits in General

Recent Employer Stock and Other Fiduciary Litigation (PDF)
43-page outline of March 4 presentation to the 2016 Plan Administrator Skills Workshop, Southwest Benefits Association. Includes detailed discussion of many recent employer stock cases, along with significant fiduciary litigation about retirement and health benefit plans. (Utz & Lattan, LLC)  

Supreme Court Reaffirms ERISA Preemption Doctrine
"The concurrences and dissent suggest that the Court is not finished wrestling with the ERISA preemption doctrine. Justices Ginsburg and Sotomayor seem inclined to take a narrow view of ERISA preemption, and Justice Breyer a potentially narrower view of preemption than the majority, while Justice Thomas would question even the constitutionality of ERISA's preemption provision. Justice Breyer's approach in Gobeille might not support ERISA preemption if there is not a ready regulatory workaround (for example, a DOL regulatory exception)." [Gobeille v. Liberty Mutual Ins. Co., No. 14-181 (U.S. Mar. 1, 2016)] (Morgan Lewis)  

Press Releases

Christine Marcks Named 2015 EBRI Lillywhite Award Winner
EBRI [Employee Benefit Research Institute]

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2016 BenefitsLink.com, 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 BenefitsLink.com, 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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