Health & Welfare Plans Newsletter

March 24, 2016

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Employee Benefits Jobs

Retirement Plan Business Development Officer
Chemical Bank
in MI

Pension Plan Administrator
DeMars Pension Consulting Services, Inc.
in KS

ESOP Administrator
Verisight
in IA

Compliance Specialist II
Newport Group
in FL

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Webcasts and Conferences

OCR Launches HIPAA Phase 2 Audits: Are you Prepared?
April 5, 2016 WEBCAST
(Morgan Lewis & Bockius LLP)

ACFC Exam Preparation Session 1: TPA Liability
April 6, 2016 WEBCAST
(ECFC [Employers Council on Flexible Compensation])

Washington Update and Helping Your Client Understand Their Fiduciary Duties
April 7, 2016 in TX
(ASPPA Benefits Council [ABC] of Central Texas)

Trends in Retirement Investing
April 20, 2016 in MO
(ASPPA Benefits Council [ABC] of Gateway St. Louis)

ACFC Exam Preparation Session 2: Best Practices
April 20, 2016 WEBCAST
(ECFC [Employers Council on Flexible Compensation])

Fiduciary Discussion with the DOL
April 21, 2016 in CT
(Worldwide Employee Benefits Network [WEB] - Hartford Chapter)

State-Sponsored Savings and Retirement Plans for Private Employers
April 21, 2016 in CA
(Western Pension & Benefits Council - Orange County Chapter)

50th Anniversary All Day Seminar
May 3, 2016 in KY
(ASPPA Benefits Council [ABC] of Greater Cincinnati)

Day At The Races: 2016 Employee Benefits Update
May 13, 2016 in IL
(JMM CPA)

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[Guidance Overview]

Spotlight on Hours of Service and ADA Under ACA Employer Mandate
"The IRS has not clarified how many hours an employer must count during short-term or long-term disability leave. For example, if an employee out on disability receives 60% of pay, can the employer credit 60% of the hours he or she would have reasonably been expected to work during that month (or 60% of the hours the employee averaged before the onset of disability)?" (Willis Towers Watson)  


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Employer's Guide to Health Care Reform, 2016 Edition

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Transcript of Oral Argument Before the Supreme Court in Zubik v. Burwell (PDF)
108 pages. Issue: Whether the HHS contraceptive-coverage mandate and its 'accommodation' violate the Religious Freedom Restoration Act by forcing religious nonprofits to act in violation of their sincerely held religious beliefs, when the government has not proven that this compulsion is the least restrictive means of advancing any compelling interest. [Zubik v. Burwell, Nos. 14-1418 et al. (3d Cir. Feb. 11, 2015; cert. pet. granted Nov. 6, 2015; argued Mar. 23, 2016)] (Supreme Court of the United States)  

On New Health Care Case, a Single Word May Tell It All
"[A]mong the four in the majority in the Burwell v. Hobby Lobby Stores decision was Justice Kennedy, and he had made a considerable effort then to make that ruling seem quite narrow. In fact, in a separate opinion then, he openly endorsed the technique the government had used for non-profit religious institutions, to allow them to opt out of the birth-control mandate, and suggested it would work for for-profit companies, too. But that is the very 'accommodation' approach that, on Wednesday, he labeled a form of 'hijacking' of non-profits' health plans." [Zubik v. Burwell, Nos. 14-1418 et al. (3d Cir. Feb. 11, 2015; cert. pet. granted Nov. 6, 2015; argued Mar. 23, 2016)] (Lyle Denniston, for SCOTUSblog)  

Views on Employment-based Health Benefits: Findings from the 2015 Health and Voluntary Workplace Benefits Survey (PDF)
"This analysis examines workers' opinions surrounding employment-based health coverage. It uses data from the 2013-2015 Health and Voluntary Workplace Benefits Survey (WBS), conducted by the Employee Benefit Research Institute (EBRI) and Greenwald & Associates, as well as historical data from the Health Confidence Survey (HCS). Both surveys examine a broad spectrum of health care issues, including workers' satisfaction with health care today, their confidence in the future of the nation's health care system and the Medicare program, as well as their attitudes toward workplace benefits." (Employee Benefit Research Institute [EBRI])  

The Excise Tax on High-Cost Health Plans (PDF)
"[This article summarizes an EBRI policy forum held on Dec. 10, 2015] to discuss 'The Excise Tax on High-Cost Health Plans' -- both to clarify what the tax would do and how employers and health-plan sponsors are reacting to it.... [D]espite the delay in the effective date of the so-called 'Cadillac tax ' on high-cost health plans, the tax has already been causing changes, as many employers have begun reducing benefits or shifting costs now to avoid the tax if and when it later goes into effect." (Employee Benefit Research Institute [EBRI])  


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April 8 webinar -- Identify the right strategy to successfully implement and integrat a HDHP into your firm. Learn the steps you will need to consider prior to implementing a plan and what do to ensure a successful post-implementation. BenefitsLink discount.



If Only the Claims Were Clean: Payers, Providers Lose Big on Inaccuracies, Poor Workflows
"While error rates for commercial health insurers for paid medical claims dropped significantly from nearly 20 percent in 2010, to 7.1 percent in 2013, more than $43 billion could have been saved if commercial insurers consistently paid claims correctly ... In 2013, Medicare led all insurers with an accuracy rating of 98.1 percent, followed by UnitedHealthcare at 97.5 percent, Humana and Cigna at 96.5 percent each, Aetna at 96 percent, Anthem at 90 percent and Regence at 85 percent[.]" (Healthcare Finance News)  

Health Insurance Coverage and Health Care Access and Affordability in Massachusetts: 2015 Update (PDF)
56 pages. "The 2015 [Massachusetts Health Reform Survey (MHRS)] highlights sustained gains in health insurance coverage since the passage of Massachusetts' 2006 health care reform law, as well as persistent gaps in health care access and affordability for many of those with insurance coverage. Low-income adults and those with health problems tend to be disproportionately impacted by these gaps. The survey findings are a reminder that the goals of health care reform are not fully achieved by simply reducing the number of people who are uninsured." (Blue Cross Blue Shield of Massachusetts Foundation and Urban Institute)  

[Opinion]

House Committee Letter to CMS: Proposed Transitional Reinsurance Payments Violate ACA, Must Be Redeposited Into General Fund (PDF)
"The statute does not provide CMS with any discretion over whether it can prioritize health insurers over taxpayers.... When asked about the legal basis for diverting these funds at a February 24, 2016, hearing before the Energy and Commerce Committee, [HHS] Secretary Sylvia Burwell provided no legal justification for these payments.... This latest payoff comes on top of the estimated $7.17 billion-and counting-in unlawful payments made to insurance companies under Obamacare's cost sharing reduction program.... CMS should immediately cease all illegal payments consistent with the law and submit them to the Treasury without delay." (Energy & Commerce Committee, U.S. House of Representatives)  

Benefits in General

Benefits Litigation Update, Spring 2016 (PDF)
9 pages. Articles include: [1] The oddity of an evenly divided Supreme Court; [2] Bell v. Anthem: Fee litigation and fiduciary responsibility; [3] EEOC v. Flambeau: ADA benefit plan safe harbor trumps EEOC wellness program voluntariness attack; [4] ADA investigations: Do your benefit websites make you a disability discrimination litigation target? [5] Supreme Court narrows plans' subrogation remedies; [6] Gallo v. Moen Inc.: Progress in repudiating Yard-Man; [7] Marin v. Dave & Buster's: ERISA class action exposure from reducing employees' hours; and [8] Group health plan's residential treatment exclusion violates Mental Health Parity Act. (Epstein Becker Green & The ERISA Industry Committee [ERIC])  

The Fundamentals of Benefits Management Tech, Part 2
"Technology doesn't add value if it's too difficult to operate. Poor user experiences can discourage engagement, create confusion and result in costly errors. Look for a vendor whose technology, while powerful, is designed with the end user in mind, providing an intuitive environment for employees (and administrators) to complete benefits-related tasks." (Benefitfocus)  

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Lois Baker, J.D., President <loisbaker@benefitslink.com>
David Rhett Baker, J.D., Editor and Publisher <davebaker@benefitslink.com>
Holly Horton, Business Manager <hollyhorton@benefitslink.com>

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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