Health & Welfare Plans Newsletter

April 15, 2016 logo logo LinkedIn logo Twitter logo Facebook logo
Get Retirement News | Advertise | Previous Issues | Search

Employee Benefits Jobs

Relationship Manager
John Hancock Retirement Plan Services

Retirement Plan Specialist
Burr Pilger Mayer
in CA

Advisor Services Consultant/Manager
NJ Based-Employee Benefit & Retirement Services Firm
in NJ

Post Your Job

View All Jobs

RSS feed for jobs RSS Feed: All Jobs

Webcasts and Conferences

New, Holistic Way to Look at Defined Benefit Plan Termination Strategies
(University Conference Services)

Innovative Strategies to Manage the Cost of Specialty Drugs
(University Conference Services)

ACA is Here to Stay: Where Do We Go From Here?
April 28, 2016 in OH
(Worldwide Employee Benefits Network [WEB] - Cleveland Chapter)

ESOPs: A Briefing for Professional Advisors
May 4, 2016 WEBCAST
(Beyster Institute)

View All Webcasts and Conferences

Post Your Event


Subscribe Now to This Newsletter (free)

We also publish the BenefitsLink Retirement Plans Newsletter (free): Subscribe Now

[Official Guidance]

Text of CMS Guidance on Data Submission Deadline for CSR Reconciliation (PDF)
Unnumbered memo, dated Apr. 15, 2016. "Data submission to determine the reconciliation of cost-sharing reductions provided for the 2014 and 2015 benefit years began on April 1, 2016. To ensure the accuracy of data submission, and to accommodate issuers that are submitting data for both the 2014 and 2015 benefit years for the first time, CMS will extend the final deadline for submission of 2014 and 2015 cost -sharing reduction reconciliation data to Friday, June 3, 2016 at 11:59 pm EDT." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  


ECFC: Advancing Healthcare Consumerism

Sponsored by ECFC [Employers Council on Flexible Compensation]

In its 35th year, ECFC is the leading organization promoting choice in benefit solutions by working together through education and advocacy to put a consumer-driven account into the hands of everyone. To join, visit

[Guidance Overview]

How Recent Cybersecurity Government Publications Impact HIPAA Security Compliance and the New Audit Initiative
"Covered entities need to be checking their email filters to catch emails sent and caught by the filters or sent to former employees or email addresses that may not be currently monitored by an employee (e.g., an email for an employee out on a leave or vacation) to ensure they capture any email that was sent to initiate one of these reviews. Since the OCR will continue to use an email until they are corrected, a covered entity that does not check for emails that might be lost in their system will be doing so at their own peril. Failure to respond to the initial request will not relieve one from the audit or compliance review." (Winstead PC)  

[Guidance Overview]

Paid Leave Laws and Challenges for Employers (PDF)
42 presentation slides. Topics: [1] Intersection of paid leave laws and ERISA; [2] Overview of state and municipal paid family medical and sick leave laws; [3] Federal legislative activity; and [4] Employer considerations/strategies. (Groom Law Group, for American Benefits Council)  

[Guidance Overview]

GASB's Updated Accounting Standards for Other Postemployment Benefits (OPEB) (PDF)
"This publication summarizes the key requirements in the updated statements, which are intended to provide a more comprehensive picture of the costs associated with state and local governments' OPEB benefits. It also notes some of the implications. As a result of the changes, which are generally very similar to the changes GASB proposed in Exposure Drafts published in 2014, sponsors of public sector plans will face significant additional work in order to prepare their financial statements." (Segal Consulting)  

Structuring Wellness Program Incentives
"A quarter of [the participants] were a part of the game arm ... [They would be paid] $1.40 for each day they met their goal once the study was completed. Then, there was a lottery arm ... where the subjects could win money for the days they met their goal. There was also a loss-framing arm, in which on Day One of every month for three months ... $42.00 [was] placed in a virtual account for them, and for every day that they didn't meet their goals, ... $1.40 [was deducted from] that account.... The loss arm achieved their goal about 45% of the time, which was 15% higher than the control group.... The lottery arm achieved their goal 35%-36% of the time, which is ... statistically no different from not paying them at all[.]" (HealthLeaders Media)  


Family and Medical Leave Guide

Sponsored by Wolters Kluwer

This guide answers those complex issues that arise as leave is being administered day-by-day. It provides a clear understanding of how the FMLA works and how you can be compliant. Use code BENEFIT20 for 20% discount.

Congress Considers Capping Health Care Tax Break for Employers
"[House Ways & Means committee chairman Kevin Brady, (R-Tex.)] contended that the tax break limits the number of choices available to employees who might want to shop for a health care plan that might better fit their needs, and the tax break may also contribute to higher costs.... However, the employer exclusion also had its defenders on the committee, including the ranking Democrat, Rep. Sander Levin, D-Mich., who called the Republican proposal another in a long series of attempts to undermine the [ACA]'s expansion of health care coverage." (Accounting Today)  

Both Parties Will (at Least) Discuss Employer Health Taxes
" 'The best way to expand health insurance choices for individuals is to truly equalize the treatment of employer purchased and individually purchased coverage,' said Avik Roy, a senior fellow at the Manhattan Institute and a witness at the hearing. The Cadillac tax was supposed to help with that problem by encouraging employers to select reasonably priced health plans. It's hard to know if that's happened because of its delay in implementation. But delaying the tax doesn't address the fundamental concerns with it." (Morning Consult)  

Insurers Warn Losses from Obamacare Are Unsustainable
"Insurers say they are losing money on their ObamaCare plans at a rapid rate, and some have begun to talk about dropping out of the marketplaces altogether.... While analysts expect the market to stabilize once premiums rise and more young, healthy people sign up, some observers have not ruled out the possibility of a collapse of the market, known in insurance parlance as a 'death spiral.' In the short term, there is a growing likelihood that insurers will push for substantial premium increases[.]" (The Hill)  

Senator Introduces Bill Requiring HHS to Pay Over $5 Billion to Treasury Department
"Sen. Ben Sasse, R-Neb., introduced a bill Thursday that would force the Obama administration to deposit $5 billion in the Treasury by 2017 as required under Obamacare's reinsurance program or face steep cuts to its departmental management fund this year and next year. Called the 'Taxpayers Before Insurers Act,' Sasse's legislation codifies penalties for [HHS] should it choose to again divert billions of dollars in reinsurance payments intended for the U.S. Treasury to insurers.... In February, the Congressional Research Service ... concluded that the [CMS]' interpretation of the [ACA's reinsurance program] appeared to be "in conflict with a plain reading of [the ACA]," and said the agency should have been able to pay a share to the Treasury." (The Daily Signal)  

Beyond Obamacare: Colorado Considers Single-Payer Model
"As Republican policymakers nationwide continue debating ways to replace Obamacare with patient-centered solutions, a Colorado group has landed a plan implementing a single-payer model of health care on November's ballot.... In the general election, Colorado residents will ... weigh in on a controversial ballot measure: Amendment 69, which would create a government-run health care plan in the Centennial State." (The Daily Signal)  


HHS Could Effectively Kill HSAs in the Exchange
"Middle-class Americans cannot afford exchange coverage; about 82 percent of Obamacare enrollees are those who receive subsidies. This figure is likely to climb to 100 percent within a few years.... The cost of coverage is high, and it fails to cover the average family's medical bills.... HHS issued regulations in March that ... [include requirements] that exchange plans must have deductibles and out-of-pocket limits that likely precludes them from being HSA-eligible.... The [IRS] has yet to issue its own rules on eligible deductibles and out-of-pocket limits for 2017. But since by law these are only supposed to be adjusted for consumer inflation, the IRS doesn't have much leeway to make exchange plans HSA-compliant[.]" (National Center for Policy Analysis Health Policy Blog)  


ERIC Highlights Importance of Employer-Sponsored Health Plans Before Congress
"[In its testimony ERIC] stressed the vital role employer-sponsored plans play in developing and implementing efforts to increase health care quality, including offering onsite health clinics that allow employees to receive care immediately; telehealth initiatives that provide employees and their families access to high-quality care no matter where they live; employer efforts in pioneering wellness programs, coordination of care; and other medical innovations." (The ERISA Industry Committee [ERIC])  

Benefits in General

In California, a Vested Right to a Benefit Does Not Create a Vested Right to the Benefit at the Same Terms in Effect at Any Time
"In 1975, the [Los Angeles] City Council passed [an ordinance] to implement the authorized subsidy program [that would help public service employees pay for their health insurance].... In 2005, the Charter sections governing the subsidy program were amended to eliminate the cap on the maximum monthly subsidy ... [In] 2011, the City Council passed [an ordinance] freezing the maximum subsidy.... Four employees in the fire and police departments [sued and] alleged that the City had not reserved the right to freeze the subsidy ... The trial court ... rejected the assertion that there was a vested right to the subsidy increases." (Liebert Cassidy Whitmore)  

First Circuit: Benefit Denial Letters Must Explain Plan's Deadline for Filing a Lawsuit
"The plan administrator had argued that the DOL regulations only required notice of the time limits for a plan's internal appeal processes and not the deadline for filing a lawsuit. The First Circuit, however, rejected this argument, finding that there was no authoritative guidance to support this interpretation of the DOL regulations." [Santana-Diaz v. Metropolitan Life Ins. Co., No. 15-1273 (1st Cir. Mar. 14, 2016)] (The Wagner Law Group)  

Press Releases

ERIC Advances Telehealth Initiative
ERIC [ERISA Industry Committee]

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 <>

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.

Links to web sites other than and are offered as a service to our readers; we were not involved in their production and are not responsible for their content.

Privacy Policy