Health & Welfare Plans Newsletter

April 21, 2016

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Employee Benefits Jobs

401(k) Plan Administrator, Full time
Benefit Associates, Inc.
in CA

Trust Accounting and Conversion Specialist
My Benefits, LLC
in GA, NY

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TPA Firm
in AZ

Defined Contribution Administrator
TPA Firm
in AZ

Defined Benefit Administrator
TPA Firm
in AZ

Retirement Plan Administrator
My Benefits, LLC
in GA, NY

Pension Analyst
My Benefits, LLC
in GA

Trust Retirement Plan Services Admin
Whitney Bank
in LA

Trust Officer
Newport Group
in MN

Sales Consultant
The Angell Pension Group, Inc.
in ANY STATE

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Webcasts and Conferences

Dollars & Sense: Health Plan Affordability for Applicable Large Employers
RECORDED
(United Benefit Advisors)

Alternatives in DC Conference
May 12, 2016 in NY
(Pensions & Investments)

Understanding the Universal Availability Rules in a 403(b) Retirement Plan
May 19, 2016 WEBCAST
(IRS [Internal Revenue Service])

Health Care Litigation Under ERISA and the ACA
June 7, 2016 WEBCAST
(ABA Joint Committee on Employee Benefits [JCEB])

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[Guidance Overview]

The ACA's Employer Shared Responsibility Determination and the Potential Employer Penalty (PDF)
25 pages. "The [ACA] creates shared responsibilities for both employers and individuals with regard to health insurance coverage.... This report examines the new employer responsibilities. To ensure that employers continue to provide some degree of health coverage, the ACA ... does not require that an employer offer employees health insurance; however, the ACA imposes penalties on a 'large' employer if at least one of its full-time employees obtains a premium credit through the newly established exchange.... The complex calculations and multiple definitions of full-time work have led to confusion among policymakers and employers. This report discusses these definitions and the application to the employer penalty in greater detail." [Report No. R43981, updated Apr. 16, 2015.] (Congressional Research Service)  


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[Guidance Overview]

Section 1332 Waivers for State Innovation and Medicaid
"Section 1332 [of the ACA] ... allows states to request waivers of Marketplace requirements in order to implement 'State Innovations' in the Marketplace. For example, a state might use an innovation waiver to expand the minimum coverage requirements for health plans... The ACA sets out four basic 'guardrails' for use of section 1332 authority. The December 2015 [CMS] Guidance elaborates on these limits: [1]The section 1332 project must cover a number of people comparable to existing coverage.... [2] The section 1332 project must not reduce affordability of coverage.... [3] The section 1332 project must provide benefits at least as comprehensive as existing benefits.... [4] The section 1332 project must be deficit neutral for the Federal budget." (National Health Law Program [NHeLP])  

Can the ACA Employer Health-Insurance Mandate Be Avoided by Reducing Employees' Hours?
"Though the Marin case calls into question whether an employer can lawfully manage the hours of its workforce in light of the increased costs of providing healthcare coverage under the ACA, it is important to note that the district court's refusal to dismiss the case does not provide an answer.... [E]mployers should carefully review, before distribution, all communications to employees regarding decisions to modify work schedules. This case demonstrates how such communications may bolster an employee's claims of discriminatory intent." (McGuireWoods LLP)  

CFOs Say Employee Health Is Strategic Business Investment, But More Tools Needed to Evaluate Its Return
"For many CFOs, attracting, retaining, and motivating performance trumps lowering costs.... There is also a focus on improving individual health through helping enrollees be better health care consumers and better manage their health with wellness programs, linking premiums to certain lifestyle factors, and offering financial incentives for wellness programs.... [O]nly 6% of CFOs are measuring a return on these investments in their health benefits and only 23% measure any outcome at all." (Grooms Benefit Solutions)  

AHIP Head Warns That ACA Premium Increases Are Coming
"Marilyn Tavenner, ... president and CEO of America's Health Insurance Programs ... says the culmination of market shifts that insurers have faced over several years will cause a stark rise in health insurance rates on Obamacare exchanges.... [T]he administration is making an effort in advance to calm fears that insurance rates will go up. They do this even as insurance representatives such as Tavenner are warning that the increases are coming." (Morning Consult)  


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ERISA Benefit Plans: Addressing and Preventing a Data Breach

Sponsored by Lorman and BenefitsLink

May 10 webinar. Learn how to prevent a plan data breach and what to do if one occurs. BenefitsLink discount.



Cigna/Anthem Not Exiting Obamacare, Unlike UnitedHealth
"UnitedHealth's decision to exit most health exchanges by 2017 ... would on the surface seem like a death knell for the [ACA]. However, other insurers have more to gain by staying put, and some are doing just that. Cigna, which currently offers plans on the public exchanges in seven states for 2016, has plans to expand.... Aetna declined to comment on UnitedHealth's decision ... However, in February Aetna's CEO Mark Bertolini ... said, 'We continue to have serious concerns about the sustainability of the public exchanges.' " (Fox Business)  

Responses to Court's Proposal for Zubik v. Burwell Still Show a Gap
"The final round of briefs in reaction to the Court's own idea for a possible compromise have now been filed ... [T]he non-profits said that the government was clinging too much to the idea, objectionable to them, that they must take a specific step to gain a separation from the process of providing contraceptives, and the government said that the degrees of separation that the non-profits demand from the source of contraceptives simply would not work in the real world of health insurance and state laws governing plans." (SCOTUSblog)  

Medicare Delays Plans for New Star Ratings on Hospitals After Congressional Pressure
"60 senators and 225 members of the House of Representatives [had] signed letters urging CMS to delay releasing the star ratings.... CMS told Congress it would delay release of the star ratings on its Hospital Compare website until [at least] July.... Mortality, readmissions, patient experience and safety of care metrics each accounted for 22 percent of the star rating, while measures of effectiveness of care, timeliness of care and efficient use of medical imaging made up 12 percent in total." (Kaiser Health News)  

Benefits in General

CBO Cost Estimate for H.R. 4294, Strengthening Access to Valuable Education and Retirement Support Act of 2015 (PDF)
"H.R. 4294, the Strengthening Access to Valuable Education and Retirement Support Act of 2015, would amend the section of the Internal Revenue Code that prohibits self-dealing transactions by fiduciaries of certain tax-favored plans, including employer-sponsored retirement plans, individual retirement accounts, and health savings accounts. The bill would add a definition of investment advice ... [and] a new statutory exemption related to investment advice that a fiduciary can provide to those tax-favored plans, plan participants, or beneficiaries.... H.R. 4294 would change requirements regarding disclosure of potential compensation accruing to the fiduciary or an affiliate.... The staff of the Joint Committee on Taxation (JCT) estimates that the bill would have a negligible effect on revenues over the 2016-2026 period. Enacting the bill would not affect direct spending." (Congressional Budget Office [CBO])  

Executive Compensation and Nonqualified Plans

Questions About Recent ISS Study on the Impact of Board Leadership Structures on CEO Pay
"ISS argues that CEOs of companies with boards chaired by an 'insider' have higher compensation than CEOs of companies with boards chaired by an 'outsider.'... To blindly follow ISS's conclusion would require shareholders to oust from the board the very leaders who have made many of these companies attractive investments in the first place and who have carefully applied the very principles that ISS espouses." (Jones Day)  

Press Releases

DOL Investigation Helps Boise Medical Employer Correct Violations in Its FMLA Protocols
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

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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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