401(k) Plan Administrator
Alliance Pension Consultants, LLC
in IL

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Daunting, but Doable: Preparing for the Next Round of HIPAA Audits
RECORDED
(McAfee & Taft)

Final Fiduciary Regulations, Part 1: Who is a Fiduciary Advisor?
May 26, 2016 WEBCAST
(FIS Relius Education)

Higher Ed, Higher Healthcare Costs
May 31, 2016 WEBCAST
(Cammack Health)

Final Fiduciary Regulations, Part 2: Navigating the BIC and more
June 2, 2016 WEBCAST
(FIS Relius Education)

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[Official Guidance]

Text of CMS Final Regs: Amendments to Special Enrollment Periods and the Consumer Operated and Oriented Plan (CO-OP) Program
43 pages. "This interim final rule with comment amends the eligibility requirements of the special enrollment period for individuals who gain access to new QHPs as a result of a permanent move so that this special enrollment period is generally available only to those individuals who had minimum essential coverage prior to their permanent move.... [This rule also amends] certain CO-OP governance requirements to provide greater flexibility and facilitate private market transactions that can provide access to needed capital. These amendments will permit a CO-OP to recruit potential directors from a broader pool of qualified candidates." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

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WEB members represent more than 25 professions and 30 areas of expertise within the pension and benefits industry-including administrators, consultants, attorneys, accountants, investment managers, communications experts and benefits managers. Join today.

[Guidance Overview]

Text of CMS Fact Sheet: Changes to Marketplace Special Enrollment Periods and CO-OP Structures (PDF)
"HHS is tightening the rules for certain special enrollment periods and making clear that SEPs are only available in six defined and limited types of circumstances.... The IFC also makes several changes to the regulations governing the CO-OP program that are intended to enhance the ability of CO-OPs to attract investors and develop new relationships that we anticipate will support their short and long-term financial viability." [Undated and unnumbered document published online May 6, 2016.] (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

CMS Acts on Special Enrollment Periods, CO-OPs
"Insurers have objected that [current rules] has given consumers who failed to enroll in coverage during open enrollment and then find that they are in need of medical care the opportunity to establish eligibility for coverage simply by moving to a new address (or claiming to have done so). Under the amended SEP, most individuals who move will (as of July 11, 2016) be eligible for an SEP only if they have been enrolled in coverage for at least one day during the previous sixty days." (Health Affairs)  

[Guidance Overview]

Health Reimbursement Arrangements: Death by a Thousand Cuts (PDF)
"[T]o qualify as integrated, an HRA must meet the following four requirements: [1] The employer offers other group coverage to the employee ... [2] The employee covered by the HRA is actually enrolled in group coverage in addition to the HRA ... [3] The HRA's reimbursements are limited to ... co-payments, coinsurance, deductibles and premiums under the other group coverage, [and/or] medical care that does not constitute an 'essential health benefit' under the ACA ... [4] The HRA permits a covered employee or former employee to choose, at least annually, to permanently opt out of the HRA." (Lockton)  

Medical Stop Loss Captives: Issues and Answers (PDF)
11 pages. "Increasing familiarity with alternative financing options, coupled with increasing ACA regulatory discomfort, are probably responsible for this rise in the comfort level employers now feel with regard to stop loss captives. As a result, the same alternative-risk financing techniques that, for decades, were used to reduce the cost of casualty risks, have recently found a new degree of popularity within self-funded healthcare programs." (QBE)  

[Advert.]

National Employee Well-Being Congress – July 26-27

Employee well-being and engagement thought leaders meet for peer-to-peer knowledge exchange; to address the overarching issues facing all employers; and to learn about innovative, sustainable cultures of health. Use code BLINK2 to attend for $195.

Private Health Insurance Exchanges: Early Evidence and Implications for the Future
"This report examines how private exchanges function, how they may affect employers and employees, and the possible implications for the [ACA]'s Small Business Health Options Program (SHOP) Marketplaces.... To the extent that private exchanges encourage workers to enroll in less-generous plans, the exchanges could expose workers to higher out-of-pocket costs. The modeling results suggest that, while moving to less-generous plans (60-percent actuarial value) increases consumers' out-of-pocket costs, premium contributions drop substantially, for a net decrease in average employee spending. However, average employee spending may increase if firms decrease their health insurance contributions when moving to private exchanges." (RAND Corporation)  

Value-Based Mental Health May Be 'Gold' for Insurers
"News that one of the nation's largest health insurance companies is pursuing an evidence-based approach to substance abuse treatment and opioid addiction could potentially speed up the slow march away from fee-for-service mental health treatment. But Cigna and other health insurers that escalate their shift to value-based payments could reap a potential bonanza by reimbursing psychiatrists and other mental health providers based on how they improve the care of their patients, mental health advocates say." (Forbes)  

What Are the Current Costs and Outcomes Related to Mental Health and Substance Abuse Disorders?
"The 2014 National Survey on Drug Use and Health (NSDUH) found that about 43.6 million adults (18.1%) in the United States had any mental illness in the past year (including mental, behavioral, or emotional disorders, but excluding developmental and substance use disorders). Mental illness was more prevalent among women (21.8%) than men (14.1%), and occurred among about a fifth of adults ages 18 to 25, as well as a fifth of adults ages 26 to 49." (Kaiser Family Foundation)  

Expansion of HIPAA Audit Program Now Underway
"What can you do to prepare yourself for the possibility of an audit? ... [1] A documented assessment and rating of potential risks and vulnerabilities to electronic protected health information ... that has been updated within the last year ... [2] An ongoing internal risk management plan to mitigate the identified risks and vulnerabilities ... [3] Gather and organize documentation of your entity's compliance activities ... [4] Review and update ... your HIPAA privacy, security and breach notification policies and procedures, as well as a listing of business associates and contact information, and your notice of privacy practices[.]" (McAfee & Taft)  

Drivers of 2017 Health Insurance Premium Changes (PDF)
"This issue brief outlines factors underlying premium rate setting generally and highlights the major drivers behind why 2017 premiums could differ from those in 2016.... [1] Underlying growth in medical costs ... [2] Sunset of reinsurance program funds ... [3] Changes in the risk pool composition and insurer assumptions ... [4] Health insurer fee ... [5] Repeal of expansion of the small group market ... [6] Changes in provider networks ... [7] Benefit package changes ... [8] Risk margin changes ... [9] Market competition ... [10] Changes in provider competition and reimbursement structures ... [11] Changes in administrative costs ... [12] Changes in geographic factors." (American Academy of Actuaries)  

Bipartisan Focus on Dependent Care FSAs, 529 Plans, and FMLA for Veterans; Republicans Mull ACA Future (PDF)
"Bipartisan legislation encouraging college savings through employer matching contributions and tax credits, raising the maximum exclusion for dependent care assistance programs and accelerating access to FMLA leaves for veterans was introduced. However, repealing and replacing the ACA remains a top priority for Republicans." (Xerox HR)  

DOL Offers Grants to Help States Boost Paid Leave Availability
"On May 5. 2016, [DOL] Secretary Thomas Perez announced the Department's Woman's Bureau is making available $1 million in grant funds for use in helping states, U.S. territories and possessions, counties and cities with at least 50,000 residents ... to fund the cost of developing and implementing paid family and medical leave programs ... [This is the] third year that the Department has offered such grants[.]" (Solutions Law Press)  

[Official Guidance]

Text of Revised Proposed Regs on Dodd-Frank Provisions Regulating Incentive Compensation Arrangements by Certain Financial Institutions (PDF)
488 pages. "Notwithstanding the recent progress [since the time that proposed regulations where issued in 2011], incentive-based compensation practices are still in need of improvement, including better targeting of performance measures and risk metrics to specific activities, more consistent application of risk adjustments, and better documentation of the decision-making process. Congress has required the Agencies to jointly prescribe regulations or guidelines that cover not only depository institutions and depository institution holding companies, but also other financial institutions.... [T]he Agencies are proposing a uniform set of enforceable standards applicable to a larger group of institutions supervised by all of the Agencies." (U.S. Securities and Exchange Commission [SEC], U.S. Department of the Treasury, Federal Reserve System, Federal Deposit Insurance Corporation [FDIC], Federal Housing Finance Agency, and National Credit Union Administration)  

President Names Henry C. Eickelberg to PBGC Advisory Committee
PBGC [Pension Benefit Guaranty Corporation]

Committee Chairman Kline and Ranking Member Scott Joint Statement on Multiemployer Pensions
U.S. House Committee on Education and the Workforce

ICMA-RC Announces Fund Restructuring
ICMA-RC

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