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Compensation & Benefits - Section 162(m) & Compensation Planning
June 8, 2016 WEBCAST
(Winstead PC)

ERISA Cases in the Supreme Court: What the Court’s 2016 Term Means for Your Plan
June 22, 2016 in IL
(Worldwide Employee Benefits Network [WEB] - Chicago Downtown Chapter)

IRA Basics
July 21, 2016 WEBCAST
(Ascensus)

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Today's Discussions on the BenefitsLink Message Boards

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[Official Guidance]

Text of DOL/HHS Checklist: Plan or Policy Non-Quantitative Treatment Limitations That Require Additional Analysis to Determine Mental Health Parity Compliance (PDF)
"Language contained in [provisions listed in this checklist] (absent similar restrictions on med/surg benefits) can serve as a red flag that a plan or issuer may be imposing an impermissible [Non-Quantitative Treatment Limitation (NQTL)]. Further review of the processes, strategies, evidentiary standards, or other factors used in applying the NQTL to both [Mental Health or Substance Use Disorder (MH/SUD)] and med/surg benefits will be required to determine parity compliance. Note that these plan/policy terms do not automatically violate the law, but the plan or issuer will need to provide evidence to substantiate compliance. The categories and examples [listed in this document] are not exhaustive and are not a substitute for any regulations or other interpretive guidance issued by the Departments." (U.S. Department of Labor [DOL] and U.S. Department of Health and Human Services [HHS])  

[Advert.]

Employer's Guide to Health Care Reform, 2016 Edition

This practical guide helps you design your employee health plans to satisfy ACA requirements; minimize penalty exposure; achieve significant cost-savings; understand new notice requirements; meet deadlines and more! Use code BENEFIT20 for 20% discount.

[Official Guidance]

Text of CMS Notice: Effectuation of 2016 Federally-Facilitated Marketplace Dental Enrollment (PDF)
Unnumbered document, dated June 1, 2016. "This bulletin announces that CMS will effectuate all remaining aged 2016 initial dental enrollment for policies without advance payments of the premium tax credit (APTCs) before the September 2016 payment cycle.... Issuers should submit complete and accurate monthly enrollment reconciliation files to CMS to effectuate all active enrollments, and to cancel any initial enrollments for which consumers have not paid their premiums, before the September payment cycle." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

IRS Employer Shared Responsibility Provision Estimator
"The Taxpayer Advocate Service developed the Employer Shared Responsibility Provision (ESRP) Estimator to help employers understand how the provision works and learn how the provision may apply to them.... If you are an employer, you can use the estimator to determine: [1] The number of your full-time employees, including FTEs, [2] Whether you might be an applicable large employer, and [3] If you are an applicable large employer, an estimate of the maximum amount of the potential liability for the employer shared responsibility payment that could apply to you based on the number of full-time employees that you report if you fail to offer coverage to your full-time employees.... This estimator is designed only for 2016 and forward." (Taxpayer Advocate Service, Internal Revenue Service [IRS])  

[Guidance Overview]

Facts About the Small Business Health Care Tax Credit
"The credit is available to eligible employers for two consecutive taxable years beginning in 2014 or later. You may be able to amend prior year tax returns to claim the credit for tax years 2010 through 2013 in addition to claiming this credit for those two consecutive years. You can carry the credit back or forward to other tax years if you do not owe tax during the year." (Internal Revenue Service [IRS])  

[Guidance Overview]

IRS Says Certain Wellness Program Rewards Cannot Be Provided Tax-Free
"The promoters claim that, by employees reducing their pay, the employer saves on employment taxes and the employees save on both employment and income taxes; yet, because of the ACA, the plan can provide a tax-free reimbursement of a significant portion of the employees' wellness premiums so that the employees do not see a reduction in their net take-home pay. In a Chief Counsel Advice memorandum, the IRS determined that the coverage provided by the wellness program plus the health screenings and other medical care provided are excludable from the employees' incomes. However, the IRS stated that any cash or cash-equivalent rewards, as well as the wellness premium reimbursement, are includable in the employees' gross incomes and subject to the FICA and income tax withholding rules." (RSM US)  

[Advert.]

Innovations in Wellness and Population Health Management - July 25-26, 2016 - Boston, MA

Health plans discuss implementation/sustainability of wellness programs, engaging consumers, incentives, & privacy. Promo Code BLINK2 takes $200 off your registration (May not combine w any other offer. Invalid twd Govt Rate/Workshop Only/Webcast

[Guidance Overview]

EEOC Issues New Guidance on Employee Wellness Programs
"An employee wellness or health program must be 'reasonably designed to promote health or prevent disease'; this criterion is evaluated case-by-case based on the relevant facts and circumstances. Of note, programs that would not meet this standard are those that measure, test, screen or collect information but do not provide any follow-up advice as to how to improve health or prevent disease. A program designed to provide the employer with information to estimate future health care costs also does not meet this standard." (Wilson Elser)  

[Guidance Overview]

New EEOC Regs Provide Roadmap for Wellness Programs
"After years of uncertainty, the final regulations provide welcome clarity on the requirements for wellness programs -- at least under federal law.... In particular, employers will need to assess the value of prizes that they offer for participating in wellness programs, to make sure they stay below the 30% cap. Also, now that the rules are more clear, employers might wish to revisit incentives in the form of premium subsidies." (Proskauer's ERISA Practice Center)  

[Guidance Overview]

EEOC's Final ADA Regs on Wellness Programs (PDF)
14 pages. "The final ADA regulations attempt to align the ADA's wellness program rules with HIPAA's wellness program rules; however, there are differences ... For example, the final ADA regulations apply to a broader scope of wellness programs.... The rules apply without regard to whether the wellness program is limited to employees enrolled in the employer's group health plan. Consequently the new rules apply to wellness programs offered to all employees -- even those not enrolled in the employer's group health plan and programs offered by employers that do not offer any health coverage." (Alston & Bird LLP)  

[Guidance Overview]

Minneapolis Becomes Only City in Midwest to Mandate Paid Sick and Safe Leave
"To help new businesses manage costs, the Ordinance allows new employers ... to provide unpaid sick and safe time for the first 12 months after hiring their first employee, regardless of the number of employees they hire during the first year. After 12 months, the employer must provide paid sick and safe time if it employs six or more employees. Beginning on July 1, 2022, new employers will no longer receive this 12-month grace period." (Littler)  

Recent Settlement Highlights the Need for HIPAA Business Associate Agreements
"If you are a health plan sponsor ... [p]ay particular attention to vendors who may have access to PHI ... e.g.: [1] Document disposal services if some of the documents contain PHI; [2] Providers of cloud and other off-site data storage facilities; [3] Technicians that may have access to PHI while troubleshooting or fixing computer software.... [An] employer with a fully insured health plan may still have business associates acting on behalf of a plan if: [1] It uses a broker that obtains PHI in order to quote coverage. [2] It has a Health FSA. [3] It has an HRA. [4] It has certain types of wellness or employee assistance programs." (Compliance Dashboard)  

The Sessions-Cassidy Bill: An ACA Alternative Spelled Out in Legislative Language
"The [Healthcare Accessibility, Empowerment, and Liberty Act of 2016] is a bold and unconventional proposal.... It would repeal the individual and employer mandates and a number of the consumer protections of the ACA, but would leave much of the infrastructure in place, including the ACA's marketplaces and income-based premium tax credits ... It does promote health savings accounts (HSAs), but 'Roth' HSAs with back-end tax benefits rather than traditional HSAs with front-end benefits." (Health Affairs)  

Beyond UnitedHealthcare: How Are Other Publicly Traded Insurers Faring on the Marketplaces?
"[The authors] reviewed the first-quarter earnings calls and regulatory filings of some of the largest, publicly traded insurers that participate in the marketplaces.... Insurers aren't heading for the exits.... Marketplace membership remains stable.... Many insurers see opportunities for growth.... Risk pools continue to evolve, but some are experiencing a healthier mix than others.... Challenges persist." (The Commonwealth Fund)  

Promoting Value for Consumers: Comparing Individual Health Insurance Markets Inside and Outside the ACA's Exchanges
"For 2016, insurers project that only 17 percent of their anticipated 15 million ACA-compliant subscribers will purchase plans sold off of exchanges. There has been a steady decline of projected nonexchange enrollment since 2014 ... [P]remiums increased somewhat more for plans sold off of the exchanges than for those sold on them ($48 vs. $40 per member per month). In large part, this lower premium increase among exchange plans appears attributable to a shift of enrollment toward HMO and 'exclusive provider organization' (EPO) plans[.]" (The Commonwealth Fund)  

[Guidance Overview]

IRS Rules Clarify Self-Employment Tax Treatment of Partners: Possible Impact on Employee Benefit Plans
"As a result of these clarifications, partnerships and LLCs that have been characterizing certain partners as 'employees' of a disregarded entity will have to re-characterize them as partners for self-employment tax purposes (thus reporting their income on a Form K-1, rather than Form W-2).... Partners in a partnership are not permitted to participate in cafeteria plans (including medical and dependent care flexible spending accounts) under Code Section 125 and in qualified transportation expense plans under Code Section 132." (Sherman & Howard)  

Court Finds Temporal Proximity Alone Is Not Sufficient to Support ERISA Discrimination Claim
"A recent decision district court ruling affirms that in a benefit discrimination claim, just as in a typical claim of employment discrimination, to survive summary judgment a plaintiff must demonstrate that a defendant's given lawful reason for taking an adverse action was pretext. Temporal proximity between an adverse action and an enrollment in an ERISA plan (without more), is insufficient to overcome an employer's legitimate, nondiscriminatory reason for the termination." [Francis v. South Central Houston Action Council Inc., No. 14-1277 (S.D. Tex. Apr. 25, 2016)] (Seyfarth Shaw LLP)  

Fringe Benefit Group Consolidates Entities
Fringe Benefit Group

Trucker Huss Opens Southern California Office
Trucker Huss

American Funds Launch Target-Date Fund Evaluator Tool
Capital Group

Advisor Group Launches Retirement Plan Practice Management Platform
Advisor Group

NFP Acquires Benefits Solutions Plus
NFP Corp.

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