Health & Welfare Plans Newsletter

September 7, 2016 logo logo LinkedIn logo Twitter logo Facebook logo
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Employee Benefits Jobs

Retirement Plan Consultant/Specialist
Associated Pension Consultants
in CA

DC Plan Administrator
Small Independent TPA Firm
in IN

401(k) Administrator
Capital Retirement Plan Services, Inc.
in PA

401(k) Relationship Manager
MVP Plan Administrators, Inc.

Distribution and Loan Processor
JM Pension Advisory, Inc.
in MD

ASC Defined Benefit Software Support Actuary
Actuarial Systems Corporation
in CA, FL, Telecommute

Pension Actuary
AKT Retirement Plan Services
in OR

Plan Administration, Documentation and Implementation Specialist
Actuarial Consultants, Inc.
in CA

Director, Account Management
Lincoln Financial Group
in IL, IN

Institutional Wealth Relationship Manager IV
BOK Financial
in TX

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Webcasts and Conferences

Health Plan Dependent Eligibility Audits: Potential Benefits and Best Practices
September 7, 2016 WEBCAST

Putting the Investment Policy Statement at the Center of Your Fiduciary Process
September 13, 2016 WEBCAST

It's Groundhog Day - Let's Do The ACA Again
September 15, 2016 WEBCAST

Retirement Plan Enrollment and Termination Issues – Beyond Scratching the Surface
September 27, 2016 WEBCAST
Trucker Huss

Financial Principles Applied to the Management of Public Pension Plans
September 27, 2016 WEBCAST
Society of Actuaries

Five Ways to Control Costs in Your Employee Health Benefit Plan Contracts
September 29, 2016 WEBCAST
International Foundation of Employee Benefit Plans [IFEBP]

Perils of CEO Pay Ratio Disclosure
October 5, 2016 in MA
Choate, Hall & Stewart LLP

Designer Defenses: What You Can Do Today to Prevent Benefits Litigation Tomorrow
October 6, 2016 WEBCAST
Jackson Lewis LLP

HIPAA Compliance Boot Camp
December 9, 2016 WEBCAST
National Business Institute

View All Webcasts and Conferences

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[Guidance Overview]

IRS Addresses ACA Reporting Requirements for Sponsors of Self-Funded Plans and HRAs
"[An] entity that covers an individual in more than one plan or program must only report for one of the plans or programs. Therefore, if an employer has both a self-funded health plan and an HRA that covers only the same people who are enrolled in the self-funded plan, then reporting is only required for the self-funded plan. Additionally, if an employer offers an insured plan, but then also offers an HRA to employees enrolled in that insured plan, reporting on the HRA is not required.... [If] an employer offers an HRA to employees who are enrolled in their spouses' employer's plan, then the employer would have to report on employees covered by the HRA."
Benefits Bryan Cave


Earn a Certificate in Benefit Plan Administration in Boston!

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

The Certificate in Benefit Plan Administration program provides a survey of the core operational areas and issues involved in administering benefit plans. Take a single course or take all three to earn a Certificate of Achievement. Learn More!

[Guidance Overview]

IRS Proposes Rules on ACA Information Reporting Under Section 6055
"If an employee is covered by more than one plan providing minimum essential coverage (MEC), reporting is required for only one of the plans. Reporting is not required for MEC that is conditional upon being covered by other reportable MEC. Employers and other covered entities may rely on the proposed TIN solicitation rules until final guidance is issued."
Willis Towers Watson

[Guidance Overview]

Penalties for HIPAA Noncompliance Rise on August 1
"[The] adjusted penalty for each February 18, 2009 or later violation of HIPAA's administrative simplification provisions, if it is established that a covered entity (CE) or business associate (BA) did not know (and by exercising reasonable diligence would not have known) that the CE or BA violated the provision, is [between] $110 (increased from $100) [and a maximum of] $55,010 (increased from $50,000).... [The] adjusted penalty for each February 18, 2009 or later violation of HIPAA's administrative simplification provisions, if it is established that the violation was due to reasonable cause and not willful neglect, is [between] $1,100 (increased from $1,000) [and a maximum of] $55,010 (increased from $50,000)."
Practical Law Company

[Guidance Overview]

Berkeley Enacts California's Newest Local Paid Sick Leave Law
"The Ordinance applies to all employers employing or exercising control over an employee's wages, hours or working conditions, or that receive or hold a Berkeley business license. However, different standards apply to a 'small business' with fewer than 25 persons working for compensation during a given week, including full-time, part-time, or temporary employees, and individuals made available to work through the services of a temporary services or staffing agency or similar entity."

Outsourcing the Baby with the Bathwater? (PDF)
"Since outsourcing is a staple of benefits management, we should keep in mind that the cost/benefit analysis of outsourcing opportunities should not be limited to comparing a vendor's fees to your gains from staff re-deployment, or your savings from staff reduction. There may be other costs inherent in outsourcing some functions, including ones we've long-since outsourced.... [B]enefits managers may, without really thinking about it, cede authority over strategic and cost-sensitive subjects to vendors that were seen primarily as providing administrative-only services."
Chelko Consulting Group


Changes to Cafeteria Plans: What You Need to Know to Prepare

Sponsored by Lorman and BenefitsLink

September 21 webinar. Explores design choices available within the regulatory framework established by the IRS, and provides tools to ensure that cafeteria plan design, documentation and administration are in compliance with applicable requirements.

Getting Doctor Lists Right
"Under [a new California law] insurance companies ... must comply with new requirements to keep directories updated at least every quarter. The law, which took effect July 1, also provides patients with some firepower to fight surprise medical bills that result from directory errors. The law's reach is broad: It applies to Covered California and private market plans, as well as Medi-Cal managed care and most job-based insurance policies."
Kaiser Health News

Coal Miners Advance Lawsuit for Retiree Health Coverage
"[A] group of retirees accused Mystic and its majority owner of purposefully draining the company of assets before it ceased operations in 2006. According to the retirees, this was done to avoid the company's ongoing obligation to provide health benefits to retired mineworkers. Weighing these state law claims for breach of contract and unlawful distribution, Judge Irene C. Berger of the U.S. District Court for the Southern District of West Virginia found the lawsuit to be preempted by ERISA." [Int'l Union, United Mine Works of America v. Mystic, LLC, No. 16-02030 (S.D. W. Va. Sept. 2, 2016)]
Bloomberg BNA

Tipping the Scales on Weight Control: New Strategies for Employers (PDF)
23 pages. "Critical considerations for increasing engagement include greater personalization to capture and respond to individualized clinical factors such as BMI and blood sugar, attention to behavioral factors like attitudes and beliefs, and establishing relationships that could serve as in-person or digital support networks. Using behavioral economics lessons to understand the roles that intellect and emotion play in behavior change is similarly important in designing rewards and incentives."
Northeast Business Group on Health [NEBGH]

Parental Leave Around the Globe: Organizations Expand Policies to Accommodate Needs of Workforce
"[M]ore than one-quarter (29%) of companies worldwide provide adoption leave beyond what is required by law. Furthermore, when asked how they handle adoption leave for same-sex couples, 87% of companies indicate the leave is handled in the same manner as opposite-sex couples."

Federal Employees Can Donate Leave to Louisiana Flood Victims
"The program would permit employees in the executive and judicial branches to donate their leave to other employees in their agency or in another agency, allowing federal workers hit by the disasters in Louisiana to get time off from work without having to use their own paid leave. Obama issued the same memorandum after the 2013 storms in Oklahoma and Superstorm Sandy in 2012."
Government Executive

GAO Report: In Most States and New Exchanges, Enrollees Continued to be Concentrated Among Few Issuers in 2014
"On average in each state and the District of Columbia, 11 or more issuers participated in each of three types of markets -- individual, small group, and large group -- from 2011 through 2014. However, in most states, the 3 largest issuers in each market had at least an 80 percent share of the market during the period.... In nearly all states, the number of issuers participating in individual markets decreased from 2013 to 2014, while fewer states' small group and large group markets had decreased participation."
U.S. Government Accountability Office [GAO]

Second Quarter Earnings Calls Offer Glimpse of How Insurers Are Faring on ACA Marketplaces, and What 2017 Might Bring
"While Cigna and Anthem reported losses from their individual market business, neither insurer has yet signaled a retreat from the ACA marketplaces, although Anthem indicated that it is waiting for premium rate approvals from state regulators before making final decisions. Cigna has told investors that they expect to improve their profitability in the marketplaces next year and over the long-term, while acknowledging that the marketplaces are still 'volatile.' Centene reported 'favorable' and Molina 'satisfactory' experiences on the ACA's marketplaces. Centene suggested they would look to expand in 2017 and beyond."
The Commonwealth Fund

CMS Sees Drop in Special Enrollment Period Selections, Plans Further Steps
"CMS announced ... a pilot project for 2017 in which it would require advance verification of SEP eligibility for some applicants before enrollment.... Advance verification has been a key demand by insurers ... However, CMS is not allowing the insurers to verify eligibility themselves, which they would prefer but which is adamantly opposed by consumer advocates; the advocates fear the reinstatement of rescissions, which were strictly limited by the [ACA]. CMS requests comments on how the SEP pilot should be designed, whom it should affect, and how its results should be evaluated."
Health Affairs

State Innovation Model Initiative Test Awards (Round One) Show Some Promising Progress and Lessons Learned
"States have leveraged multi-payer efforts to implement payment and delivery system reforms, engaged the provider community in SIM-related activities, and used a range of policy levers to effect change. Some of the most substantial changes to delivery systems and payment methods are in areas where public and private payers are working together to accelerate transformation."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

Benefits in General

Seasonal Workers May Affect Health and Retirement Benefit Obligations
"The number of seasonal workers you hire may impact whether your agency is subject to certain ACA obligations.... [S]easonal workers may be entitled to paid sick leave under California's Healthy Workplaces, Healthy Families Act.... [W]hen the employer hires an employee who is already a member of [the California Public Employees' Retirement System (CalPERS)], the employee must be enrolled in membership with the employer, even if a seasonal worker. In addition, if full-time employment has a fixed term of more than six months, or more than one-year for a part-time employment (an average of at least 20 hours per week), the employee is entitled to membership."
Liebert Cassidy Whitmore

Executive Compensation and Nonqualified Plans

Data Collection for Calculating CEO Pay Ratio
"For most companies, the first two steps will be to: [1] Take inventory of the number of employees in each country and total employees overall (excluding CEO).... [2] Consider the Company's circumstances and goals.... [C]ompanies should consider running the pay ratio calculation based on 2016 pay, as a 'dress rehearsal' to see how well their systems operate and get an idea of what the actual ratio will be."
Winston & Strawn LLP

NYSE Says Boards May Unilaterally Amend Equity Plans to Allow Maximum Withholding on Equity Awards
"As a result of the change in the accounting rules, many companies are considering amending their equity plan to allow the plan administrator discretion to withhold shares up to the maximum statutory withholding requirement, particularly in the case of an equity plan that provides for liberal share recycling ... Allowing for maximum share withholding (up to 39.6% for federal tax purposes) will have a cash outflow issue for a company."
Meridian Compensation Partners, LLC

Press Releases

PBGC to Pay Benefits at Vertellus Specialties Inc.
PBGC [Pension Benefit Guaranty Corporation]

NAPA Announces the Retirement Industry’s Top DC Wholesalers
National Association of Plan Advisors [NAPA]

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David Rhett Baker, J.D., Editor and Publisher
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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.

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