Health & Welfare Plans Newsletter

September 15, 2016 logo logo LinkedIn logo Twitter logo Facebook logo
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Employee Benefits Jobs

Webcasts and Conferences

Retirement Forum, Twentieth Anniversary Celebration and HERO Awards Reception
September 20, 2016 in DC
WISER [Women’s Institute for a Secure Retirement]

DOL's Proposed Form 5500 Modernization Initiative
October 6, 2016 WEBCAST
ASPPA [American Society of Pension Professionals & Actuaries]

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[Guidance Overview]

Employee Classifications, Employer Shared Responsibility Tax and Medicare Collide
"[Information Letter 2016-0030] restated [the IRS] position that the employer shared responsibility tax is assessed based on the facts and circumstances of how many hours the employees work in a particular month, and that the employer's policies or classifications provide no protection from the tax assessment.... [T]he fact the employee was in fact eligible for and receiving Medicare did not change whether the employer might be subject to the employer shared responsibility tax for this individual if he or she worked 30 or more hours per week."
Winstead PC

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[Guidance Overview]

The Look Back Measurement Method: Full-Time Employees
"Every employer adopting the look back measurement method must document its specific dates and timeframes and incorporate that document into its SPD.... Once an employer has a system in place that accurately tracks its employees' hours of service the next step is to classify an employee as a full-time employee, a part-time employee, a variable hour employee, a seasonal employee, or an ongoing employee. Different rules apply to each employee classification."
Accord Systems, LLC

[Guidance Overview]

Flex Contributions and Opt-Out Payments Under ACA (PDF)
"[E]mployers that offer flex contributions and/or opt-out payments face some unique issues in determining if the health coverage they offer to employees is affordable under the ACA's shared responsibility rules. Depending on how the program is structured, these contributions and payments can adversely affect affordability."
Xerox HR Services

[Guidance Overview]

ACA Nondiscrimination Guidance Addresses Tagline Language Standards
"The FAQs address various Section 1557 issues, including: [1] Selecting the top 15 languages spoken by individuals with [limited English proficiency (LEP)], for which taglines must be provided; [2] Certain states and territories with greater or fewer than 15 languages listed; [3] How to reflect languages with multiple dialects; [4] Future changes in the population of individuals with LEP."
Practical Law Company

[Guidance Overview]

October 15 Deadline Approaching for Medicare Part D Notices
"[I]f you as an employer offer prescription coverage to any Medicare Part D eligible employees (whether or not retired), or Medicare Part D Medicare-eligible spouses or dependents, you must provide those individuals with a [notice] to advise them whether your drug plan's total gross value is at least as valuable as the standard Part D coverage ... [T]here are five instances in which such notice must be provided: [1] prior to an individual's initial enrollment period for Part D; [2] prior to the effective date of enrollment in your company's prescription drug coverage; [3] upon any change in your plan's creditable status; [4] prior to the annual election period for Part D (which begins each October 15); and [5] upon the individual's request."
Fraser Trebilcock


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.

[Guidance Overview]

City of Berkeley Passes Paid Sick Leave Ordinance
"The Ordinance applies to any person who, in a calendar week, performs at least two hours of work within Berkeley's geographic boundaries.... Eligible employees accrue one paid sick leave hour for every 30 hours worked.... Accrued leave may be capped at 72 hours, although small businesses may cap accrued leave at 48 hours. Accrued but unused leave carries over from year to year ... Unlike state paid sick leave law, employers cannot limit the amount of leave employees may use during the year."
Hanson Bridgett LLP

Vanguard Enhances Benefits for Its Employees
"[N]ew parents will now be eligible for six weeks of fully paid time off, and mothers giving birth will be eligible for up to 16 weeks paid time off with an increased disability benefit. New parents through adoption and surrogacy will receive assistance with associated costs in addition to being eligible for equal time off."
Pensions & Investments


Employees Need Congress to Protect Account-Based Health Plans
"Now more than ever, hardworking Americans need to rely on account-based plans such as Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) in order to make healthcare more affordable, manageable, and predictable. They are counting on Congress to recognize this and take action against the looming 'Cadillac' tax."
The Hill


Postal Service Health Benefits and the FEHBP: The Urgent Case for Getting Reform Right
"The 2016 Postal Service Reform Act proposes shifting postal retirees' primary health care coverage from the Federal Employees Health Benefits Program (FEHBP) to Medicare.... The proposal's impact on both postal retirees and taxpayers could be substantial.... This arrangement drives excessive Medicare use, and thus imposes ever higher costs on both Medicare beneficiaries and taxpayers. Postal annuitants would be forced to enroll in Medicare Part B while continuing premium payments to the FEHBP if they want to maintain any FEHBP benefits or choice among FEHBP plans."
The Heritage Foundation


Grand Theft Health Insurance!
"[In] 2014 the administration was supposed to collect $10 billion to fund the individual market reinsurance program and an additional $2 billion to reimburse the Treasury, but only collected a total of $9.7 billion. Yet, rather than scale back payments to insurers, the administration actually made the payouts more generous -- by about 40 to 50 percent... [E]ven after doing that, the administration still had $1.7 billion left over. Rather than pay even that amount back to the Treasury, the administration carried it forward to use to pay insurers in 2015."
The Daily Signal

Benefits in General

Discretion and Preemption: Unraveling ERISA, State Insurance Law
"While the California federal court ... acknowledged the existence of the deemer clause, the court still found the California ban on discretionary clauses applicable based on a finding that '[S]ection 10110.6 applies to contracts.' But that finding directly conflicts with ERISA's preemption provision, which has federalized garden-variety disputes over health and disability benefits and removed claims relating to such benefits from the ambit of breach-of-contract actions even where such benefits are provided though insurance." [Thomas v. Aetna Life Ins. Co., No. 15-1112 (E.D. Cal. Aug. 15, 2016)]
DeBofsky & Associates, P.C.

Cost of Employee Benefits for Private Industry Employers in the Northeast: $13.34 Per Hour in June 2016
"In June 2016, employee benefits cost private industry employers in the Northeast $13.34 per hour worked, the highest of the four U.S. census regions... Employee benefits costs were lowest in the South, where employers spent $8.50 per hour worked.... Nationwide ... employee benefits cost employers $9.77 per hour."
U.S. Bureau of Labor Statistics [BLS]

Collected Comment Letters Submitted to DOL on Notice of Proposed Form 5500 Revisions
Text of 23 comment letters submitted as of today; page will be updated as additional comment letters are submitted.
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

Press Releases

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