Health & Welfare Plans Newsletter

September 26, 2016

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Plan Administrator
Boutique actuarial consulting & TPA firm
in FL

Client Services / Receptionist / Distribution Processer
The Finway Group
in IA

Executive Compensation and Benefits Tax Specialist
Cherry Bekaert
in DC, FL, GA, MD, NC, VA

Executive Assistant
Third Party Administrator
in PA

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Webcasts and Conferences

Employee Plans Determination Letter Program Changes In 2017
RECORDED
IRS [Internal Revenue Service]

Self-funded Health Plans: What Do We Have to Cover?
September 29, 2016 WEBCAST
Littler Mendelson

Breakfast Forum: Mergers and Acquisition Issues - What Affect Does it Have on Your Clients?
October 20, 2016 in CA
Western Pension & Benefits Council - Orange County Chapter

401(k) Beyond the Basics 11: Safe Harbor 401(k) Plan Design
October 31, 2016 WEBCAST
FIS Relius Education

Effect of Death on 401(k) Plans [2016]
November 1, 2016 WEBCAST
FIS Relius Education

457(b) Plans for 401(k) Practitioners; New Proposed Regs [2016]
November 15, 2016 WEBCAST
FIS Relius Education

Self-Funded Health Plans: What Employers Need to Know About Advantages and Risks
November 15, 2016 WEBCAST
HRWebAdvisor

The Dirty Dozen: Correcting Commonplace Errors [2016]
November 22, 2016 WEBCAST
FIS Relius Education

Required Minimum Distributions [2016]
November 30, 2016 WEBCAST
FIS Relius Education

Fundamentals of Cross-Tested Plans - A 3-Part Program [2016]
December 6, 2016 WEBCAST
FIS Relius Education

Ethics: Doing it Right [2016]
December 14, 2016 WEBCAST
FIS Relius Education

1099-R: An Ongoing Challenge Revisited [2016]
December 15, 2016 WEBCAST
FIS Relius Education

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[Guidance Overview]

The Look Back Measurement Method, Part 3: Ongoing Employees
"An ongoing employee is an employee who has been employed for at least one standard measurement period.... An ongoing employees status is solely determined by the standard measurement period unless there is an initial measurement period ... [T]he standard measurement period is typically the same for all ongoing employees as opposed to the initial measurement period which is unique to each individual employee, if applicable, depending on the employee's start date."
Accord Systems, LLC

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[Guidance Overview]

New Nondiscrimination Rules Impact Health Care Providers and Health Plans
"Whether a form of language assistance is required is determined based on the nature of the communication and the importance of the health program or activity.... If providing translation services assistance is a 'reasonable step,' the covered entity must offer a qualified interpreter for oral communications and a qualified translator for paper or electronic communications.... Such language assistance must be provided free of charge and in a timely fashion."
Williams Mullen

[Guidance Overview]

HHS Issues Guidance on ACA Nondiscrimination Requirements
"The Taglines are short statements that explain that language assistance services are available free of charge. The Taglines must be included in at least the top 15 languages spoken by [limited English proficiency (LEP)] individuals in the state(s) served by the Covered Entity in [1] significant publications and communications ... [2] conspicuous physical locations where the entity and the public interact, and [3] on the Covered Entity's website in a conspicuous location accessible from the home page. The Taglines must be posted in at least the top two languages spoken by LEP individuals in the state(s) served by the Covered Entity in small-sized, significant publications and communications."
Nixon Peabody LLP

[Guidance Overview]

Electronic Distribution of Health and Welfare Benefits Documents: Five Steps to Getting It Right in the ACA Age
7 pages. "Identify the documents to be distributed electronically, and whether any elections will be electronic ... Evaluate potential notice recipients ... Prepare an electronic distribution policy ... Collect consents (where necessary) ... Keep good records."
Mintz Levin, via BNA Tax Management Memorandum

[Guidance Overview]

How to Respond When ACA Electronic Reporting Triggers Notification of an Incorrect TIN
"Employers should prepare for mismatch notifications and take care not to run afoul of discrimination laws. Importantly, employers should not automatically assume that the employees whose information generates mismatches are not authorized to work in the United States."
Ogletree Deakins

[Advert.]

Is Your Wellness Program Ready for 2017?

Sponsored by Lorman and BenefitsLink

September 29 webinar. We will attempt to reconcile differences in the regulations under the ADA, GINA and HIPAA, with the goal of identifying changes that should be implemented no later than plan years beginning on January 1, 2017.


[Guidance Overview]

Are Wellness Programs Under Attack by the EEOC? (PDF)
"This [article] first examines the federal law applicable to [employer-sponsored wellness programs (EWPs)], the recent court challenges by the EEOC, the new ADA and GINA final rules, and the status of proposed legislation to void the rules. It closes by providing the results of a Q&A session with industry experts and advice on what employers should do to ensure that their EWPs pass muster with the new EEOC rules, both applicable on January 1, 2017."
Wolters Kluwer

Court Rejects ADA 'Safe Harbor' But Approves Pre-Regulations Wellness Program as 'Voluntary'
"[T]he court agreed with the EEOC's interpretation ... that the 'safe harbor' provision does not apply to wellness programs. But the court actually held in this case that the employer's wellness program was voluntary and, based upon the law in effect prior to the effective date of the EEOC's regulations, entitled the employer to judgment on that specific issue." [EEOC v. Orion Energy Systems, Inc., No. 14-1019 (E.D. Wis. Sept. 19, 2016)]
Littler

Self-Insured Plans May Struggle to Get SSNs from Employees
" 'Given all the advice that has been circulated, including by the IRS, regarding the dangers of responding to solicitations for personal financial information, including SSNs, it is likely that employees' initial reaction to these requests will be to ignore them,' said Ann Caresani, an attorney with Tucker Ellis in Cleveland. 'Employers should explain exactly why they are required by law to ask for SSNs and that they are required to keep asking, and [they should] provide a trusted contact for verification that this is a legitimate request.' "
Society for Human Resource Management [SHRM]

Three Ways to Help Employees Be Their Own Health Advocates
"Tell employees they're protecting themselves.... Point your employees to technology.... Offer a 'script.' "
Mercer/Signal

Success Factors for Reducing Employee BMI
"Coaching participants enjoyed the following results: Participants gained 0.56 less pounds than non-participants on average. Those who added fruits and vegetables to their diet lost an additional 0.65 pounds on average. Those who added whole grains to the diet lost up to an additional 4.26 pounds on average. Those who added two strength training sessions per week also lost an additional 1.23 pounds on average."
HealthFitness

Can Your Benefits Firm Handle a Benefits Bear Market?
"[W]hat does a bear market in benefits look like? What can cause a bear market? Commission compression? A move to fee for service? Government intervention including changes in tax laws? Obamacare collapsing? The budget deficit getting higher with rising health care costs being a big contributor? The MLR? Hospitals getting squeezed? Higher deductibles and employee contributions? All these factors appear to be present right now, favoring a need for change. Could it signal a coming bear market?"
Joe Markland

HIPAA Settlement Illustrates Importance of Reviewing and Possibly Updating Business Associate Agreements
"The settlement includes a monetary payment of $400,000 and a comprehensive corrective action plan. [Care New England Health System (CNE)] provides centralized corporate support for its subsidiary affiliated covered entities, which include a number of hospitals and health care providers in Massachusetts and Rhode Island. These functions include, but are not limited to, finance, human resources, information services and technical support, insurance, compliance and administrative functions."
U.S. Department of Health and Human Services [HHS]

Calculating Shared Savings: Administrative Formulas Versus Research-Based Evaluations
"Shared savings lie at the core of many recent health care payment and delivery reforms, most prominently those involving accountable care organizations (ACOs).... Although the main conclusions often overlap, there are times when administrative formulas and research-based evaluations can produce strikingly different results, provoking substantial confusion and consternation among stakeholders. This post looks at the advantages and disadvantages of the two approaches and discusses how they can be melded to best serve administrative, payment, and research needs."
Health Affairs

Blue Cross of Nebraska Dropping Out of ACA Marketplace
"Blue Cross Blue Shield of Nebraska announced [Sept. 23] that is pulling out of the ObamaCare marketplace in the state, becoming the latest insurer to cite financial losses when reducing participation in the healthcare law. The move is especially significant given that it is a Blue Cross plan, which form the backbone of the ObamaCare marketplaces.... Nebraska ... will still have two insurers, Aetna and Medica, on its marketplace next year."
The Hill

Only 10% of Health Plans Received Top NCQA Quality Ratings
"The NCQA Health Insurance Plan Ratings 2016-2017 report indicates that 10% received a top rating of 4.5 or 5.0 out of 5. Of those 105 plans, 23 received the highest score of 5.0. The stop scorers include 13 commercial plans, eight Medicare plans, and two Medicaid plans. On the other end of the scale, 27 plans (3%), earned the lowest ratings of 1.0 to 2.0."
HealthLeaders Media

Benefits in General

New IRS e-Services Authentication Process Requires Re-Registration
"The IRS ... is strengthening the authentication process for identifying users and that the new, more stringent procedures will require existing users to re-register (Oct. 24 is the target date for the start of re-registration) ... Any current e-account holder is affected, which the IRS said includes: [1] Electronic return originators; [2] Return transmitters; [3] Large business taxpayers required to e-file; [4] Software developers; [5] Health care law insurance provider fee/branded prescription drug filers; [6] Health care law information return transmitters/issuers; [and] [7] Reporting agents[.]"
Journal of Accountancy

Executive Compensation and Nonqualified Plans

Dispelling Some Common Misconceptions About Determining the CEO Pay Ratio
"[T]his would be a good time to address some common questions ... and perhaps dispel some lingering myths: ... A comprehensive pay definition is the best route to find the median employee ... Sampling won't save much time and effort ... A more cost-effective sampling approach invites added scrutiny ... Sampling will yield more volatility in the pay ratio ... A lower pay ratio is always preferable."
Willis Towers Watson

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Lois Baker, J.D., President  loisbaker@benefitslink.com
David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
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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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