Health & Welfare Plans Newsletter

October 5, 2016

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Intac Actuarial Services
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Estate & Pension Advisory Board
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Swerdlin & Company
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Webcasts and Conferences

Employee Benefits Survey: Understanding the Strategic Value of Health Benefits
October 20, 2016 WEBCAST
HANYS Benefit Services

Fundamentals of Fiduciary Responsibilities
October 27, 2016 in NY
Bond, Schoeneck & King, PLLC

Experts' Guide to Employee Benefits Research
November 10, 2016 WEBCAST
ABA Joint Committee on Employee Benefits [JCEB]

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[Guidance Overview]

Final Forms for ACA Reporting Released
"For calendar year 2016, forms are required to be filed with the IRS by Feb. 28, 2017 (or March 31, 2017, if filing electronically).... Individual statements for the 2016 calendar year must be furnished by Jan. 31, 2017.... The 2016 forms and instructions are largely unchanged from 2015 versions. Most of the changes were made to provide additional clarification, rather than make substantive revisions."
Chelko Consulting Group

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[Guidance Overview]

Final Instructions to Forms 1094-C and 1095-C Released: Key Takeaways
"[T]he final instructions include more concise language when discussing the information return and payee statement penalties.... [T]he IRS makes it clear ... that if an employer elects to use substitute Forms and file using paper with the IRS, the Forms must be printed in landscape format.... The biggest change to the Forms 1094-C and 1095-C is an employer will no longer be able to use the good faith efforts standard to protect itself from filing information returns or payee statements with inaccurate or incorrect information.... [No] change will be more burdensome than the tighter filing deadline."
Accord Systems, LLC

[Guidance Overview]

Paid Sick Leave Final Rule for Federal Contractors
"[W]here the requirements of an applicable state or local law and new Part 13 differ, satisfying both will require a contractor to comply with the requirement that is more generous to employees. This is of particular importance to contractors that operate within California, which has a number of municipalities setting sick leave law requirements that differ from those of Part 13 and the EO."
Dentons

[Guidance Overview]

DOL Publishes Final Rule Establishing Paid Sick Leave Requirements for Federal Contractors
"The [DOL] established four major categories of federal contracts that are covered by the final rule establishing mandatory paid sick leave ... The new rule does contain some exceptions and exclusions from coverage for certain types of agreements that might otherwise fall into one of [these categories]. However, those exceptions and exclusions are narrow ... The new rule applies not only to covered federal contracts, but also to subcontracts of any tier under a covered contract."
Kilpatrick Townsend

[Guidance Overview]

HIPAA Compliance: Not Just an Issue for Health Care Providers
"[A]ny employer that sponsors a self-insured group health plan for its employees will have substantial HIPAA compliance obligations and the failure to satisfy such obligations can have significant adverse consequences. Therefore, as part of the acquisition due diligence process, it is essential for potential purchasers to assess a target company's level of HIPAA compliance."
Dechert

[Guidance Overview]

Minneapolis Amends Recently Enacted Paid Sick Leave Law
"The amendments come on the heels of neighboring St. Paul adopting its own paid sick leave law, and bring the Minneapolis Ordinance more in line with St. Paul's requirements concerning frontloading, payment of employees when on leave, tracking accrual of available paid sick time, and recording required information."
Littler

ACA Reporting: New Forms, Announcements from IRS Remind HR Pros What's Ahead
"In addition to the final forms, the IRS announced changes to the identity authentication process for e-Services, which includes tools used in connection with the electronic filing through the Affordable Care Act Information Returns (AIR) Program system. According to the feds, the changes will strengthen protections for e-Services accounts by requiring two-factor authentication to use the feds' Secure Access platform."
HR Benefits Alert

Adventures in Healthcare: The Dawn of the High-Value Health Plan
"Expanding the [IRS] 'safe harbor' to permit coverage of additional evidence-based services prior to meeting the plan's deductible would increase clinical effectiveness of HSA-HDHPs. This expanded safe harbor may include selected high-value services that are frequently used as health plan quality metrics and included in pay-for-performance programs.... Adoption of this voluntary, clinically nuanced HDHP or 'High Value Health Plan' has the potential to mitigate cost-related nonadherence, enhance patient-centered outcomes, allow for premiums lower than most preferred provider organizations and health maintenance organizations, and substantially reduce aggregate healthcare expenditures."
American Journal of Managed Care

'Concierge Care' Provides a Patient-First Health Benefits Approach
"With direct primary care (DPC), individuals and/or their employer pay a monthly retainer fee that allows the patient to receive all necessary primary care without further cost or involvement by insurance carriers ... A wrap-around health care plan from an insurance carrier or a self-insured employer kicks in beyond these services. Typical DPC coverage costs an average of $77 per patient per month ... The model is therefore more adaptable for employee benefits programs."
Society for Human Resource Management [SHRM]

Benefits in General

The Enforceability of ERISA Forum Selection Clauses: Two Recent 'Against-The-Trend' Cases and an Uncertain Future (PDF)
"The majority of courts to address this issue have ruled in favor of enforcing forum selection clauses. However, going against the trend, two federal district courts recently determined that forum selection clauses are automatically invalid and unenforceable within the ERISA context ... [At] the beginning of this year, the U.S. Supreme Court declined to review a [third] case in which the Sixth Circuit Court of Appeals had ruled in favor of enforcing a plan's forum selection clause.... The [DOL] without any success thus far, has consistently filed amicus briefs in support of the view that forum selection clauses in ERISA plans are invalid and unenforceable."
Trucker Huss

Fifth Circuit Provides Guidance on When ERISA Governs Severance Plans
"The Gomez court held that '[i]t is thus the existence or nonexistence of an 'ongoing administrative program' ... that is the key determinant of whether severance plans are governed by ERISA' rather than the form of the payments. 'Even for plans that result in only a lump-sum payment, that administrative scheme can be found in a number of other features that require discretion the eligibility determination; calculations of the payment amount (such as deductions and detailed formulas); the provision of additional services beyond the severance payment (such as insurance); and the establishment of procedures for handling claims and appeals.' " [Gomez v. Ericsson, Inc., No. 15-41479 (5th Cir. July 8, 2016)]
Begos Brown & Green LLP

Executive Compensation and Nonqualified Plans

Settlement of Director Pay Lawsuit Provides Best Practices Framework
"Under the terms of the settlement, Citrix has agreed to implement and maintain the following corporate governance reforms for at least five years. [1] Limits on annual equity compensation grants for non-employee Directors.... [2] Shareholder approval of plan amendments.... [3] Enhanced disclosures on Director compensation practices.... [4] Designated Compensation Committee responsibilities."
Meridian Compensation Partners, LLC

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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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