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[Guidance Overview]
ACA Information Returns (AIR) Working Group Meeting, Nov. 15, 2016 (PDF)
50 presentation slides. Topics: [1] Adding a software developer package; [2] Changes to the AIR Submission Composition and Reference Guide; [3] Demonstration of manifest and crosswalk; [4] Demonstration of Form 1095-C schema and crosswalk; [5] October questions and response appendix; [6] General AIR mailbox and e-Help Desk information.
Internal Revenue Service [IRS]
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[Advert.]
Preconference Workshop Announced!
![Sponsored by Health Benefits Conference & Expo [HBCE]](https://benefitslink.com/bnrs/2016/HBCE_26thAnnual_top.jpg "Sponsored by Health Benefits Conference & Expo [HBCE]")
From new strategies in population health management to cost-containment solutions and ACA updates, HBCE will provide the in-depth information you need to keep your benefit plans compliant and your employees engaged. Want to enhance your learning? Register today!
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[Guidance Overview]
Legislative Actions to Repeal, Defund, or Delay the ACA (PDF)
25 pages. "This report summarizes legislative actions taken to repeal, defund, delay, or otherwise amend the ACA since it was enacted.... Table 1 summarizes the ACA changes that have been signed into law. Table 2 lists all the House-passed ACA bills. Table 3 summarizes the ACA provisions in the vetoed reconciliation bill.... This report is updated periodically to reflect legislative and other developments." [Report R43289, dated Nov. 10, 2016]
Congressional Research Service [CRS]
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Employers Believe Telehealth Impacts Health and Cost, and Few Small Employers Offer Wellness Programs (PDF)
"Nearly half of employers have or are considering a decrease in medical benefits for employees and 75% have or are considering increasing employee premiums ... Only the largest employers offer a wellness program as less than 20% of those with 1,000 employers have programs. 40% of employers have implemented and another 50% are considering offering telehealth and telemedicine benefits.... 75% of employers are considering or have implemented a price transparency tool for employees."
Houston Business Coalition on Health
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Actuaries' Work Group Report on the Stop Loss Factors (PDF)
8 pages. "In 2009, the National Association of Insurance Commissioners (NAIC) requested that the American Academy of Actuaries review the Risk-Based Capital formulas currently used for medical excess of loss business and recommend one formula for all carriers writing this business using data from the Society of Actuaries. As a result, the Academy's Stop Loss Work Group developed this report."
Stop Loss Factors Work Group, American Academy of Actuaries
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Arizona and Washington Voters Approve Paid Sick Leave Measures
"Voters in Arizona and Washington approved ballot measures that will require employers to offer paid sick leave to workers beginning in 2017 and 2018, respectively. The two states join Connecticut, California, Massachusetts, Oregon and Vermont in offering statewide paid-sick-leave programs. And a wave of similar ordinances has swept through cities and counties across the country."
Society for Human Resource Management [SHRM]
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[Advert.]
How to Survive an ACA Audit
Dec. 13 webinar. Ensure that your policies and procedures mitigate audit inquiries from various federal agencies. Documentation and record retention will be the key to minimizing potential penalties.
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Insurer's Risk Corridor Payment Claims Dismissed
"Land of Lincoln claimed that the risk corridor statute entitled it to payment according to the statutory and regulatory formulas, that HHS had entered into an express or implied contract to make the risk corridor payments, and that the government had taken its property without compensation in violation of the Fifth Amendment's Takings Clause.... Judge Lettow ... [rejected] each of the plaintiff's claims on the merits." [Land of Lincoln Mutual Health Ins. Co. v. U.S., No. 16-744C (Fed. Cl. Nov. 10, 2016)]
Health Affairs
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Court Rejects Amicus Brief from House of Representatives in Risk Corridor Case
"A federal court denied the United States House of Representative's motion to file an amicus curiae brief in a class action lawsuit brought by Health Republic Insurance Company over the federal government's nonpayment of risk corridor payments under the [ACA] risk corridor program. The court held that because the proposed brief raised a novel ground for dismissal, the brief improperly imposed upon the Department of Justice's exclusive authority to litigate the case[.]"
Wolters Kluwer
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Trump Win Won't Derail Health Industry Transactions
"Initiatives spurred by the [ACA], including value-based care and cost-effective payment models, aren't going away, even if Obamacare is repealed in whole or in part ... And, because those developments set the industrywide transactions trend -- including consolidations like mergers and joint ventures -- in motion, there isn't any reason to believe it will stop either[.]"
Bloomberg BNA
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[Opinion]
Donald Trump Is About to Face a Rude Awakening Over Obamacare
"To guarantee that people with pre-existing conditions can get affordable health insurance, you need to have rules requiring guaranteed issue and community rating. To keep insurance companies in business because of guaranteed issue and community rating, you need to have an individual mandate. And because poor people can't afford health insurance, you need subsidies. Combine all three, and what you have, in a nutshell, is ... Obamacare."
The Washington Post; subscription may be required
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Benefits in General
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Handling a DOL Audit with Ease (PDF)
"Traditionally, DOL audits of employee benefit plans have focused primarily on retirement plans, such as 401(k) plans. However, now that the DOL has started enforcing compliance with the [ACA], health plan audits are on the rise. Depending on the complexity of your plan design, availability of documents, degree of cooperation between the DOL and your plan administrators, and the number of potential violations, an audit can take anywhere from several weeks to over a year."
Cowden Associates, Inc.
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Employee Benefit Issues to Keep You Awake at Night
"Does your employer have ERISA fiduciary insurance? ... Do you know the amount of fees paid by your 401(k) plan for 2015? Do you know both the fees in an absolute dollar amount and as a percent of assets? ... Does your 401(k) plan have an investment policy? ... What standard do you impose upon your vendors? ... Is your investment advisor a fiduciary? ... Do you have complete, historic retirement plan records? ... Are your temporary/staffing workers, independent contractors, and leased employees your employees for the [ACA] (ACA) purposes?"
Jackson Lewis P.C.
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Executive Compensation and Nonqualified Plans
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Apple Must Include Shareholder Proposal on Executive Compensation in Proxy
"The SEC found that: [1] The proposal focuses on senior executive compensation, so that the company could not omit the proposal from its proxy materials in reliance on rule 14a-8(i)(7). [2] The proposal was not so inherently vague or indefinite that neither the shareholders voting on the proposal, nor the company in implementing the proposal, would be able to determine with any reasonable certainty exactly what actions or measures the proposal requires [rule 14a-8(i)(3)]. [3] The company did not lack the power or authority to implement the proposal [rule 14a-8(i)(6)].... [T]his no-action letter is a worrisome development for next year."
Winston & Strawn LLP
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Examining the Impact of the 2016 U.S. Elections on Executive Compensation
"[If] the Dodd-Frank Act were to be fully repealed, the currently effective say-on-pay, say-when-on-pay, and say-on-golden-parachute requirements would be repealed along with the Compensation Committee independence and Chairman/CEO structure proxy disclosure rules ... All of these rules are well-established at this point, so it would not be surprising to see these rules remain in place and to see some or all of the Dodd-Frank Act executive compensation rules that are not yet effective be repealed or modified."
Latham & Watkins
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Press Releases
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David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager
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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