Retirement Plan Investment and Advisory Analyst
Envoy Financial
in CO

401(k) Account Manager
BlueStar Retirement Services, Inc.
in FL, Telecommute

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[Guidance Overview]

Agencies Release Final Rule Aimed at Expanding Short-Term, Limited-Duration Insurance Coverage

"The ability to renew or extend an existing STLDI policy expands upon the proposal, where the Agencies asked whether STLDI should be continued for 12 months or longer with the issuer's consent, including whether expedited reapplication would be appropriate.... The preamble to the Final Rule explains how rate lock-in would work to allow an enrollee to string together essentially renewable STLDI policies for longer than 36 months."
Groom Law Group

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Sixth Circuit Joins Sister Circuits: Denial of Plan Benefits Confers Standing Even If Not Billed Directly for Medical Services

"[T]he Sixth Circuit affirmed the district court's determination that the plaintiff has the standing to bring his claim despite the failure to allege a financial loss. The court noted that '[e]very circuit court to consider this issue agrees that a plaintiff in Springer's shoes does not need to suffer financial loss. The Fifth, Ninth, and Eleventh Circuits have each held that the denial of plan benefits is a concrete injury for Article III standing even when patients were not directly billed for their medical services.' " [Springer v. Cleveland Clinic Employee Health Plan Total Care, No. 17-4181 (6th Cir. Aug. 14, 2018)]
Kantor & Kantor

Court Blocks Austin Paid Sick Leave Law

"The Texas Third Court of Appeals Aug. 17 blocked an ordinance that would take effect Oct. 1. A prior ruling from the [459th] District Court denied a temporary injunction to a business coalition challenging the paid sick leave mandate.... The Texas Public Policy Foundation, representing a coalition of business groups that includes the Texas Association of Business, the National Federation of Independent Business, and the American Staffing Association, challenged the Austin ordinance because they say it violates the state's minimum wage law." [Texas Assoc. of Business et al. v. City of Austin, No. 03-18-00445 (Tex. 3d App. Aug. 17, 2018)]
Bloomberg BNA

Wellness: Experience and Emotion vs. Technology and AI

"Does the technology allow for customization to the company culture and brand? What will the employees' interaction with the technology be: personalized and unique or will everyone have the same experience? Are there communication features; what are they and who manages the communications? ... Is the program going to be burdensome to manage or will it be simplistic and come with management and support? ... [D]oes the technology report back to you on the specific metrics you are looking to impact?"
Frenkel Benefits

CMS Proposes Rule to Address Risk Adjustment Program for the 2018 Benefit Year

"The proposed rule would allow the program to continue for the 2018 benefit year. It explains the justification for utilizing statewide average premium in the calculation of risk adjustment transfers, and expands on the reasoning behind operating the HHS-operated risk adjustment program in a budget-neutral manner.... Comments on the proposed rule should be submitted by September 7."
Wolters Kluwer Law & Business

HHS Secretary Says Agency Can Eliminate Drug Rebates

"[HHS] Secretary Alex Azar said it was within his agency's power to eliminate rebates on prescription drug purchases ... Drugmakers say they are under pressure to provide rebates to the few PBMs that dominate the market ... and that those payers do not pass on enough of those savings to patients ... The drugmakers say the rebates force them to raise the price of their therapies over time to preserve their business."
Reuters

[Official Guidance]

Text of IRS Notice 2018-67: Request for Comments Regarding the Calculation of Unrelated Business Taxable Income Under Section 512(a)(6) for Exempt Organizations with More Than One Unrelated Trade or Business; Interim and Transition Rules (PDF)

36 pages. "Section 512(a)(6) requires an organization subject to the unrelated business income tax under Section 511, with more than one unrelated trade or business, to calculate unrelated business taxable income (UBTI) separately with respect to each trade or business. This notice discusses, and solicits comments regarding, various issues arising under Section 512(a)(6) and sets forth interim guidance and transition rules relating to that section.... [B]ecause ... VEBAs, and SUBs are taxed differently than other exempt organizations under Section 511, the Treasury Department and the IRS request comments regarding how these exempt organizations' investment income should be treated for purposes of Section 512(a)(6).... [T]he Treasury Department and the IRS do not believe that the provision of the fringe benefits described in Section 512(a)(7) is an unrelated trade or business. Accordingly, any amount included in UBTI under Section 512(a)(7) is not subject to Section 512(a)(6)."
Internal Revenue Service [IRS]

Financial Wellness Programs: One Size Doesn't Fit All

"Financial wellness programs may not be the right fit for some organizations. There may be a moral imperative that drives commitment for some, while others require a business imperative to justify the investment. Regardless of the rationale, a logical starting point would be for an organization to survey its employees and assess the need."
Strategic Benefit Services

Financial Wellness Programs Can Benefit from a Group Long-Term Care Option (PDF)

"For Gen-Xers and Baby Boomers, 'retirement readiness' is a pressing concern, and includes addressing retirement income, healthcare, and various related expenses.... LTC insurance can play a critical role in providing 401(k) insurance for those who see its value[.]"
Employee Benefits and Wellness Excellence Presented by HR.com

What Does the CEO Pay Ratio Data Say About Pay? (PDF)

"Our analysis finds company size as measured by employee count is the primary driver of the CEO Pay Ratio; company revenue and market capitalization are secondary drivers. Deeper analysis uncovers industry trends that may provide companies additional context as they compare their CEO Pay Ratios to those of their peers. Ultimately, despite some interesting trends uncovered, analysis of the CEO Pay Ratio data provides little actionable intelligence for companies and questionable, if any, value for investors. More concerning, we find potential avenues for critics of executive pay to manipulate the data to serve their interests or constituencies."
ExeQuity

ACA-Compliant Health Insurance for Part-Time Executives

We have three senior executives who are part-time and don't work enough hours to be eligible for the GHP. Two are on Medicare. We'd like to somehow help pay for the health insurance or Medigap coverage they've obtained elsewhere. We realize that direct reimbursement creates an employer payment plan that runs afoul of the ACA. Any ideas? It's my understanding that we could increase their taxable wages to help them pay for these individual insurance policies and/or Medigap coverage, but that we can't require that the funds be used for that purpose. However, we would want to determine the amount of the increase by doing some research on how much this alternative insurance is costing and base the compensation adjustment on our findings. Would that pass muster?
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Most Popular Items in the Previous Issue

Text of IRS Q&As on Employer Shared Responsibility Provisions Under the ACA
Internal Revenue Service [IRS]

Text of DOL 'ERISA Compliance Assistance' on Association Health Plans (PDF)
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

Self-Funded ERISA Health Plans and New Jersey's 'Surprise' Out-of-Network Medical Bill Law
Epstein Becker Green

Press Releases

Cowden Associates, Inc. Hires Three Up-and-Coming Health and Benefits and Actuarial Analysts
Cowden Associates, Inc.

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