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BenefitsLink Health & Welfare Plans Newsletter

July 12, 2013

Employee Benefits Jobs

Client Service Representative
for Associated Pension Consultants in CA

Account Manager
for Cammack LaRhette Consulting in NY

Associate Account Manager
for Cammack LaRhette Consulting in NY

ESOP Administrator
for Blue Ridge ESOP Associates in ANY STATE

Operations Manager
for Professional Capital Services in PA

Manager of Functional Department
for The Angell Pension Group, Inc. in ANY STATE

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Webcasts and Conferences

Second-Stage ESOP Transactions
September 17, 2013 WEBCAST
(National Center for Employee Ownership)

ESOP Audits and Voluntary Compliance Programs
September 24, 2013 WEBCAST
(National Center for Employee Ownership)

How to Prepare for an IRS Employee Plans Audit - Phone Forum
August 29, 2013 WEBCAST
(Internal Revenue Service (IRS))

The Demise of DOMA and the Effects on Employee Benefit Plans (Webcast)
July 17, 2013 WEBCAST
(American Society of Pension Professionals & Actuaries (ASPPA))

Health Care Reform for Employers: Now What? - Denver
September 17, 2013 in CO
(Lorman Education Services)

Health Care Reform for Employers: Now What? - St. Louis
September 17, 2013 in MO
(Lorman Education Services)

View All Webcasts and Conferences


[Guidance Overview]

What the Delay of the Employer Mandate Means for Plan Sponsors (PDF)
"The transition relief is welcome news in that it relieves the pressure associated with updating plan documents and administrative systems, as well as the costs associated with expanding coverage. It also provides the opportunity for the IRS to issue additional guidance on how to apply the rules for special types of situations ... Employers who intended to rely on one of the transition rules previously announced for 2014 should keep in mind that the latest IRS guidance does not provide special transition rules for 2015." (Drinker Biddle)

[Guidance Overview]

With the Employer Mandate and Insurer Reporting Requirements Delayed, What's Left for 2014?
"The delay does not affect the following provisions of ACA that are applicable to employer sponsored group health plans which are scheduled to take effect in 2014: Pre-existing condition exclusions... Exclusion of adult children ... Waiting periods limited... Annual dollar limits... Annual limit rule ... Coverage for certain clinical trials... Essential health benefits ... Cost sharing ... Maximum annual deductible... Reinsurance fees." (Troutman Sanders)

[Guidance Overview]

'Pay or Play' Reprieve Leaves Employers Facing Other 2014 Health Care Reform Deadlines
"The first priority for employers wishing to take advantage of added time to comply with [the] Affordable Care Act's pay or play penalty to maximize their planning opportunities and to minimize their potential Code Section 4980H consequences should be to clean up worker classifications, to track all hours worked for all employees and collect all other relevant employee data." (Solutions Law Press)

[Guidance Overview]

Expatriate Coverage Under Health Care Reform
"The issue of principal concern is whether an expatriate continues to be subject to health care reform while working outside the U.S.... Another key issue is whether foreign nationals sent to work in the U.S. are subject to health care reform's requirements. Although the Departments have issued some guidance in this area (including an expatriate health plan FAQ and a summary of benefits and coverage (SBC) compliance FAQ), it is not enough to allow companies to fully address their obligations under health care reform when they send employees on international assignment." (Baker & McKenzie)

Employer Mandate Upheld by Fourth Circuit
"[T]he Fourth Circuit Court ruled on Thursday that Congress had clear authority to impose the requirement that larger employers provide adequate health insurance for their workers or pay a financial penalty to the government. This was the first major ruling on the employer mandate's constitutionality since the Supreme Court last year upheld a different mandate in the 2010 law, requiring individuals to obtain health coverage or pay a penalty.... The Supreme Court had sent the case back to the Fourth Circuit to rule on constitutional challenges that the Justices did not decide when they ruled on major parts of the health care law a year ago." [Liberty Univ. v. Lew, No.10-2347 (4th Cir. July 11, 2013)] (SCOTUSblog)

Text of Fourth Circuit Decision Rejecting Liberty University's Challenge to ACA Employer Mandate (PDF)
62 pages. Excerpt: "[The court finds] that the employer mandate is no monster; rather, it is simply another example of Congress's longstanding authority to regulate employee compensation offered and paid for by employers in interstate commerce. To begin, we note that unlike the individual mandate (as construed by five justices in NFIB), the employer mandate does not seek to create commerce in order to regulate it.... Further, contrary to Liberty's assertion, the employer mandate does not require employers to 'purchase an unwanted product.' Although some employers may have to increase employee compensation (by offering new or modified health insurance coverage), employers are free to self-insure, and many do.... Requiring employers to offer their employees a certain level of compensation through health insurance coverage is akin to requiring employers to pay their workers a minimum wage[.]" [Liberty Univ. v. Lew, No.10-2347 (4th Cir. July 11, 2013)] (U.S. Court of Appeals for the Fourth Circuit)

Walmart on Trial for Counting FMLA-Qualifying Absences
"No-fault attendance policies may simplify the administration of attendance issues, but employers should be careful not to count absences protected by the Family and Medical Leave Act and the Americans with Disabilities Act. Otherwise, as a recent court case demonstrates, employers with such point-based progressive discipline policies risk being on the wrong side of an employment termination claim for alleged FMLA and/or ADA violations." [Green v. Wal-Mart Stores, East, L.P., WL 3223629 (S.D. Ohio, June 25, 2013)] (Thompson SmartHR Manager)

Obamacare Expands Drug Coverage, But Out-of-Pocket Expenses Go Up
"The Obamacare requirement to include drug coverage as a standard benefit will expand the population receiving insurance assistance with drug costs. In the existing individual and family health insurance market, nearly one out of five health plans do not include prescription drug coverage. However, consumers with existing drug coverage who enroll in Bronze or Silver plans will likely see their drug out-of-pocket costs increase assuming trends observed in public Obamacare rate filings persist." (HealthPocket)

Wellpoint Fined $1.7 Million for Exposing Health Data Online
"Security weaknesses in a WellPoint online application database exposed information for 612,402 individuals between October 2009 and March 2010, according to the agency. Data included names, dates of birth, addresses, Social Security numbers, telephone numbers and health information. WellPoint, the second largest U.S. health insurer, agreed to the fine to settle potential violations of healthcare privacy laws." (Reuters)

Governor Says Repeal of Massachusetts Employer Health Insurance Mandate Will Stick Despite Obamacare Delay
"[Massachusetts] Governor Deval Patrick said Thursday that he will not block the repeal of a state mandate for employers to provide health insurance to their workers or pay a penalty, though the Obama administration last week announced a delay in the federal program that was supposed to take its place.... Some business groups saw the requirement as onerous and initially pushed to loosen the law, but the Patrick administration agreed to eliminate it because a similar federal mandate was set to take effect in January. The repeal was included in the 2014 budget, which Patrick likely will act on tomorrow." (The Boston Globe)

Healthcare Spending Growth Continues Slight Upward Trend (PDF)
"National health expenditures (NHE) in May 2013 grew 4.2% relative to May 2012. The April NHE growth rate was 0.9% greater than gross domestic product (GDP) growth over the same period. (The GDP growth rate for May is not yet available.) The health spending share of GDP was 18.1% in April, up from 16.4% at the start of the recession in December 2007." (Altarum Institute)

Health Care Price Growth at 20+ Year Low (PDF)
"Health care prices in May 2013 were 1.0% higher than in May 2012, a one-tenth drop from the April rise, representing a low in our series that extends back to January 1990. The 12-month moving average, at 1.7%, is the lowest since a fractionally lower reading in September 1998." (Altarum Institute)

[Opinion]

The Employer Mandate Delay May Have Drastic Consequences
"The result could well be a substantial collapse of employer-sponsored health coverage -- something which could not be easily be rebuilt the following year if the employer mandate is imposed then.... In order to keep health plans solvent, premiums will have to go up -- and for every increase, more people will decide they are better off without coverage.... The individual mandate penalty was supposed to limit this effect, and the employer mandate was supposed to isolate most workers from it. With both of those mandates delayed, unenforceable, or gone completely, there is nothing to prevent an upward spiral of premiums, higher taxpayer-funded subsidies and more people being uninsured." (Forbes)

[Opinion]

The ACA's Threat to Multiemployer Health Plans (PDF)
"The ACA threatens the viability of multiemployer health plans in four ways: 1) the high employee threshold of the employer mandate, 2) the reinsurance fee, 3) the definition of qualified health plans, and 4) the lack of multiemployer-specific administrative guidance. We believe it may be impossible to reverse the damage done to these plans if these issues are not resolved. The [International Brotherhood of Electrical Workers] cannot afford to sit on the sidelines as the ACA threatens to harm our members by dismantling multiemployer health plans" (International Brotherhood of Electrical Workers)

[Opinion]

The American Way of Birth: Costliest in the World
"[Our healthcare system does not need] third-party payers who know they can always raise premiums to cover these ridiculous costs so never bother to argue, but [instead it needs] engaged (and sometimes enraged) consumers who refuse to be treated like patsies. Inject millions of such consumers into our system and we will soon see hospitals find a way to price services fairly." (John Goodman's Health Policy Blog)

Benefits in General; Executive Compensation

Success Stories: Say on Pay Turnarounds
"[This article focuses] on a few companies that are really getting it right -- those companies that received a very low or a failed vote last year, and then turned it around in 2013.... [A chart] lists the companies with the largest change in SOP results in 2013 versus 2012 ... [Many] companies worked diligently over the past year to make meaningful changes to their pay programs and to communicate those changes to investors." (Farient Advisors)

Litigation Over Executive Compensation Disclosures Rises from the Dead
"The [California state court's] decision was not necessarily in favor of the plaintiffs. Instead, it was only a decision by the Court, with the consent of both parties, to decide the merits of the case based on the evidence submitted to date.... According to the Court, 'as reflected by the volume of argument ink and evidentiary materials submitted by both sides, this case is about disclosures that were not made, and whether those disclosures are "material" within the meaning of that term as applied to proxy statements.'" (Michael S. Melbinger, Winston & Strawn LLP)

Proskauer ERISA Litigation Newsletter, July 2013
"[T]he U.S. Supreme Court granted certiorari in Heimeshoff v. Hartford Life & Accident Insurance Co. where it is expected to rule next term on whether plan sponsors may dictate in the plan document when claims for benefits accrue. The decision may have significant implications for defending benefit claims based on a statute of limitations defense depending on the scope of the Court's ruling.... [A second article] discusses various benefit issues in Puerto Rico. In particular, ... the impact of the [ACA], ERISA and the PBGC." (Proskauer Rose LLP)

Press Releases

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