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BenefitsLink Health & Welfare Plans Newsletter

December 17, 2013

Webcasts and Conferences

Breaking Down the Many ?Fiduciary? Roles, Obligations and Service Models Today
January 15, 2014 WEBCAST
(American Society of Pension Professionals & Actuaries (ASPPA))

Health Care Reform for Employers: Now What?
January 15, 2014 in KY
(Lorman Education Services)

How to Define Full Time Employees under the ACA
January 22, 2014 WEBCAST
(Know Benefit Compliance )

ACOs Summit 2014
January 27, 2014 in TX
(Opal Events)

Employee Plans Technical Guidance Phone Forum
February 26, 2014 WEBCAST
(Internal Revenue Service (IRS))

View All Webcasts and Conferences


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Hand-picked links to the web's best news articles,
official guidance, jobs, webcasts and more.
[Guidance Overview]

Cafeteria Plans Need to Move Fast to Take Advantage of Year-End IRS Guidance
"Many of the provisions of the Notice will affect the amount reportable as income on 2013 Forms W-2. Thus, it is important for those responsible for preparing such forms to be aware of the new guidance as soon as possible.... The Notice permits amendments to be made retroactively on or before the last day of the first plan year beginning on or after December 16, 2013. Such an amendment may be effective retroactively to the first day of the plan year including December 16, 2013, provided that the cafeteria plan operates in accordance with the guidance under the notice. The Notice has different effects based on the type of plan, and what the employer has done so far[.]" (Calhoun Law Group)


[Advert.]

23rd Annual National Health Benefits Conference & Expo - Jan. 28-29, FL

Sponsored by HBCE- Health Benefits Conference & Expo

Hear Here: Sprint, L.L. Bean, We Energies, City of Houston, Eastman Chemical, Univ. of IA, AL & S.FL, Palm Beach Co Schools, Crowley Maritime Corp, Anoka Co, S. Shore Hospital, more. Jan 28-29 - Hi quality, moderate cost. Complete Program brochure online now !



New York Catholic Organizations Win Court Challenge to Obamacare Contraception Mandate
"[Federal district court Judge Brian] Cogan barred the government from enforcing the mandate against Catholic Health Care System, Catholic Health Services of Long Island, Cardinal Spellman High School and Monsignor Farrell High School.... The U.S. [had] issued a rule exempting the archdiocese [itself], but schools and health-care affiliates were still subject to the law, which takes effect Jan. 1. Cogan wrote: The groups 'have demonstrated that the mandate, despite accommodation, compels them to perform acts that are contrary to their religion... And there can be no doubt that the coercive pressure here is substantial.'" [ Roman Catholic Archdiocese of New York et al. v. Sebelius , 12 Civ. 2542 (E.D.N.Y. Dec. 16, 2013)] (Newsmax and Bloomberg News Service)

OSHA Retaliation Complaint Form Is Online and Available to Employees
"OSHA currently enforces the whistleblower and anti-retaliation protections of 22 statutes, including the Affordable Care Act ... Much like OSHA's in-person or written complaint portals, the online form solicits information about the complainant and the employer, inviting the complainant to describe his or her protected activity and the employer's allegedly retaliatory or discriminatory response. The form even asks the complainant to opine on how management learned of the protected activity." (Quarles & Brady LLP)

A Guide to Obamacare's Ever-Changing Deadlines
"The deadline for enrolling in insurance coverage that starts on Jan. 1 is Dec. 23. That's eight days later than the initial deadline of Dec. 15. But it's also eight days before the deadline to actually get your first premium payment to your insurer, which is Dec. 31 -- unless your insurance company sets the deadline later. Got all that straight? A lot of insurance shoppers, understandably, do not." (The Washington Post; subscription may be required)

The Numbers Behind 'Young Invincibles' and the Affordable Care Act
"Because the ACA includes a risk adjustment system that transfers funds from individual market insurers in a state with younger and healthier enrollees to those with older and sicker enrollees, what really matters for next year is the demographic composition of actual enrollment in total in each state compared to what insurers as a whole projected. In the future, the goal remains to get a proportionate mix of enrollees by age in a given state.... [B]ecause premiums are still allowed to vary substantially based on age, the financial consequences of lower enrollment among young adults are not as great as conventional wisdom might suggest." (Kaiser Family Foundation)


[Advert.]

ACOs Summit 2014 - The viability & future business outlook of ACOs - January 27-28, Austin, TX

Sponsored by Opal Events

You want to know the viability & future business outlook of ACOs going into 2014, right? Is the idea of accountability in healthcare sustainable given today's approach? This January, we'll convene a robust group of experts to tackle these issues and more.



ACA Promises to Extend Coverage to Millions of Young Adults, Yet Many Will Remain Uninsured
"Data as far back as 2007 from a Commonwealth Fund Biennial Health Insurance Survey showed that young adults ages 24 and older -- at the time not generally eligible for dependent coverage -- enrolled in employer-based plans when they were offered at nearly the same rate as older adults: 78 percent versus 84 percent. Cost, not hubris, appears to be the determining factor[.]" (HealthAffairs)

Findings from the 2013 Consumer Engagement in Health Care Survey (PDF)
"9.7 percent of the population was enrolled in a CDHP, up from 9.6 percent in 2012, while enrollment in high-deductible health plans (HDHPs) increased from 16 percent in 2012 to 18 percent in 2013. Overall, 26.1 million individuals with private insurance, representing 15 percent of that market, were either in a CDHP, or in an HDHP that was eligible for a health savings account (HSA) but had not opened the account. Unlike in prior years, when health reimbursement arrangements (HRAs) and HSAs were examined separately, HRA enrollment fell, while HSA enrollment increased." (Employee Benefit Research Institute [EBRI])

A Roadmap to High Quality Affordable Health Care for All Americans
"This document reviews current research outlining the key drivers of health care costs and advances a new policy framework for bending the cost curve and improving the quality of patient care. These recommendations include: [1] Advancing a new federal-state partnership to reduce costs and improve value. [2] Removing barriers to delivering quality health care. [3] Accelerating health system and delivery reforms to transform the health care system and promote value. [4] Addressing underlying health care cost drivers and paying for care that is proven to work. [5] Strengthening the health care infrastructure necessary for a high-quality care delivery system. [6] Increasing the emphasis on reducing waste, fraud, and abuse in the health care system." (America's Health Insurance Plans [AHIP])

Consumer Protections for Web Brokers that Participate in the Health Insurance Marketplace (PDF)
"In addition to the official marketplace websites, federal regulations allow 'web brokers' to sell marketplace health plans and to help consumers enroll in financial assistance for coverage.... Marketplaces are not required to allow web brokers to sell marketplace plans and help consumers enroll in financial assistance. But any marketplace that does should implement protections so that consumers are not adversely affected. This brief outlines recommended consumer protections for marketplaces that allow web brokers to sell marketplace coverage and help consumers apply for financial assistance." (Families USA)

ML Strategies Health Care Reform Update, December 16, 2013 (PDF)
Topics include: Policymakers Focused on Long Term Care Hospital Reform; NIH Looking to Shift Funding to Individual High-Risk Research: Implementation of the Affordable Care Act; and Other HHS and Federal Regulatory Initiatives. (ML Strategies, LLC)

Building Your Health Plan's Defined Contribution Strategy
"Defined Contribution plans make clear the employer's subsidy for benefits, allowing employees and prospective employees to easily determine the value of the employer's benefit program. This transparency may create the need for variable contribution levels based on employees statuses. It may also require national companies with locations around the U.S. to create a formula that takes into account local medical pricing to ensure an equal contribution amount is provided to employees in different locations." (Healthcare Trends Institute)

Moody's Says Latest Federal Requests and Rules Put New Pressure on Health Insurers
"The latest changes 'impose additional financial risks' on [insurance] companies, Moody's said ... The guidelines disclosed Thursday [December 12] are 'credit negative,' meaning they're not great news for people who have lent money to insurers. The timing is 'especially troublesome' because it gave insurers less than three weeks to change procedures and computer programs to accommodate the changes, Moody's said. That 'will very likely cause more confusion for individuals insured under these policies,' the report added." (Kaiser Health News)

U.S. Ranks Near Bottom on Efficiency of Health Care Spending
"A new study ... reveals that the United States health care system ranks 22nd out of 27 high-income nations when analyzed for its efficiency of turning dollars spent into extending lives.... [E]very additional hundred dollars spent on health care by the United States translated into a gain of less than half a month of life expectancy. In Germany, every additional hundred dollars spent translated into more than four months of increased life expectancy." (Physicians for a National Health Program [PNHP])

Benefits in General; Executive Compensation

Supreme Court Upholds Reasonable Contractual Limitations Period in ERISA Plan
"Since ERISA does not impose a statute of limitations for filing claims for benefits, employers sponsoring plans that do not include limitations provisions applicable to such claims should consider amending their plan documents to add a reasonable limitations period. Incorporating a limitations period in the terms of the plan would avoid the imposition of a borrowed state law limitations period (which in some states could be extensive) and would prevent the imposition of different limitations periods in cases where employers are sued in different jurisdictions." (Holland & Knight)

Supreme Court Holds That a Three-Year Contractual Limitations Period for Benefit Claims Is Neither Unreasonable Nor Contrary to ERISA
"This is a big, unanimous win for contractual limitations periods for benefit claims in an ERISA plan. From the defense perspective, even though this case is about a disability plan every plan sponsor should review all of its ERISA plan documents to determine whether an internal limitations period is appropriate for benefit claims. And from the plaintiff perspective, every claim should be aggressively pursued through the administrative process and then quickly filed in court if denied; there's an undertone in the decision that the delays plaintiff had in pursuing her claim were unreasonable, so it was not unreasonable to apply a limitations period that provided three years from start to finish to exhaust administrative remedies and file suit." [Heimeshoff v. Hartford Life and Accident Ins. Co., No. 12-729 (S.Ct. Dec. 16, 2013)] (James E. Arnold & Associates, LPA)

Supreme Court Holds that Plan Can Start Limitation Clock Before Benefit Claim Accrues
"The Court had little trouble rejecting any argument that the limitation provision was unreasonably short, given that administrative procedures ordinarily would be completed within about a year, 'leaving the participant with two years to file suit.' The Court left open the possibility that the evaluation could change if substantially less time was expected to remain at the end of a proceeding." [ Heimeshoff v. Hartford Life and Accident Ins. Co. , No. 12-729 (S.Ct. Dec. 16, 2013)] (Begos Brown & Green LLP)

Supreme Court Limits Timing of Certain ERISA Claims
"[T]his decision confirms that there are no requirements under ERISA with respect to when a reasonable statute of limitations can begin to run. Employers should check their plan documents to ensure that any limitation on a participant's ability to bring a lawsuit is reasonable, and that the limitation is spelled out unambiguously in the policy. It is also a good idea to include such language in denial of claim letters." [ Heimeshoff v. Hartford Life and Accident Ins. Co. , No. 12-729 (S.Ct. Dec. 16, 2013)] (Fisher & Phillips LLP)

ERISA Plan Document Limitations Periods Are Enforceable
"[At oral argument,] the Justices did not seem terribly concerned that the enforcement of ERISA limitations periods poses a serious obstacle to beneficiaries getting their day in court.... Running through the Court's opinion is a clear sense that Heimeshoff could have sued earlier, and indeed that any ERISA beneficiary who truly deserves to be in court has ample time to file a lawsuit, or ample ability to make the case for equitable tolling." (SCOTUSblog)

Text of Amicus Brief Filed by American Benefits Council Supporting Exemption from FICA Withholding for Certain Severance Payments (PDF)
"When the issue in the case is evaluated not merely from the perspective of the merits of the taxpayer's position on which supplemental unemployment compensation benefits are excluded from taxable wages for FICA purposes, but also from he perspective of the merits of the government's position that relies on the revenue rulings, there can be no doubt that the taxpayer's position is preferable, since the taxpayer's position provides a coherent and sensible answer to the issue, whereas the government does not offer an alternative to the taxpayer's position that is coherent or supportable." [U.S. v. Quality Stores, No. 12-1408 (on petition for certiorari to 6th Cir.; brief as amicus curiae in support of respondent Quality Stores, Inc.)] (American Benefits Council)

Year-End Financial and Tax Strategies for Restricted Stock, RSUs, and Stock Options
"Unless you were already definitely planning to sell company stock or exercise options soon, most experts feel that unease about higher tax rates in your future should not be the only reason for doing so at the end of the year. However, if you are considering option exercises or stock sales at year-end, you should be aware of the thresholds for higher tax rates and may want to consider keeping your income below them, if possible." (myStockOptions.com)

CEO Pay Increasingly Performance-Based
"Regardless of how pay is measured, pay for S&P 1500 CEOs was up in 2012 but grew at lower rates than in the previous year. The median increase in target pay -- salary and target cash incentives plus the grant-date value of stock options, restricted stock and performance plans -- was 5.9% in 2012, down from 8.9% the year before. When looking at pay CEOs actually earned -- salary and annual and long-term incentives earned plus the value of vested and exercised awards -- the median increase fell from 19.7% to 11.7% over the same time period." (Towers Watson)

NASDAQ Proposes Amendments to Compensation Committee Member Independence Rules
"The proposed rule change provides that the board of directors of a listed company may take a director's receipt of any consulting, advisory or other compensatory fees into consideration when assessing the independence of the director for purposes of serving on the company's compensation committee. Therefore, a director would not be automatically disqualified from serving on the compensation committee of a listed company if the director received consulting, advisory or other compensatory fees from the company or any of its subsidiaries." (Holland & Knight)

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