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Individual Insurance Advisor
Northwestern Benefit Corporation of Georgia
in GA

DC Implementation Specialist
Milliman
in CA, OR, WA

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Required Minimum Distributions
March 20, 2014 WEBCAST
(ASC Institute)

Basics of Qualified Retirement Plans
April 3, 2014 WEBCAST
(ASC Institute)

HIPAA Privacy & Security
April 11, 2014 in GA
(Thomson Reuters / EBIA)

Cafeteria Plans
April 22, 2014 in CA
(Thomson Reuters / EBIA)

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Proposed Regs Incorporate IRS Litigation Position on UBTI for VEBAs and SUB Trusts
"The principal objective of the reproposal is to state expressly in regulations the IRS position that investment income earned during a taxable year is subject to UBTI if the organization's year-end assets exceed the account limit under IRC section 419A for that year (without taking into account any post-retirement medical reserve).... The reproposal would clarify the regulation with respect to the method the IRS views as correct for calculating UBTI, to take account of such investment income, and add examples clearly illustrating this approach." (Sutherland)

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Set Yourself Apart From Your Peers With the CEBS Designation

Co-sponsored by the International Foundation of Employee Benefit Plans and the Wharton School of the University of Pennsylvania, the CEBS designation gives you the knowledge and confidence to succeed in today's business environment. Learn More!

The Employer Responsibility Final Rule (Part 2)
"The employer mandate is meant to keep employers from ceasing to offer coverage they were already offering. The transition provisions in this regulation are crafted to ensure that employers do not cut back on coverage, and to that extent fulfill this purpose. The individual mandate, on the other hand, is intended to extend coverage." (Timothy Jost in Health Affairs Blog)

To Pay or Play Under the ACA? Government Contractors May Not Have a Real Choice
"Relevant statutes, regulations, and guidance appear to refer interchangeably to the 'assessable payment' as a penalty or a tax. These mixed references raise the question of whether the appropriate treatment is as a tax or a penalty. Certainly, the allowability of any such assessable payment under government contracts law remains untested and unclear. As a result, government contractors in particular must proceed with caution here because opting to pay the 'penalty' under the ACA may result in the incurrence of unallowable costs." (McKenna Long & Aldridge LLP)

Small Employers Catch a Big Break!
"The U.S. Treasury Department estimates that 96 percent of employers have less than 50 employees and are never going to be subject to the employer mandate and that 2 percent of employers have 100 or more employees. The other 2 percent of employers fall between 50 and 99 employees and will receive the benefit of this extension of time. The Treasury Department says that many of these mid-sized employers did not previously offer health coverage, or offered health coverage that does not comply with the requirements of the ACA, and so relief is provided until 2016 to assist these mid-sized employers in transitioning into compliance with the employer mandate." (Ogletree Deakins)

2014 American Bar Association Midwinter Meeting Report of 2013 FMLA Cases (PDF)
Comprehensive 322-page report of significant FMLA decisions handed down by the federal courts in 2013; includes every FMLA decision from 2013. (Subcommittee on the Family and Medical Leave Act, Committee on Federal Labor Standards Legislation, American Bar Association, via FMLA Insights)

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Feb. 26 Webinar -- Private Health Insurance Exchanges for Large Employers

We will discuss the Mechanics of private exchanges for large employers; benefits and potential drawbacks of private exchanges; legal implications of private exchanges - what we know and what you should know when talking to private exchange providers.

11th Circuit Mandates Proactive Gathering and Review of SSA Information in LTD Claim Review
"Without asking Plaintiff for the information generated during the SSA investigation, LINA upheld its denial on the second appeal, explaining in the letter that the SSA decision was independent of its decision.... While the Court recognized that Plaintiff had the burden of establishing her entitlement to benefits, and that LINA was not required to 'ferret out evidence in [Plaintiff's] or the SSA's possession,' it found it 'troubling' that LINA 'treated the SSA process and the evidence generated by it as irrelevant and unavailable' once it had denied Plaintiff's claim at the initial level." [ Melech v. Life Insurance Co. of North America (LINA) , No. 12-14999 (11th Cir. Jan. 6, 2014)] (Womble Carlyle)

Prescription Drug Coverage and the ACA's Medication Costs
"On the whole, the 4 types of metal plans averaged a 34% increase in drug cost-sharing as compared to copayments and co-insurance fees in the pre-reform market.... When compared to the average out-of-pocket costs for plans in the 2013 pre-reform individual health insurance market, copayments and coinsurance fees were 58% higher for Bronze Plans.... Copayments and co-insurance averaged 15% higher for [Platinum-level] plans. Silver and Gold plans had drug costs increase 36% and 28% respectively." (HealthPocket)

HSAs Exceed 10 Million, Continue Stable Growth
"HSA accounts rose to 10.7 million, holding assets totaling over $19.3 billion, a year over year increase of 25% for HSA assets and 30% for accounts for the period of December 31st, 2012 to December 31st, 2013.... The average funded HSA account balance at the end of 2013 was $2,356 from $2,283 at the end [of] 2012, a 3.2% increase... Direct employer relationships are the largest driver of new HSA accounts, accounting for 38% of all new HSA accounts in 2013." (Devenir)

Employer and Worker Contributions to HRAs and HSAs, 2006-2013
"The percentage of workers reporting that their employers contribute to the account increased. Among individuals with employer contributions, the percentage with contributions between $200-$499 and $750-$999 increased while contributions of $1,000 or more fell in 2013. Workers with employee-only coverage dropped their contributions, but those with family coverage kept their contribution levels steady." (Employee Benefit Research Institute [EBRI])

Five Features of Value-Based Insurance Design Plans Are Associated with Higher Rates of Medication Adherence
"Value-based insurance design (VBID) plans selectively lower cost sharing to increase medication adherence.... VBID plans that were more generous, targeted high-risk patients, offered wellness programs, did not offer disease management programs, and made the benefit available only for medication ordered by mail had a significantly greater impact on adherence than plans without these features. The effects were as large as 4-5 percentage points." (Health Affairs)

March Marketplace Payment Processing Cycle: Enrollment & Payment Data Reporting and Restatement (PDF)
45 presentation slides. Excerpt: "In March, CMS will make payments for the March payment month which will include: [1] Payments for the March enrollment month (enrollments effective in March as of February 15, 2014); and [2] Payments for restatements to the January and February enrollment data, including updated effectuated enrollment data for prior months and any retroactive enrollment data. In this presentation we will outline how enrollment and payment data will be submitted for the March payment month and how to update payments for prior enrollment months (e.g. January and February) under the interim payment process." (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)

House Committee Presses Administration for Answers, Documents Regarding Latest Obamacare Delay
"House Energy and Commerce Committee leaders [on February 12] sent a letter to Treasury Secretary Jack Lew ... seeking documents related to: [1] The costs or burdens of the law's requirements on employers with more than 50 employees, and on employers with more than 100 employees, that Treasury relied upon when delaying employer mandate; [2] The costs or penalties for individuals under the health law that have been prepared for or by Treasury; [3] The constitutional or statutory authority of Treasury to delay the employer mandate; and [4] All documents exchanged between or among Treasury, HHS, and the Executive Office of the President [EOP] referring or relating to the latest delay of the employer mandate and, specifically, feedback or analysis provided by HHS or the EOP to Treasury." (House Committee on Energy and Commerce)

Enrollment in the Health Insurance Marketplace Increases by 53 Percent in January
"Enrollment in the Health Insurance Marketplace continued to rise in January, with a 53 percent increase in overall enrollment over the prior three month reporting period ... Nearly 3.3 million people enrolled in the Health Insurance Marketplace plans by Feb. 1, 2014 (the end of the fourth reporting period for open enrollment), with January alone accounting for 1.1 million plan selections in state and federal marketplaces." (U.S. Department of Health and Human Services)

Analyzing the Health Exchange Enrollment Report Issued Feb. 12, 2014
"Ultimately, the goal of the ACA is to reduce the number of the uninsured, but this can happen by enrolling individuals who would otherwise have become uninsured as well as enrolling individuals who are currently uninsured. The January report does not tell us how many enrollees fit in each category. But a Gallup poll released on February 12 found that the rate of uninsured in the U.S. had dropped sharply from 17.1 in the fourth quarter of 2013 to 16 percent in the first quarter of 2014, while the rate of uninsured 26- to 34-year olds dropped from 30.2 to 25.7 percent." (Timothy Jost in Health Affairs Blog)

Health Insurance Marketplace: February 2014 Enrollment Report (PDF)
53 pages. Excerpt: "[C]onsistent with expectations, the proportion of young adults (ages 18 to 34) who have selected a Marketplace plan through the [state-based marketplaces (SBMs)] and [the federally-facilitated marketplace (FFM)] has continued to grow faster in the fourth month of the open enrollment period than in the prior three months, resulting in a 3 percentage point increase in the share of plan selections in the fourth month (27 percent) compared to the prior three months (24 percent)." [ Summary Infographic also available. ] (Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services)

Some Same-Sex Couples Denied Family Policies on Insurance Marketplaces
"On the one hand, federal rules say that legally married same-sex couples should be treated the same as opposite-sex couples when it comes to determining eligibility for premium tax credits and cost-sharing subsidies that reduce the cost of marketplace plans.... But when it comes to defining 'family' for health insurance purposes, there's no clear federal definition; the decision is left up to the states. Moreover, if state law doesn't spell out what 'family' or 'spouse' means for insurance purposes, insurers generally have flexibility to make those determinations themselves." (Kaiser Health News)

Senate GOP Puts Forth a Health Reform Proposal: The Burr-Coburn-Hatch Plan
"By repealing Obamacare rather than trying to fix that law, the [Patient Choice, Affordability, Responsibility, and Empowerment Act, or the Patient CARE Act (PCA)] presents a clear alternative with all of the key elements of a market-based health reform. In any event, Obamacare is too lengthy and interconnected to address coherently through a series of one-off amendments. Having cleared the slate, the authors of the PCA provide an internally consistent reform that avoids the heavy emphasis on mandates and federal regulatory control that permeates Obamacare." (James Capretta and Joseph Antos in Health Affairs Blog)

Evaluation of Increased Adherence and Cost Savings of an Employer Value-Based Benefits Program Targeting Generic Antihyperlipidemic and Antidiabetic Medications
"Plan sponsors are increasingly evaluating the use of value-based benefit design (VBBD) to change member behavior. This [zero co-pay] program used a reduction in cost sharing to incentivize members to use more generic drugs and to enroll in a care management coaching program. The study also demonstrated that a VBBD program can have a positive impact on adherence and cost outcomes among those who participate compared with nonparticipants." (Academy of Managed Care Pharmacy)

Obamacare Will, in Fact, Encourage Employers to Cut Jobs
"[If] employers are going to take advantage of the one-year delay in enforcement of the employer mandate, they have to attest (under penalty of perjury) that they aren't cutting jobs or reducing hours because of Obamacare. By pointing this out as a possibility -- or an outcome to be avoided -- the administration is acknowledging what it long denied: The law creates incentives for employers to cut hours and jobs.... The regulation delaying the employer mandate tries to give employers some flexibility, allowing them to reduce the number of employees for 'bona fide business reasons' ... This raises the question of how the administration intends to enforce the very exception it has created." (Bloomberg)

Obamacare Creates New Ways to Prosecute American Business
"[T]his rule includes a provision that says you have to have the right motives for having a certain number of employees to be in compliance with Obamacare.... You must certify to the IRS -- under the threat of perjury -- that the reasons for your employee head count have nothing to do with your opposition to or avoidance of Obamacare.... It's jaw-dropping that if you fall below 100 employees, the burden will be on you to prove that you meant no disrespect to Obamacare." (Ed Rogers in The Washington Post; subscription may be required)

Deadline Looms for Quality Stores FICA Refund Claims for Severance Payments
"[E]mployers may have a separate deadline for situations in which the IRS has issued a notice of claim disallowance for FICA refund claims. In such cases, an employer must either: (i) bring suit to contest the disallowance within two years after the issuance of the notice or (ii) obtain an extension of the time to file such a suit with the IRS. This process can be initiated by filing IRS Form 907, Agreement to Extend the Time to Bring Suit. However, because the IRS is not required to grant an extension requested pursuant to an employer filing Form 907, employers may also wish to file suit." (McDermott Will & Emery)

The Fiduciary Exception to the Attorney-Client Privilege: What It Is, and Why It Matters
"[T]he magistrate judge dealt, in a very clean and easily understood manner, with the key issues that come into play under [the fiduciary exception to the attorney-client privilege in ERISA litigation], which have to do with its borders: to be exact, what attorney-client communications are subject to disclosure under this exception, and what ones are not.... Plans and their outside ERISA lawyers ... need to remember that their communications can end up in a courtroom in later litigation that cannot even be foreseen at the time of the communications in question, and should be careful with regard to the accuracy, context, phrasings and tone of such communications as a result." [ Kenney v. State Street Corp. , No. 9-10750-DJC (D. Mass. Dec. 2013)] (Stephen Rosenberg of The McCormack Firm, LLC)

Weighing in on Executive Comp
"The intersection of executive pay with the company's performance is seen as a critical element in say-on-pay votes, but Georgeson's research shows that total shareholder return relative to a company's peers is a bigger factor than absolute return, [said Rajeev Kumar, senior managing director for corporate governance and research at Georgeson, a proxy solicitation and corporate governance consulting company].... Smaller companies are more likely to fail to win majority support than large companies, he said, attributing that fact to large companies' greater experience with shareholder engagement and greater resources to support outreach." (Treasury & Risk)

OneAmerica Recognized for Best Practices in Behavioral Finance OneAmerica Financial Partners

MassMutual Retirement Services Adds Five Industry Professionals to Sales Team MassMutual Retirement Services

BlackRock Launches CoRI Funds BlackRock, Inc.

Alegeus Technologies Announces eClaims Manager to Automate Benefit Account Adjudication Processes and Improve the Participant Experience Alegeus Technologies, LLC

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