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United Retirement Plan Consultants
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NRECA [National Rural Electric Cooperative Association]
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Minimum Essential Coverage and the Multi-State Plan
"Under the final [IRS regulation], the required contribution is reduced by employer contributions to a 125 cafeteria plan if [1] the employee does not have the option to take the contribution as a taxable benefit (such as cash), [2] the contribution may be used to pay for [minimum essential coverage], and [3] the contribution may only be used to pay for medical care.... Employer contributions to an HRA can only count toward an employee's required contribution if they are required under the terms of the plan or can otherwise be determined within a reasonable time before the employee must decide whether to enroll in the group health plan.... [A] determination of affordability is based on the employer contribution that would be charged to an employee who does not participate in [an employer's] wellness program, unless the program relates to tobacco use[.]" (Health Affairs)

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Forum on Rewarding Healthy Behaviors ? Feb 4-5 2015 ? Las Vegas

Learn from Employee Health leaders how innovative workplace wellness strategies, preventive health management initiatives and evidence-based success impact workforce productivity, improve overall employee wellness and increase ROI.

HHS Wastes No Time Issuing Proposed Rules Modifying Minimum Value Rules
"HHS has proposed to amend its final MV regulations to require that, in order to provide minimum value, an employer-sponsored plan not only must meet the quantitative standard of the actuarial value of benefits, but also must provide a benefit package that meets a minimum standard of benefits. Moreover, in order to satisfy MV, an employer plan must provide substantial coverage of both inpatient hospital services and physician services.... HHS proposes that the changes to its MV final regulations will apply to employer-sponsored plans, including plans that are in the middle of a plan year, immediately on the effective date of the final regulations." (Mintz Levin)

2016 Benefit and Payment Parameters Proposed Rule: Reinsurance, Risk Adjustment, and Risk Corridor Programs; Health Insurance Rate Review; and the Individual and SHOP Exchanges
"Several methods are available to contributing entities for counting enrollees two of which -- the snapshot count and snapshot factor methods -- are explained in greater depth in the proposed rule ... The proposed rule also explains how contributing entities can prorate contributions if they cover enrollees for only part of the year.... The proposed rule extends to 2015 a safe harbor for non-compliance with the risk adjustment and reinsurance data requirements, recognizing the complexity of the requirements.... [The] rule proposes a number of changes in the ACA rate review program.... The proposed rule makes a number of changes in the rules governing exchanges (which are once again referred to as exchanges rather than marketplaces).... [HHS] is considering changing the default rule so that enrollees who do not affirmatively change plans would be auto-reenrolled into a low-cost plan (perhaps randomly) in the same metal level if the cost of the enrollee's plan increased, or increased more than a threshold amount (5 or 10 percent).... Proposed amendments to the SHOP rule would allow exchanges to assist an employer in administering continuation coverage by collecting premiums for such coverage directly from former employees." (Health Affairs)

2016 Benefit and Payment Parameters Proposed Rule, Consumer Provisions; Hardship Exemptions
"CMS and the IRS have decided to grant an automatic hardship exemption to individuals who live in states that have failed to expand Medicaid, who have household incomes below 138 percent of the federal poverty level, who are under age 65, and do not qualify for traditional Medicaid or Medicare.... The benefit provisions ... contain a number of proposals for actual changes in current qualified health plan (QHP) benefits rules, but also propose a number of potential changes or approaches to changes for comment without actually adopting them as proposals. It is a very dense document, full of new ideas." (Health Affairs)

IRS Releases 2015 Versions of Forms for Trustee Reporting of HSA Contributions and Distributions
"The instructions in Form 5498-SA no longer indicate that complete identification numbers are reported to state and local governments, and they now mention employer identification numbers as a type of personal identification number that may be truncated.... These 2015 forms should not be used until 2016, when reporting for the 2015 tax year is due. Those preparing forms with truncated identification numbers should be careful to truncate only the identification number of the 'participant' (on Form 5498-SA) and the 'recipient' (on Form 1099-SA)." (Thomson Reuters / EBIA)

[Advert.]

ERISA Audits: What We All Knew but Forgot

December 17 webinar. The risk of audit, scope of the exams, and scale of potential penalties create hazards for the unprepared plan sponsor and fiduciaries. This webinar is critical for employers and plan fiduciaries to be prepared. BenefitsLink discount .

Adoption Benefits Can Boost Recruitment Efforts for Employers
"Typically, adoption benefits employers offer include financial reimbursement for adoptive parents' legal fees, travel costs and home studies -- total costs to families can range into the tens of thousands of dollars -- as well as paid or unpaid leave of from one to 18 weeks, like that offered parents of newborn biological children[.]" (Bloomberg BNA)

'Cadillac Tax' Will Wallop Retiree Health Plans By 2020
"According to [a recent] study ... 15 percent of active employee plans are projected to incur the tax upon its activation in 2018, a rate that is expected to increase to 19 percent by 2020.... [R]esearchers estimate the tax would result in a cost increase of up to $480 per employee per year for plans expected to incur the tax.... 81 percent of early retiree plans for U.S. employers are likely to incur the Cadillac tax, and this rate is projected to increase to 84 percent by 2020. That would result in an annual per employee per year tax amount of $1,069[.]" (Wolters Kluwer Law & Business)

Retirees with Health Coverage Say They Are Financially Comfortable But Still Worry About Health Costs
"This survey examines the attitudes of U.S. retirees who receive retiree health benefits from their employer via a private exchange. A majority of these retirees reported higher than anticipated health costs and 84% were concerned about future increases. Retirees were more satisfied than older employees with their finances and less likely to have reduced spending and delayed major expenditures." (Towers Watson)

State of Oklahoma Asks Supreme Court for Faster ACA Appeal
"The state of Oklahoma, arguing that the Supreme Court should consider the views of a state government when it rules on the legality of federal tax subsidies to be paid to insurance-buying consumers under the [ACA], has urged the Court to review that state's case when it considers the already granted case of King v. Burwell . Following a request by the Obama administration, Oklahoma's case is on hold now at the U.S. Court of Appeals for the Tenth Circuit, while the Justices review the King case." [ Oklahoma ex rel. Pruitt v. Burwell , No. CIV-11-30-RAW (E.D. Okla. Sept. 30, 2014)] (SCOTUSblog)

House Republicans Sue Obama Administration Over ACA
"The lawsuit -- filed against the secretaries of [HHS] and the Treasury -- focuses on two crucial aspects of the way the administration has put the [ACA] into effect. The suit accuses the Obama administration of unlawfully postponing a requirement that larger employers offer health coverage to their full-time employees or pay penalties.... The suit also challenges what it says is President Obama's unlawful giveaway of roughly $175 billion to insurance companies under the law." [ U.S. House of Representatives v. Burwell and Lew , No. 14-cv-01967 (D.D.C. filed Nov. 21, 2014)] (The New York Times; subscription may be required)

The Extended 'Fix' for Canceled Health Insurance Policies: Latest State Action
"The continued existence of noncompliant policies may have the greatest negative impact on the small-group market, and the Small Business Health Options Program (SHOP) marketplaces in particular. Early anecdotal reports suggest that a significant number of small employers chose to renew their existing coverage prior to the availability of the SHOP. If this trend continues through 2017, it may not only affect premiums for compliant small-group policies, but also demand for SHOP coverage." (The Commonwealth Fund)

Obama, Gruber: Two Peas in a Pod
"In an analogous but different way, MIT economics professor Jonathan Gruber turns out to be President Barack Obama's Alexander Butterfield. Don't misunderstand -- I am not suggesting that President Obama is guilty of obstruction of justice or contempt of Congress as Richard Nixon was. But I am suggesting that Gruber's taped revelations will turn out to be terribly and irreversibly damaging to President Obama and Obamacare. Gruber's tapes document how the Obama administration deliberately misled Congress and the American people in order to get Obamacare enacted and implemented. They make it impossible to deny what really happened." (Leroy Goldman, in Blue Ridge News)

DOL Regulatory Agenda, Fall 2014
A list of the upcoming regulatory projects of the DOL, including the Employee Benefits Security Administration [EBSA]. Also available: Fall 2014 Statement of Regulatory Priorities . (U.S. Department of Labor)

New Annual Filing Requirements for Multiple Employer Retirement Plans -- and Some for Welfare Plans Too (PDF)
"An interim final regulation from DOL... provides that the [2014] annual return/report (Form 5500) of a MEP must include a list of participating employers and a good faith estimate of the percentage of total contributions (employer and employee) made by each participating employer during the plan year.... It is required of all MEPs including defined benefit, defined contribution, and welfare benefit plans.... The contribution percentages reported can be developed using the same method (cash, modified cash, or accrual) for calculating the good faith estimate that is used for recognizing other financial transactions on the Form 5500." (Buck Consultants at Xerox)

DOL's New Audit Focus: Health Plan Claims and Appeals, and Hard-to-Value Retirement Plan Assets
"DOL representatives have expressed concern that the complexity of health and welfare benefits adjudication creates an inherent risk of error (or, worse, fraud). The DOL is also concerned that benefits are being systematically denied at the initial claim level, because, more often than not, participants do not appeal the initial claims determinations. Further, the DOL is questioning whether plans are providing sufficient and understandable information regarding the reasons for denial of a claim, such that participants can adequately avail themselves of the appeals process." (Proskauer's ERISA Practice Center)

Federal District Court: Participant in Possession of Accurate SPD Cannot Rely on Oral Misrepresentation
"Here, Forristall argues that Fedex's liability stems from Strong's mistaken impression that Mary remained eligible for coverage under Forristall's [group health] insurance plan after the divorce and his failure to correct the relevant data entries in Fedex's computer system. This argument, however, directly touches on Fedex's recordkeeping and disclosure duties as an ERISA plan administrator, which include providing participants with an accurate written description of the plan.... To permit plan participants to bring state law claims premised on oral explanations that deviate from the statutorily required written plan description would undo Congress's intent of insuring the integrity and consistency of ERISA plan administration." [Forristall v. Federal Express Corp., No. 1:13-cv-11454-RGS (D. Mass. Nov. 21, 2014)] (U.S. District Court for the District of Massachusetts)

Employer Errors in Dealing with Additional Medicare Tax
"If an employer fails to withhold the correct amount of additional [0.9% 'high earner'] Medicare tax and discovers the error in the year in which it should have withheld the tax, the employer should make an interest-free adjustment on the applicable corrected employment tax return (e.g., Form 941-X), and the missed amount of additional Medicare tax should be deducted from other wages or remuneration that it pays to the employee on or before the last day of that year. However, whether or not the employer is able to deduct the correct amount of additional Medicare tax from the employee's other wages or remuneration, the employer must report and pay the correct amount of additional Medicare tax.... If an employer mistakenly withholds too much additional Medicare tax and discovers that error in the same year ... the employer must first repay or reimburse the employee for the overwithholding before the end of the calendar year; if the employee is not repaid or reimbursed before the end of the year, the overwithholding cannot be corrected with an interest-free adjustment." (Ford & Harrison LLP)

Clearwater Compliance CEO Bob Chaput Appointed to Advisory Board of the Association for Executives in Healthcare Information Security Clearwater Compliance

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