Actuary
Benetech
in CA, NC

ERISA Attorney
Kraw & Kraw Law Group
in CA

401k/DC Plan Administrator
Lebenson Actuarial Services
in NV

Associate Pension Administrator
Alliance Pension Consultants, LLC
in IL

Pension Administrator
TPA Firm in the South Bay/Monterey Peninsula, CA
in CA

Retirement Pension Plan (Experienced Plan Administrator)
Schiller's Pension Consulting
in CA

Retirement Education Specialist
The Newport Group
in NC

Benefits Administrator / Entry Level
Buck Consultants a Xerox Company
in IN, KY, OH

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6th Annual Financial Advisor Retirement Symposium
April 1, 2015 in NV
(Financial Advisor and Private Wealth Magazines)

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ACA Requirements for Coverage of Preventive Services
"The [ACA] requires non-grandfathered group health plans to provide benefits for items or services recommended by the U.S. Preventive Services Task Force (USPSTF).... The USPSTF-recommended preventive services benefits must be provided as of the first day of the plan year that begins on or after the date that is one year after the date the recommendation is issued.... The USPSTF published a matrix that includes the USPSTF recommendations issued in 2013 and 2014 and the date those recommendations become effective." (Hodgson Russ LLP)

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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.

December 5 Deadline for Insurers, Certain Self-Insured Health Plans to Submit 2014 Transitional Reinsurance Program Contribution Data
"Friday, December 5, 2014 is the last day for health insurers and certain self-insured group health plans that are 'contributing entities' to submit their required 2014 enrollment counts for the transitional reinsurance program contributions ... HHS extended the 2014 data submission deadline to submit the 2014 enrollment counts ... but to date has not modified the deadline for making the required transition reinsurance program fees." (Solutions Law Press)

Reimbursing Employees for Individual Health Insurance Policies Subjects Employers to Hefty Excise Taxes
"When an employer reimburses an employee for an individual health insurance premium, or pays the premium directly to the insurer, it has (perhaps inadvertently) established a 'group health plan' which is subject to the so-called Public Health Service Act mandates of ACA.... The November FAQ makes it abundantly clear that characterizing the payment or reimbursement as taxable wages does not 'undo' its group health plan status, and thus, the arrangement can still not satisfy the Public Health Service Act mandates." (Benefits Bryan Cave)

HHS Proposes 2016 Reinsurance Contribution Rate and Out-of-Pocket Maximums (PDF)
6 pages. "Plan sponsors can now determine the amount of reinsurance fees that will be paid for 2016.... The guidance does not discuss how HHS will adjust these payments after the three years to collect $25 billion. Employers may be required to make additional payments if the [published] rates do not collect the amount required; or they may receive refunds." (Buck Consultants at Xerox)

Ninth Circuit Rules Assignee Health Care Providers May Sue Health Plans Under ERISA for Payment of Benefits
"Although the clinic could bring suit for denied benefits, the Ninth Circuit held that the scope of the patients' assignment did not encompass claims for breach of fiduciary duty. The court found that language stating, 'this is a direct assignment of my rights and benefits under this policy,' with no specific reference to breach of fiduciary duty claims, was insufficient to demonstrate that patients intended to assign their rights to bring suit for breach of fiduciary duty." [ Spinedex Physical Therapy USA Inc. v. United Healthcare of Arizona, Inc. , No. 12-17604 (9th Cir. Nov. 5, 2014)] (Littler)

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2015 Mid-Sized Retirement & Healthcare Plan Management Conference

Will you have a job in 5 years? The future of employee benefit plans and departments starts with decisions being made now! Register by Dec. 31 and save $200 off the full fee; use code BENL . 99% of past attendees agree -- it's time and money well spent!

When an Employee Falls Off a Ladder at Work, Is His Absence Covered by FMLA?
"When [employers] communicate to an employee that they must be fully healed or completely released, [they] fail under the ADA to engage in an independent assessment as to whether the employee might need a reasonable accommodation to return to work.... Unlike the ADA, there is no 'undue hardship' argument under the FMLA, so [employers] must live with the reality that FMLA absences often hamper [their] ability to properly staff our operations.... [T]he FMLA regulations presume that the employer will return the employee to the same shift, since a return to a different shift (particularly when it's a move from 1st to 2nd shift) is not an equivalent position." (FMLA Insights)

Employers Unfamiliar with Information on the Quality of Health Plans
"Only 7 percent of employers who offer health insurance use objective quality information ... 60 percent of employers offering health insurance say quality ratings are an important factor when choosing a plan, though most are unfamiliar with independent sources of quality data ... 36 percent of employers offering health insurance say their organization uses quality data provided directly by the health plan[.]" (Robert Wood Johnson Foundation)

EEOC Challenges Honeywell's Wellness Program
"Given the claims against Honeywell, employers most at risk for EEOC challenge are those that impose high penalties (thousands of dollars), those that require biometric screening, and those that include spouses in the biometric screening required for the incentives. Under Honeywell's program, $2,000 of the $4,000 reported penalties related to smoking status, $1,000 for the employee and $1,000 for the spouse. Individuals who declined the biometric screening (which tested for smoking status among other things) were treated as smokers regardless of actual status." (Stinson Leonard Street)

Philadelphia Mayor's Task Force Recommends Mandatory Paid Sick Leave
"The report makes the following recommendations: [1] Employers with 15 or more employees should provide paid sick leave to qualifying employees.... [2] Sick leave should be available to employees for their own injury, medical care, and health conditions, as well as those of family members, including children, spouses, domestic partners, parents, grandparents, grandchildren, and siblings (including foster, step, and in-law relationships).... [3] No compensation should be provided for any earned and unused time at separation from employment.... If Philadelphia adopts these recommendations as law, an estimated 120,000 of the 200,000 workers currently without paid sick leave would become entitled to the new leave." (Ballard Spahr LLP)

Historically Slow Growth in Health Spending Continued in 2013; Underlying Slow Cost Growth Is Continuing
"The data reported by the [Office of the Actuary at CMS] show that 2013 was another year of historically slow growth in national health expenditures. National health expenditures rose just 1.4 percent in real per capita terms in 2013, slower than the 1.5 percent increase in real per capita GDP in 2013. The last three years -- 2011, 2012, and 2013 -- are the three slowest years of growth in real per capita national health expenditures since record-keeping began in 1960." (The White House Council of Economic Advisers)

National Health Spending in 2013 Continued Pattern of Low Growth
"Major areas where spending growth slowed (from 2012) included: Private health insurance (2.8 percent) ... Medicare spending (3.4 percent) ... Out-of-pocket spending (3.2 percent) ... Hospital spending (4.3 percent) ... Physician and clinical services (3.8 percent) ... Major areas where spending growth accelerated in 2013 (over 2012) included: Retail prescription drugs (2.5 percent) ... Medicaid expenditures (6.1 percent)." (Health Affairs)

Pace of Health Care Cost Increases Falls to a 54-Year Low
"The share of the economy devoted to health care, which appeared to be growing inexorably for decades, has been the same since 2009.... Spending for health care in 2013 averaged $9,255 a person ... Health spending grew at about the same pace as the economy and accounted for 17.4 percent of the gross domestic product, which reflects the total output of goods and services." (The New York Times; subscription may be required)

Big Changes in Fine Print of Some 2015 Health Plans
"Customers of more than 900 plans will see their out-of-pocket maximum for medical bills increase, usually to $6,600 for individuals, the most allowed by law for next year. Only about 250 plans are lowering their out-of-pocket maximums. About 180 plans are being discontinued for at least some customers, and the rest are keeping the same limits." (The New York Times; subscription may be required)

Among Eleven Nations, American Seniors Struggle More with Health Costs
"[N]early one-in-five (19%) Americans ages 65 and older say they had a medical problem but did not visit a doctor, skipped a medical test or a treatment recommended by a doctor, did not fill a prescription or skipped doses of their medicine because of cost constraints. By comparison, a far smaller share of elderly Canadians (9%), British (5%) and French (3%) -- all of whom have government-funded health insurance programs -- reported cost-related constraints on access to health care." (Pew Research Center)

Eleventh Circuit: Limitations Period Begins When Benefit Payments Stop
"The Court said that, as in this case, in the absence of a final or formal denial, an ERISA cause of action accrues -- and the limitations period begins to run -- when the claimant has reason to know that the claim administrator has clearly repudiated the claim or amount sought. MetLife's conduct -- failing to provide benefits on or after May 1, 1997 -- demonstrated a clear and continuing repudiation of Witt's rights, and therefore caused the six year statute of limitations to start running ... Further, MetLife's subsequent courtesy review in 2011 did not restart the statutory clock." [ Witt v. Metropolitan Life Ins. Co. , No. 14-11349 (11th Cir. Nov. 25, 2014)] (Cary Kane ERISA Lawyer Blog)

The Importance of Hiring a Quality Auditor to Perform Your Employee Benefit Plan Audit (PDF)
24 pages. "This advisory describes why a financial statement audit is important; risks to plan sponsors if a quality audit is not performed; evaluating auditor qualifications; the proposal process, including the request for proposal, proposal evaluation and auditor selection; and documenting the agreement." (American Institute of Certified Public Accountants [AICPA])

Resolve Deferred Compensation Errors Before Year's End
"[ IRS Notice 2008-113 ] provides relief from Internal Revenue Code Section 409A penalties for operational errors that occurred earlier this year and in 2013. It also addresses 2012 operational errors and confirms that December 31, 2014, is the deadline for obtaining relief for 2012 errors. The Notice, however, does not provide relief for errors left uncorrected more than two years after they occurred. [This article's] road map highlights the available correction options for certain early and missed nonqualified plan payments that occurred during 2012, 2013 and 2014." (Society for Human Resource Management [SHRM])

Multnomah Group Adds To Its Consulting Team Multnomah Group

PSCA?s 57th Annual Survey Validates the Success of the Defined Contribution System PSCA [Plan Sponsor Council of America]

Acclaris Simplifies Healthcare Reimbursement Acclaris

Goodwin Procter Expands ERISA and Executive Compensation Practice with Addition of Natascha George in Boston Goodwin Procter LLP

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