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New ACA Recordkeeping Requirements Including 1094-C and 1095-C Forms
February 10, 2015 WEBCAST
(Triton Benefits)

401(k) Advisor Symposium in Scottsdale, AZ on February 12th
February 12, 2015 in AZ
(401k Rekon)

The Intelligent Fiduciary: Common Problems You Can Avoid
February 19, 2015 in NY
(Worldwide Employee Benefits Network [WEB] - New York Chapter)

Employer Mandate: Covering the Right Employees
February 24, 2015 WEBCAST
(Hill, Chesson & Woody)

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Finding Liberation in the Big Picture of the Employer Shared Responsibility Tax (PDF)
10 pages. "There are ways to utilize the [employer shared responsibility reporting regulations (ESRR)] to minimize an employer's potential exposure to liability for the employer shared responsibility tax.... [T]he employer must know its workforce, their positions, the business needs and any seasonal fluctuations, turnover, the premiums charged to workers or different groups of workers, the restrictions, if any, on an employer's flexibility to charge different premiums to different work groups and the income levels of the different workers; know when the employer shared responsibility tax can be assessed; and know what the ESRR require and what they do not require. Sometimes what is not said is as important as or more important than what is said." (Greta Cowart of Winstead P.C., via Bloomberg BNA Tax Management Memorandum)

[Advert.]

On-Site Employee Health Clinics Summit ? Mar 11-12 2015 ? Atlanta

Case studies and strategies from innovative employers to leverage on-site clinics to drive down health costs and increase employee health care accountability through quality care in a convenient setting.

ACA Tasks: Shared Responsibility Reporting (PDF)
31 presentation slides. Topics include: [1] How to report individuals who elect health coverage; [2] The intricacies of Shared Responsibility reporting for employers; and [3] Separate reporting for multiple federal employer identification numbers within a single controlled group of employers. (Morgan Lewis)

Calendar Year Health Plans Must Complete Online CMS Disclosure by March 1 (PDF)
"March 1, 2015 is a Sunday, and we expect that CMS will say that filings made for calendar year plans on Monday, March 2, 2015 are timely. CMS has not announced that, however, so cautious calendar-year plan sponsors will want to complete the online filing no later than March 1. A CMS filing is also required within 30 days of termination of a prescription drug plan and for any change in a plan's creditable coverage status. Some plans are exempt from the filing requirement." (Lockton)

Massachusetts Replaces Maternity Leave Act with Parental Leave Act
"The new law requires employers to provide both women and men with time off 'for the purpose of giving birth' or adopting a child. While the new statute does not define how the phrase 'giving birth' applies to men, it is clear that the Massachusetts legislature intended to provide equally protected time off for men and women when they are having or adopting a child." (Littler)

Understanding the ACA's State Innovation Waivers
"Considerable uncertainty surrounds the potential scope of the 'waivers for state innovation' authorized under the [ACA], which allow states to modify how they implement key elements of health reform beginning in 2017.... Section 1332 waivers have the potential to give states flexibility to alter certain provisions of health reform -- particularly related to the health insurance marketplaces, the federal subsidies available through the marketplaces, and the ACA's 'shared responsibility' requirements for individuals and employers. The waivers are limited in scope, however, and must ensure comprehensive coverage, affordability, comparable enrollment, and budget neutrality." (Center on Budget and Policy Priorities)

Senate Republican Proposal: The Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act
"The Patient CARE Act provides a legislative roadmap to fully repeal the President's health care law, known as Obamacare, and replace the law with common-sense measures that would: Establish sustainable, patient-centered reforms ... Modernize Medicaid to provide better coverage and care to patients ... Reduce unnecessary defensive medicine practices and rein in frivolous lawsuits ... Increase health care price transparency to empower consumers and patients ... Reduce distortions in the tax code that drive up health care costs[.]" [Also released: [1]  Detailed summary of the proposal; [2]  Side-by-side comparison to Obamacare; [3]  Frequently asked questions on the proposal; and [4] Information on how the tax exclusion works .] (U.S. Senate Committee on Finance)

Employer Responsibilities Arising from the Anthem Data Breach
"With respect to fully insured plans, Anthem has the obligation to notify participants and is completely liable for the breach. Anthem may communicate general information to plan sponsors (e.g., steps being taken to address the breach). Some employers may want to send additional communications to employees to ease their fears. For self-insured plans, Anthem, as a business associate, must notify the plan sponsor regarding the scope of the breach (i.e., identify those participants who have been affected). Because Anthem will communicate directly with the participants, the plan sponsor does not need to notify them of the breach. Some employers, however, may want to send an additional communication to affected employees to ease their fears. In accordance with servicing agreements and the business associate agreements, Anthem should be liable for the breach." (The Wagner Law Group)

Honored in the Breach: Plan Sponsor's Action Items Upon an Insurer's Data Breach
"[I]f a plan participant's name, Social Security number, address, or other identifying information were compromised while held by an insurer or TPA, that would constitute a breach for purposes of [HITECH] and HIPAA.... [S]tate-level breach notification laws also are likely to be implicated.... If the plan is insured, the insurer is the covered entity responsible for investigating the situation, undertaking appropriate mitigating measures, and providing all required notices to plan participants, regulators, and, in some instances, the media.... If the plan is self-insured, the responsibility for investigating a breach and providing any required notice, by default, falls on the plan and the employer as its sponsor." [Editor's note: includes a list of action items for employers.] (Ogletree Deakins)

Potential Anthem Data Breach: What Group Health Plan Sponsors Should Do Next
"If your group health plan is administered or provided through Anthem or another Blue Cross and Blue Shield organization, you and your advisors/consultants should be evaluating the potential impact to your employees. If your group health plan is self-insured, [you should be] assessing the current status and impact of your HIPAA Privacy and Security Policies and Procedures, including your and Anthem's obligations around any required notifications for unauthorized disclosures of protected health information (PHI)." (Polsinelli PC)

Data Security Processes Essential for Wellness Program PHI
"PHI data breaches can occur in very mundane, low-tech ways, and on a small scale. For example, consider the scenario in which a group of employees who have just undergone biometric screening are waiting in line to learn their results. Suppose the person giving out the results tells the employee at head of the line his BMI and blood pressure numbers in a manner that's audible to others waiting in line. That means a breach has occurred -- whether the others waiting in line are listening or not. Similarly, if results are printed out and one employee's results are visible to others, that's a breach too. No hacking required." (Employee Benefit News)

Supreme Court Bids Adieu to Yard-Man Inferences (PDF)
"[The] Court held that the Yard-Man line of cases, 'a thumb on the scale' in favor of construing retiree health benefits provided through collective bargaining as irrevocable lifetime promises, was 'not compatible with ordinary principles of contract law.' On that point, the Court was unanimous. A concurring opinion by four Justices suggested, however, that disagreement remains on exactly how 'ordinary principles of contract law' affect the interpretation of welfare benefit plans." [ M&G Polymers USA, LLC v. Tackett , No. 13-1010 (U.S. Jan. 26, 2015)] (Steptoe & Johnson LLP)

Employees Receiving ACA Premium Subsidies Can File Retaliation Claims on DOL Website
"Interim final regulations explain the procedural hoops that apply once an individual files a complaint, but the rules do not explain the factors OSHA will consider in assessing whether retaliation has occurred. For example, does an employee have a whistleblower claim if, after qualifying for premium assistance, his hours of employment are reduced so he doesn't qualify as a full-time employee for purposes of the employer mandate? The answer should be 'no,' but the regulations are silent on this issue and employment actions are frequently misconstrued as retaliation." (Lockton)

Task Force of Healthcare Providers and Insurers Shifting to Incentive-Based Contracts
"A unified vision of shifting to incentive based contracts has brought together health systems Ascension, Trinity Health, Partners HealthCare, and Advocate Health Care, insurance titans Aetna and Health Care Service Corp., and Caesars Entertainment and the Pacific Business Group on Health to form the Healthcare Transformation Task Force. The goal of the task force is to transform 75% of their business contracts to incentive based contracts focused on improving healthcare quality and lowering healthcare costs." (Sheppard Mullin)

Cross-State Health Insurance Proves Popular But Unsuccessful
"If states allowed any insurer to enter their market, insurance commissioners fear insurers would cluster in less regulated places and pick off consumers in more highly regulated states, which would make the risk pools in those states less stable.... Despite the potential to make more money, companies haven't jumped at the opportunity in states that have lowered barriers." (Governing)

Ogletree Deakins Welcomes Employee Benefits Ace Lorne Dauenhauer in Portland Ogletree Deakins

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