Health & Welfare Plans Newsletter

March 30, 2015

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Employee Benefits Jobs

Pension Administrator
Retirement Strategies, Inc.
in GA

Benefits Associate
Ogletree Deakins
in OR

Manager, Plan Documents
TIAA CREF
in CO, NC

Junior Defined Contribution Administrator
Pension Investors Corporation of Orlando, Inc.
in FL

401(k) Plan Conversion Specialist
MVP Plan Administrators, Inc.
in NC

Plan Conversion/Client Transition Manager
Pentegra Retirement Services
in NY

Defined Benefit Administrator - Actuarial Assistant
TPA Firm
in AZ

Retirement Plan Coordinator & Life Ins Administrator
Woodbury Financial Planning Firm
in NY

Sr Retirement Document Compliance Consultant
TIAA-CREF
in ANY STATE

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Webcasts and Conferences

Employer Mandate Implementation: Do You Qualify for Transition Relief?
RECORDED
(Hill, Chesson & Woody)

Health Care is Going Retail A Three Part Series - Part 1 The Retailization of Health Care
RECORDED
(von Briesen & Roper, s.c.)

Employer, Health Plan Implications Of Anthem Breach
April 2, 2015 WEBCAST
(American Bar Association [ABA])

The Year in Benefits: Insights and Strategies for Retirement, Health, and Executive Compensation Plans
April 8, 2015 in DC
(ALI-ABA [American Law Institute-American Bar Association])

Service Agreements 2015
April 10, 2015 WEBCAST
(SunGard Relius)

IRS's Voluntary Closing Agreement Program -- When EPCRS Just Isn't Good Enough
April 16, 2015 in CA
(Western Pension & Benefits Council - Orange County Chapter)

View All Webcasts and Conferences



Considerations for 2016 Health Insurance Rate Development, Rate Filing, and Rate Review (PDF)
14 pages. "While uncertainty remains for issuers on the impact of the ACA risk mitigation programs on their 2014 financial results, many issuers will have significantly more experience under the ACA reforms with which to develop 2016 rates than they previously had.... The regulations and guidance for 2016 include several provisions that will necessitate changes to some of the plans offered in 2015." (Wakely Consulting Group)


[Advert.]

Register -- MBGH Annual Conference for Health Benefits and Health Care

Sponsored by Midwest Business Group on Health [MBGH]

The Midwest Business Group on Health's 35th Annual Conference will be held April 29-30 in Chicago, featuring leading employers and industry experts providing objective, timely and practical information on the latest research, trends and best practices.



Lifetime Retiree Health Care Cost Projections Rise 6.5%
"A healthy couple retiring at 65 this year will likely spend more than $266,000 on Medicare Part B, which covers doctors' visits and outpatient services, and Part D prescription drug plans as well as supplemental Medigap insurance over their lifetime ... That is up 6.5% from last year's projection ... When expected dental, vision, hearing costs not covered by Medicare, as well as co-pays and other out-of-pocket medical costs are included, lifetime cost estimates increase to nearly $395,000 for a 65-year-old couple retiring this year." (Mary Beth Franklin, in Investment News)

EEOC Votes on Proposed Wellness Rule, as House Hearing Focuses on Bills to Rein in Agency
"Although the proposed rule is likely to allow employee wellness programs to have financial incentives up to 30 percent of the cost of coverage (and 50% for tobacco cessation programs), the EEOC may also propose a number of conditions and/or reporting requirements on employers to ensure their wellness programs are voluntary and are not a 'a subterfuge for discriminating based on a health factor.' " (HR Policy Association)

Job Lock and Employer-Provided Health Insurance: Evidence from the Literature
"The report reviews the research on three types of job lock: [1] Workers remaining in jobs in which they are not satisfied because of the fear of not being able to get health insurance at a new job (or not being able to buy or afford it in the individual market); [2] Workers being reluctant to start a business because they do not want to lose employer-provided health insurance; and [3] Workers staying employed (or employed full time) in order to obtain employer-sponsored insurance, when they would otherwise prefer to retire or work part time. All three types of job lock are likely to be reduced by the Affordable Care Act[.]" (Dean Baker, Center for Economic and Policy Research, for AARP)

Supreme Court Vacates Seventh Circuit's Contraceptive Coverage Ruling In Light of Hobby Lobby
"The U.S. Supreme Court has vacated the Seventh Circuit's denial of a preliminary injunction requested by a nonprofit religious university challenging health care reform's contraceptive coverage mandate, and remanded the case for further consideration.... This case could also end up at the Supreme Court again, but the next step will be to see how the Hobby Lobby decision and revised accommodation process affect the outcome in the lower courts." [ Univ. of Notre Dame v. Burwell , No. 14-392 (U.S. Mar. 9, 2015)] (Thomson Reuters / EBIA)


[Advert.]

Join us at the 2015 IHC FORUM & Expo in Atlanta June 23-25

Sponsored by Institute for Healthcare Consumerism [IHC]

The 6th Annual IHC FORUM & Expo Atlanta is part of the ONLY conference series 100% dedicated to HealthCare Consumerism?where employers, brokers, health plans, TPAs, consultants & providers gather under ONE roof to LEARN, CONNECT and SHARE!



CalPERS Urged to Avoid Obamacare 'Cadillac Tax'
"The staff report suggested that CalPERS could cut costs and get some relief from the Cadillac Tax by switching members from two Blue Shield and Anthem broad provider networks ... to narrower networks offered by the same organizations. The impact on members of switching to a narrower network would be 'less significant' than the risk of the tax, the staff believes. Members have the same benefits but fewer provider options. The 'vast majority' retain their primary care physicians." (Calpensions)

GAO Review of the Audit of the PCORI Financial Statements for 2013 and 2014
"GAO found that the independent public accountant's (IPA) audit of the Patient-Centered Outcomes Research Institute's (PCORI) 2014 and 2013 financial statements was performed in accordance with professional standards, in all material respects." (U.S. Government Accountability Office [GAO])

Arbitrator Rules for Iowa State Employees on Health Care
"An arbitrator empowered to determine a contract impasse between the State of Iowa and its 19,000 state and judicial branch employees ... accepted the union's health insurance proposal requiring the overwhelming majority of the state and judicial branch employees to pay a $20 monthly healthcare premium.... The health insurance issue was a major sticking point in reaching a new two-year collective bargaining pact, with Governor Branstad's negotiators unsuccessfully seeking a 10 percent employee premium payment for AFSCME members in 2016 and 15 percent in 2017." (American Federation of State, County and Municipal Employees [AFSCME])

[Opinion]

King v. Burwell: Loss of Subsidy Does Not Mean Loss of Coverage
"A loss of subsidy does not automatically mean a loss of coverage. Insurance plan enrollment in the exchanges is governed by other provisions of the ACA, as well as by pre-ACA federal and state insurance laws that apply to the broader market." (The Heritage Foundation)

[Opinion]

The Time Is Now To Fix Medicare ACOs
"ACOs are the most promising market-based solution, but Medicare ACO performance has been inhibited by specific program design flaws.... [1] Providers should be given more time to participate in the limited or no-risk track ... [2] ACOs should be able to defer annual reconciliation to accrue a larger beneficiary population to meet the minimum savings rate (MSR).... [3] Beneficiary assignment and retention should be improved.... [4] ACO's should be afforded delivery tools to succeed, specifically certain payment waivers.... [5] As it does in Medicare Advantage, CMS should reward good quality by ACOs as well as penalizing poor quality.... [6] Most substantively, CMS should remedy several flaws in how it establishes, updates and resets an ACO's financial benchmark." (Health Affairs)

Benefits in General; Executive Compensation

[Official Guidance]

Text of IRS Final Regs: Certain Employee Remuneration in Excess of $1,000,000 Under Section 162(m)
"[T]he final regulations modify Section 1.162-27(e)(2)(vi)(A) to provide that a plan satisfies the per-employee limitation requirement if the plan specifies an aggregate maximum number of shares with respect to which stock options, stock appreciation rights, restricted stock, restricted stock units and other equity-based awards may be granted to any individual employee during a specified period under a plan approved by shareholders in accordance with Section 1.162-27(e)(4). This clarification is not intended as a substantive change.... Commenters suggested that the clarification to Section 1.162-27(f)(3) should apply to RSU's granted after the publication of final regulations and not merely to remuneration payable under a RSU after the date of publication. These final regulations adopt this suggestion." (Internal Revenue Service [IRS])

DOL Makes Good on Promise of ERISA Plan Criminal Investigations
"[EBSA] closed 365 criminal investigations in fiscal 2014, representing a nearly 30% increase since fiscal 2010. EBSA's criminal investigations, including its participation in criminal investigations with other law enforcement agencies, led to the indictment of 106 individuals -- including plan officials, corporate officers and service providers -- for offenses related to employee benefit plans[.]" (Employee Benefit Adviser)

Five Plan Document Provisions to Reduce ERISA Litigation Risk
"[1] Ensure a deferential standard of review ... [2] Avoid exceptions to the administrative exhaustion requirement ... [3] Limit the deadline for participants' suits... [4] Control the place where participants can sue ... [5] Prohibit the assignment of claims." (Corporate Counsel; free registration required)

Posting SPD on Intranet Without Notice to Participants Was Noncompliant Electronic Disclosure
"Company intranets are a common and convenient tool for benefit communications -- but if ERISA's electronic distribution rules are not followed, the plan administrator may not be able to rely on the posted materials in litigation.... Merely placing SPDs on a website, without notifying participants of their availability and significance (and the right to a paper copy), does not satisfy ERISA's requirement that the distribution method be reasonably calculated to ensure actual receipt and result in full distribution." [ Thomas v. CIGNA Group Ins. , No. 09-CV-5029 (E.D.N.Y. Mar. 2, 2015)] (Thomson Reuters / EBIA)

Communication and Education Are Keys to Executive Benefits Engagement
"Criteria used for determining NQDCP eligibility varied amongst categories, with job grade (28 percent) and salary plus title (20.8 percent) cited most often. Informal funding continues to be a popular strategy for managing NQDCP asset-to-liabilities and increased in prevalence this year to 62 percent from 57.2 percent in 2013. Companies are primarily using corporate-owned life insurance (54 percent) as compared to taxable securities (42 percent) or cash (19 percent) as their informal funding vehicle of choice." (Prudential)

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