Health & Welfare Plans Newsletter

April 2, 2015

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Employee Benefits Jobs

Account Manager
National Retirement Services, Inc.
in NC

Compliance Analyst
National Retirement Services, Inc.
in NC

Legislative and Technical Director
Employers Council on Flexible Compensation
in ANY STATE, DC

Pension Installation Coordinator
Western & Southern Financial Group
in OH

Retirement Specialist
Nationwide Retirement Services
in FL

Senior Benefits Consultant
Deckelbaum & Associates, LLC
in NC

Client Service Manager
Charles Schwab
in AZ

Client Service Manager
Charles Schwab
in TX

Senior Client Service Manager
Charles Schwab
in AZ

Senior Client Service Manager
Charles Schwab
in TX

Client Service Team Manager
Charles Schwab
in TX

Attorney/Sr. Attorney
The Standard
in ANY STATE, OR

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Webcasts and Conferences

Hedge Fund Due Diligence: ERISA and Other Legal Concerns
RECORDED
(Wagner Law Group P.C.)

The New 162(m) Regulations: What You Need to Know Now
April 15, 2015 WEBCAST
(ABA Joint Committee on Employee Benefits)

Workplace Culture/Emotional Health & Compliance with Mental Health Parity
June 2, 2015 WEBCAST
(Midwest Business Group on Health)

Affordable Care Act: 2015 Update for Tax Professionals
June 2, 2015 in NY
(Hodgson Russ)

Incredibly Credible Assumptions Audio/Webcast
June 10, 2015 WEBCAST
(Conference of Consulting Actuaries)

HSAs, HRAs, and Consumer-Driven Health Care
October 7, 2015 in WA
(Thomson Reuters / EBIA)

View All Webcasts and Conferences



[Guidance Overview]

CMS Health Insurance Oversight System: Plan Finder Product Data Collection Quick Reference Guide (PDF)
"The Plan Finder Product Data Collection is a module within the Health Insurance Oversight System (HIOS) responsible for collecting Issuer general identification information, product information, quarterly enrollment data for each product, and requesting component IDs for products. Issuers use Plan Finder to submit information about health insurance products in the Individual and Small Group Markets. This guide provides an overview of Plan Finder functionality and how to view and edit Issuer information, create and edit products, and request component IDs." [Also available: 49-page Plan Finder -- Issuer User Manual .] (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])


[Advert.]

Celebrate! It's National Employee Benefits Day

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

Give yourself a pat on the back for all that you do and the important role you play in your colleagues' well-being! Celebrate the day by learning how to expand your workplace wellness program to encompass all areas of total well-being. Learn More!



[Guidance Overview]

CMS Enterprise Portal and Health Insurance Oversight System: Quick Reference Guide (PDF)
"To access the Health Insurance Oversight System (HIOS), users will need to go through the CMS Enterprise Portal and register for a CMS EIDM account. EIDM is the acronym for CMS' Enterprise Identity Management system which includes Identity Management, Access Management, Authorization Assistance Workflow Tools, and Identity Lifecycle Management functions (i.e., Password Reset, Forgot User ID, etc.).... This guide provides detailed steps on how users register for a CMS EIDM account and request access to HIOS." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])

Impact of the ACA on the Staffing Industry
"Employees that work through a temporary staffing agency intended for short-term assignments have been presumed employees of a temporary staffing agency. As a result, agencies are responsible for offering appropriate coverage and determining whether it is subject to the employer mandate penalties. The IRS discussion of temporary workers gets even trickier. Based on all of the facts and circumstances, the staffing firm is the common law employer of the worker performing services for a client organization, and therefore the responsible party for the employer mandate." (AkkenCloud)

EEOC May Pursue Federal Right to Equal Coverage for Same-Sex Spouses and Transgender-Related Procedures
"[A recent internal] memo states that the EEOC is interested in litigating charges regarding issues of 'first impression' such as benefit coverage for same-sex couples and insurance benefits afforded to transgender individuals. While ERISA (and other current federal law) does not require benefit plans that provide benefits to opposite sex spouses to provide equivalent coverage to same-sex spouses, the EEOC clearly believes that such a right is found Title VII. The EEOC will likely argue that failure to provide such coverage constitutes sex discrimination because entitlement to coverage turns on the sex of the employee's spouse." (Seyfarth Shaw LLP)

A Long Road Ahead: Achieving True Parity in Mental Health and Substance Use Care (PDF)
24 pages. "[A] significant number of mental health professionals included in networks of Qualified Health Plans (QHPs) included in health insurance exchanges may not actually be available to plan participants.... [O]nly 14% of the psychiatrists listed in QHPs in the Maryland exchange were actually accepting new patients and available for an appointment within 45 days.... [M]any practicing psychiatrists do not accept health insurance, confining their clientele to people with the resources to pay out of pocket." (National Alliance on Mental Illness [NAMI])


[Advert.]

Prevention and Well-Being Congress - May 5-6 - SanDiego

Sponsored by World Congress

Challenge the way you think about wellness and reposition your program. Understand the role of employer and employee accountability, comply with new incentives rules and integrate technology customized to impact your workforce.



Navigators and Brokers Dataset
"This Dataset tracks each state's regulatory and exchange design data regarding navigators and brokers. For example, the dataset captures whether or not brokers can work on the exchange, and whether or not they can act as navigators as well." (Robert Wood Johnson Foundation)

Interactive Online Tool: The Health Spending Explorer
"The Health Spending Explorer on the Peterson-Kaiser Health System Tracker helps users examine five decades worth of numbers documenting expenditures by federal and local governments, private insurers, and individuals on 15 categories of health services, including hospitals, physician & clinic care, and prescription drugs. The data -- which spans from 1960 to 2013 -- is drawn from the National Health Expenditure Account[.]" (Henry J. Kaiser Family Foundation)

Benefits in General; Executive Compensation

[Guidance Overview]

IRS Finalizes 162(m) Equity Grant Transition Regulations for Companies Going Public
"The final rules make no changes to the original IRS proposal. They clarify that the transition relief ... expires at different dates depending on the type of equity grant made: [1] Stock options, stock appreciation rights and restricted stock: For these types of grants, the transition relief applies to all grants made on or before the end of the transition period.... [2] Restricted stock units and phantom shares: For these types of grants, the transition relief applies only to compensation paid on or before the end of the transition period." (Towers Watson)

When May an Agent Act on Behalf of an ERISA Plan Participant or Beneficiary?
"State law may authorize an individual to be the agent of an ERISA plan participant or beneficiary. This article discusses when ERISA permits such an individual, on behalf of the agent's principal, to: [1] pursue a benefit claim; [2] obtain plan or benefit information; [3] determine the time and form of benefit payment; [4] determine to whom the plan makes a benefit payment; [5] make beneficiary designations; ... [and take various other actions]. The article also discusses when ERISA and [HIPAA] permit a state-law agent to make healthcare decisions for the agent's principal in ERISA healthcare plans, or obtain information from a healthcare plan[.]" (Albert Feuer, via SSRN)

When the Intranet is Not Enough: Rules for Electronic Disclosure of Plan Documents
"If employees have work-related computer access, ERISA disclosures may be delivered electronically, or posted on the intranet, if the employees have the ability to effectively access documents furnished in electronic form at any location where the employee is reasonably expected to perform his duties, and are expected to have access to the employer's electronic information as an integral part of those duties. It is not enough that they have access somewhere at work or have access at a common location (like a break room). Accessing the computer has to be an actual requirement for their job function." [ Thomas v. CIGNA Group Ins. , No. 09-CV-5029 (E.D.N.Y. Mar. 2, 2015)] (Fox Rothschild LLP)

Another Court Enforces DOL's Electronic SPD Rules
"[T]he DOL regulations governing the electronic distribution of SPDs.... limit this option to participants who can effectively access electronic documents wherever the participant is reasonably expected to perform his or her duties, and for whom access to the employer's electronic information system is a regular part of those duties. While that may have been true of this employee before she became disabled, it was not the case when she actually needed the SPD. This was after she had terminated her employment (due to the disability), thereby losing access to the intranet. As a result, she could not access the SPD during the 12-month period in which she was required to submit proof of her disability." [ Thomas v. CIGNA Group Ins. , No. 09-CV-5029 (E.D.N.Y. Mar. 2, 2015)] (Spencer Fane)

The Rise and (Maybe) Fall of the Golden Parachute
"The practice of sending executives off with golden parachutes is ubiquitous in corporate America -- but shareholders are pushing back, in ways that could substantially deflate them.... [T]he Council of Institutional Investors -- whose members hold over $3 trillion in assets -- approved a policy encouraging shareholders to require that boards consider executive tenure and performance before signing off on those giant stock awards. The idea: To make sure a CEO is still incentivized to do well by the company rather than rush it towards a merger." (The Washington Post; subscription may be required)

Employee Stock Purchase Plans: The Biggest Personal Income Tax Return Mistakes to Avoid
"[1] Not filing Form 8949 after an immediate sale of ESPP shares at purchase.... [2] Paying tax on the discount too early.... [3] Directly using what appears as the cost basis on your Form 1099-B.... [4] Paying the wrong tax on the discount.... [5] Using the wrong price when there is no lookback.... [6] Paying tax twice on the discount." (myStockOptions.com)

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