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Verisight
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Verisight
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The Newport Group
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The Newport Group
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Charging for COBRA Coverage: Cadillac Tax Proposals Prompt a New Look
RECORDED
(Thomson Reuters / EBIA)

Alternatives in DC Conference
May 19, 2015 in NY
(Pensions & Investments)

Don't Do That With Your ESOP: Legal and Fiduciary Issues
May 19, 2015 WEBCAST
(National Center for Employee Ownership)

Target Date 3.0
May 20, 2015 in FL
(ASPPA Benefits Council [ABC] of Central Florida)

Double Trouble
May 21, 2015 in GA
(ASPPA Benefits Council [ABC] of Atlanta)

Administrative Appeals Process for Risk Adjustment Payments/Charge and Reinsurance Payments
May 29, 2015 WEBCAST
(Centers for Medicare & Medicaid Services [CMS])

Employer Reporting Obligations Under the Affordable Care Act
June 4, 2015 WEBCAST
(Seyfarth Shaw LLP)

Voluntary Fiduciary Correction Program Workshop
June 16, 2015 WEBCAST
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

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International Foundation of Employee Benefit Plans [IFEBP]

CMS FAQ 10524: Reinsurance Contribution Information Needed for Certain Group Health Plans
"Q. Why did some group health plans receive an email requesting information regarding their reinsurance contribution submission even if the employer, issuer, Third-Party Administrator (TPA) or Administrative-Services Only (ASO) contractor already submitted a reinsurance contribution for their respective covered lives? A. [CMS] is contacting group health plans for whom CMS has been unable to locate a 'ACA Transitional Reinsurance Program Annual Enrollment and Contributions Submission Form' for the 2014 Benefit Year, and requesting that plans provide information to confirm the status of their Form filing for the 2014 Benefit Year, so that CMS can reconcile records.... CMS requests that these group health plans complete the information on the webpage https://reinsurancecontributions.secure.force.com/ by answering a series of questions." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])

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CMS Webinar Slides: FF-SHOP Employer and Employee Enrollment Process, May 7, 2015 (PDF)
55 slides. Topics include: [1] FF-SHOP Issuer Sales and Marketing Working Group invitation; [2] Overview of FF-SHOP enrollment process; [3] Employer decisions/options after eligibility determination; [4] Premium calculations and employer contribution methods; [5] Qualified employee decisions/options after eligibility determination; [6] Enrollment submission and initial payment. (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])

EEOC Proposed Regs Require a Gut Check for Wellness Programs (PDF)
"The EEOC stated in Footnote 24 of the proposed regulations that it 'does not believe' that the bona fide benefit plan safe harbor 'is the proper basis for finding wellness program incentives permissible.' ... With this shot across the bow, the EEOC has made it clear that it does not agree with courts -- such as the court in [ Seff v. Broward County ] -- that have applied the bona fide benefit plan safe harbor to incentive-based wellness programs. How a court would weigh this guidance, in view of contrary precedent in some federal circuits, remains to be seen. What is clear, however, is that the EEOC has not ceded the litigation position taken in Seff and Honeywell ." (Alston & Bird LLP)

Key Differences Between EEOC Proposed Wellness Regs and HIPAA
"[1] The EEOC proposed rule ... places an incentive cap not only on health-contingent programs, but also on participatory programs that include health questionnaires with disability-related inquiries or medical examinations.... [2] The EEOC proposed rule does not dispute the 50 percent incentive level for tobacco-related programming, unless nicotine testing is involved. If the tobacco-related program involves a medical test for nicotine, the incentive cap is 30 percent.... [3] [R]equiring wellness participation for health plan eligibility would deem the program involuntary, according to the EEOC.... [4] When a wellness program is part of a group health plan, the EEOC's proposed rules require employers to provide a detailed notice to participants separate from other notices that are required by HIPAA." (Ascende)

Agencies Clarify Requirements for Coverage of Contraceptives and Other Preventive Services
"Because the Departments believe that their earlier guidance may have been interpreted in good faith as not requiring coverage without cost sharing of at least one form of contraceptive in each method, the Departments will only enforce this guidance with respect to plan or policy years beginning on or after 60 days from the publication of [ FAQ XXVI ]." (Health Affairs)

Should Covered Entities Be Concerned About Their Business Associates' HIPAA Compliance? (PDF)
"The HIPAA violations of your business associates can negatively affect you in some circumstances. But different business associates performing different services and handling different types of PHI present different levels of risk for you. In appropriate circumstances, you may want to consider a more proactive approach to the HIPAA compliance of your business associates or potential business associates." (Alston & Bird LLP)

A Radical Approach to Huge Hospital Bills: Set Your Own Price
"A small benefits consulting firm called ELAP Services is causing commotion by suggesting an alternative: Refuse to pay. When hospitals send invoices with charges that seem to bear no relationship to their costs, the Pennsylvania firm tells its clients (generally medium-sized employers) to just say no. Instead, employers pay hospitals a much lower amount for their services -- based on ELAP's analysis of what is reasonable after analyzing the hospitals' own financial filings.... Hospitals are unhappy but have failed to make headway against it in court." (Kaiser Health News)

Drug Costs Top $50,000 a Year for Half Million Americans
"The latest drug spending trend report from pharmacy benefit manager Express Scripts shows 576,000 Americans with annual medication costs of $50,000 or more. That's a 63% increase in 2014 from 2013 when 352,000 Americans had such high costs. While the number of patients with annual spending above $50,000 was just 0.2% of patients, the amount of drugs they and their health plans or employers paid for accounted for 16% of total spending[.]" (Forbes)

How Has the Individual Insurance Market Grown Under the ACA?
"[A]nalysis of recently-submitted 2014 filings by insurers to state insurance departments ... shows that 15.6 million people had major medical coverage in the individual insurance market -- both inside and outside of the Marketplaces -- as of December 31, 2014. Enrollment was up 4.9 million over the end of 2013, a 46% increase.... [J]uxtaposing these enrollment figures with the federal government's estimate of 6.7 [million] Marketplace enrollees as of October 15, 2014 suggests that about 43% of all individual market coverage was purchased through the marketplaces in 2014." (Henry J. Kaiser Family Foundation)

Obamacare Official: Creating a State Exchange Is 'Very, Very Complex'
"The CEO of HealthCare.gov ... said states would not be able to immediately set up their own insurance marketplaces if the Supreme Court rules against ObamaCare this summer. Kevin Counihan, the director of HealthCare.gov, told an audience ... that creating an exchange is a 'very, very complex activity' that could not be achieved in just a few months. It would not be something that folks could do for this next open enrollment period,' he said ... referring to the sign-up period that begins in November." (The Hill)

Anthem's Brand Suffers Small Ding After Data Breach
"Anthem Inc.'s brand has taken a noticeable hit since hackers stole nearly 79 million customer records from the health insurer's computer systems earlier this year. But the impact was blunted by positive perceptions of the way the company handled the breach ... Before the data breach 51 percent of consumers said Anthem Blue Cross Blue Shield was a better brand than other insurers and After the breach, that figure dropped to 45 percent." (Indianapolis Business Journal)

New York City Mayor Proposes National Paid Family Leave That His Own Employees Don't Get
"[New York City Mayor Bill de Blasio's] 13-point plan will call for a $15 minimum wage, universal pre-kindergarten programs -- and paid family leave.... The half a million people who work for the city don't receive paid maternity or paternity leave through their own health plan. In fact, New York City's health plan lags far behind even the most basic [ACA] plans when it comes to maternity care." (The Washington Post; subscription may be required)

As Employers Try to Avoid the Cadillac Tax, Treasury and the IRS Need to Act
"The three main factors currently driving employers to redesign their health plans and increase employee costs are: [1] the plan value threshold limits triggering the excise tax ($10,200 for individual coverage and $27,500 for family coverage); [2] the assessment of the tax starting in 2018, and [3] after 2018 the threshold limits will only be indexed to CPI. If the Treasury and IRS were to draft regulations providing relief around any of those three points, it would certainly relieve pressure on employers actively looking for ways to restructure health benefits. The challenge, however, will be that those three factors are set in the ACA statute, decreasing the regulatory flexibility afforded to Treasury and IRS." (Health Affairs)

IRI Fact Book 2015 Unveiled Insured Retirement Institute [IRI]

Maresh Yoshida 401k Group Announces Corporate Name Change InTrust Fiduciary Group

SageView Expands in California SageView Advisory Group

American Benefits Systems, d.b.a. Simpkins & Associates is Certified to Industry Best Practices Centre for Fiduciary Excellence [CEFEX]

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