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Sick with Apprehension: Will Your Sick Leave and PTO Policies Comply with California?s New Paid Sick Leave Law by the Deadline?
May 27, 2015 WEBCAST
(Ogletree Deakins)

Future of Retirement Plan Advice
June 3, 2015 WEBCAST
(Pensions & Investments)

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Where There's Smoke There's Questions: Designing Compliant Wellness Programs That Target Tobacco Use
"[1] Is it acceptable to design a program where employees who use tobacco may avoid a higher insurance premium (or surcharge) only by quitting tobacco use? No.... [2] Are there any limits to the 'reasonable alternative standard' an employer can require for tobacco users to obtain the reward? Yes.... [3] Is it acceptable to design a program that restricts participation in certain health benefit options to employees who are tobacco-free (i.e., maintain a tobacco-free 'threshold' requirement for participation in certain health plans)? Generally, no.... [4] Does it matter whether an employer characterizes the different treatment of employees who use tobacco (and refuse to complete an alternative standard) and tobacco-free employees as a penalty or a reward? No." (Verrill Dana LLP)

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IRS Further Explains Large-Employer ACA Reporting
"Under the new guidance , if a large employer's workforce is comprised entirely of part-time employees who were not full-time in any month of the year, it does not have to submit a Form 1095-C. The guidance also indicates how to report on coverage to employees during their months of hire and termination, and provides more details on reporting COBRA coverage for three categories of COBRA qualified beneficiaries." (Thompson SmartHR Manager)

ACA FAQs Address Coverage of Preventive Services
" FAQ XXVI clarifies that if a provider recommends a particular type [of contraception] as medically necessary for an individual, the group health plan must defer to the professional's determination. Medical necessity considerations include the severity of side effects, differences in permanence and reversibility of contraceptives, and an individual's ability to appropriately use the item or service." (The Wagner Law Group)

Philadelphia Paid Sick Leave Law Takes Effect (PDF)
"The new law requires employers with at least 10 employees to provide paid sick leave and smaller employers to provide unpaid leave.... As Philadelphia's sick leave ordinance took effect, the state legislature was considering preempting local leave laws. The state Senate has already passed a bill (SB 333) that would apply retroactively to January 1, 2015 to prevent Pennsylvania municipalities from imposing their own sick leave requirements on businesses." (Buck Consultants at Xerox)

The Titanic Redux (PDF)
"We've all heard the phrase, 'Doing that is like rearranging the deck chairs on the Titanic.' The point of the phrase is to call out the disproportionality of action taken in the face of a really big problem. And so it may be when we consider three heavily promoted health care cost management techniques: [1] Consumerism / High Deductible Health Plans, [2] the Defined Contribution Approach to determining the amount of employer health plan subsidies, and [3] Private Exchanges." (Chelko Consulting Group)

Health Insurers Seek Hefty Rate Boosts
"In New Mexico, market leader Health Care Service Corp. is asking for an average jump of 51.6% in premiums for 2016. The biggest insurer in Tennessee, BlueCross BlueShield of Tennessee, has requested an average 36.3% increase. In Maryland, market leader CareFirst BlueCross BlueShield wants to raise rates 30.4% across its products. Moda Health, the largest insurer on the Oregon health exchange, seeks an average boost of around 25%. All of them cite high medical costs incurred by people newly enrolled under the Affordable Care Act." (The Wall Street Journal; subscription may be required)

Medicare Physician Payment Rates: Better Data and Greater Transparency Could Improve Accuracy
"The American Medical Association/Specialty Society Relative Value Scale Update Committee (RUC) has a process in place to regularly review Medicare physicians' services' work relative values (which reflect the time and intensity needed to perform a service). Its recommendations to [CMS] ... may not be accurate due to process and data-related weaknesses.... The Protecting Access to Medicare Act of 2014 included a provision for GAO to study the RUC's process for developing relative value recommendations for CMS.... CMS should better document its process for establishing relative values and develop a process to inform the public of potentially misvalued services identified by the RUC. CMS should also develop a plan for using funds appropriated for the collection and use of information on physicians' services in the determination of relative values." (U.S. Government Accountability Office [GAO])

The Impact of Same-Sex Marriages on Benefit Plan Administration
"If the Court concludes that same-sex couples have a fundamental right to marriage or that states must recognize same-sex marriages lawfully performed out-of-state, then health plans that define a spouse as a member of the opposite sex will need to be amended to cover lawfully married same-sex spouses. In addition, employers would no longer be able to cherry pick the types of spousal benefits they provide and would have to make available the same benefits to same-sex married couples that they currently offer opposite-sex married couples." (Bloomberg BNA)

'Cadillac Tax' a Major Roadblock to Consumer-Driven Health Plans (CDHPs) and Affordable Health Care (PDF)
A two-page flier describing the Cadillac Tax, how it is assessed, and its impact on consumer-driven health plans. (Employers Council on Flexible Compensation [ECFC])

Testimony to House Oversight Subcommittee Hearing on the Use of Administrative Actions in the Implementation of the ACA (PDF)
11 pages. "[T]his Subcommittee recently questioned whether the administration's employer coverage and cost sharing regulations exceed constitutional limits and intrude upon Congress's legislative and appropriations authority. Parallel challenges to agency implementation of the Act's cost-sharing and premium tax credit provisions have also made their way into two pending lawsuits. Regardless of their outcome, these suits and the ongoing disagreement between the political branches regarding ACA's implementation highlight the constitutional obligations and risks that attend administration of complex legislation, and underscore the need for continuing legislative oversight." [Ms. Papez is Former Deputy Assistant Attorney General, Office of Legal Counsel, U.S. Department of Justice.] (Elizabeth P. Papez, Esq., of Winston & Strawn LLP)

Republican Proposals for King v. Burwell Ruling
"Top Republican legislators are pondering how to respond should the Supreme Court rule that the federal ObamaCare subsidies are illegal in 37 states (the states that didn't establish their own health insurance exchanges).... [T]hese subsidies trigger the individual and employer mandates in those states, meaning this ruling could significantly impact the way ObamaCare works. Here are a few Republican proposals for how to respond in this scenario[.]" (Health Care Lawsuits, a project of the Independent Women's Forum)

Coalition Letter to Senators Supporting Small Group Expansion (S. 1099) Legislation (PDF)
"[We] applaud your introduction of legislation (S. 1099) maintaining the current definition of a small group market as 1-50 employees, and giving states the flexibility to expand the group size if the market conditions in their state necessitate the change.... Repealing the ACA-mandated expansion and returning to the historical role of state determination would allow flexibility and ensure a broad array of coverage options and mitigate dramatic premium increases. Expanding the small group market to include groups up to 100 at this time would reduce choice for this segment of the market.... [E]xpanding the small group market to include all groups with up to 100 employees would have an immediate impact on premiums due to new rating rules, required Essential Health Benefits, and minimum actuarial value and cost sharing requirements." (Society for Human Resource Management, U.S. Chamber of Commerce, and 17 other trade associations)

AHIP President and CEO Karen Ignagni to Lead EmblemHealth; AHIP EVP Dan Durham Appointed Interim CEO America?s Health Insurance Plans [AHIP]

Prudential Day One Target Date Funds Pass $1 Billion in Assets Prudential Financial, Inc.

Refund Fees Being Mailed for Registered Tax Return Preparer Test IRS [Internal Revenue Service]

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