Health & Welfare Plans Newsletter

June 24, 2015

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Employee Benefits Jobs

Regional Sales Consultant
United Retirement Plan Consultants
in CO

Technical Product Director - Fixed/Stable Value
Nationwide
in OH

Defined Benefit Pensions Specialist
Nationwide Insurance
in OH

401(k) Daily Processor
Swerdlin & Company
in GA

ESOP Administrator
Swerdlin & Company
in ANY STATE, GA, MA

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Webcasts and Conferences

Mutual Fund Compliance Summit and Investment Advisor Compliance Summit
July 15, 2015 in NY
(Financial Research Associates)

ERISA Litigation Update
July 23, 2015 in NY
(Worldwide Employee Benefits Network [WEB] - New York Chapter)

View All Webcasts and Conferences



[Guidance Overview]

ACA Rules for Embedded Individual Out-of-Pocket-Maximums to Apply in 2016
"Group health plan sponsors will need to appropriately credit incurred eligible health expenses toward the plan's [out-of-pocket maximum (OOPM)]. They must also consider whether to separate EHBs from non-EHBs or use one in-network OOPM for all health benefits. To apply the embedded OOPM only to in-network EHBs, the plan sponsor must clearly define which expenses will be considered EHBs for purposes of the plan.... [M]any employer-sponsored group health plans are expected to apply the OOPM to both in-network EHBs and non-EHBs to avoid the administrative burden of separating them out." (Towers Watson)


[Advert.]

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[Guidance Overview]

Four Steps Required Prior to ACA E-Filing
"Identify your responsible official(s) and contacts.... Register with IRS e-services.... Transmitters need to complete the ACA Information Return Transmitter Control Code (TCC) Application online through e-services and receive a TCC in the mail.... Transmitters need to complete an error-free communication test." (International Foundation of Employee Benefit Plans [IFEBP])

[Guidance Overview]

Massachusetts Attorney General Publishes Final Rule on Earned Sick Time
"Employers who are eligible for the safe harbor must determine whether it is in their best interest to fully comply with the law on July 1, or to take advantage of the safe harbor through the end of 2015. Employers who have begun drafting new policies based on the EST law and draft regulations must review those policies to ensure that they are in full compliance with the final regulations." (Fisher & Phillips LLP)

[Guidance Overview]

An Overview of Oregon's New Paid Sick Leave Law
"Portland employers must continue to comply with the Portland ordinance until the statewide law takes effect on January 1, 2016. The Eugene City Council voted to repeal its own city ordinance upon the Governor's signing of the statewide legislation ... The new law prohibits other local governments within Oregon from creating their own sick leave requirements for private employers, so companies can rest assured that they will not be faced with having to comply with multiple local sick leave laws within the state in the future." (Fisher & Phillips LLP)

[Guidance Overview]

Oregon Enacts Paid Sick Leave
"The new law creates significant traps for unwary employers. In addition to prohibiting employers from retaliating against employees for requesting, taking, or inquiring about sick leave, the law prohibits employers from denying or interfering with legitimate sick leave requests. Employers also are prohibited from conditioning sick leave approval on employees finding replacement workers or working alternate shift to make up for time missed. Further, the law mandates that employers may require [documentation only] for sick leave absences lasting three days or more. Finally, covered employers will be required to post a notice describing the new law." (Jackson Lewis P.C.)

When Does a Workplace Wellness Program Become Coercive, Rather Than Voluntary?
"But many employers say the [EEOC] proposal doesn't clear up conflicts between the health law and the ADA. In addition, it restricts their ability to offer rewards ... Some employers say the rule could force them to cut the size of wellness programs' financial incentives or penalties, particularly for families and smokers.... Consumer groups are also unhappy, saying the proposal strips workers of important protections against health or disability-related discrimination by loosening earlier government definitions of what constitutes voluntary." (Kaiser Health News)

California Caps What Patients Pay for Pricey Drugs. Will Other States Follow?
"Starting in 2016, most people will pay a maximum of $150 or $250 per prescription, per month. These caps are for Covered California's so-called silver and platinum plans. Bronze plans will have caps of $500. This policy will apply only to the 2.2 million people who buy coverage on the individual market. A bill under consideration in the California legislature would extend that protection to many people with employer-based plans, as well." (Kaiser Health News)

ACA Litigation Beyond King v. Burwell
"The courts at all levels have repeatedly dismissed ACA challenges. Some of these dismissals have addressed the merits of the challenges, but in most instances courts ... have held that the plaintiffs bringing these cases have not in fact suffered an injury from the laws or administration actions that they challenge, and thus the federal courts have no jurisdiction to hear their complaints." (Health Affairs)

Benefits in General; Executive Compensation

Key Questions for Section 409A Compliance
"Section 409A imposes very specific constraints for structuring NQDC arrangements. The checklist [in this article] includes general requirements for Section 409A compliance. Failure to comply with Section 409A may subject the participant to current income tax on the amount purportedly deferred, plus interest and substantial additional taxes." (Fulcrum Partners)

Dodd-Frank's Next Act: Compensation Disclosure
"Section 953(b), the other shoe waiting to drop, will arguably generate more headlines [than pay-for-performance], highlighting wage disparity by requiring the reporting of a ratio of CEO or 'principal executive officer' pay to that of his or her company's rank-and-file employees.... Depending on whom you ask, these new disclosures are either yet another unjustified incremental addition to a CFO's financial reporting workload or a valuable enhancement of transparency that will benefit investors." (CFO)

Press Releases

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David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager

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