Pension Consultants/ Administrators
Leading Northern NJ Actuarial Firm
in NJ

Relationship Manager
John Hancock Retirement Plan Services
in TX

Employee Benefits Associate
Kelley Drye & Warren, LLP
in NY

Retirement Plan Administrator
Matthews Benefit Group, Inc
in FL

Manager, Operations
Verisight
in CA

Relationship Manager I
The Standard
in LA

Accounting and Conversion Specialist
Retirement Systems of Arizona
in AZ

Senior Policy Analyst
National Business Group on Health
in DC

Retirement Plan Compliance Administrator
Pension Corporation of America
in OH

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How Obergefell v. Hodges Ruling Can Impact Your Employee Benefit Plans
July 7, 2015 WEBCAST
(Aon Corporation)

Who?s the Employer/Employee? 03: Identifying Related Employers
July 13, 2015 WEBCAST
(SunGard Relius)

Mercer and CFO Research - Pension Risk Survey Results
July 16, 2015 WEBCAST
(Mercer)

Advanced Cross-Tested Plans: Adding More Tools - Cincinnati
July 29, 2015 in OH
(SunGard Relius)

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Submitting Your Own ACA Reporting Forms? The IRS has Homework for You!
"Employers submitting their own Reporting Forms, third parties submitting Reporting Forms on behalf of others, and developers of filing software (combined, Submitting Entities) are required to complete the following steps prior to being able to electronically submit any Reporting Forms: [1] Register with the IRS's e-services website ... [2] Obtain an AIR Transmitter Control Code (TCC), a unique identifier authorizing each Submitting Entity to submit the Reporting Forms, and [3] Pass a series of technical/system tests to ensure that Reporting Forms will be properly submitted when due.... Conflicting guidance suggests that employers submitting their own paper Reporting Forms may need to complete the first two steps but not the third step." (Lockton)

[Advert.]

Private & Public Exchange Summit, July 15-16

Join Payer and Exchange executives in July for the 6th Annual Private and Public Exchange Summit. The Summit will explore approaches for health plans and exchanges to improve market share, encourage engagement, and reduce the cost trend.

CMS Webinar: 2014 Reinsurance Payments: Issuer Reports and Timeline
28 presentation slides; June 15, 2015. Topics: [1] Provide issuers with an overview of the June 30, 2015 Issuer Reinsurance Payment Report; [2] Walk through the schedule of reinsurance payments for 2014; and [3] Describe any adjustments to reinsurance payments. (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])

IRS Health Care Tax Tip 2015-38: Get to Know the Small Business Health Care Tax Credit
"To be eligible for the credit, you must: [1] have purchased coverage through the Small Business Health Options Program -- also known as the SHOP marketplace; [2] have fewer than 25 full-time equivalent employees; [3] pay an average wage of less than $50,000 a year; [4] pay at least half of employee health insurance premiums.... Even if you are a small business employer who did not owe tax during the year, you can carry the credit back or forward to other tax years." [Updated July 1, 2015.] (Internal Revenue Service [IRS])

California and Massachusetts Employers Feverishly Prepare for Paid Sick Leave (PDF)
9 pages. "[California] Employers that have 'unlimited' vacation or PTO policies ... would still need to track paid sick time accrual and usage, and report the amount of available sick leave on employees' pay stubs or other payday documents. If they opt to frontload the paid sick time, they may avoid tracking accrual by hours of work but would still have to track and report sick leave use and availability.... [Massachusetts employers] may require certification of the need for sick time if an employee uses that time for more than 24 consecutively scheduled work hours. Employers cannot delay the taking of leave or withhold payment for earned sick time because they have not received the certification." (Buck Consultants at Xerox)

Massachusetts Issues Regulations on Earned Sick Time for Student Workers and Faculty
"The new Massachusetts Earned Sick Time Law outlines regulations that govern sick time accrual and use as it relates to student workers and faculty. The final regulations exempt most student workers from coverage under the law.... [A]ll full-time, part-time and adjunct faculty are entitled to earn and accrue paid sick leave." (Holland & Knight)

District Court Holds That Providers Lack Standing to Sue ERISA Plans If the Patients Remain Liable to the Provider
"The court concluded that Plaintiffs' patient agreements did not constitute assignments of the right to sue under ERISA because: [1] mere agreement for direct payment to a provider, without more, is not a valid assignment; [2] Plaintiffs' patient agreements did not manifest an intent to assign ERISA rights, and [3] the risk of non-performance did not run with right to receive payment." [ Brown v. Blue Cross Blue Shield of Tennessee, Inc. , No. 1:14-CV-00223 (E.D. Tenn. June 9, 2015)] (Seyfarth Shaw LLP)

Supreme Court to Rule on Preemption of Vermont Health Care Reporting
"Sixteen states are developing similar databases to which all payers must report, and the 2nd Circuit's holding creates 'a gaping hole' in those databases, by cutting out data for tens of millions of Americans covered by self-insured plans, according to Gobeille's brief. Because most Americans who receive health insurance coverage from their employers are covered by self-insured plans, 'an all-payer claims database that omits self-insured plans cannot be considered accurate or comprehensive.' " [ Gobeille v. Liberty Mutual Ins. Co. (2d Cir. Feb. 4, 2014, cert. pet. granted June 29, 2015)] (Thompson SmartHR Manager)

Ten Things to Know About Telemedicine
"[1] It's 'unstoppable'.... [2] It typically costs less, although savings can vary.... [3] It's more than one kind of care.... [4] It's moving to the workplace.... [5] A $49 price tag is common for primary care... [6] When family members can't be at the bedside of a critically-ill family member, some hospitals now provide updates via telemedicine.... [7] Rural hospitals and skilled nursing facilities use telemedicine... [8] It's a quick solution for minor ailments.... [9] Most people can connect.... [10] It's growing fast." (The Alliance)

Employers See Opportunities After King v. Burwell Decision
"More employers believe the decision will have a positive effect than a negative effect -- 29% compared to 17% -- although a slight majority (54%) doesn't believe this ruling affects them one way or the other.... Just under half of all respondents that currently offer coverage to early retirees -- 45% -- say they are considering steering retirees to the public exchange or have already begun to do so.... Employers are much less likely to consider the public exchange as an alternative source of coverage for currently eligible part-time employees.... Relatively few respondents -- 16% -- believe that the increase in the number of Americans with health insurance has affected their employees' ability to access health care -- so far." (Mercer/Signal)

Pharmaceutical Industry Payments to Doctors Are Ingrained, According to CMS Data
"That doctors receive big money from the pharmaceutical industry is no surprise. The latest data released by [CMS] shows that such interactions are widespread, with not only doctors, but thousands of dentists, optometrists, podiatrists and chiropractors receiving at least one industry payment from August 2013 to December 2014. What is being seen for the first time now is how ingrained pharmaceutical companies and their sales reps are in the lives of those who write prescriptions for their products.... 768 doctors received payments on more than half of the days in 2014. More than 14,600 doctors received payments on at least 100 days in 2014." (National Public Radio)

Plan Selections by County in the Health Insurance Marketplace
"The dataset provides the total number of Qualified Health Plan selections by county for the 37 states that use the HealthCare.gov platform, including the Federally-facilitated Marketplace, State Partnership Marketplaces and supported State-based Marketplaces for the Marketplace open enrollment period from November 15, 2014 through February 15, 2015, including additional special enrollment period (SEP) activity reported through February 22, 2015." (Assistant Secretary for Planning and Evaluation [ASPE], U.S. Department of Health and Human Services [HHS])

Risk Adjustment Program Requiring Large Payments from Massachusetts Insurers
"[T]he state Connector Authority issued notifications to inform 16 companies in the 650,000-person merged market of the new payments and charges under a risk adjustment program mandated under Obamacare. Boston-based Minuteman Health covers 15,000 people in Massachusetts and New Hampshire and is being hit with a charge of $3,064,679. 'It represents about 71 percent of our total premium for 2014,' CEO Tom Policelli [said] ... Connector officials say the program will result in $61 million in transfers among insurers ... [or] about 3 percent of the $1.98 billion in merged market premiums[.]" (Lowell Sun)

CBO Analysis of Approaches to Reduce Federal Spending on Military Health Care (PDF)
22 presentation slides. Topics include: [1] Recent proposals to restructure TRICARE; [2] Slowing the growth of health care costs: options examined by CBO; [3] Cumulative budgetary effects of policy options that would raise military retirees' cost sharing, 2015 to 2023; [4] Potential for savings in other approaches. (Congressional Budget Office [CBO])

Sound the Alarm: The Private Insurance Exchanges Are Coming!
"The most important measure already taken by many employers is to increase cost sharing, especially by requiring high deductibles that must be paid before most benefits kick in.... The use of narrower provider networks also helps to reduce the employers' contribution to health care payments.... As if the deterioration in employer-sponsored plans has not already been enough, this switch to using a defined contribution voucher in private insurance exchanges will be a disaster for affordable health care for employees and their families." (Physicians for a National Health Program [PNHP])

IRS Rule for Premium Payment Plans Could Have 'Devastating Effects' on America's Small Businesses
"A new [IRS] policy imposing a $100 a day fine per employee on small businesses that offer traditional health reimbursement accounts (HRAs) goes into effect [July 1] and the consequences could be crippling for America's smallest employers....The bipartisan Small Business Healthcare Relief Act ... would provide a remedy to this situation by enabling small businesses to continue to use [HRAs] which allow employers to provide pre-tax dollars to employees to pay for medical care and services." (National Association for the Self-Employed [NASE])

Text of SEC Proposed Rule: Listing Standards for Recovery of Erroneously Awarded Compensation (PDF)
198 pages. "[The SEC is] proposing new Exchange Act Rule 10D-1 to set forth the listing requirements that exchanges would be directed to establish pursuant to Section 10D of the Exchange Act ... [along with] rule amendments to Regulation S-K, to the forms by which foreign private issuers file their Exchange Act annual reports, and for certain investment companies, to Form N-CSR and Schedule 14A. These amendments would require disclosure of the listed issuer's policy on recovery of incentive-based compensation and information about actions taken pursuant to such recovery policy." (U.S. Securities and Exchange Commission [SEC])

SEC Fact Sheet: Listing Standards for Clawing Back Erroneously Awarded Executive Compensation
"[L]isted companies would be required to develop and enforce recovery policies that in the event of an accounting restatement, 'claw back' from current and former executive officers incentive-based compensation they would not have received based on the restatement. Recovery would be required without regard to fault. The proposed rules would also require disclosure of listed companies' recovery policies, and their actions under those policies.... [T]he listing standards would apply to incentive-based compensation that is tied to accounting-related metrics, stock price or total shareholder return. Recovery would apply to excess incentive-based compensation received by executive officers in the three fiscal years preceding the date a listed company is required to prepare an accounting restatement." (U.S. Securities and Exchange Commission [SEC])

Cancel Your Plans for the Independence Day Weekend So You Can Study the SEC's Proposed Compensation Clawback Rules!
"The proposal would require each company to adopt its recovery policy no later than 60 days following the date on which the listing exchange's listing rule becomes effective.... The proposed rules would apply to incentive-based compensation based on stock price or total shareholder return.... [T]he proposed rules would give companies the discretion not to recover excess incentive-based compensation received by executive officers if the expense of recovery would exceed the amount to be recovered ... However, the rules would require extensive disclosure of the circumstance of any decision not to pursue recovery." (Winston & Strawn LLP)

SEC Issues Proposed Rule on Mandatory Clawbacks
"[T]he Proposed Rule would apply to all current and former Section 16 officers who earned 'incentive' compensation during a three-year 'look back period' ... The Dodd-Frank Act defines excess incentive-based compensation as 'the amount by which incentive compensation previously paid to the executive officer exceeds what would have been paid to the executive officer under the restated financial statements.'... [T]he SEC staff broadly interpreted this provision to also mean incentive compensation linked to the achievement of a specific stock price or to total shareholder return (TSR).... [W]hat would have been a company's stock price or TSR if it had initially issued correct financial statements is not known or knowable. Undaunted by this challenge, the SEC staff crafted the Proposed Rule to require a public company to 'estimate' this stock price or TSR through any reasonable method." (Meridian Compensation Partners, LLC)

Case Study: Diagnosing Effective Deferred Compensation Programs for a Governmental Hospital's Executives
"Upon seeing the current age and service data of the initial group to be covered, Milliman recommended that only 'post-plan effective date service' be counted toward meeting the vesting requirements. This would allow a 'golden handcuff' feature to be attached to the program. Projections were illustrated under two different vesting schedules ... and three separate investment return scenarios ... This gave the client an idea of the variances in ultimate employer costs and benefits paid depending on their selection of plan design, vesting schedule, and investment return assumption under various 'actual' market conditions. The study included sensitivity analysis of selected assumptions on the cost projections and the consequences of variances between actual investment returns on any assets accumulated under the plan compared to assumed returns." (Milliman)

How the Same-Sex Marriage Ruling Impacts Employee Benefits
"There are a number of questions that will need to be answered in future guidance.... In the event any employee benefit plans require changes, what would be the effective date of the change? What deadline might apply to making such changes? Will new 'change in status' events be created for mid-year election changes to Section 125 cafeteria plans?" (Ascende)

Mercer Announces Leadership Changes in North America and European/Pacific Regions Mercer

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