Health & Welfare Plans Newsletter

August 27, 2015

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Employee Benefits Jobs

Plan Consultant
Transamerica Retirement Solutions
in MA

Benefits Service Center Supervisor
Milliman
in TX

Employee Benefits Attorney
Wiggin and Dana LLP
in CT, NY

Benefits Account Manager & Department Manager
Owen-Dunn Insurance Services
in CA

Retirement Planning Consultant
Transamerica Retirement Solutions
in PA

401(k) Administrator
Swerdlin & Company
in GA

401K Plan Administrator
Atlantic Pension Services Inc.
in PA

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Webcasts and Conferences

Avoid the ACA New Shared Responsibility Payment to the IRS
September 2, 2015 WEBCAST
(First Advantage)

Participant Restrictions Under IRC ?436 AFTAP Rules
September 10, 2015 WEBCAST
(ASPPA [American Society of Pension Professionals & Actuaries])

Hot Topics in Employee Benefits: Developments in Employee Benefits and Executive Compensation
September 16, 2015 WEBCAST
(Morgan Lewis & Bockius LLP)

Supreme Court?s Decision in Tibble v. Edison International: What Are the Must Know Lessons for Plan Fiduciaries?
September 17, 2015 in CA
(Western Pension & Benefits Council - Orange County Chapter)

Safe Harbor 401(k) Workshop - Cleveland
October 1, 2015 in OH
(SunGard Relius)

Advanced Cross-Tested Plans: Adding More Tools - Cleveland
October 2, 2015 in OH
(SunGard Relius)

American Conference Institute?s Employee Benefit Plans Conference
November 17, 2015 in NY
(American Conference Institute)

2015 Regional Conference
November 17, 2015 in MO
(State and Local Government Benefits Association [SALGBA])

View All Webcasts and Conferences


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[Guidance Overview]

New Guidance on Reenrollment of 2015 Enrollees
"Insurers will get a list of their enrollees ... The guidance includes talking points that insurers can use to reach out to the enrollees on this list, advising them how to address each of the potential issues that may affect them. Of particular importance is getting individuals who have not yet filed form 8962 to reconcile their 2014 tax credits to file their taxes and the form.... The FFM will passively auto-enroll 2015 enrollees who continue to be eligible for coverage for 2016 and do not actively enroll, if their QHP insurer has provided the FFM with a 2016 reenrollment crosswalk template to indicate in what plan the 2015 enrollees will be reenrolled." (Timothy Jost, in Health Affairs)


[Advert.]

Register for NBCH's 20th Annual Conference, Nov. 16-18 in Dallas

Sponsored by National Business Coalition on Health [NBCH]

This must-attend event convenes employers, health plans, providers, business health coalitions and other key stakeholders focused on the future of health care and benefits. Free admission for employers that are members of an NBCH coalition. Join us.



Effects of Financial Incentives on Workplace Wellness Program Participation and Utilization of Health Care Services and Spending (PDF)
"Participation in health risk assessments (HRAs) increased by 50 percentage points among members of unions that bargained in the incentive ... Participation in the biometric screening program increased 55 percentage points when financial incentives were provided. Biometric screenings led to an average increase of 0.31 annual prescription drug fills, with related spending higher by $56 per member per year. Otherwise, no significant effects of participation in HRAs or biometric screenings on utilization of health care services and spending were found." (Employee Benefit Research Institute [EBRI])

Weighing the Cost of Health Care & Value-Based Choices
"The first step in becoming an informed healthcare consumer is planning ahead. When patients understand their benefit plan, payment responsibilities, and the healthcare options available to them at work and in their community, they are well on their way to being a savvy decision-maker and proactive manager of their health." (Marathon Health)

Increasing Employee Cost-Sharing (PDF)
"Since the dawn of consumerism, however, opponents have been concerned that employees may decide not to seek care at all. Ultimately, if a participant does not get necessary care, the result can be more costly care down the road because of complications from untreated conditions. Studies to date do indicate that as cost-sharing is introduced, utilization is decreased. Unfortunately, these studies do not indicate whether participants are reducing necessary or unnecessary care." (Marsh & McLennan Agency LLC)

The Future of Employee Premium Assistance Through Waivers Under the ACA
"For states that seek to protect and expand the [employer-sponsored health insurance] market, combining public dollars with employee and employer contributions is an attractive alternative. Using a State Innovation Waiver ... a state could create a [Health Insurance Premium Payment Program] that ... would take some of the money currently spent on tax credits and reduced cost sharing in a state-based exchange or the federally facilitated marketplace and redirect it to pay a portion of the employee premium cost and underwrite some of the out-of-pocket expenses." (Health Affairs)


[Advert.]

Executive Forum on On-Site & Near-Site Employee Health Clinics ? Chicago

Sponsored by World Congress

Executive Forum on On-Site & Near-Site Employee Health Clinics ? Chicago ? Sep 17-18 ? HR/Benefits Staff: Attend for $195* ? use code BLINK1 ? (*valid only for HR/Benefits Staff as defined on event website. Please visit for qualifications)



Obamacare Is Facing Another Big Threat: Accounting
"The creation of ACA health exchanges may be the final nail in the coffin for retiree health-care benefits. The exchanges make it easier for states to phase out health-care plans because pre-Medicare retirees now have other, affordable options.... About 70% of governments offer health benefits to retirees. That suggests it's likely the state retiree population could be large enough -- even 1 million could make a significant difference -- to skew the exchange population older (and likely sicker) and increase premiums." (Quartz)

ACA 'Premium Stabilization' Program Hits CO-OPs, Small Plans
"[At] least for 2014 assessments, a 'risk adjustment' program set up under the law appears to be having an unintended consequence -- new consumer-oriented 'co-ops' also created under the ACA with government funding; small, low-cost plans that employ narrow provider networks; Medicaid managed care plans; and hospital-sponsored plans are among those being hit with big payments they must make to other insurers. BlueCross BlueShield plans, which often dominate state markets, appear to be the winning recipients in many cases." (Bloomberg BNA)

Insurers Win Big Health-Rate Increases
"[The Tennessee insurance] commissioner ... [has approved] the full 36.3% increase sought by the biggest health plan in the state, BlueCross BlueShield of Tennessee.... [The] Kentucky Insurance Commissioner ... approved the 25.1% increase requested by the Kentucky Health Cooperative, the largest insurer on the state's insurance exchange.... Oregon ... allowed an average 25.6% increase for Moda Health Plan Inc., the biggest plan on that state's exchange.... Ohio ... approved a 14.5% increase from Medical Mutual. In Michigan, BlueCross BlueShield won approval for the average 11.4% increase[.]" (The Wall Street Journal; subscription may be required)

Blue Cross and Blue Shield of New Mexico Will Not Offer Individual Products on the New Mexico Health Insurance Exchange in 2016
"According to the insurer, the premium rates BCBSNM charged for individual insurance products in 2014 and 2015 did not cover the claims costs the insurer incurred -- ultimately resulting in a $19.2 million loss.... The decision comes after the Office of the Superintendent of Insurance (OSI) formally denied the insurer's 51.6 percent premium rate increase earlier this month." (The Business Journals)

Millions in the Red, Nevada Obamacare Insurer Has Failed
"Nevada Health CO-OP, which launched in 2012 with two federal loans totaling $65.9 million, will shutter its operation and will not offer coverage for 2016. Coverage for all current plans will remain good until Dec. 31, and members will be able to sign up with other carriers for Jan. 1 coverage when open enrollment begins in November." (Las Vegas Review-Journal)

[Opinion]

A Healthy Side of Health Insurer Mega-Mergers
"Anthem's proposed merger with Cigna following Aetna's acquisition of Humana has set off alarms about lack of competition in the health-insurance industry. But policy makers should consider the potential benefits of industry consolidation. The greater efficiency and market power of larger insurance plans could lower prices for consumers by offsetting the bargaining power of health-care providers." (The Wall Street Journal; subscription may be required)

Benefits in General; Executive Compensation

[Guidance Overview]

SEC Adopts Final Pay Ratio Rules (PDF)
"The rules only cover employees who are employed as of a date within the last three months of the registrant's fiscal year.... The rules exclude workers who provide services to the registrant or its consolidated subsidiaries as independent contractors or leased workers if the workers are employed by an unaffiliated third party and their pay is determined by that unaffiliated party.... The rules allow registrants to exclude individuals who became employees of the registrant as a result of a merger or acquisition that occurred during the fiscal year." (Alston & Bird LLP)

[Guidance Overview]

SEC Approves Final Rules for Pay Ratio Disclosure
"Companies should consider drafting 'pay ratio' as early as in connection with the 2016 proxy season disclosure, not necessarily to include the disclosure in their 2016 proxy materials, but to begin to understand the context of the disclosure and to strategically consider whether supplemental ratios or other information will assist with interpreting the pay ratio disclosure in a meaningful way given the company's business circumstances." (Holland & Knight)

Market Performance and Pension Contributions Drive Rise in CEO Pay
"[T]he median total compensation of CEOs of U.S. public companies in the Russell 3000 index soared 11.9 percent in 2014 over the previous year and as much as 34.7 percent over 2010. Equity awards (excluding stock options) represent 34.7 percent of the total value of the CEO pay package, and the median grant-date value of stock awards grew about 25 percent in 2014.... Only a small part of CEO earnings comes from base salary; performance-based components now dominate.... Most CEOs on the top 25 list are not from large companies ... More and more companies have been introducing cash flow as a performance metric in their short-term incentive (STI) design[.]" (The Conference Board)

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