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Featured This Week
- Analysis: ACA Reforms Affect Every Aspect Of U.S. Health Care System, 3/14 (511.-1)
- Analysis: Healthy San Francisco, 3/14 (509.-15)
- Analysis: Bona Fide Wellness Programs, 3/14 (326.-3)
- Analysis: Covered Compensation Tables For 2012-2014, 3/14 (174.4.-45)
April 4, 2014
Goal Of 7 Million Signups Met For First ACA Open Enrollment Period
“The Affordable Care Act is here to stay,” said President Barack Obama in a statement marking the end of the first open enrollment period for the health insurance marketplace and announcing that 7.1 million Americans have signed up for private health insurance plans through the marketplace, exceeding the original goal set by the administration…
Reforms Have Potential To Change Insurance Map Of The Country
Thirty-two million people under age 65 were underinsured in the United States in 2012, which means they had health coverage but it provided inadequate protection against high health care costs relative to their income, a recent Commonwealth Fund report finds. The first report to examine the underinsured at the state level, it finds that the rate of underinsured ranged from a low of 8 percent in New Hampshire to highs of 16 percent in Mississippi and Tennessee and 17 percent in Idaho and Utah…
Investment Representative Who Did Not Exercise Authority Over Failed Plan Investment Was Not ERISA Fiduciary
A registered investment advisor representative who recommended the investment of plan assets in a risky start-up venture that eventually failed was not subject to suit as a fiduciary under ERISA, according to Fifth Circuit U.S. Court of Appeals in Tiblier, et al v. Dlabal, et al. The registered representative did not actually exercise discretionary authority with respect to the transaction at issue, the court stressed…
April 3, 2014
HHS Releases Security Risk Assessment Tool To Help Providers With HIPAA Compliance
A new security risk assessment (SRA) tool to help guide health care providers in small to medium sized offices conduct risk assessments of their organizations is now available from the Department of Health and Human Services (HHS)…
Employers Are Warned Away From Reducing Employee Hours Just To Avoid ACA Fines
Capping employees’ weekly hours below 30 to avoid triggering employer mandate penalties imposed by the Patient Protection and Affordable Care Act (ACA) carries with it the risk of ERISA litigation, according to Craig Martin and Nary Kim, of the law firm of Jenner & Block, in an article for CFO.com entitled Capping Hours to Avoid ACA Costs Could Violate ERISA. ERISA Sec. 510, Martin and Kim point out, disallows discharging, fining, suspending, expelling, disciplining, or discriminating against participants and beneficiaries for exercising employee benefit plan rights to which they are entitled, and also forbids employers from interfering with the attainment of any right to which a participant may become entitled under either their plan or Title I of ERISA…
IRS Provides Guidance On Health FSA Carryovers And HSA Eligibility
In Notice 2013-71, the Internal Revenue Service modified health flexible spending arrangements’ (health FSAs) use-it-or-lose-it rule, and now allows employers to amend their cafeteria plans to provide for the carryover of up to $500 in unused health FSA contributions to the immediately following plan year. While Notice 2013-71 provided a much-wished-for easing of the use-it-or-lose-it rule, it has provided for some confusion for employers who have both a high-deductible health plan (HDHP) with a health savings account (HSA) and a health FSA with a carryover feature. The IRS Office of Chief Counsel has issued Memorandum 201413005 to answer some questions concerning the health FSA carryover and HSA eligibility…
IRS Provides Safe Harbor Under Health Insurance Providers Fee For Premiums Written For Expatriate Plans
In Notice 2014-24, the Internal Revenue Service has provided a temporary safe harbor for “covered entities” that report direct premiums written for expatriate plans on a Supplemental Health Care Exhibit (SHCE) in connection with the annual fee imposed on insurers of U.S. health risks. The fee is imposed by Sec. 9010 of the Patient Protection and Affordable Care Act (ACA), as amended, for calendar years beginning after 2013, and is based on net premiums written after December 31, 2012….
April 1, 2014
Qualified Retirement Plans Wait For More Post-Windsor Guidance
The Internal Revenue Service continues to work on guidance for qualified retirement plans following the Supreme Court’s decision in United States v. Windsor, Robert Neis, deputy benefits tax counsel, Treasury Office of Tax Policy, said during a webcast sponsored by the American Bar Association (ABA) Section of Taxation on March 26. Neis reviewed the IRS’s guidance to date and acknowledged that qualified retirement plans are eagerly awaiting the expected guidance…
Implementing Total Replacement CDHP Resulted In Decreased Prescription Use: EBRI
Moving to an HSA-eligible high deductible health plan reduced the number of both generic and brand-name prescriptions filled, according to data from one large employer that implemented a total replacement consumer-driven health plan (CDHP). The study, Brand-Name and Generic Prescription Drug Use After Adoption of a Full-Replacement, Consumer-Directed Health Plan With a Health Savings Account, found that at the end of the four-year follow-up period, the generic drug rate was greater by 4.5 percentage points for hypertension, 15.4 percentage points for dyslipidemia, and 7.8 percentage points for asthma/COPD (chronic obstructive pulmonary disease). No significant effects were detected for diabetes. The report was published by the Employee Benefit Research Institute (EBRI) in the March 2014 EBRI Notes…
March 31, 2014
Victims Of Domestic Abuse Are Eligible For Exchange Premium Tax Credits: IRS
In Notice 2014-23, the Internal Revenue Service has released guidance on circumstances in which a married victim of domestic abuse who is unable to file a joint tax return may claim a premium tax credit under Code Sec. 36B for coverage under a qualified health plan…
Hours Scheduled This Year Will Determine If An Employee Is Considered Full-Time In 2015, SHRM Says
While the Patient Protection and Affordable Care Act’s (ACA) employer shared responsibility provisions have been delayed until 2015 for large employers with 100 or more full-time employees and until 2016 for midsize employers with 50 to 99 employees, employers need to start counting hours this year, since hours scheduled in 2014 will determine if an employee is considered full-time in 2015, according to a recent article from the Society for Human Resource Management (SHRM)…
Viewed Deferentially, Administrator’s Second Attempt To Interpret Floor-Offset Plan Still Unreasonable
Applying the deferential standard of review as required by the Supreme Court’s prior ruling to the Xerox pension plan administrator’s second attempt to calculate the benefits of rehired employees who had received a lump-sum distribution, the Second Circuit U.S. Court of Appeals found the administrator’s new interpretation to be without support in the terms of the plan and therefore unreasonable. In addition, even assuming the administrator’s new offset method was reasonable, the offset violated ERISA’s notice requirements and therefore could not be applied to the rehired employees’ benefits. The case is Frommert v. Conkright…