Spencer and Benefits NetNews – October 3, 2014

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October 3, 2014

Exchange Make-Up Varies, But Most Large Issuers Participate: GAO

In more than two-thirds of states, insurance issuers with the largest market share in 2012 participated in Health Insurance Exchanges in 2014, according to a report from the Government Accountability Office (GAO). In fact, most states saw Marketplace participation by issuers with at least 5 percent of the market share. Issuers with smaller market shares tended not to participate…

(Read Intelliconnect) »

Plan Terms Permit Benefit Suspension During Post-NRA Employment

Adopting “the analysis and conclusions of the district court,” the Sixth Circuit U.S. Court of Appeals has held that plan terms permitted the administrator of an airline pilot’s pension plan to suspend benefits (with no subsequent actuarial adjustment) for pilots who choose to keep flying after age 60, the normal retirement age under the plan. The case is
Canada v. American Airlines, Inc. Pilot Retirement Benefit Program

(Read Intelliconnect) »

October 2, 2014

Private Exchanges Are A Viable Option For Employees In 2016, Say Nearly A Quarter Of Employers

Apparently driven by a desire to save money and encourage consumerism, 28 percent of midsize to large employers responding to a July 2014 survey by global professional services company Towers Watson said they had already extensively evaluated the viability of private exchanges and 24 percent said private exchanges could provide a viable alternative for their active full-time employees as soon as 2016…

(Read Intelliconnect) »

Young Adults Visited Emergency Rooms More Often After ACA

Per capita health care spending for young adults (ages 19-25) with employer-sponsored insurance grew at a rate nearly double that of other adults (ages 26-64) during 2011 and 2012, the first two years after implementation of the provision in the Patient Protection and Affordable Care Act (ACA) that allows parents to include their adult children in family health plans, according to a study released by the Health Care Cost Institute. After 2010, young adults’ use of health services grew rapidly—particularly emergency room visits and behavioral health admissions…

(Read Intelliconnect) »

October 1, 2014

Text: IRS, HHS, DOL, Final Regulations, Amendments To Excepted Benefits

(Read Intelliconnect) »

Departments Finalize Excepted Benefits Rules For Dental And Vision Coverage, EAPs

The Departments of Labor, Health and Human Services (HHS) and the Treasury (Departments) have jointly issued final regulations that address the treatment of dental and vision benefits and employee assistance programs (EAP) as limited excepted benefits, which are generally exempt from the Patient Protection and Affordable Care Act’s (ACA) market reform requirements. The rules apply to group health plans and group health insurance issuers for plan years starting in 2015. The rules finalize some, but not all, of the proposed rules issued on December 24, 2013, with minor modifications. The Departments indicate that additional guidance on limited wraparound coverage is forthcoming. The final regulations were published in the October 1
Federal Register

(Read Intelliconnect) »

Private Exchanges On The Rise

Retail health insurance marketplaces, or exchanges, have already dramatically changed the world of employer benefits and health insurance, and employers’ increasing shift of health care decisions onto employees will continue to fuel the growth of exchanges, according to PwC Health Research Institute (HRI), in a statement about its newly-released report, The
Rise of Retail Health Coverage, based on results from the PwC 2014 Employer Touchstone Survey. HRI expects public exchanges to grow rapidly in the next few years, with 8 million already enrolled in the ACA Marketplace in the first year alone…

(Read Intelliconnect) »

September 30, 2014

Half Of Employers Expect To Trigger Cadillac Tax In 2018

Nearly half (48 percent) of employers expect to be subject to the Patient Protection and Affordable Care Act’s (ACA) Cadillac tax on high cost health plans in 2018, according to recent research from Towers Watson. In addition, 82 percent believe that they could cross the threshold by 2023…

(Read Intelliconnect) »

Voluntary Benefits Are Attractive Option For Employers As Economy Improves

Seven in 10 employers offer voluntary benefits to improve morale for their existing employees and to attract and retain new talent, according to a recent LIMRA study…

(Read Intelliconnect) »

Eliminating Right To Transfer Profit-Sharing Balance To Defined Benefit Plan Did Not Violate Anti-Cutback Rule

Although “deeply troubled” by the impact on workers’ retirement benefits, the Ninth Circuit U.S. Court of Appeals held that DHL did not run afoul of ERISA’s “anti-cutback” rule when, in acquiring the courier Airborne Express, it eliminated from the company’s retirement income plan the right to transfer funds from participants’ profit-sharing plan. To the extent ERISA’s anti-cutback rule was designed to protect workers’ “justified expectations of receiving the benefits their employers promise them,” the provision failed to do so here, the court lamented. However, the problem was not the amendment at issue in this case; it was the actuarial assumptions made in calculating the offset to participants’ monthly retirement benefits—assumptions that the plan participants had not challenged in their lawsuit. The case is
Andersen v. DHL Retirement Pension Plan (No. 12-36051)…

(Read Intelliconnect) »

September 29, 2014

Healthcare.gov Weakness With Data Security And Privacy Continue

Healthcare.gov has security and privacy weaknesses that expose data to increased and unnecessary risk of unauthorized access, according to Report No. GAO-14-730 from the Government Accountability Office (GAO). While CMS has taken many steps to ensure the security of private data, more needs to be done to reduce the risk of unauthorized access. Personally identifiable information is maintained on the federally facilitated Marketplace (FFM) and interchanged with a number of federal agencies, private business and states via the CMS data hub. Significant risk exists with data exchange among four states. In addition, CMS did not test all components of Healthcare.gov before making the site available to the public and has not fully implemented security and privacy controls…

(Read Intelliconnect) »

Jointly Employed Manager Covered By FMLA

Upholding a jury’s award of less than $50,000 to an employee who was fired by Trans States Airlines when he took Family and Medical Leave Act (FMLA) leave despite the company’s denial of his request, a Seventh Circuit U.S. Court of Appeals panel found that he was covered by the FMLA even though the airline employed only 33 employees at or within 75 miles of O’Hare airport where he worked because he was a joint employee of at least one other company. The Seventh Circuit also found that the district court did not abuse its discretion in awarding $325,000 in attorneys’ fees to the employee in light of the defendants’ conduct. The case is
Cuff v. Trans States Holdings, Inc. (No. 13-1241)…

(Read Intelliconnect) »