Spencer Benefits Reports Netnews – December 5, 2014


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December 5, 2014

Massachusetts Succeeds With Coverage, Struggles With Costs

Massachusetts has had ongoing success at maintaining near universal health insurance coverage following the state’s enactment of its comprehensive health reform law in 2006. Paying for health care continues to be troublesome, however. Those are the findings of the latest Massachusetts Health Reform Survey (MHRS), funded by the Robert Wood Johnson Foundation and the Blue Cross Blue Shield of Massachusetts Foundation…

        (Read Intelliconnect) »

Retirement Readiness Is Major Worry For U.S. Employers

Despite the fact that more employers are embracing 401(k) plan automatic features, target-date funds and education, retirement readiness worries remain, according to recent research from Towers Watson. More than three-quarters of large and midsize U.S. employers that sponsor 401(k) and 403(b) defined contribution (DC) plans say retirement readiness has become a major issue for their employees, and a vast majority of plan sponsors have taken steps to meet this growing challenge by boosting their savings and investment education programs, and continuing to embrace automatic features and target-date funds for their DC plans…

        (Read Intelliconnect) »

Telemedicine Boosts Efforts To Achieve Positive Patient Outcomes

Health care providers are actively pursuing telemedicine advancements despite reimbursement and regulatory challenges, according to a survey of senior health care executives by Foley & Lardner LLP…

        (Read Intelliconnect) »

December 4, 2014

IRS Issues 2016 Inflation-Adjusted Code Sec. 36B Premium Assistance Tax Credit Table

In Rev. Proc. 2014-62, the IRS has adjusted for inflation the applicable percentage table in Code Sec. 36B(b)(3)(A)(i), which is used to calculate an individual’s insurance premium tax credit for tax years beginning in 2016, and also the required contribution percentage in Code Sec. 36B(c)(2)(C)(i)(II), which is used to determine whether an individual is eligible for affordable employer-sponsored minimum essential coverage under Code Sec. 36B for plan years beginning in 2016. In addition, the guidance cross-references an inflation-adjusted required contribution percentage under Code Sec. 5000A(e)(1)(A) for plan years beginning in 2016, which is used to determine whether an individual is eligible for an exemption from the individual shared responsibility payment because of a lack of affordable minimum essential coverage…

        (Read Intelliconnect) »

Employers Missing Out On Big Chances To Communicate With Employees

Most employers (56 percent) say improving employees’ understanding and perceived value of benefits is their main focus, yet companies still lack personalized benefits communication at a time when it’s commonly expected by employees. These are among the findings of a new survey of more than 330 employers conducted by the non-profit National Business Coalition on Health and Benz Communications…

        (Read Intelliconnect) »

December 3, 2014

HHS Proposes Standards For Insurance Issuers And Marketplaces In 2016

The Department of Health and Human Services (HHS) has issued a proposed rule establishing standards for insurance issuers and Marketplaces for 2016. The proposed rule sets forth payment parameters and information related to the risk adjustment, reinsurance, and risk corridors programs; the cost sharing parameters and cost sharing reductions; as well as user fees for the Federally-facilitated Exchange (FFE). In addition, the proposed rule covers standards for the annual open enrollment period for the individual market in benefit years on or after Jan. 1, 2016, essential health benefits, qualified health plans (QHPs), network adequacy, quality improvement strategies, the Small Business Health Options Program (SHOP), guaranteed availability, guaranteed renewability, minimum essential coverage, the rate review program, the medical loss ratio (MLR) program, and related topics. The proposed rule was published in the November 26 Federal Register…

        (Read Intelliconnect) »

IRS Releases Guidance On Hardship Exemptions From ACA Individual Shared Responsibility Payment And Minimum Essential Coverage

The IRS has released final regulations relating to the requirement to maintain minimum essential coverage enacted by the Patient Protection and Affordable Care Act (ACA). Notice 2014-76, released concurrently with the regulations, provides a comprehensive list of all hardship exemptions that may be claimed on a federal income tax return without obtaining a hardship exemption certification. The final regulations were published in the November 26
Federal Register

        (Read Intelliconnect) »

President’s ‘Unilateral Actions’ Draw Strong Reaction: GOP Sues Obama

House Republicans filed suit against the Obama Administration over what it refers to as its “unilateral actions” on the Patient Protection and Affordable Care Act (ACA) that the GOP claims abuses the power of the president’s executive authority. The lawsuit was filed against the Secretaries of the Health and Human Services and Treasury Departments, and accuses the Obama Administration of unilaterally delaying the employer mandate of the ACA and alleges that it allowed illegal transfers of funds to insurance companies…

        (Read Intelliconnect) »

December 2, 2014

Text: IRS, Rev. Rul. 2014-32, Qualified Transportation Fringes

        (Read Intelliconnect) »

IRS Issues Guidance On Transportation Fringe Benefits

In Rev. Rul. 2014-32, the IRS has provided guidance for employers who wish to provide transit pass benefits to employees through the use of a smartcard (a plastic card with an imbedded memory chip). The guidance modifies and supersedes previously released guidance regarding the use of transit cards and debit cards, and when an employer may use a bona fide cash reimbursement arrangement to provide a qualified transportation fringe benefit…

        (Read Intelliconnect) »

Modest Health Benefit Cost Growth Continues As Consumerism Kicks Into High Gear

Employers took action on several fronts to hold down growth in the average per-employee cost of health benefits to 3.9 percent in 2014, according to recent research from Mercer. While this was a bigger increase than last year’s historically low increase, it is still well below the 7 percent average rate of growth over the past 15 years. The
National Survey of Employer-Sponsored Health Plans found that total health benefit cost averaged $11,204 per employee in 2014; this includes employer and employee contributions for medical, dental and other health coverage…

        (Read Intelliconnect) »

December 1, 2014

Mental Health Parity Information Is Updated On EBSA Website

The Employee Benefits Security Administration (EBSA) has updated its website with revisions to the Mental Health Parity web page. Material on the web page now includes a revised Mental Health Parity Part of the Self Compliance Tool and a revised Mental Health Parity Provisions Questions and Answers in an updated Compliance Assistance Guide that includes new provisions for the Pension Protection and Affordable Care Act (ACA)…

        (Read Intelliconnect) »

Wellness Incentives Are Adopted By More Employers For This Year’s Open Enrollment

Few employers plan to eliminate or make major changes in their health care benefits in the near future—but changes are inevitable, and these include the growth of wellness programs designed to address worker risks and behaviors, which drive chronic conditions, and account for a large percentage of overall spending, according to recent research from the Employee Benefit Research Institute (EBRI)…

        (Read Intelliconnect) »

Health Care Provider Allowed To Sue ERISA Plans For Payment Of Benefits

A health care provider had standing, as assignee of plan beneficiaries, to bring claims for payment of benefits against several ERISA-governed health plans and their claims administrator, the Ninth Circuit U.S. Court of Appeals has ruled. However, the provider did not have standing to bring claims for breach of fiduciary duty. The court also held that a nonprofit association of chiropractors lacked associational standing to bring suit against the claims administrator for its allegedly wrongful withholding of payments because the requested relief would require the participation of the association’s individual members. The case is
Spinedex Physical Therapy USA Inc. v. United Healthcare of Arizona, Inc. (No. 12-17604)…

        (Read Intelliconnect) »