Spencer Benefits Reports NetNews – October 9, 2015

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Featured This Week


New Reports




October 9, 2015


Adults with health insurance are still experiencing barriers to dental coverage

It is not surprising that uninsured adults might have unmet needs for dental care, but, according to a report on the Urban Institute’s Health Reform Monitoring Survey (HRMS), adults with full-year health insurance coverage have also said they have unmet dental care needs (citing the Kaiser Commission on Medicaid and the Uninsured 2012; Long et al. 2012). Despite the fact that access to health insurance was greatly expanded by the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) many Americans are experiencing the same financial barriers to dental services they encountered prior to the ACA’s passage, the Urban Institute has found…

(Read Intelliconnect) »

Mercer develops 2016 top 10 compliance-related issues for employers

Many employers are in the final stages of designing their 2016 health benefit programs, contribution strategies, vendor terms, and employee communications. To assist in this effort, Mercer has recently published the top 10 compliance-related issues employers should address in health benefit planning for the upcoming year. Mercer says referring to this list will assist employers in keeping pace with the latest Patient Protection and Affordable Care Act (ACA) and other developments impacting health plans…

(Read Intelliconnect) »

Eleventh Circuit orders reconsideration of pre-Tibble fiduciary breach cases dismissed as time barred

The Eleventh Circuit U.S. Court of Appeals has vacated and remanded two prior decisions that applied an interpretation of ERISA’s six-year statute of limitations that was subsequently rejected by the U.S. Supreme Court. The cases were remanded for reconsideration consistent with the continuing duty of care standard validated by the Supreme Court…

(Read Intelliconnect) »

October 8, 2015


Shifting costs, reducing benefits are among employers’ strategies to avoid tax in 2018

Although it doesn’t take effect until 2018, employers nationwide are taking steps to determine whether they will trigger the Cadillac tax and then most are taking actions to avoid it. That’s according to a survey from the International Foundation of Employee Benefit Plans (IFEBP) that finds that nearly nine in ten employers have calculated whether their health plan will trigger the Cadillac tax, and 60 percent say that without any future changes, their plan will face the tax…

(Read Intelliconnect) »

Tips for employees to maximize their annual enrollment experience

Open enrollment is just around the corner, recently noted consultant Aon Hewitt, and employees will soon need to make some important decisions about health care benefits. Aon Hewitt has provided a list of tips to help employees get the most of open enrollment this year…

(Read Intelliconnect) »

Plan fiduciaries not liable for failure to foresee drop in company stock price

Noting that allegations of fiduciary breach based on over-or undervaluing stock are implausible as a general rule, plan fiduciaries could not be held liable, absent special circumstances, for failing to foresee a decline in company stock in which plan participants had invested, the Eleventh Circuit U.S. Court of Appeals has ruled…

(Read Intelliconnect) »

October 7, 2015


More than 10 percent of U.S. workforce on FMLA leave at any given time, analysis finds

A new analysis of Family and Medical Leave Act (FMLA) data from FMLASource®, a ComPsych® Corporation program, revealed that more than 10 percent of the U.S. workforce is on FMLA leave at any given time. FMLA provides employees with an unpaid leave of absence of up to 12 weeks per year for the birth or adoption of a child, for an employee’s own serious medical condition or for the care of a family member with a serious medical condition. The complexities of FMLA and its frequently changing requirements can pose administrative challenges for employers as well as increased costs and liability risk…

(Read Intelliconnect) »


“Microgroups” are dropping employer-sponsored coverage and expect employees to purchase exchange coverage

Some small employers, often “microgroups” (those with fewer than 10 employees), are dropping group coverage with the expectation that their employees will purchase individual policies on the health insurance exchanges and potentially receive financial assistance, according to a new report from the Robert Wood Johnson Foundation (RWJF) and the Urban Institute. Because the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) does not apply the employer mandate to companies with less than 50 employees, there is no penalty for small employers to choose not to provide health insurance, the researchers noted…

(Read Intelliconnect) »

Some market plans now ‘roughly comparable’ to employer-sponsored coverage

Since the implementation of the Patient Protection and Affordable Care Act (ACA), health insurance coverage purchased by low- and moderate-income individuals through the health insurance marketplace is “roughly comparable” to the coverage provided through employer-sponsored plans. The Commonwealth Fund found that tax credits allow those with low and moderate income to pay amounts that are similar to what employees pay under employer-sponsored plans. Yet, higher-income individuals in the market were found to pay more for premiums than their counterparts with coverage subsidized by their employers and larger shares of those in the individual market paid higher deductibles than those in the employee-sponsored market…

(Read Intelliconnect) »

October 6, 2015


Lawmakers pass measure revising definition of small businesses under the ACA

The Senate on October 1 passed, by voice vote, the Protecting Affordable Coverage for Employees Act (PACE) (HR 1624), which amends the definition of small businesses and protects them from possible increases in health care premiums under the Patient Protection and Affordable Care Act (ACA). The House approved the measure on September 28, also by voice vote, and the president is expected to sign the bill…

(Read Intelliconnect) »

Deadline for MLR, risk corridor reporting extended for certain issuers

If a health insurance issuer timely submitted its 2014 medical loss ratio (MLR) reporting forms and risk corridors plan-level data form and was required to resubmit those forms in September 2015, despite an original rebate payment deadline of September 30, 2015, CMS will not treat the issuer as out of compliance with the regulatory deadline if the issuer pays the rebates no later than October 30, 2015…

(Read Intelliconnect) »


Prescription drug costs will increase at double-digit rates in 2016

Health benefit plan cost trend rates for 2016 will increase for most medical plan options and increase substantially for prescription drug coverage to double-digit rates, according to forecasts from the 2016 Segal Health Plan Cost Trend Survey, Segal’s nineteenth annual survey of health plan cost trends…

(Read Intelliconnect) »


October 5, 2015


House approves bill exempting certain religious groups from ACA mandate

House lawmakers on September 28 approved, by unanimous consent, the Equitable Access to Care and Health (EACH) Bill (HR 2061), which would exempt certain religious groups, such as Christian Scientists, from the individual mandate under the Patient Protection and Affordable Care Act (PPACA) (P.L. 111-148). Specifically, the measure would extend current religious exemptions to individuals who rely solely on a religious method of healing and for whom the acceptance of medical health services would be inconsistent with their religious beliefs…

(Read Intelliconnect) »

10.5M remain uninsured but eligible, HHS working on outreach

Despite about 17.6 million Americans gaining health insurance coverage under the Patient Protection and Affordable Care Act (ACA), almost 10.5 million individuals remain uninsured but eligible for coverage in the health insurance marketplaces. HHS Secretary Sylvia Burwell and the Office of the Assistant Secretary for Planning and Evaluation (ASPE) reviewed the changes brought about by the ACA in the last five years as the agencies prepare for the third open enrollment period. The uninsurance rate has dropped among three races studied and both genders, and coverage gains have been observed in individual market coverage and Medicaid as well as in the marketplace…

(Read Intelliconnect) »


401(k) fees continue to decline

The cost of investing in long-term mutual funds (equity, hybrid, and bond funds) was less in 2014 than in 2013, for 401(k) plan participants, which is consistent with a pronounced downward trend since 2000, according to an annual research report issued by the Investment Company Institute (ICI). In addition, the ICI study confirmed prior ICI research showing that participants who invest in mutual funds in their 401(k) plans tend to hold lower-cost funds…

(Read Intelliconnect) »