Spencer & Benefits Reports NetNews – September 12, 2014

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September 12, 2014

Vast Majority Of Large Employers Offered Health Benefits To Workers

The vast majority (94 percent) of employers with 100 or more employees offered health benefits to at least some of their workers in 2014, according to the Kaiser Family Foundation/Health Research & Educational Trust’s (HRET) 2014 Employer Health Benefits Survey. Kaiser/HRET noted that this is good news since starting in 2015 employers with 100 or more full-time equivalent workers could face penalties under the Patient Protection and Affordable Care Act (ACA) if they do not offer affordable health coverage to employees. Employers with 50 to 99 employees will face these penalties in 2016…

(Read Intelliconnect) »

Employer Mandate Isn’t Pushing Workers Into Part-Time Gigs

Despite claims that the Patient Protection and Affordable Care Act (ACA) would lead to an increase in part-time work, no ACA-attributable increase was seen by the Urban Institute for 2014. The Urban Institute issued a brief exploring the theory that part time work would increase at the expense of full time employment, concluding that the small increase that was seen is attributable to economic recovery…

(Read Intelliconnect) »

September 11, 2014

Health Spending Growth Remained Slow In 2013: CMS

Health spending growth remained slow in 2013, with faster growth on the horizon due to the Patient Protection and Affordable Care Act’s (ACA) coverage expansion, economic growth and an aging population according to the CMS Office of the Actuary. Sequestration, sluggish economic recovery and increases in private health insurance cost-sharing requirements attributed to the slow growth of 3.6 percent for health spending in 2013. Overall, in 2013 health care expenditures sponsored or paid for by the government (federal, state, and local) are expected to have reached $1.3 trillion, which is a 3.2 percent growth, as compared to 3.9 percent growth, or $1.6 trillion seen in spending by business, households and private sources…

(Read Intelliconnect) »

Majority Of Companies Value Healthy Work-Life Balance

The majority of companies (83 percent) encourage a healthy work-life balance among their employees, according to a recent study of senior executives from Battalia Winston. Overall, most companies valuing work-life balance have programs and policies in place to support that stance: 73 percent offer flexible schedules; 66 percent offer teleworking options; and 63 percent have implemented technology, like teleconferencing and video-chat, to reduce required travel…

(Read Intelliconnect) »

Retiree Allowed To Sue To Enforce ERISA Guaranteed Rights Without Exhausting Plan Remedies

A retiree was not required to exhaust administrative remedies before bringing suit to enforce the substantive guarantee under ERISA and IRS regulation to lump-sum benefits without unreasonable delay, the DC Circuit U.S. Court of Appeals has ruled in Stephens, et al. v. Pension Benefit Guaranty Corporation. ERISA and the IRS regulations, and not the plan, framed the basis of the claimant’s right to relief, the court reasoned…

(Read Intelliconnect) »

September 10, 2014

Improvements Can Be Made To Protect 401(k) Participants: GAO

Improvements can be made to better protect participants in managed accounts offered by 401(k) plans, according to the Government Accountability Office (GAO) in the report, Improvements Can Be Made to Better Protect Participants in Managed Accounts (GAO-14-310)…

(Read Intelliconnect) »

Bulletin Confirms Form And Manner Of Discontinuance, Renewal Notices

Updated versions of the correct form and manner of conveyance for discontinuation and renewals notices, which are mandated by the Public Health Service Act (PHSA), as it was amended by the Patient Protection and Affordable Care Act (ACA), was announced in a bulletin issued as part of the CMS Insurance Standard Bulletin Series. This bulletin integrates the feedback received by CMS from previous issuances of draft standard federal notices, which were released earlier this year…

(Read Intelliconnect) »

Out-Of-Pocket Costs For Specialty Drugs Lowest In Platinum Plans

Platinum plans incurred the lowest average out-of-pocket costs for five common specialty drugs among 2015 Health Exchange plans whose rate filings have been made public, according to a study by HealthPocket. The specialty drugs included in the study were Humira, Copaxone, Gleevec, Atripla, and Norditropin…

(Read Intelliconnect) »

September 9, 2014

Small Businesses In Five States Will Get Early Access To SHOP Exchanges

Small business in Delaware, Illinois, Ohio, Missouri and New Jersey will be able to access the online portal for the Small Business Options Program (SHOP) Exchange in late October ahead of the November 15 start of open enrollment, according to the Department of Health and Human Services. By providing this “soft launch” period, any problems encountered through the online portal will be able to be fixed by the start of open enrollment for the federally-facilitated SHOPs…

(Read Intelliconnect) »

Employers, IRS Lay Groundwork For Sec. 6056 Reporting

The Patient Protection and Affordable Care Act (ACA) requires applicable large employers (ALEs)—generally employers with at least 50 full-time employees, including full-time equivalent employees—to file information returns reporting the terms and conditions of the health care coverage, if any, provided to full-time employees. This is known as “Sec. 6056 reporting.” Under transition relief in Notice 2013-45, Sec. 6056 reporting is optional for 2014. The first Sec. 6056 information returns required to be filed are for 2015 and subsequent years…

(Read Intelliconnect) »

DB Plan Participants Were Entitled To Enhanced Benefits Under Plan’s Unambiguous Change Of Control Provision

Defined benefit plan participants were entitled to enhanced benefits under the plan’s change of control provision because the provision’s meaning was unambiguous and the participants satisfied all of the requirements of the provision, according to the Sixth Circuit U.S. Court of Appeals in Adams, Jr. v. Anheuser-Busch Companies, Inc…

(Read Intelliconnect) »

September 8, 2014

Text: HHS, Final Rule, Annual Eligibility Redeterminations For Exchange Participation and Insurance Affordability Programs

(Read Intelliconnect) »

HHS Finalizes Rule Regarding Auto-Renewal Of Health Insurance On Exchanges

A final rule providing for auto-renewal of health insurance purchased through the federal Health Insurance Exchange and establishing notice requirements for insurance issuers that will not renew policies due to beneficiaries that move out of the geographic service area has been issued by the Department of Health and Human Services. The final rule clarifies that the general word “Exchange” refers to both state Exchanges (state Exchange) and the federally-facilitated Exchanges (FFEs); and FFEs include state partnership Exchanges. These procedures will be used for the 2015 benefit year, despite comments suggesting it be postponed until 2016. The final rule was published in the September 5 Federal Register…

(Read Intelliconnect) »

Full D.C. Appellate Panel To Rehear Decision Striking ACA Premium Subsidies

The U.S. Court of Appeals for the District of Columbia has granted a petition for a rehearing en banc of Halbig v. Burwell, in which three of the court’s judges reversed a district court’s ruling that the ACA’s premium subsidies apply to both state-operated and federally-established Exchanges. The motion for a full-panel rehearing was a good tactical move for the defendants, partly because it could slow down the Halbig case’s progress in reaching the Supreme Court, according to Tom Christina of Ogletree Deakins. This is because other cases in different federal courts have raised the same issue regarding regulations under Code Sec. 36B, and the Obama administration may decide they would prefer one of those to reach the Supreme Court first, he explained back in July, when the Halbig decision was announced…

(Read Intelliconnect) »

Consumer Complaints Prompt Washington To Provide Special Enrollment Period

Washington’s Insurance Commissioner, Mike Kreidler, has announced a limited special enrollment period for people who have experienced difficulty enrolling in health coverage through Washington’s Exchange, Washington Healthplanfinder, or who have had billing or payment issues…

(Read Intelliconnect) »