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- Analysis: Lifetime and annual limits, rescissions, discrimination, 4/16 (513.-1)
- Analysis: ACA effective dates, 4/16 (511.-7)
(Read Intelliconnect) »
- Analysis: HSAs, 4/16 (356.-5)
(Read Intelliconnect) »
- Analysis: Minimum medical loss ratios, 4/16 (533.-1)
(Read Intelliconnect) »
Congressional subcommittee holds hearing on how to promote a healthy workforce
Innovations employers are using to control costs and provide higher quality coverage to their employees were the topics of a hearing conducted recently by the Subcommittee on Health, Employment, Labor, and Pensions, as part of ongoing work by the Task Force on Health Care Reform. According to Subcommittee Chairman Rep. Phil Roe (R-TN), “…employers of all sizes are still developing creative strategies to help control costs and meeting the changing needs of the workforce.”
Wellness programs increase satisfaction with benefits
Employees who have access to a wellness program are more likely to be satisfied with the employer’s overall benefits package, according to a recent survey from Four Seasons Financial Education (FSFE)….
Court to PBGC: Provide better rationale for nixing pre-NOIT request for lump-sum benefit
The Pension Benefit Guaranty Corporation (PBGC) Appeals Board failed to explain adequately its rationale for denying, under ERISA’s distress termination rules, a participant’s request for a lump-sum distribution of his pension benefit in a case where both the request and the plan administrator’s denial occurred before the notice of intent to terminate (NOIT) was issued to the PBGC, the U.S. District Court for the District of Columbia (DC DC) has ruled….
Online SHOP enrollment transition relief extended, states should plan for 2019
State-based Small Business Health Options Programs (SHOP) that have not yet provided online enrollment capabilities are permitted to use direct enrollment for plan years beginning in 2017 and 2018. CMS and the Center for Consumer Information & Insurance Oversight (CCIIO) is providing this extension as a transitional measure, available only to SHOPs that currently use direct enrollment….
IRS issues May 2016 AFRs
The May 2016 short-term, mid-term, and long-term applicable federal interest rates (AFRs) have been issued by the IRS. The May mid-term 175 percent AFR (Annual) rate, used to calculate interest charged to the funding standard account for underpayments of quarterly contributions under Code Sec. 412(m), is 2.51 percent….
Employers don’t like the employer mandate, but it’s not because they don’t want to offer coverage
Employers do not like the Patient Protection and Affordable Care Act’s (ACA) (P.L. 111-148) employer mandate, according to a recent survey from Mercer. The survey asked employers what changes they would like to see made to the ACA. Repealing the excise tax (also known as the Cadillac tax) was first, with 85 percent in favor, but repealing the employer mandate was second, favored by 70 percent….
ERISA plan’s noncompliance with claims-procedure rule prompts de novo review absent harmless mistake
An ERISA plan’s failure to comply with the Department of Labor’s claims-procedure regulation when denying a claim for benefits will result in the claim being reviewed de novo in federal court unless the plan has otherwise established procedures in full conformity with the regulation and can show that its failure to comply with the regulation was inadvertent and harmless, the U.S. Court of Appeals for the Second Circuit held. In addition, civil penalties are not available to a plan participant or beneficiary for a plan’s failure to comply with the regulation. Finally, a district court may exercise its discretion to consider a plan’s noncompliance as good cause warranting the introduction of additional evidence outside the administrative record….
PCORI’s financial audit conducted properly, no significant issues reported
The Patient-Centered Outcomes Research Institute (PCORI)’s financial statements did not have any significant issues of noncompliance or weaknesses, and the independent public accountant (IPA) was qualified to conduct the audit. The Government Accountability Office (GAO) reviewed the IPA’s qualifications, and found the audit was conducted in accordance with generally accepted standards….
Ways and Means hearing on health care reform examines consumer-driven solutions
How best to provide Americans with a more active role in the choice and control over their health insurance and health care was the common question addressed at a recent House Ways and Means Committee hearing on health care and taxes. The benefits and disadvantages of deductible employer-paid health care premiums and the need for consumerism to drive down costs were examined in particular….
Concerned about the Cadillac tax? Implement an HSA
Employers concerned about the Patient Protection and Affordable Care Act’s (ACA) (P.L. 111-148) Cadillac tax should consider implementing a high deductible health plan (HDHP) with a health savings account (HSA), according to a recent brief from HSA Bank. The brief,
Now Is the Time to Plan for the Cadillac Tax, noted that HSA-compatible HDHPs are often less expense than traditional plans and less likely to hit the Cadillac tax’s thresholds…
ACA risk shifting programs may actually be too effective
The risk adjustment program, found in section 1343 of the ACA, worked as intended by shifting funds to insurers that have high-cost enrollees. The American Academy of Actuaries (the Academy) found that the loss ratio differences among insurers were compressed into a smaller range by both the ACA’s risk adjustment program and reinsurance program payments. The policy analysis noted that insurers receiving the largest risk adjustment payments actually had below average loss ratios….
PBGC issues May 2016 interest rates for valuing terminating pension plans
For single-employer pension plans terminating April through June 2016, and for multiemployer plans involved in a mass withdrawal, the interest rate established by the PBGC for calculating immediate annuities is 2.77 percent, down from the 2.82 percent rate that applied in January through March 2016. The interest rate for calculating immediate lump sums in May 2016 is 1.00 percent, the same as the rate that applied in April 2016….
Confident about ACA compliance? Not so much, business owners say
Only 25 percent of business owners are completely confident their organizations understand the Patient Protection and Affordable Care Act’s (ACA) regulations. And less than half feel they are well prepared to effectively manage the complexities of eligibility and affordability requirements of benefit plans under the ACA. That’s according to the fourth annual ADP Midsized Business Owners Study….