Spencer’s Benefits Reports NetNews – July 24, 2015

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July 24, 2015


Health coverage information returns must be filed by self-insured employers

All employers that provide self-insured health coverage to their employees must file an annual health coverage information return for coverage provided in 2015, regardless of the employer’s size, the IRS has recently advised…

(Read Intelliconnect) »

Undercover test reveals marketplace mess, GAO gets coverage for 11 fictitious enrollees

The federal health insurance marketplace does not adequately verify the identity or eligibility of enrollees seeking health insurance coverage, according to a Government Accountability Office (GAO) report on the results of an undercover evaluation of the federal health insurance marketplace’s eligibility and enrollment controls. The report revealed that through multiple undercover tests, the GAO was able to obtain subsidized coverage under the Patient Protection and Affordable Care Act (ACA) for 11 out of 12 fictitious applicants in 2014…

(Read Intelliconnect) »

States have taken steps to enhance Exchanges, but more can be done

All 50 states and the District of Columbia have already taken steps to enhance their Health Insurance Exchanges to make them more patient-friendly, according to recent research from the National Health Council (NHC). However, NHC cautions that there is a wide variety in what has been done in each state, and a need for greater action to ensure plans sold through the Marketplace meets the needs of individuals with chronic diseases and disabilities…

(Read Intelliconnect) »

July 23, 2015


After design changes, health care costs will increase 4.5 percent in 2016

In 2016, health care costs will increase 6.5 percent, but after likely changes in benefit plan design, such as higher deductibles and co-pays, the net growth is expected to be 4.5 percent, according to recent research from PricewaterhouseCooper’s (PwC) Health Research Institute (HRI). The report, Medical Cost Trend: Behind the Numbers 2016, noted that while cost increases are low, medical inflation still outpaces general economic inflation. In addition, while the health sector has adopted structural changes to improve efficiency and quality, most of the slowing growth is attributable to cost-shifting onto consumers…

(Read Intelliconnect) »

IRS takes aim at DB plan lump-sum risk-transferring programs

The IRS intends to amend the required minimum distribution regulations under Code Sec. 401(a)(9) to provide that qualified defined benefit (DB) plans generally are not permitted to replace any joint and survivor, single life, or other annuity currently being paid to retirees with a lump-sum payment or other accelerated form of distribution. The changes apply as of July 9, 2015, though an exception will be provided for “pre-notice accelerations…”

(Read Intelliconnect) »

Uninsured rate falls to lowest levels since 2008

According to a Gallup poll, the uninsured rate among U.S. adults aged 18 and older was at its lowest level since 2008, when Gallup started to track the metric. For the second quarter (Q2) of 2015, the uninsured rate fell to 11.4 percent, down nearly 6 percentage points since the fourth quarter (Q4) of 2013. The 2013 Gallup numbers were measured prior to individual mandate requirement going into effect…

(Read Intelliconnect) »

July 22, 2015


Insurers, pharmacy companies, unions join forces to kill Cadillac tax

As part of a broad effort to repeal a section of the Patient Protection and Affordable Care Act (ACA), a coalition of pharmaceutical companies, insurance plans and unions filed a Lobbying Registration with Congress for a new organization called the Alliance to Fight the Forty. The group describes itself as an “alliance of companies seeking repeal of the 40 [percent] excise tax on health plans,” referring to the ACA’s excise tax on high cost employer-sponsored health coverage, also known as the “Cadillac tax…”

(Read Intelliconnect) »


Enrollees spent less on meds in Q1 2015 vs. Q1 2014

New Health Insurance Exchange plan enrollees spent less on medications in the first quarter of 2015 compared to the same time a year ago, according to the third edition of the Express Scripts Exchange Pulse report…

(Read Intelliconnect) »


July 21, 2015


No injunctions warranted in consolidated contraceptive accommodation cases, CA-10 rules

The Tenth Circuit held that the EBSA Form 700 accommodation allowing religious non-profit organizations to opt-out of the contraceptive mandate under the Patient Protection and Affordable Care Act (ACA) did not violate the Religious Freedom Restoration Act (RFRA) or constitute a substantial burden on the religious exercise of several religious organizations. The court held that the accommodation was sufficient to relieve the organizations of the obligation to provide, pay for, or facilitate contraceptive coverage under the ACA. As a result, the court either reversed injunctions that were granted to the religious organizations or affirmed the denial of injunctions which would have allowed the organizations to avoid the accommodation process.

(Read Intelliconnect) »

HSA balances increased 37 percent in 2014

The average health savings account (HSA) balance increased 37 percent in 2014, from $1,408 to $1,933, according to recent research from the Employee Benefit Research Institute (EBRI). EBRI estimates that enrollment in HSA-eligible high deductible health plans was approximately 17 million policyholders and dependents in 2014…

(Read Intelliconnect) »


Texas amends wellness program regulations to reflect federal standards

The Texas Department of Insurance has adopted amendments to regulations concerning wellness programs. The amendments, which take effect on July 22, 2015, reflect updates adopted in federal regulations addressing wellness programs pursuant to the Patient Protection and Affordable Care Act…

(Read Intelliconnect) »

July 20, 2015


California DIR reminds employers of paid sick leave notice requirements

The California Department of Industrial Relations (DIR) has issued a reminder to employers that they are required to notify workers in writing about their rights under the Healthy Workplace Healthy Family Act of 2014 (Assembly bill 1522)—California’s new paid sick leave law—that took effect on July 1, 2015.

(Read Intelliconnect) »

Supreme Court’s recognition of same-sex marriage will further extend spousal rights to retirement benefits

The recent Supreme Court decision validating same-sex marriage as a constitutionally protected right will have significant employee benefit ramifications for individuals as well as employers and plan administrators. By extending the fundamental right of marriage to same-sex couples, the decision also will effectively extend to such parties the right to many employee benefits that have been exclusively provided to heterosexual couples. While some plans may have already allow for the equivalent treatment of opposite sex and same-sex couples, many plans will need to be reviewed and amended to accommodate the transformed national landscape…

(Read Intelliconnect) »


ERISA Advisory Council to meet August 18-20

The Advisory Council on Employee Welfare and Pension Benefit Plans, also known as the ERISA Advisory Council, will hold a meeting on August 18-20, in Washington, D.C., at the Liaison Capitol Hill Hotel at 415 New Jersey Avenue NW…

(Read Intelliconnect) »