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Older News | May 28, 2015

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arrow icon Text of Ninth Circuit Opinion Amending Harris v. Amgen in Consideration of Supreme Court's Dudenhoeffer Decision (PDF)
U.S. Court of Appeals for the Ninth Circuit

63 pages. Excerpt from the syllabus: "In the amended opinion, on remand from the United States Supreme Court for reconsideration in light of Fifth Third Bancorp v. Dudenhoeffer, the panel reversed the district court's dismissal of a class action brought by current and former employees of Amgen, Inc., and an Amgen subsidiary under [ERISA], alleging breach of fiduciary duties regarding two employer-sponsored pension plans.... The panel held that the plaintiffs sufficiently alleged that the defendants violated their duty of loyalty and care by failing to provide material information to plan participants about investment in the Amgen Common Stock Fund. Agreeing with the Sixth Circuit, the panel held that the defendants' preparation and distribution of summary plan descriptions, including their incorporation of Amgen's SEC filings by reference, were acts performed in their fiduciary duty. The panel also reversed the dismissal of derivative claims, as well as a claim that the defendants caused the plans directly or indirectly to sell or exchange property with a party-in-interest." [Harris v. Amgen, No. 10-56014 (9th Cir. May 26, 2015)]
arrow icon Measuring the Optimism, Outlook and Direction of America on Employee Benefits (PDF)
Lincoln Financial Group

"88% of respondents feel optimistic about the future; 75% feel 'in control' of their lives today. Yet, regarding their financial futures, less than one in five feel very secure, and only 18% are confident they could cover their current expenses in the event of a major injury or illness.... Nearly 95% of employees agree they are more likely to enroll in benefits they feel familiar with and educated about.... About half (49%) of surveyed employees identified cancer as their top health concern. Yet, enrollment in benefits like critical illness and accident insurance remains low."
arrow icon The Post-Launch Problem: The ACA's Persistently High Administrative Costs
Health Affairs

"Between 2014 and 2022, CMS projects $2.757 trillion in spending for private insurance overhead and administering government health programs (mostly Medicare and Medicaid), including $273.6 billion in new administrative costs attributable to the ACA. Nearly two-thirds of this new overhead -- $172.2 billion -- will go for increased private insurance overhead. Most of this soaring private insurance overhead is attributable to rising enrollment in private plans which carry high costs for administration and profits. The rest reflects the costs of running the exchanges, which serve as brokers for the new private coverage and will be funded (after initial startup costs) by surcharges on exchange plans' premiums."
arrow icon Text of Amicus Brief Urging Supreme Court Review of Ninth Circuit Decision Allowing Participant to Seek Recovery of Benefits from Claims Administrator (PDF)
American Benefits Council and America's Health Insurance Plans [AHIP]

"The question in this case is not whether an ERISA plan beneficiary may bring suit under 29 U.S.C. Section 1132(a)(1)(B) to recover benefits due to him. Rather, the question is who he may sue.... The Ninth Circuit's reasoning appears to rest on a misconception that amici and their members are uniquely positioned to dispel. The panel seemed to believe that there is no difference between an ERISA plan administrator and a mere claims administrator.... As amici's members know well from serving as plan sponsors, insurers, and claims administrators, those roles are different indeed. In fact, the record in this very case highlights the stark contrasts between plan administrators and claims administrators. Unfortunately, however, the panel failed to appreciate that crucial distinction." [Spinedex Physical Therapy USA Inc. v. United Healthcare of Arizona, Inc., No. 12-17604 (9th Cir. Nov. 5, 2014; cert. pet. filed Apr. 24, 2015)]
arrow icon DOL Publishes New FMLA Notice and Medical Certification Forms
FMLA Insights
5/27/2015 [Guidance Overview]

"In the instructions to the health care provider on the certification for an employee's serious health condition, the DOL has added the following simple instruction: 'Do not provide information about genetic tests, as defined in 29 C.F.R. section 1635.3(f), genetic services, as defined in 29 C.F.R. section 1635.3(e), or the manifestation of disease or disorder in the employee's family members, 29 C.F.R. section 1635.3(b).' DOL added similar language to the other medical certification forms as well."
arrow icon DOL Audit Quality Study: Employee Benefit Plan Auditors Are Not Making the Grade
Belfint Lyons & Shuman, CPAs

"[The DOL recently] compared auditing retirement plans to brain surgery.... [after releasing] a report from a study that the agency conducted on the quality of retirement plan audits. The results are not favorable. As one would expect, the number of deficiencies the DOL noted show a direct correlation to the size of a firm's employee benefit practice. It appears that many general accounting practitioners are performing these audits and do not have adequate experience or knowledge to perform sufficient audits under the professional standards."
arrow icon Patient-Centered Outcomes Research Fee on Health Plans Is Due July 31
5/27/2015 [Guidance Overview]

"The PCOR fee is assessed based on the number of employees, spouses and dependents that are covered by the plan. The fee is $1 per covered life for plan years ending before Oct. 1, 2013, and $2 per covered life thereafter, subject to adjustment by the government. For plan years ending between Oct. 1, 2014, and Sept. 30, 2015, the fee is $2.08. The Form 720 instructions are expected to be updated soon to reflect this increased fee."
arrow icon FSA, HRA, HSA Comparison Chart
Marsh Consulting Group
5/27/2015 [Guidance Overview]

"The minimum deductible for an HSA compatible HDHP plan remains at $1,300 for self-only coverage and $2,600 for family coverage. The 2016 HDHP out-of-pocket maximums will be $6,550 for single coverage and $13,100 for family coverage, an increase of $100 and $200 respectively. Also new for 2016, is the requirement that all plans limit the maximum out-of-pocket incurred by any one person to the single out-of-pocket limit of the plan, even if the individual is enrolled in family coverage."
arrow icon The DOL's Re-Proposed Definition of Fiduciary: Its Impact on Large Retirement Plans
Mintz Levin
5/27/2015 [Guidance Overview]

"While the fiduciary and prohibited transaction rules set out in ERISA and the Code impact small and large plans alike, the practical compliance requirements applicable to these two cohorts of plans could not be more different. Individuals who act as fiduciaries for large plans tend to be more sophisticated on the general subject of investing than their small-plan counterparts. The Department of Labor has recognized this to be the case in its proposed regulations and drafted the regulations accordingly."
arrow icon Is it Education or Is It Advice? (PDF)
ERISAdiagnostics, Inc., via Thompson Pension Plan Fix-It Handbook

"The proposed regulations closely follow the Financial Industry Regulatory Authority's guidance. Like the proposed regulation, FINRA provides an exclusion for certain communications, as long as they do not include (either standing alone or in combination with other communications) a recommendation of a particular security or securities. FINRA notes that as allocation information becomes narrower or more specific, it gets closer to becoming a recommendation. DOL says it believes that the proposal's guidelines on investment education cover information that is generally provided to participants, but the agency encourages input that will help clarify the line between advice and education."
arrow icon DOL Regulatory Agenda, Spring 2015
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]

EBSA items in the Proposed Rule stage include [1] Pension Benefit Statements; [2] Conflict of Interest Rule -- Investment Advice; [3] Amendment to Claims Procedure Regulation; [4] Revision of the Form 5500 Series and Implementing Related Regulations Under ERISA; [5] Coverage of Certain Preventive Services Under the ACA; [6] Fiduciary Requirements for Disclosure in Participant-Directed Individual Accounts Plans -- Timing of Annual Disclosure; and [7] Summary of Benefits and Coverage and Uniform Glossary. Items in the Final Rule stage include [1] Amendment of Abandoned Plan Program; [2] Electronic Filing of Apprenticeship & Training Notices, and Top Hat Plan Statements; and [3] Adoption of Amended and Restated Voluntary Fiduciary Correction Program.
arrow icon Treasury Department Regulatory Agenda, Spring 2015
U.S. Department of the Treasury

IRS items in the Proposed Rule stage include [1] Application of Section 409A to Nonqualified Deferred Compensation Plans; [2] Implementation of Windsor; [3] Health Insurance Provider's Fee; [4] Nondiscrimination Relief for Closed Defined Benefit Plans; [5] Request for Information on Suspensions of Benefits Under the Multiemployer Pension Reform Act of 2014; and others. Items in the Final Rule stage include [1] HIPAA Portability: Special Enrollment Procedures, Tolling, and Interaction with FMLA; [2] Cafeteria Plans; [3] Accrual Rules for Defined Benefit Plans; [4] Determination of Minimum Required Pension Contributions; [5] Notice to Participants of Consequences of Failing to Defer Receipt of Qualified Retirement Plan Distributions; Expansions of Applicable Election Period and Period for Notices; [6] Reporting and Notice Requirements for Deferred Vested Benefits Under Section 6057; [7] Modifications to Minimum Present Value Requirements for Defined Benefit Plan Distributions; [8] Removal of Rollover Allocation Rule from Designated Roth Regulations; [9] Minimum Value of Employer Sponsored Coverage; [10] Health Insurance Premium Tax Credit Additional Issues; and [11] Coverage of Certain Preventive Services Under the ACA.
arrow icon Massachusetts Attorney General Creates Safe Harbor from Requirements of State's Sick Leave Law
5/27/2015 [Guidance Overview]

"Under the supplemental regulation, employers with PTO policies, including sick, personal, vacation, and/or combined PTO policies, that were in place as of May 1, 2015, and that provide employees the right to use at least 30 hours of paid time off during calendar year 2015, are deemed to be in compliance with the new law from July 1, 2015 through December 31, 2015, even though they might not technically satisfy all of the requirements imposed by the new law."
arrow icon 'Best Interests' for Fiduciaries 101
The Prudent Investment Adviser Rules
5/27/2015 [Opinion]

"In most cases ... the issue of 'best interests' is really not confusing at all. Is recommending a fund that has consistently underperformed its applicable benchmark in a client's best interests? Is recommending a 'closet index' fund in a client's best interests? Is recommending a fund whose annual fee is 300% higher than a fund with a comparable historical performance in a client's best interests?"
arrow icon Bank Guilty Plea Limits Non-Felon Choice of Service Providers
Treasury & Risk

"Last May the $26.2 billion Employee Retirement System of Texas responded to Credit Suisse Group AG's guilty plea for tax fraud by saying that it had 'a policy against hiring firms convicted of felonies.' Last week, five more global banks joined the list of those admitting to criminal behavior ... Texas ... confirmed that it will continue doing business with four of the five, including Citigroup Inc., JPMorgan Chase & Co., Barclays Plc, and UBS Group AG. It has also resumed doing business with Credit Suisse.... As more and more banks enter guilty pleas, it makes it increasingly tough for clients to cut them out on principle."
arrow icon The Retirement 'Danger Zone'
NBC News

"Data from T. Rowe Price ... indicate that underexposure to stocks past a certain point can actually hurt performance and send investors into retirement with less money saved.... A Prudential study of retirement savings found that an extended period of low interest rates could increase the risk that a retiree would run out of money from 21 percent to 54 percent."
arrow icon IRA Balances, Contributions and Rollovers, 2013 (PDF)
Employee Benefit Research Institute [EBRI]

36 pages. "The average account balance decreased from $91,864 in 2010 to $87,668 in 2011 before increasing to $119,804 in 2013 -- an increase of 30.4 percent from 2010 to 2013, and 14.1 percent from 2012 to 2013.... The percentage of individuals who contributed to their IRA was relatively consistent ranging from 12.1 percent in 2010 to 13.8 percent in 2013.... The percentage of contributors who contributed the maximum rose from 43.5 percent in 2010 to 53.5 percent in 2012.... When examining the same individuals that were in the database each year from 2010 to 2013, the median percentage change in these individuals' account balances was a 33.6 percent increase."
arrow icon Illinois Legislators Forge Ahead on Public Pension Liability
National Tax-Deferred Savings Association [NTSA]

"SB0843 includes provisions that would make ... changes to the Cook County pension system [including] imposing a cap on salary for pension purposes; terminating the use of higher salaries earned in other retirement systems under the Retirement Systems Reciprocal Act; incrementally decreasing 'highest average annual salary' incrementally increasing the required retirement age ... change funding, including the tax rate limitation ... [and] requiring additional employee contributions."
arrow icon EEOC Proposes Clarification of Application of ADA to Employer Wellness Program Incentives
Blank Rome LLP
5/27/2015 [Guidance Overview]

"The Proposed Regulation clarifies that significant incentives may be offered to group health plan participants to encourage and reward participation in wellness programs without violating the ADA. However ... the Proposed Regulation imposes limits that would prohibit many employer wellness programs that the Joint Regulations currently permit and imposes a new notice requirement on employers."
arrow icon Individual Coverage Outpaces Small Business-Sponsored Health Insurance in California
California Healthline

"[E]nrollment in California's small business market in 2014 dropped by 11% to 2.1 million enrollees. Meanwhile, enrollment in the individual market increased by 47% to 2.18 million ... While there is no historical data for comparison, the numbers appear to mark the first time that the state's individual market has outpaced small business enrollment[.]"
arrow icon Quality Now Trumps Quantity in Stats on Uninsured
The Wall Street Journal; subscription may be required

"For years, the Current Population Survey conducted by the U.S. Census Bureau overestimated the number of people without health insurance. Last year, the Census Bureau revised the survey to correct the error, which was likely caused by the way the government asked Americans about their coverage. The fix ... should produce more-accurate estimates. But responses obtained with the new methodology aren't compatible with responses collected using the previous approach, making it harder to examine uninsured rates over the years at a crucial moment -- as Americans try to gauge the success of the Affordable Care Act."
arrow icon Ten Unexpected Changes the Tibble Decision Brings to 401(k) Fiduciaries, Service Providers and Plan Sponsors
Fiduciary News

"The most unexpected impact is... nothing changes ... You're going to see a lot more dead trees ... There will be increased demand for 3(38) advisors ... Revenue sharing will be treated very differently, if it exists at all ... Institutional class and low-cost index funds will dominate ... A 'Race to the Bottom' on fees will lead to poorer investment performance ... You're going to see a lot fewer investment options ... More law suits, but not just for the reasons you think ... There will be fewer 401k Service Providers ... There will be fewer 401k Plans."
arrow icon Expenses Paid by Defined Benefit Plans: Survey Results (PDF)
Penbridge Advisors, LLC; free registration required for full report

"Most plans' total expense ratios are between 0.50% and 1.50% ... Investment Management is the largest expense.... Source of payments varies widely.... In-house pension management resources are constrained."
arrow icon PBGC Regulatory Agenda, Spring 2015
Pension Benefit Guaranty Corporation [PBGC]

In the Proposed Rule stage: [1] Missing Participants; Pension Protection Act of 2006; [2] Multiemployer Plans; Electronic Filing Requirements; [3] Benefit Payments; [4] Annual Financial and Actuarial Information Reporting; Changes to Waivers. In the Final Rule stage: [1] Reportable Events and Certain Other Notification Requirements; [2] Multiemployer Plan Partitions; Multiemployer Pension Reform Act of 2014; and [3] Cash Balance Plans; Benefit Determinations and Plan Valuations for Statutory Hybrid Plans; Pension Protection Act of 2006.
arrow icon Insurers Expect Larger Premium Rise for 2016
Society for Human Resource Management [SHRM]

"Medical claim cost increases will remain in the high single digits. The growth in claims costs for 2015 [has] ranged from 7.2 percent for health maintenance organizations (HMOs) to 9.0 percent for indemnity fee-for-service plans ... Specialty drug cost and use will continue rising.... Similar to the prior year, the surveyed insurers agreed that the top three plan design changes in 2015 will involve wellness initiatives, accountable care organizations (ACOs), and narrow or tiered provider network offerings."
arrow icon Obamacare Insurance Premiums to Jump as Much as 51%

"According to states that have released rate requests, New Mexico's market leader Health Care Service Corp. is asking for an average premium spike of 51.6 percent; Tennessee's top insurer BlueCross BlueShield of Tennessee wants an average spike of 36.3%; Maryland's market leader CareFirst BlueCross BlueShield is requesting an average spike of 30.4%; and Oregon's top insurer, Moda Health, is seeking a 25% spike."
arrow icon The Individual Mandate Under the ACA (PDF)
Congressional Research Service [CRS]
5/27/2015 [Guidance Overview]

17 pages. "This report describes the individual mandate as established under the [ACA]. It also discusses the ACA reporting requirements designed, in part, to assist individuals in providing evidence of having met the mandate." [CRS Report R41331]
arrow icon An In-Depth Report on Target Date Fund Glide Paths (PDF)
Target Date Solutions

"Safety at the target date is the most important benefit ... There is no fiduciary upside to taking risk at the target date. Only downside.... There is a 'risk zone' spanning the 5 years preceding and following retirement during which lifestyles are at stake.... Most participants withdraw their accounts at the target date, so 'target death' (i.e., Through) funds are absurd, and built for profit. All TDFs are de facto 'To' funds.... Employers should educate employees about the importance of saving, and report on saving adequacy."
arrow icon The Process of a Fiduciary's Decision Is Often a Determinant of Prudence
Holland & Knight

"Often times, whether a fiduciary has breached his or her duty is not determined by the outcome of a decision but the process that went into the decision, and whether the process demonstrated prudence. Many cases hinge on the following three simple questions: [1] Did the fiduciary take reasonable measures to stay informed? [2] Did the fiduciary give due consideration to the issue? [3] Did the fiduciary consult an expert when appropriate to do so? Whether a fiduciary should or should not have acted can always be debated but a lack of process leading up to an act or omission is often fatal to the defense in a breach of fiduciary duty case."
arrow icon Preparing for Pension Risk Transfer (PDF)

"This paper will focus on the 'how,' outlining the steps involved in the most complete form of pension risk transfer: a buy-out transaction. Whether or not a buy-out is imminent, there are preparations a plan sponsor can undertake to make a future transaction easier and to shorten the timeline for execution."
arrow icon Text of Agency FAQs on ACA Implementation (Part XXVII): Limitations on Cost-Sharing, and Provider Nondiscrimination
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]
5/26/2015 [Official Guidance]

Limitations on Cost Sharing under the Affordable Care Act

"In the final HHS Notice of Benefit and Payment Parameters for 2016 ..., HHS clarified that under section 1302(c)(1) of the [ACA], the self-only maximum annual limitation on cost sharing applies to each individual, regardless of whether the individual is enrolled in self-only coverage or in coverage other than self-only.... [T]he Departments received questions regarding the application of the clarification to self-funded and large group health plans [and] are issuing the following FAQs ...

Q1. Does PHS Act section 2707(b) apply this requirement to all non-grandfathered group health plans? Yes.... Q2. Does the clarification of section 1302(c)(1) of the [ACA] apply for plan or policy years that begin in 2015? No. The Departments will apply this clarification only for plan or policy years that begin in or after 2016. Q3. Does the clarification of section 1302(c)(1) of the [ACA] apply to self-only coverage or other coverage that is not self-only coverage under a high-deductible health plan (HDHP) as defined at section 223(c)(2) of the Internal Revenue Code? Yes....

Provider Nondiscrimination

On April 29, 2013, the Departments issued FAQs which addressed, among other issues, provider nondiscrimination requirements under PHS Act section 2706(a).... The House Committee on Appropriations subsequently [directed CMS] to provide a corrected FAQ or provide an explanation. The Departments are issuing the following FAQs in response ...

Q4. What is the Departments' approach to PHS Act section 2706(a)? ... Until further guidance is issued, the Departments will not take any enforcement action against a group health plan, or health insurance issuer offering group or individual coverage, with respect to implementing the requirements of PHS Act section 2706(a) as long as the plan or issuer is using a good faith, reasonable interpretation of the statutory provision.... Q5. Does Q2 in FAQs About Affordable Care Act Implementation Part XV continue to apply? No. [It] is superceded by this FAQ[.]"

arrow icon The Rise of Healthcare Provider-Sponsored Health Insurance
Healthcare Payer News

"With the ACA's mandate to control healthcare costs, increasingly high deductibles and growing enrollment in ACA exchange plans, Medicaid managed care and Medicare Advantage, the insurance market is beckoning health systems. They might be able to offer a strong value proposition -- lower premiums, easier access, expanded primary care and more affordable medical bills.... Given the shift of healthcare resources to primary and preventive care, there are real, long-standing problems with the health insurance model that could be solved uniquely when the payer is owned by the provider business getting paid."
arrow icon Four Words That Imperil Health Care Law Were All a Mistake, Writers Now Say
The New York Times; subscription may be required

"How those words became the most contentious part of President Obama's signature domestic accomplishment has been a mystery.... The answer, from interviews with more than two dozen Democrats and Republicans involved in writing the law, is that the words were a product of shifting politics and a sloppy merging of different versions. Some described the words as 'inadvertent,' 'inartful' or 'a drafting error.' But none supported the contention of the plaintiffs, who are from Virginia."
arrow icon Chronic Care Management Programs Have Become Standard for Health Plans
RAND Corporation

"[T]he study found that all plans, regardless of size, location, and ownership, offer programs to support members with chronic conditions. Plans typically identify those members based on claims and laboratory data, and then match them to appropriate interventions and resources based on need and risk. While internal evaluations suggest that these programs improve care and reduce cost, plans report difficulties in engaging members and providers, leading to the programs being underutilized."
arrow icon Derivatives, De-Risking and Disclosures
Pension Risk Matters

"If true that lower interest rates may discourage some plan sponsors from fully transferring risk to a third party insurer via a buy-out but they nevertheless seek to more actively manage pension risks, one could logically expect a greater use of a strategy such as Liability-Driven Investing (LDI). To the extent that LDI frequently entails the use of derivatives, those plan sponsors in favor of LDI may want to take note of a recent move by the [SEC]....[C]ertain registered funds could soon be asked to publish a considerable bounty of data about how they price securities, characteristics of trading counterparties and the specific use of derivative instruments."
arrow icon San Bernardino Bankruptcy Exit Plan Cuts Some Pension Costs

"A San Bernardino plan to exit bankruptcy follows the path of the Vallejo and Stockton exit plans, cutting bond debt and retiree health care but not pensions. Then it veers off in a new direction: contracting for fire, waste management and other services. The contract services are expected to reduce city pension costs. Other pension savings come from a sharp increase in employee payments toward pensions and from a payment of only 1 percent on a $50 million bond issued in 2005 to cover pensions costs."
arrow icon The Fiduciary Hierarchy
The Retirement Plan Blog

"There is a hierarchy of service models available in the 401(k) marketplace. Each of which offers Plan Sponsors a different level of support with regard to investment selection and monitoring. Here is a brief description of each in the order of lowest to highest fiduciary protection: [1] Due Diligence Support.... [2] Fiduciary Certificate or Warranty.... [3] Directed Trustee... Section 3(21) Fiduciary ... [5] Section 3(38) Fiduciary... [6] Discretionary Trustee."
arrow icon IRS Provides Resources for Electronic Filing of Form 1094/95 Information Returns
Thomson Reuters / EBIA

"With the mandatory filing deadline fast approaching and many reporting entities being required to file electronically, employers, coverage providers (such as insurers and multiemployer plans), and their advisors will need to follow developments carefully to ensure that they are prepared for compliance. While it is encouraging to see an emphasis here on correcting mistakes (since glitches are bound to arise in the first reporting period), many details still need to be worked out -- exemplified by the IRS's decision to waive the electronic signatures for this year's voluntary filings."
arrow icon IRS Provides Further Guidance on Reporting Employer Health Coverage Information on Forms 1094 and 1095
Thomson Reuters / EBIA
5/26/2015 [Guidance Overview]

"The forms are used by the IRS to enforce Code section 4980H employer penalties, as well as individual mandate and tax credit eligibility rules. The latest guidance consists of an updated Q&A document covering basic reporting requirements and a new Q&A document addressing more specific issues that may arise while completing Forms 1094 and 1095."
arrow icon Six Key Activities CFOs and CHROs Should Perform Together to Optimize Employee Benefit Programs
Grooms Benefit Solutions

"Advanced Strategic Planning ... Collaborate to align HR and finance metrics with company objectives... Evaluate outsourced partnerships... Utilize technology to drive efficiencies... Measure... Educate and Value."
arrow icon IRS Continues to Expand, Encourage and Simplify Correction Program in 2015 Updates to EPCRS
Katten Muchin Rosenman LLP

"Under the 2015 updates, the IRS is continuing to provide incentive for plan sponsors to correct errors promptly, rather than wait for a governmental auditor to discover the error and require correction along with a hefty sanction."
arrow icon Employers: Are You Ready to Report Offers of Health Insurance?
Jackson Lewis P.C.
5/26/2015 [Guidance Overview]

"[A]pplicable large employers should be thinking about ... If the employer contributes to a multiemployer plan on behalf of some or all of its employees, has it coordinated reporting and information exchanges with the multiemployer plan administrator? ... How does an employer ensure compliance with COBRA when it is using the look back method to determine full-time employee status?... Does the employer have an administrative process in place to ensure that it promptly responds to exchange notices indicating that employees have claimed eligibility for exchange subsidies?... Employers sponsoring self-insured plans generally have to transmit to the IRS the Social Security numbers of spouses and dependents of employees covered under the plan. Is the employer able to comply with this requirement?"
arrow icon Are Top Hat Plans Entitled to a Discretionary Standard of Review?
Stinson Leonard Street

"A recent First Circuit Court of Appeals decision held that the abuse of discretion standard would apply to a top hat plan that incorporated the standard into its plan documents.... The plan gave discretion to the company to decide the claim and the court upheld the company's decision that the executive had voluntarily retired and therefore was not entitled to severance benefits under the plan." [Niebauer v. Crane & Co., No. 14-2059 (1st Cir. Apr. 21, 2015)]

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