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Benefits in the News

Older News | May 31, 2016

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Health Insurers Find Back Door to Limit Choice
USA TODAY
[Opinion]
5/27/2016
"Insurance companies ... [have] cooked up a clever way to justify exclusions from formularies by founding and funding a group called the Institute for Clinical and Economic Review, or ICER.... ICER, which holds itself out as a kind of Consumer Reports for drugs, is basically an industry-backed comparative effectiveness calculator. That ICER is industry backed isn't the problem, it's that it uses comparative effectiveness to lend an air of legitimacy to the formulary shenanigans. Different people respond differently to medications. The blue pills don't always work the same as the red pills. Individuals, it turns out, are different."
Supreme Court Hands Verizon Retirees Victory in Pension Spinoff Case
InsuranceNewsNet.com
5/27/2016
"[T]he U.S. Supreme Court vacated a lower court decision and sent the case back to be re-evaluated, giving the class action suit, advanced by the Association of BellTel Retirees Inc., a significant shot in the arm.... At issue... is whether the plaintiffs can show they suffered 'concrete harm' as a result of the company's actions. The Verizon retirees argue that the company, in selling off pension assets to Prudential Insurance Company as a group annuity, is putting all retiree pensions at risk." [Pundt v. Verizon Comm., No. 15-785 (S. Ct. cert. pet. granted May 23, 2016)]
DOL Tries to Find a More Ideal Balance in the Final 'Investment Advice' Rules (PDF)
Dechert LLP
[Guidance Overview]
5/27/2016
32 pages. "The Final Rule is arguably the most significant change to the fiduciary rules governing retirement plans since ERISA was enacted, and it has the potential to disrupt many trends and practices by which financial products are currently marketed and sold to retirement investors.... There is an important impact on certain market participants who themselves might not be fiduciaries, but whose business will be affected by those who are -- notably, registered investment companies ('funds') and their sponsors. The Final Rule could significantly impact funds' intermediary-distribution channels, and may therefore lead to changes in demand for certain types of funds, share classes and intermediary-compensation arrangements."
IRS Checklists for Retirement Plan Documents
Internal Revenue Service [IRS]
[Guidance Overview]
5/27/2016
"Listed [at this page] are IRS checklists for retirement plan documents categorized into subject matter packages that Employee Plans Specialists use when reviewing retirement plan documents.... Each package contains: [1] An Explanation that provides guidance in the law and legal citations. [2] Alert Guidelines (Worksheets) you can use to review retirement plans.... [3] Plan Deficiency Paragraphs (Checksheets) that are pre-approved wording that, if used by plan sponsors, will satisfy the applicable Internal Revenue Code requirements."
Universal Pensions: A Progressive Alternative to Retirement Savings
The Hill
[Opinion]
5/27/2016
"[The] proposed Universal Pension would simplify the system and foster participation by reducing the amount of paperwork, financial sophistication, and fees that are required to save. Participation would be voluntary, but working Americans would be encouraged to open an account with a $500 tax rebate. And contributions by workers without tax liability would be eligible for an expanded refundable credit to bolster retirement savings for lower-income families."
HHS Issues Final Rule on ACA Nondiscrimination Provisions Under Section 1557 (PDF)
Groom Law Group
[Guidance Overview]
5/27/2016
"Health insurance issuers should first determine whether they receive federal financial assistance from HHS (they most likely do, so any conclusion to the contrary should be carefully reviewed).... Issuers that are related to TPAs should consider whether the TPA is 'independent' and, if not, should take steps to ensure that benefits are administered in a nondiscriminatory manner.... Employers sponsoring group health plans should first determine whether the employer receives federal financial assistance from HHS for any purpose. Employers should also ensure that benefit design decisions made by the employer in its role as a plan settlor are adequately and appropriately documented."
It's Time to Review Your Wellness Program Under New ADA and GINA Final Rules (And HIPAA And...)
Drinker Biddle
[Guidance Overview]
5/27/2016
"A chart summarizing the applicable rules under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Genetic Information Nondiscrimination Act of 2008 (GINA), and the Americans with Disabilities Act of 1990 (ADA) appears at the end of this [article].... The EEOC urges employers to adopt best practices to protect confidentiality of medical information and genetic information. The EEOC suggests that such practices include adoption and communication of strong privacy policies, training for individuals who handle confidential medical information, encryption of electronic files, and policies that require prompt notification of employees whose information is compromised if data breaches occur."
New ACA Anti-Discrimination Rules: Language Assistance for Non-English Speakers
Holland & Hart LLP
[Guidance Overview]
5/27/2016
"Covered entities should immediately evaluate their policies and processes for interacting with individuals with limited English proficiency and, where necessary, modify them to comply with the new, heightened standards by July 18, 2016. Among other things, they will need to prepare the required notices and taglines by October 16, 2016, and arrange for appropriate and timely interpreter and, as appropriate, translator services."
Choosing Default Investment Alternatives for 401(k)s Requires Close Due Diligence
InvestmentNews
5/27/2016
"Brightscope reports that plan assets invested in TDFs already exceed $1.1 trillion ... and are likely to hit $2 trillion by 2020. But successfully gathering assets doesn't necessarily mean that a TDF is the right choice for every plan's QDIA. It certainly doesn't mean that TDFs are well-suited for every plan participant."
ERISA Advisory Council to Discuss Cybersecurity, Other Benefit Plan Issues at June Meeting
Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]
5/27/2016
"The council's discussion includes 'Cybersecurity Considerations for Benefit Plans' on June 7, and 'Participant Plan Transfers and Account Consolidation for the Advancement of Lifetime Plan Participation' on June 8. Both topics will be discussed on June 9; however, the meetings' schedule is subject to change."
IRS Letter Addresses Readily Available Test When Bus Company Does Not Accept Debit Cards
Thomson Reuters / EBIA
[Guidance Overview]
5/27/2016
"If an employer cannot offer cash reimbursements for a particular transit provider, and more convenient vouchers like debit cards cannot be used, the employer may need to make a difficult decision: deal with the practical challenges of distributing the available vouchers for that provider, or refuse to pay benefits for that provider because the administrative burdens of dealing with the available vouchers outweigh the value of the transit benefit."
HHS, DOL and Treasury Release New Summary of Benefits and Coverage Templates and Accompanying Documents
Proskauer's ERISA Practice Center
[Guidance Overview]
5/27/2016
"The SBCs provided to consumers must follow a uniform format and contain certain information. This information includes uniform standard definitions of medical and health coverage terms, a description of the coverage, cost-sharing requirements, and information regarding any exceptions, reductions or limitations under the coverage.... The changes to the requirements and templates and all relevant effective dates are described [in this article]."
Reproposed Regs Will Significantly Change the Structure of Incentive Compensation at Financial Institutions with $1 Billion or More in Assets (PDF)
Frederic W. Cook & Co., Inc.
[Guidance Overview]
5/27/2016
12 pages. "While most commentary to date has focused on the rules applicable to entities with assets of $50 billion or more (Level 1 and Level 2 entities), the rules that affect Level 3 entities ($1 billion to $50 billion in assets) are also far reaching and will substantially affect the design and administration of their incentive compensation programs. In particular, it appears impermissible for any incentive compensation plan for any employee to provide payment based solely on quantitative criteria."
Understanding the Nuances of Your ESOP Plan Language: Forced or Involuntary Distributions
Principal Financial Group
5/27/2016
"Many plan sponsors do not realize that retired participants can also be forced out of the ESOP if they do not elect to receive a distribution when eligible. This is true regardless of their account balance and regardless of the plan document language. This provision is found in IRC 411(a)(11). Though many plan documents do not state this directly, it may be inferred[.]"
Virginia Insurer's Decision to Drop Bronze Plans Prompts Concerns
Kaiser Health News
5/27/2016
"News that a CareFirst BlueCross BlueShield subsidiary will stop selling bronze level plans on the Virginia marketplace next year prompted some speculation that it could signal a developing movement by insurers to drop that level of coverage altogether. The reality may be more complicated and interesting, some experts said, based on an analysis of plan data."
Be on the Lookout for Marketplace Notices
Frenkel Benefits
5/27/2016
"[T]he Federally-Facilitated Marketplaces (FFM) will send an employer [a notice] when one of their employees accesses marketplace coverage and receives a tax credit. These notices will be sent out to employers throughout 2016 with plans for the first notices to be sent out in the coming weeks. Employers should be on the lookout for these notices since they will have 90 days to appeal a notice or face the risk of a fine."
DOL and Treasury Update 2015-2016 Regulatory Agendas for Employee Benefits
Sutherland Asbill & Brennan LLP
5/27/2016
"The DOL's agenda and related materials include 13 pending projects related to employee benefits ... . The IRS Business Plan includes 28 pending items addressing retirement benefits and 14 pending items addressing executive compensation, health care and other benefits.... There are no new projects added to the agendas since they were last published."
The Impact of Student Loan Debt on Defined Contribution Retirement Plan Participation: The Plan Sponsor Perspective
Plan Sponsor Council of America [PSCA]
5/27/2016
11 pages. "[T]he degree to which Millennial employees cite student loan debt as creating a 'Moderate' (26.0 percent) or 'High' (8.9 percent) barrier to saving for retirement is significant. These findings are particularly noteworthy within select industries, such as in the service industry where 42.5 percent of respondents rate student loan debt as a 'Moderate ' or 'High' barrier, or in the technology or telecommunications industry where 45.5 percent of respondents rate student loan debt as a 'Moderate' or 'High' barrier."
Health Insurers Increase Borrowing Due to Impact of ACA
A.M. Best Company
5/27/2016
"U.S. health insurance carriers have increased the amount of borrowed money on their statutory balance sheets by nearly 100% over a four-year period, to approximately $6.4 billion at year-end 2015 from just under $3.3 billion in first-quarter 2011 ... [T]he financial leverage for the health industry has increased to more than 30% due to mergers & acquisitions and is expected to increase to well above 40% with the completion of two large mergers that are pending[.]"
Blue Shield 'Lifts the Veil' on Executive Pay
Kaiser Health News
5/27/2016
"In its first detailed disclosure on executive pay, nonprofit Blue Shield of California said Chief Executive Paul Markovich made $3.5 million last year -- a 40 percent increase since he took the top job in 2013. The San Francisco-based health insurer has faced criticism for years from consumer advocates about its lack of transparency on executive compensation, and the issue attracted even more scrutiny after a state audit raised questions about the insurer's big pay increases."
Your CEO Pay Ratio Will Be an Estimate Even If You Don't Use Statistical Sampling
Willis Towers Watson
[Guidance Overview]
5/27/2016
"[S]ome companies that they're reluctant to employ statistical sampling in calculating their CEO pay ratios based on the notion that their calculation will not be as accurate as if they had used actual data for their entire workforce.... [The SEC] does not require companies to calculate Summary Compensation Table (SCT) total compensation for all employees to identify the median employee. As a result, every company will be using a less-than-100%-accurate methodology to arrive at an estimate of the median pay[.]"
The Retirement Income Dilemma: An In-Plan Solution
Principal Financial Group
5/27/2016
26 pages. "Plan sponsors can help address most of the risks by offering an in-plan lifetime income solution. The plan sponsor's task in selecting the product is no greater than any other fiduciary decision, and it can provide a significant benefit to the employees. One solution that may provide the greatest overall benefit is income insurance, in the form of an in-plan deferred income annuity (DIA)."
Ohio Makes a Baker's Dozen
Energy & Commerce Committee, U.S. House of Representatives
5/27/2016
"The state of Ohio announced [on May 26] that its CO-OP would shutter, forcing its more than 20,000 participants to find new coverage within the next 60 days. The announcement marks 13 out of the original 23 Obamacare CO-OPs that have closed its doors at a total cost to taxpayers of $1.36 billion."
How to Increase Competition Under the ACA
BDO Center for Healthcare Excellence and Innovation
[Opinion]
5/27/2016
"[M]ost of the 'new' insurance plans on the exchanges are just different iterations on health plans already being offered by legacy insurance carriers. The ACA has been devoid of the kind of brisk new health plan company formation that was seen with the launch of Medicare's Part D drug benefit and its Medicare Advantage program. The question is, why? One of the big culprits, [the authors] believe, is the cap that the ACA places on the operating margins of insurance carriers."
Text of CMS FAQ on Waiting Periods for Essential Health Benefits (PDF)
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]
[Official Guidance]
5/26/2016
Unnumbered document, dated May 26, 2016. "For plans that must provide coverage of the essential health benefit package under section 1302(a) of the [ACA], if an issuer imposes a waiting period before an enrollee can access a covered benefit, is that a violation of the EHB requirements? Yes.... After further consideration of whether pediatric orthodontia should be excepted from this prohibition on waiting periods, we are revising our policy to no longer allow waiting periods for pediatric orthodontia, as we have determined that the same concerns we previously noted also apply to these benefits."
DOL Warns Broker Dealers to Prep for Fiduciary Deadline; AARP to Deploy 'Mystery Shoppers'
ThinkAdvisor
5/26/2016
"Broker-dealers should be 'nervous' if they don't have policies and procedures in place before the [DOL] fiduciary rule's first deadline hits next April, Timothy Hauser, one of the chief architects of the rule, said ... Nancy Smith, executive vice president and corporate secretary at AARP, said ... that AARP will not only continue to advocate for the fiduciary rule but plans to assemble some members to act as 'mystery shoppers' to see if advisors are complying. The retirement advice 'problem is not just a few bad actors,' Smith said. 'All financial professionals can face enormous institutional and peer pressure to act in a way that's not in the client's best interest.' "
HHS Issues Final ACA Nondiscrimination in Health Programs and Activities Regulation
McDermott Will & Emery
[Guidance Overview]
5/26/2016
"The nondiscrimination provision extends to employers who as plan sponsors receive federal financial assistance to fund their employee health benefit programs; however, an employer that otherwise receives federal financial assistance does not become subject to the rule simply by offering employee health benefits.... Third-party administrators are only liable for their own discriminatory actions based on decisions that are within the scope of their authority, such as discriminatory claims denials. A discriminatory plan design would be the liability of the self-insured group health plan, with OCR reviewing whether the third-party administrator and the self-insured group health plan are legally separate on a case-by-case basis."
DOL Backs Foot Locker Workers in Pension Case
Bloomberg BNA
5/26/2016
"The DOL has asked the U.S. Court of Appeals for the Second Circuit to rule that a group of Foot Locker Inc. workers can bring a class action against the company without having to prove that each individual worker relied on Foot Locker's misrepresentations about the effects of a 1996 pension plan change. If the Second Circuit agrees with the DOL, the ruling would make it easier for workers to file class actions under [ERISA], whereas a decision to the contrary would limit the ability to obtain class-wide relief in cases claiming that an employer misled its workers about retirement benefits."
IRS Doubted Legality of Obamacare Payments, Former Official Says
The Hill
5/26/2016
"David Fisher, who was the IRS's chief risk officer, told the House Ways and Means Committee that agency officials questioned whether the [ACA] provided the authority to make certain payments to insurers without an appropriation from Congress. Most senior IRS officials ended up concluding that the payments were legal after a meeting with the White House to hear its legal justification, and the administration eventually went ahead with disbursing the funds."
How Much of That Part-Time Income Can You Afford to Spend in Retirement?
Ken Steiner, FSA Retired
5/26/2016
"Many individuals who are retired take a part-time job to supplement their income in retirement. Frequently, these retirees believe that this income can increase their annual retirement spending budget by the net amount received during the year from such employment ... [This article] will encourage retirees who work to possibly consider taking a longer-term 'actuarial' perspective by spreading the present value of this extra income over their remaining period of retirement."
New Health Benefits Survey Shows Continued Employer Focus on Containing Costs (PDF)
Conrad Siegel Actuaries
5/26/2016
"Of employers who do offer spousal coverage, 27 percent required a surcharge to cover the spouse, compared to 16 percent in 2014. The average surcharge in 2015 was $2,288, which increased from $1,730 in 2014....The average percentage of the medical premium that employees paid for single coverage in 2015 was 15 percent, which has remained relatively constant over the past several years. The average premium share for family coverage was 20 percent in 2015.... 50 percent of employers offer a plan with either an HSA or an HRA account option. This is up significantly from last year at 41 percent."
Fiduciary Responsibilities: An Overview for Retirement Plan Sponsors
Fiduciary Plan Governance, LLC
5/26/2016
"As a plan sponsor, you should regularly receive fee disclosures that include the following information: [1] A description of the services provided; [2] The status of the service provider as an ERISA fiduciary; [3] A clear statement of compensation and fees; [4] Termination charges, if any. They should become part of your permanent due diligence file after you've reviewed them to make sure they're complete and accurate. If you aren't getting them, ask. It's up to you to make sure you have the information you need."
The ACA's Section 1332: Escape Hatch or Straightjacket for Reform?
Health Affairs
5/26/2016
"In state capitols across the country, health care lobbyists and consultants are pushing a relatively unknown provision of the [ACA] (ACA): Section 1332. According to some proponents, these waivers will 'turbocharge state innovation' and will provide states with an 'exit strategy' from the ACA. But is the hype true? Will Section 1332 waivers be as truly transformative to our health care system as suggested? ... A serious, objective examination of the new Section 1332 federal guidance sparks far more questions than answers for policymakers."
Chicago's Pension Patch Job?
Pension Pulse
[Opinion]
5/25/2016
"In Chicago, powerful public unions are going head to head with a powerful and unpopular mayor who got rebuffed by Illinois's Supreme Court when he tried cutting pension benefits. Now, they are tinkering around the edges, increasing the contribution rate for new employees of the city's smallest pension, which is not going to make a significant impact on what is truly ailing Chicago and Illinois's public pensions. All these measures are like putting a band-aid over a metastasized tumor."
Pension Debt for Chicago Worker Pensions Doubles; Now More Than $21 Billion
Illinois Policy Institute
5/25/2016
"Thanks to new government reporting standards, Chicago's municipal-workers and laborers pension funds' debt doubled in 2015 to more than $21 billion. That's $20,500 of pension debt per Chicago household.... The doubling of the funds' pension debt did not occur because of some unforeseen financial calamity or economic collapse. Instead, it occurred because [GASB] ... demanded that public pensions be more honest in their calculations."
Fiduciary Rule Had Support from a Surprising Contingent
Financial Planning
5/25/2016
"Over the years the [DOL] spent developing and then reworking the fiduciary rule, Assistant Secretary Phyllis Borzi and her colleagues regularly received support from a surprising quarter -- people who work for some of the companies that most vehemently fought it. 'Wherever I would go, people would come up to me, wearing name tags of companies that were wildly opposed to what we were doing, and they would say, "You go, girl" ', Borzi told an audience at an Institute for the Fiduciary Standard event this week. 'And that kept us going.' "
Taxes, Fees, and Your Health Insurance Premiums
America's Health Insurance Plans [AHIP]
[Opinion]
5/25/2016
"What determines how much you pay in health insurance premiums? That's a complicated question that involves a number of factors ... [One] factor that receives less attention is the total amount of various taxes and fees paid by health insurance companies. We must understand these costs and aim to reduce or end these taxes and fees if we are to address the affordability of coverage."
Pension Strategy in Today's Market Environment (PDF)
SEI
5/25/2016
"Given the market volatility in Q1 and industry reports highlighting an overall decrease in funded status of corporate pensions, should plan sponsors be reacting by de-risking their pension plans? ... Are there other contributing factors that make initiating a de-risking strategy not necessarily conducive to the current market environment? ... Are there certain scenarios where plans should be de-risking? ... If a plan sponsor doesn't necessarily meet the profiles mentioned above, what strategies should they be considering in the current environment?"
Will You Ever Understand Your Medical Bill?
National Center for Policy Analysis Health Policy Blog
[Opinion]
5/25/2016
"It is hard not to get carried away on a wave of outrage when reading stories of patients faced with ridiculous bills, which (even if they can understand them) they might never be prepared to pay. A new crop of entrepreneurs is hoping to solve this problem.... The Obama Administration itself is getting into the act, having just announced a competition to design 'A Bill You Can Understand,' which will give prizes of $5,000 each to two designers who meet the challenges of making bills comprehensible and improving the workflow that generates them."
Addressing Cybersecurity in Your Retirement Plan TPA Contract
von Briesen & Roper, s.c.
5/25/2016
"Plan fiduciaries clearly have an obligation to protect retirement plan assets. Given that cyber-attacks may jeopardize the safety of those assets, employers should consider cybersecurity as it relates to the safety of plan assets when making decisions to select or retain a TPA and/or trustee for its plan(s). It is less clear what the employer's exposure would be in the event an employee's identity would be stolen as a result of a cyber-attack on the retirement plan TPA if no theft of retirement plan assets occurs."
Understanding How Payment and Benefit Designs Work Together in Health Care
Health Affairs
5/25/2016
"Many of those experimenting with or interested in implementing reforms don't understand the nuances of the payment methods and or benefit designs involved: their strengths and weaknesses; how to combat potential weaknesses; what performance measures should be used to counter possible unintended consequences; and how these incentives may affect provider pricing. Having a greater understanding of the nuances inherent in provider and consumer incentives can help implementers determine where their reforms fall short and how they can address those challenges."
100-Participant 401(k) Plan Subject of New ERISA Fiduciary Breach Class Action
Nixon Peabody LLP
5/25/2016
"Proving that even modest size 401(k) plans are fair game, a fiduciary breach class action suit has been filed against the plan sponsor and fiduciaries of ... [a plan with] approximately 130 participants and $9.8 million in assets. The suit claims that ... the plan's investment options ... include mutual funds, pooled separate accounts and a guaranteed investment contract offered by Voya. Voya is also the plan's recordkeeper.... The ERISA fiduciary breach allegations are the same as those made in the cases against the giant employers and their plans[.]"
Missouri to Ban Small-Group Products of Resulting Firm If Aetna and Humana Merge
FierceHealthPayer
5/25/2016
"In a preliminary order, Missouri Department of Insurance Director John Huff writes that if Aetna and Humana's deal eventually closes, the company and its subsidiaries must 'cease and desist' from doing business throughout the state in the comprehensive individual, comprehensive small-group and group Medicare Advantage markets. In the individual MA market, Aetna-Humana would have to stop doing business in certain counties in Missouri that the state has determined would be adversely affected by competition."
Implementing a Single-Employer DB Plan Spin-Off
Milliman Retirement Town Hall
5/25/2016
"A plan sponsor in an ongoing pension plan is generally not allowed to transfer the responsibilities for the liabilities of active participants unless the plan is being terminated. If the assets and liabilities related to active participants are spun off into a new separate plan, that plan can then be terminated with the liability responsibility transferred... If 3% or more of plan assets are spun-off into a new plan, a complicated actuarial calculation must be done to determine the assets allocated to each plan, based on PBGC liability categorization rules for underfunded plan terminations."
Missouri Says Aetna-Humana Merger Is Anti-Competitive
Modern Healthcare Online; free registration required
5/25/2016
"Missouri insurance officials have issued a preliminary order against the merger of Aetna and Humana, the first state to find serious antitrust problems with the massive transaction. However, Aetna and Humana have 30 days to 'submit a plan to remedy the anti-competitive impact of the acquisition.' ... But some antitrust experts aren't convinced selling off assets to another insurer will solve all concerns.... Aetna has received approval for the Humana deal in 15 out of a necessary 20 states."
Aegon Retirement Readiness Survey 2016: A Retirement Wake-Up Call
Aegon
5/26/2016
"Improvements in planning and saving have been offset by decreases in feelings of personal responsibility related to providing sufficient income in retirement. Moreover, around the world, many workers are heavily reliant on government benefits and are not saving enough to adequately fund their retirement income needs. Inadequate attention is being given to address the costs and implications of increased life expectancy. Fundamental changes are needed for people to achieve their retirement aspirations and to support retirement systems that are affordable, inclusive, and equitable. Governments, employers, and individuals must continue to expand upon actions that are proven effective while innovating new solutions for the future."
The Cost/Benefit Analysis of Self-Funding Employee Health Benefits
Stephen Rosenberg, The Wagner Law Group
5/25/2016
"Large self-funded employers ... have the deep pockets to hire major, brand name administrators. Smaller employers sometimes end up with smaller, less sophisticated administrators, either because of cost or because they simply don't know what to look for in picking an administrator. These operational risks place a smaller employer with a self-funded plan at risk of losses, and need to be accounted for by smaller companies in, first, deciding whether to self-fund health benefits and, second, in planning how to do so."
Designing the DC Plan of the Future
BNY Mellon
5/26/2016
16 pages. "Sponsors have sought to address the limitations of DC plans by borrowing best practices from the DB arena. While stopping short of a full-scale return to the pension model, the so-called 'institutionalization' of DC plans relies on the following approaches:[1] Increased use of low-fee, institutional vehicles; [2] Greater use of alternative strategies; [3] Generating an income stream during retirement. The benefits of each of these approaches are explained in greater detail [in this article]."
Court Boots Executive's $21 Million ERISA Claim Under Stock Rights Plan
Bloomberg BNA
5/25/2016
"In affirming a federal district court's decision, the U.S. Court of Appeals for the Ninth Circuit held ... that the Booz Allen stock rights plan wasn't covered by [ERISA] because it wasn't designed or intended to provide retirement or deferred income. With this ruling, the Ninth Circuit joins the Third, Fifth and Eighth circuits in holding that to qualify as an employee pension benefit plan subject to ERISA, 'the paramount consideration is whether the primary purpose of the plan is to provide deferred compensation or other retirement benefits.' " [Rich v. Shrader, et al., No. 14-55484 (9th Cir. May 24, 2016)]
CFOs and HR Execs Face Millions in Personal Liability Due to Unmanaged Health Plans
Forbes
[Opinion]
5/26/2016
"Employers typically have extremely rigorous oversight of retirement benefits with independent investment committees, regular audits and more. Though the same fiduciary responsibility exists for health benefits, evidence suggests that the vast majority of employers have fallen short."
Best Interest Contract Exemption Permits Proprietary Products and Commissioned Sales
Mintz Levin
[Guidance Overview]
5/25/2016
"The BIC exemption broadly (though not universally) acts to preserve access to commissions provided that the advice is not conflicted and is in the 'best interest' of the investor.... The exemption permits advisors and financial institutions to continue to receive commissions for providing fiduciary advice, provided that the financial institution/advisor acts in the retirement investor's best interest, does not receive unreasonable compensation, observes anti-conflict policies, and makes certain required disclosures."
EEOC Final Rules on Employer Wellness Programs: What Employers Need to Know
Holland & Knight
[Guidance Overview]
5/25/2016
"The EEOC rules provide a roadmap for employers to draft or revise wellness plans that, by the EEOC's standards, comply with the ADA and GINA. Specifically, employers should ensure that the information requested or medical testing involved in their wellness plans does not exceed that permitted by the rules. Additionally, employers should confirm that their wellness plans satisfy the criteria for voluntariness set forth in the final rules."
The Final Fiduciary Rule Has Arrived Finally (PDF)
Warner Norcross & Judd LLP
[Guidance Overview]
5/25/2016
"[F]irms should promptly begin evaluating and developing project teams to: Assess the new rule's impact on current services and operations ... Open dialogs with the firm's third-party product and service providers ... Review, refine and strengthen the firm's supervisory controls over retirement plan related services, products and relationships.... Map revenue streams to identify all instances of variable compensation with respect to retirement related services and products.... Review and likely restructure compensation related incentives, policies and practices.... Create and adopt required disclosures ... Create model BIC PTE contracts ... Establish recordkeeping practices and procedures for maintaining for six years those records required to demonstrate compliance with the BIC PTE."
CMS Releases Medicare Current Beneficiary Survey (MCBS) Public Use File
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]
5/25/2016
"Beginning with data collected in the 2013 Medicare Current Beneficiary Survey (MCBS), a public use file (PUF) and accompanying documentation is available free for download ... The MCBS PUF is an easy to use data file with select data items that allow researchers to conduct analysis on health disparities, access to and satisfaction with healthcare, and medical conditions for community dwelling Medicare beneficiaries. The MCBS PUF ... provides a publically available alternative for those researchers interested in the health, health care use, access to and satisfaction with Medicare of beneficiaries, while providing the very highest degree of protection to the Medicare beneficiaries' protected health information meeting all necessary de-identification of the data and mitigating disclosure risk."
Partial Self Funding and Population Health Management: Facts, Concepts, and Strategies
WellNet
5/25/2016
34 presentation slide. Topics include: [1]  Opportunity provided by the ACA; How do Fully Insured / Self Funded Plans compare ? ERISA; [2] Financial Breakdown of Self Funded Plans: A Review of Individual Components: What is Stop Loss Insurance? What are my network options ? How do you choose a Third Party Administrator? Underwriting Partially Self Funded Plans; Risk Sharing Strategies. [2] Strategies for Health Improvement and Cost Reduction: Claim Auditing; On Site Clinic; Restricted Networks; Reference Based Pricing; Telemedicine; Medical Tourism; Sample Population Health Management."
Americans' Experiences with ACA Marketplace and Medicaid Coverage: Access to Care and Satisfaction
The Commonwealth Fund
5/25/2016
"Sixty-one percent of enrollees who had used their insurance to get care said they would not have been able to afford or access it prior to enrolling. Doctor availability and appointment wait times are similar to those reported by insured Americans overall. Majorities with marketplace or Medicaid coverage continue to be satisfied with their insurance."
New Overtime Rules May Affect Benefits Plans
The Huffington Post
5/25/2016
"The laws surrounding most employee benefits plans allow various classifications to be deemed non-discriminatory as long as all those individuals within the same classification are treated the same. Therefore, some companies today may offer only certain benefits or benefits levels to certain groups of employees.... Many plans include overtime in their plan definition of compensation. The change could also affect plans that exclude overtime pay from the plan's definition of compensation if the new overtime pay causes the definition to become discriminatory in favor of highly compensated employees (HCEs)."
IRS Issues Final Regulations for Designated Roth Account Distributions (PDF)
Ascensus
5/24/2016
"As a result of this change, if a taxpayer receives a designated Roth account distribution and also directly rolls over designated Roth account assets to a Roth IRA or to another designated Roth account, then the pretax amounts will be allocated first to the direct rollover, rather than being allocated pro rata to each destination. Also, a taxpayer may direct the allocation of pretax and after-tax assets that are distributed from a designated Roth account that are directly rolled over to multiple destinations."

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