June 2013
From the editors of CCH's BENE and BAN products, here are hot topics from recent Employee Benefits Management Directions newsletters as well as recent explanatory updates in Employee Benefits Management. Also included are recent explanatory updates to the Benefits Answers Now product.
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Hot Topics in Employee Benefits Management:
Equitable defenses cannot override express plan terms in ERISA action for equitable relief, Supreme Court rules, Employee Benefits Management Directions, Issue No. 539, May 7, 2013 — An ERISA plan’s express terms govern in an ERISA §502(a)(3) action for equitable relief, and equitable doctrines based on unjust enrichment principles cannot override the plan in such equitable-lien-by-agreement cases, the U.S. Supreme Court has ruled (US Airways v. McCutchen, April 16, 2013, Kagan, E).
EBSA's latest FAQs include guidance on SBCs, Employee Benefits Management Directions, Issue No. 537, May 7, 2013 — The Employee Benefits Security Administration (EBSA) (in conjunction with the HHS and IRS), has issued frequently asked questions (FAQs), that focus on requirements for summaries of benefits and coverage (SBCs), and include information on templates and sample language.
Regulations won't be issued on ACA's provider non-discrimination, clinical trial provisions, Employee Benefits Management Directions, Issue No. 540, May 21, 2013 — The Employee Benefits Security Administration (in conjunction with the Departments of Health and Human Services (HHS) and the Treasury have issued Affordable Care Act Implementation FAQs Part XV. This set of frequently asked questions (FAQs) address the Affordable Care Act's (ACA) provisions regarding the annual limit waiver, provider non-discrimination, coverage for individuals participating in approved clinical trials, and transparency reporting.
EBSA issues guidance and notices for health care coverage options, COBRA elections, Employee Benefits Management Directions, Issue No. 540, May 21, 2013 — The Employee Benefits Security Administration (EBSA) has issued guidance, pending future issuance of regulations or other guidance, on a requirement under section 1512 of the Patient Protection and Affordable Care Act (ACA) that notice be given to employees through the new state health care exchanges, also known as the health insurance marketplaces. The guidance also includes information on model COBRA election notices.
What's New in Employee Benefits Management:
Subrogation — The Supreme Court's decision in US Airways v. McCutchen (see story above) is discussed at ¶10,055.
SBCs — EBSA's FAQs on summaries of benefits and coverage (SBC) (see story above) is discussed at ¶10,240.
ERRP —The Centers for Medicare and Medicaid Services (CMS) has issued a notice that sets forth termination dates for several processes under the Early Retiree Reinsurance Program (ERRP) in preparation for the Jan. 1, 2014, program sunset date. The notice is discussed at ¶53,260.
Annual limit waiver — EBSA has issued FAQs that address the Affordable Care Act’s provisions regarding the annual limit waiver. See ¶10,310 for details.
Minimum value — Proposed regulations on the minimum value of eligible employer-sponsored plans are discussed at ¶10,140.
ACA notice — ESBA has issued model notices on health care coverage options. The notices are at ¶226,135 and ¶226,136.
Exchange notice — EBSA's guidance and new deadline for providing notice about the exchange to employees (see story above) is discussed at ¶10,097.
Maximum vehicle value — The 2013 maximum vehicle value can be found at ¶150,590.
2014 HSA amounts — The health savings account (HSA) amounts for 2014 are at ¶39,067.
What's New in Benefits Answers Now (BAN):
EBSA issues guidance and notices for health care coverage options. The Employee Benefits Security Administration (EBSA) has issued guidance, pending future issuance of regulations or other guidance, on a requirement under the Patient Protection and Affordable Care Act (ACA) that notice be given to employees regarding coverage options available through the new state health care exchanges, also known as the health insurance marketplaces. These notices must be provided to employees by October 1, 2013. An overview of the exchange notice can be found at ¶20,067.
IRS issues 2014 inflation-adjusted amounts for HSAs. The Internal Revenue Service has issued inflation adjusted amounts for health savings accounts (HSAs) for 2014. For calendar year 2014, the annual limitation on deductions for an individual with self-only coverage under a high deductible health plan (HDHP) is $3,300. For calendar year 2014, the limitation on deductions for family coverage under a HDHP is $6,550. Find out more about the HSA limits at ¶23,700, ¶23,715, and ¶23,740.
CMS sets termination dates for processes under ACA’s Early Retiree Reinsurance Program. The Centers for Medicare and Medicaid Services (CMS) has issued a notice that sets forth termination dates for several processes under the Early Retiree Reinsurance Program (ERRP) in preparation for the Jan. 1, 2014, program sunset date. To find out more about the termination dates for the ERRP, see ¶22,875.
States with federally-facilitated exchanges can not run state-based SHOP exchanges in 2014. The Centers for Medicare and Medicaid Services (CMS) has released frequently-asked-questions (FAQs) on the Small Business Health Options Program (SHOP) exchanges. The FAQs confirm that the CMS plans to propose regulations that would allow only states that have received conditional approval to operate a state-based individual exchange to also operate a state-based SHOP exchange in 2014. More information about SHOP exchanges can be found at ¶20,065.
Workers want better benefits communication, Colonial Life survey finds. American workers say understanding their benefits is very important—and there’s a lot their employers could do to improve benefits communication, according to recent research from Colonial Life & Accident Insurance Company. Individuals whose employers offer benefits are nearly unanimous (98%) in saying it’s at least somewhat important to understand the benefits provided to them by their employer, and a strong majority—73%—say it’s very important. See the discussion at ¶40,200 for more information about the importance of benefits communication.
What's New in Spencer’s Benefits Reports:
Large Employers Must Provide Health Coverage. Beginning in 2014, the ACA assesses payments on certain large employers with 50 or more employees, including employers that do and do not offer health coverage (Report 550.-1).
Health Insurance Reporting. Under the ACA, employers have a number of reporting responsibilities, including the reporting of health insurance coverage, the cost of coverage, among others (Report 558.-1).
Early Retiree Reinsurance Program. The ACA established a temporary reinsurance program to reimburse part of the claims costs for participating employment-based plans that provide health insurance coverage for early retirees. The CMS plans to terminate the program on Jan. 1, 2014 (Report 531.1.-1).
FMLA Eligibility: Court Cases. Over the years, there have been many lawsuits filed under the FMLA. This report summarizes the rulings in a number of cases that deal with employee eligibility under the FMLA (Report 327.1.-25).
Work/Life Benefits. Employees’ attitudes toward work/life benefits are analyzed based on surveys by the Society for Human Resource Management (SHRM) and the Families and Work Institute (Report 327.-1).
New Pension/Benefits Titles Added:
Employee Benefit Plan Review (June)
Employee Benefits Answer Book, 11th Edition
401(k) Advisor (June)
Journal of Deferred Compensation (Summer)
Journal of Pension Benefits (Summer)
Pension Benefits (June)
Plan Correction Answer Book, 4th Edition
Qualified Domestic Relations Order Answer Book, 5th Edition, 2013 Cumulative Supplement
Quick Reference to COBRA Compliance, 2013-2014 Edition