Benefits Compliance & Legal Issues
2011 Medicare Premiums, Deductibles and Co-Insurance
This Sibson Consulting Capital Checkup provides useful information about Medicare changes for employers who pay Part B premiums or deductibles for their retiree population.
Uploaded: November 16, 2010
2011 Retirement Plan Limits
This easy-to-read chart from Sibson Consulting provides a listing of IRS dollar limits for retirement plans as well as the Social Security wage base. Also included is information on the Pension Benefit Guaranty Corporation (PBGC) premiums for 2011.
Uploaded: November 10, 2010
2012 Reporting & Disclosure Calendar for Benefit Plans
Sibson Consulting’s 2012 Reporting & Disclosure Calendar for Benefit Plans summarizes compliance requirements for qualified, single employer benefit plans.
Benefits Compliance Calendar 2012
Uploaded: January 17, 2012
2012 Retirement Plan Limits
This easy-to-read chart from Sibson Consulting provides a side-by-side comparison of IRS dollar limits for retirement plans in 2012 versus 2011. It also provides information on the Social Security wage base and on the Pension Benefit Guaranty Corporation (PBGC) premiums for 2012.
Uploaded: March 2, 2012
Affordable Care Act - Clarification of Rules on Coverage for Children to Age 26
This November 2010 publication by Sibson Consulting provides an overview of the age 26 mandate and summarizes several rounds of clarifications issued by regulatory agencies. It also includes a list of action steps for plan sponsors.
Clarification - Age 26 Mandate
Uploaded: November 12, 2010
Affordable Care Act - DOL/EBSA Web Page
This page on the DOL/EBSA website provides links to guidance, regulations, Fact Sheets and Model Notices for provisions of the Patient Protection and Affordable Care Act that are of particular interest to employers. Among the topics for which links are provided are grandfathered status, external review, coverage of preventive care, extension of coverage to adult children, preexisting condition exclusions, lifetime and annual limits, rescissions, patient protections and early retiree reinsurance. The page also provides links to related websites.
Uploaded: November 26, 2010
Affordable Care Act - FAQ #7 and Mental Health Parity Implementation
This set of FAQs egard implementation of the market reform provisions of the Affordable Care Act, as well as FAQs regarding implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).
Uploaded: April 17, 2012
Affordable Care Act - Preventative Care Benefits Guidance and RFI
This January 2011 edition of the Segal Company’s Health Care Reform Insights examines the federal government’s clarification that value-based insurance design is permitted with respect to preventive care benefits and that further guidance will be forthcoming based on responses to the government’s RFI.
ACA - Guidance on Preventive Benefits
Uploaded: January 25, 2011
Affordable Care Act - Regulations on Appeals Process
This Hewitt Associates report discusses the regulations that the DOL and HHS released in August, 2010, covering the Federal External Review Process and the Model Notices the agencies provided.
Commentary - Regulations on Appeals Process
Uploaded: October 21, 2010
Affordable Care Act Implementation - FAQ # 8 – Summary of Benefits and Coverage
This set of frequently asked questions covers the Summary of Benefits and Coverage document that group health plans and issuers must provide to participants and beneficiaries by September 23, 2012.
FAQ - Summary of Benefits and Coverage
Uploaded: April 17, 2012
Affordable Care Act Implementation - Commentary on Federal Guidance Released in September
This Hewitt article adds clarity to guidance that HHS and the DOL have issued regarding grandfathered status, claims and appeals, dependent coverage to age 26, and out-of-network emergency services.
ACA - Commentary on September 2010 Implementation Guidance
Uploaded: October 21, 2010
Affordable Care Act Implementation – FAQ #1
This is the first of several sets of frequently asked questions that the Department of Labor’s EBSA has available on its website.
Uploaded: October 21, 2010
Affordable Care Act Implementation – FAQ #2
This is the second set of frequently asked questions that the Department of Labor’s EBSA has available on its website.
Uploaded: October 21, 2010
Affordable Care Act Implementation – FAQ #3
This is the third set of frequently asked questions that the Department of Labor’s EBSA has available on its website.
Uploaded: October 21, 2010
Affordable Care Act Implementation — FAQ #4
This is the fourth set of frequently asked questions that the Department of Labor’s EBSA has available on its website.
Uploaded: November 1, 2010
Affordable Care Act Implementation — FAQ #5 and Mental Health Parity
This fifth set of frequently asked questions about the ACA also includes information on the Mental Health Parity and Addiction Act of 2008.
Uploaded: January 3, 2011
Amendment to Interim Final Regs on Grandfathered Status for Health Plans Under ACA
The modification published November 17, 2010, and linked below states that a group health plan does not lose its grandfathered status merely because the plan (or its sponsor) enters into a new policy, certificate, or contract of insurance after March 23, 2010.
Grandfathered Status Not Lost With Change of Insurers
Uploaded: November 16, 2010
Aon Hewitt Summary of Final DC Participant Fee Disclosure
This report summarizes and comments on the DOL’s participant fee disclosure regulations released in October 2010.
Fee Disclosure - DC Participants
Uploaded: November 18, 2010
CHIP – New Health Benefit Eligibility Notice for Employees by May 1, 2010
This Benefits Alert from Nixon Peabody concerns a model information notice from the DOL that all employers with group health plans must issue to employees as early as May 1, 2010.
CHIP - New Benefit Notification Rules
Uploaded: November 4, 2010
CHIP/Medicaid–Employee Notice Now Required
This March 2010 Sibson Consulting article provides background and information on the Department of Labor’s Model Notices about health insurance premium assistance that is available for low-income children. All employers who offer health care benefits are now required to notify employees about the assistance that is available through their state CHIP/Medicaid programs.
CHIP/Medicaid - Employee Notice
Uploaded: November 9, 2010
Cash Balance Plans - Relief on Interest Crediting Rates
Hewitt Consulting offers guidance on the November 2009 announcement by the Treasury Department and IRS providing interest rate relief to cash balance plans.
Cash Balance Plans - Crediting Rates
Uploaded: October 22, 2010
Compliance Alert – Defined Benefit Plans Intranet Posting Requirement
The Segal Company issued this Alert reminding DB plan sponsors that they must post certain information that was filed as part of the Form 5500 on their intranets after the Form 5500 is filed.
Uploaded: November 4, 2010
Compliance Assistance for Health and Retirement Plans
This section of the EBSA site provides useful tools and a wealth of information for ensuring that your health and retirement plans adhere to federal regulations. It also includes FAQs, Model Notices and other information on a broad array of plan management issues.
EBSA Benefit Plans Compliance Assistance
Uploaded: October 15, 2010
DOL’s Final Regulations on Disclosure to DC Plan Participants
Sibson Consulting’s February 2011 Bulletin linked below examines plan-related and investment-related information that plan sponsors must provide to participants in self-directed DC plans.
Final Regulations - Participant Fee Disclosure
Uploaded: January 26, 2011
EBSA - SBC Instruction Guide for Group Plans
EBSA developed this guide to assist employers in the completion of their Summary of Benefits and Coverage (SBC) based on the SBC Template.
SBC Instructions - Group Plans
Uploaded: February 10, 2012
EBSA - Fee Disclosure Failure Notice
This page on the EBSA website outlines action a plan sponsor can take to avoid a prohibited transaction when a plan service provider fails to disclose fee information it is required to under 408(b)(2). The page contains a link to a model notice of covered service provider’s failure to comply as well as links to a 408(b)(2) Fact Sheet and Final Regulations.
Uploaded: February 29, 2012
EBSA - Model 401(k) Plan Fee Disclosure Form for Plan Sponsors
This 11-page model 401(k) fee disclosure form helps plan sponsors identify all of the fees associated with their retirement plans. A glossary is included to help clarify terms.
401(k) Model Fee Disclosure Form
Uploaded: February 29, 2012
EBSA - Detail of Changes to Final 408(b)(2) Fee Disclosure Rule
The DOL’s EBSA has provided information detailing the changes made to the interim 408(b)(2) fee disclosure rule that was published in July, 2010.
Changes to Final 408(b)(2) Fee Disclosure Rule
Uploaded: February 3, 2012
EBSA - Sample Completed Summary of Benefits and Coverage
The DOL’s EBSA has provided a sample completed Summary of Benefits and Coverage (SBC) using the template the agency developed. The SBC is the four-page summary mandated by the Patient Protection and Affordable Care Act.
EBSA Sample Summary of Benefits Coverage
Uploaded: January 26, 2012
EBSA - Summary of Benefits and Coverage - Compliance Guidance
EBSA has provided this document to guide employers on compliance with providing a Summary of Benefits and Coverage to all healthcare plan participants as mandated by PPACA.
Uploaded: February 10, 2012
EBSA - Summary of Benefits and Coverage - Final Regulations
EBSA published the final regulations covering the Summary of Benefits and Coverage mandated by PPACA to be made available to all healthcare plan participants.
Uploaded: February 10, 2012
EBSA - Template for PPACA’s Summary of Benefits and Coverage
The DOL’s EBSA has provided a template for the Summary of Benefits and Coverage mandated under the Patient Protection and Affordable Care Act.
EBSA Template for PPACA’s Summary of Benefits Coverage
Uploaded: January 26, 2012
EBSA Fact Sheet – Final Rule on 408(b)(2) Fee Disclosure Rule
The DOL’s EBSA has created a Fact Sheet summarizing the service provider fee disclosure requirements. The deadline for implementation was pushed back from April 1, 2012, to July 1, 2012.
EBSA Fact Sheet – Final Rule on 408(b)(2) Fee Disclosure
Uploaded: February 3, 2012
EBSA – Final 408(b)(2) Plan-Level Fee Disclosure Rules
EBSA published the final rules covering 408(b)(2) plan-level fee disclosure rules in the Federal Register on February 3, 2012. The full text is available below in PDF format.
Uploaded: February 29, 2012
EBSA – Understanding Retirement Plan Fees and Expense
EBSA has provided an easy-to-read article for retirement plan sponsors on its website in conjunction with the February 2012 publication of 408(b)2 plan-level fee disclosures. The article includes explanations of the major categories of plan fees as well as basic information on investment fees. There are also links to several other supporting publications, most notably a link to a model 401(k) plan fee disclosure form.
Understanding Retirement Plan Fees
Uploaded: February 29, 2012
ERISA Litigation - Fiduciaries Breached Duty by Investing in Retail Share Class
Law firm Nixon Peabody looks at a July 2010 court ruling that should make fiduciaries of self-directed retirement plans think twice before offering retail share classes as investment options when less expensive institutional share classes are available.
ERISA Litigation - Retail Funds
Uploaded: November 4, 2010
FMLA for Military Families
Hewitt Consulting explains the October 2009 amendment to the Family and Medical Leave Act that expands FMLA provisions for military families.
Uploaded: October 22, 2010
FMLA – DOL’s Online Access to Information About Rights and Responsibilities
This page on the DOL’s Wage and Hour Division website is part of the elaws program. This Family and Medical Leave Act Advisor provides information about the basic rights and responsibilities of employees and employers under FMLA. It includes information about the 2012 expansion of rights for military families and airline flight crews.
FMLA - DOL Online Elaw Resource
Uploaded: March 8, 2012
FMLA – Fact Sheet on Proposed Rulemaking Affecting Military Families and Flight Crews
This DOL Fact Sheet outlines the major provisions of the changes and also includes a link to the Proposed Rule Website which has deadlines and procedures for submitting comments.
FMLA - Military Families and Airline Crews
Uploaded: March 8, 2012
Fact Sheet – Amendment to Regulations on Grandfathered Status
This November 2010 HHS publication is a brief synopsis of the amendment of earlier regulations whereby group health plans will be allowed to switch insurance companies and shop for the same coverage at a lower cost while maintaining their grandfathered status, so long as the structure of the coverage doesn’t violate one of the other rules for maintaining grandfathered plan status.
Fact Sheet - Amended Regs, Grandfathered Status
Uploaded: November 16, 2010
Fact Sheet – Transparency for Annual Dollar Limits of Mini-Med Plans
This Fact Sheet posted on the HealthCare.gov website December 9, 2010, discusses how health insurers offering mini-med plans must notify consumers in plain language that their plan offers extremely limited benefits and direct them to the HealthCare.gov website where they can get more information about other coverage options.
Fact Sheet - Mini-Med Plan Annual Limits
Uploaded: December 13, 2010
Fact Sheet: Definition of the Term “Fiduciary”
This Fact Sheet issued in March of 2011, lays out EBSA’s proposal to redefine a fiduciary under ERISA to better reflect the relationships between investment advisers and their employee benefit clients.
Uploaded: August 31, 2011
Fact Sheet—EBSA’s Contributory Plans Criminal Project
This Fact Sheet provides background information on EBSA’s Contributory Plans Criminal Project (CPCP) to combat criminal abuse of contributory health care and retirement benefit plans. The Fact Sheet also discusses enforcement actions and recent criminal prosecutions.
Uploaded: November 26, 2010
Fiduciary Checklist for Retirement Plan Sponsors
This is a synopsis of prudent fiduciary practices as articulated by attorney Sherwin Kaplan of Nixon Peabody. The list is not all-inclusive, but is a good place to start.
Uploaded: October 25, 2010
Final Rule to Improve Transparency of Fees and Expenses to 401(k) Participants
This is the published version of the DOL’s final rule regarding fee and expense disclosure at the participant level.
Reporting Fees and Expenses to 401(k) Participants
Uploaded: November 21, 2010
Form 5500 – Fact Sheet on E-Filing, Electronic Signatures, and Civil Penalties
This Fact Sheet provides information on filing help that is available from EBSA. It also covers streamlined options for small business, electronic signatures on the Form 5500 and civil penalties for non-compliance.
Form 5500 - Electronic Filing Fact Sheet
Uploaded: October 18, 2010
GINA - Background on EEOC’s Final Rule on Title II
This link to the EEOC’s website provides background information on Title II of GINA and includes a Q&A format that addresses such questions as “Who must comply with Title II of GINA?”
Uploaded: November 10, 2010
GINA - Final Regulations
On November 9, 2010, the EEOC published a final rule in the Federal Register to implement Title II of the Genetic Information Nondiscrimination Act of 2008 (GINA).
Uploaded: November 10, 2010
GINA Regulations Curtail Health Risk Assessments
This October 2009 Benefits Alert from law firm Nixon Peabody discusses how the GINA regulations impose significant limitations on health risk assessments.
Uploaded: November 9, 2010
GINA Regulations Require Redesign of Wellness and Disease Management Incentives
This Bulletin from The Segal Company’s Sibson Conulting reviews the impact of federal regulations governing the use of genetic information on wellness and disease management plans.
GINA Regs - Impact on Wellness, Disease Management
Uploaded: November 9, 2010
Genetic Information Discrimination – EEOC
This EEOC link discusses the prohibition against using genetic information under the Genetic Information Nondiscrimination Act of 2008 (GINA) to discriminate against employees and applicants.
Uploaded: November 10, 2010
Guidance for Governmental Plans
This Segal Company Compliance Alert reviews information from the IRS on safe harbor rollovers and extension of the effective date for governmental plans to comply with normal retirement age rules from plan years beginning on or after January 1, 2011. It also reviews required minimum distribution rules as well as paid time off contributions.
Uploaded: November 9, 2010
Guidance on Annual Limit Waivers and Minimum Loss Ratio for Mini-Meds
This November 2010 commentary by Aon Hewitt discusses the HHS’s waiver process for mini-med plans whose annual limits for essential services is below those required by the ACA. The article also outlines a new requirement for group health plans and health insurers to issue specific notices to participants of these plans.
Mini-Meds - Annual Limits and Medical Loss Ratio
Uploaded: November 16, 2010
HHS Resources for Creating a Summary of Benefits and Coverage
This page on the HHS website provides access to a whole host of additional information for preparing a Summary of Benefits Coverage. Included are links to instructions and guides for the sample benefit calculations for common scenarios that are a requirement of the regulations.
SBC - Sample Benefits Coverage Calculations
Uploaded: March 1, 2012
IRS - Interim Report on 401(k) Compliance Check Questionnaire
This Interim Report from the IRS summarizes the responses from approximately 1,200 randomly selected sponsors of 401(k) plans. The plan sponsors completed an online questionnaire designed to measure the overall compliance levels among 401(k) plans, evaluate the effectiveness of IRS voluntary compliance programs and determine how the IRS can foster greater compliance.
401(k) Compliance Check Questionnaire
Uploaded: February 14, 2012
IRS Employee Plans News - March 2012
The March 2012 issue has articles on new guidance encouraging plans to offer lifetime income options, an update on the Determination Letter Program, the IRS’ 401(k) plan projects and other employer plan-related topics.
Uploaded: April 17, 2012
IRS Employee Plans Newsletter - December 2011
This issue of the IRS Employee Plans Newsletter outlines significant changes to the Employee Plans Determination Letter Program and also provides a cumulative list of changes in plan qualification requirements for 2011.
IRS December Employee Plans Newsletter
Uploaded: December 20, 2011
IRS Employee Plans Newsletter - October 2011
This issue of the IRS Employee Plans Newsletters contains a number of articles of interest to employers, including a 2011-2012 Priority Guidance Plan.
IRS October 2011 Employee Plans Newsletter
Uploaded: December 20, 2011
IRS Fall 2011 Retirement Plan Newsletter - Employers
The Fall edition of this IRS newsletter has articles on 2012 salary deferral contributions, paying retirement benefits and an update on the IRS’s 401(k) Compliance Check Questionnaire Project.
Uploaded: January 17, 2012
IRS Summer 2011 Retirement Plan Newsletter - Employers
The IRS’ summer 2011 newsletter for employers who sponsor retirement plans contains articles on avoiding and correcting compensation errors in retirement plans and on withholding federal income tax on plan distribution. The newsletter also contains useful links to IRS educational materials for plan sponsors as well as links to the DOL/EBSA website.
IRS Summer 2011 Retirement Plans Newsletter
Uploaded: August 24, 2011
Impact of EEOC’s Final Regulations on Health Risk Assessments and Wellness Programs
This report by Aon Hewitt reviews the final regulations issued in November 2010 and discusses the implications for health risk assessments and wellness/disease management programs.
Uploaded: November 16, 2010
Impact of the Affordable Care Act on Dental and Vision Benefits
This December 2010 publication by Sibson Consulting discusses the impact that health care reform has on dental and vision benefits, particularly with respect to whether these benefits are considered “excepted benefits.” The article also includes a suggested list of action steps.
ACA - Dental and Vision Benefits
Uploaded: December 10, 2010
In-Plan Roth Rollovers—New Guidance and 2010 Forms 1099-R and 8606 Reporting Instructions
This article on the IRS website outlines the main features of the agency’s November 2010 guidance concerning in-plan Roth rollovers.
Roth In-Plan Rollovers - IRS Guidance
Uploaded: November 26, 2010
Interim Final Rules—Coverage of Preventive Services Under ACA
This link to the Federal Register provides the text of the interim final rules for group health plans and health insurance issuers regarding the coverage of preventive services under the Patient Protection and Affordable Care Act. The publication also includes a request for comments.
Uploaded: November 26, 2010
Model Language to Notify Plan Participants of Annual Dollar Limits That Apply to Mini-Med Plans
This December 2010 notice from the Department of Health and Human Services provides model language that mini-med health plans must use to disclose the annual dollar limits of the plan to participants.
Model Language - Mini-Med Plans
Uploaded: December 13, 2010
New Rules on Paying for Over-the-Counter Medications
This Sibson Consulting Capital Checkup summarizes the IRS guidelines on the provision in the Affordable Care Act that limits reimbursement for over-the-counter medications to those that are prescribed.
Reimbursement for OTC Medicines
Uploaded: December 13, 2010
New Safe Harbor Rollover Explanations and Other Helpful Retirement Plan Guidance from the IRS
This Sibson Consulting Compliance Alert reviews information from the IRS on safe harbor rollovers, rollovers to Roth IRAs, sample plan amendments for automatic features in 401(k) plans, and guidance on paid time off contributions to profit sharing or 401(k) plans.
Uploaded: November 9, 2010
Non-Qualified Deferred Compensation – IRS Requires Review of Compensation Agreements
This Benefits Alert from law firm Nixon Peabody concerns a new IRS requirement for employers to review compensation agreements that make payments contingent upon the recipient signing a release.
Non-Qualified Plans - Review of Agreements
Uploaded: November 4, 2010
PBGC - 2010 Maximum Insurance Benefit
This October 2009 press release from the Pension Benefit Guaranty Corporation announced the maximum insurance benefit for participants in underfunded pension plans terminating in 2010 will be $54,000 per year for those who retire at age 65. The announcement includes a chart showing the maximum annual monthly benefits for retirees and survivors beginning from age 45 to 75.
Uploaded: October 25, 2010
PBGC - 2010 Pension Insurance Premiums Fact Sheet
This PBGC Fact Sheet provides information on insurance premiums for 2010.
Uploaded: October 25, 2010
Q&A on Title II of GINA for Small Businesses
The EEOC provides this online guide to compliance with Title II of GINA for small businesses in a question and answer format.
GINA Title II - Q&A for Small Businesses
Uploaded: November 10, 2010
Recommended Preventive Services Under the ACA
The ACA requires new plans and issuers to cover certain preventive services without any cost-sharing for the enrollee when delivered by in-network providers. Interim final regulations, issued in July 2010, do not apply to grandfathered plans and issuers. This website provides links to the items and services that must be covered under the interim final regulation.
Uploaded: January 3, 2011
Regulations on Grandfathering Under the Affordable Care Act
This June 2010 bulletin by Sibson Consulting discusses the federal government’s initial regulations on grandfathered plans. It contrasts provisions that apply to all plans versus those that are grandfathered, as well as changes that can cause a plan to lose its grandfathered status.
Uploaded: November 12, 2010
Regulations on Preventive Care Under the Affordable Care Act
This Sibson Consulting Bulletin analyzes the July 2010 interim final regulations covering the specific list of preventive services that ACA requires certain group health plans to cover with no cost sharing. The bulletin also looks at the implications for plan sponsors.
Uploaded: November 10, 2010
Revisions to ACA’s Grandfathering Rules Permit Change in Insurers
This Segal Co. Capital Checkup discusses the revision to the Affordable Care Act’s Grandfathering provision that allows plan sponsors to change health insurance coverage without losing grandfathered status under certain conditions.
Revision of Grandfathering Rules
Uploaded: January 6, 2011
Rules for Coverage on Adult Children Clarified
This June 2010 publication by Sibson Consulting reviews the regulations for the age 26 mandate issued in April and May 2010. Included is an overview of the mandate and who is covered by it as well as discussion of how the mandate interacts with Michelle’s Law and other student health plans.
Uploaded: November 12, 2010
The Fix Is In – Common Plan Mistakes
Articles from the Retirement News for Employers present common mistakes that happen in retirement plans. They describe the problem, how it happened, how to fix it and how to lessen the probability of the problem happening again.
IRS - Common Retirement Plan Mistakes
Uploaded: October 15, 2010
Third Set of Regulations Under the Affordable Care Act
This Sibson Consulting Bulletin examines the third set of regulations published by the federal agencies charged with implementing the new health care reform law. This set, issued in July 2010, covers rules that apply to all group health plans and those that apply only to non-grandfathered plans. The Bulletin also looks at implications for plan sponsors.
Uploaded: November 10, 2010
2011 Medicare Premiums, Deductibles and Co-Insurance
This Sibson Consulting Capital Checkup provides useful information about Medicare changes for employers who pay Part B premiums or deductibles for their retiree population.
Uploaded: November 16, 2010
2012 Reporting & Disclosure Calendar for Benefit Plans
Sibson Consulting’s 2012 Reporting & Disclosure Calendar for Benefit Plans summarizes compliance requirements for qualified, single employer benefit plans.
Benefits Compliance Calendar 2012
Uploaded: January 17, 2012
Affordable Care Act - Clarification of Rules on Coverage for Children to Age 26
This November 2010 publication by Sibson Consulting provides an overview of the age 26 mandate and summarizes several rounds of clarifications issued by regulatory agencies. It also includes a list of action steps for plan sponsors.
Clarification - Age 26 Mandate
Uploaded: November 12, 2010
Affordable Care Act - DOL/EBSA Web Page
This page on the DOL/EBSA website provides links to guidance, regulations, Fact Sheets and Model Notices for provisions of the Patient Protection and Affordable Care Act that are of particular interest to employers. Among the topics for which links are provided are grandfathered status, external review, coverage of preventive care, extension of coverage to adult children, preexisting condition exclusions, lifetime and annual limits, rescissions, patient protections and early retiree reinsurance. The page also provides links to related websites.
Uploaded: November 26, 2010
Affordable Care Act - FAQ #7 and Mental Health Parity Implementation
This set of FAQs egard implementation of the market reform provisions of the Affordable Care Act, as well as FAQs regarding implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).
Uploaded: April 17, 2012
Affordable Care Act - Preventative Care Benefits Guidance and RFI
This January 2011 edition of the Segal Company’s Health Care Reform Insights examines the federal government’s clarification that value-based insurance design is permitted with respect to preventive care benefits and that further guidance will be forthcoming based on responses to the government’s RFI.
ACA - Guidance on Preventive Benefits
Uploaded: January 25, 2011
Affordable Care Act - Regulations on Appeals Process
This Hewitt Associates report discusses the regulations that the DOL and HHS released in August, 2010, covering the Federal External Review Process and the Model Notices the agencies provided.
Commentary - Regulations on Appeals Process
Uploaded: October 21, 2010
Affordable Care Act Implementation - FAQ # 8 – Summary of Benefits and Coverage
This set of frequently asked questions covers the Summary of Benefits and Coverage document that group health plans and issuers must provide to participants and beneficiaries by September 23, 2012.
FAQ - Summary of Benefits and Coverage
Uploaded: April 17, 2012
Affordable Care Act Implementation - Commentary on Federal Guidance Released in September
This Hewitt article adds clarity to guidance that HHS and the DOL have issued regarding grandfathered status, claims and appeals, dependent coverage to age 26, and out-of-network emergency services.
ACA - Commentary on September 2010 Implementation Guidance
Uploaded: October 21, 2010
Affordable Care Act Implementation – FAQ #1
This is the first of several sets of frequently asked questions that the Department of Labor’s EBSA has available on its website.
Uploaded: October 21, 2010
Affordable Care Act Implementation – FAQ #2
This is the second set of frequently asked questions that the Department of Labor’s EBSA has available on its website.
Uploaded: October 21, 2010
Affordable Care Act Implementation – FAQ #3
This is the third set of frequently asked questions that the Department of Labor’s EBSA has available on its website.
Uploaded: October 21, 2010
Affordable Care Act Implementation — FAQ #4
This is the fourth set of frequently asked questions that the Department of Labor’s EBSA has available on its website.
Uploaded: November 1, 2010
Affordable Care Act Implementation — FAQ #5 and Mental Health Parity
This fifth set of frequently asked questions about the ACA also includes information on the Mental Health Parity and Addiction Act of 2008.
Uploaded: January 3, 2011
Amendment to Interim Final Regs on Grandfathered Status for Health Plans Under ACA
The modification published November 17, 2010, and linked below states that a group health plan does not lose its grandfathered status merely because the plan (or its sponsor) enters into a new policy, certificate, or contract of insurance after March 23, 2010.
Grandfathered Status Not Lost With Change of Insurers
Uploaded: November 16, 2010
CHIP – New Health Benefit Eligibility Notice for Employees by May 1, 2010
This Benefits Alert from Nixon Peabody concerns a model information notice from the DOL that all employers with group health plans must issue to employees as early as May 1, 2010.
CHIP - New Benefit Notification Rules
Uploaded: November 4, 2010
CHIP/Medicaid–Employee Notice Now Required
This March 2010 Sibson Consulting article provides background and information on the Department of Labor’s Model Notices about health insurance premium assistance that is available for low-income children. All employers who offer health care benefits are now required to notify employees about the assistance that is available through their state CHIP/Medicaid programs.
CHIP/Medicaid - Employee Notice
Uploaded: November 9, 2010
EBSA - SBC Instruction Guide for Group Plans
EBSA developed this guide to assist employers in the completion of their Summary of Benefits and Coverage (SBC) based on the SBC Template.
SBC Instructions - Group Plans
Uploaded: February 10, 2012
EBSA - Sample Completed Summary of Benefits and Coverage
The DOL’s EBSA has provided a sample completed Summary of Benefits and Coverage (SBC) using the template the agency developed. The SBC is the four-page summary mandated by the Patient Protection and Affordable Care Act.
EBSA Sample Summary of Benefits Coverage
Uploaded: January 26, 2012
EBSA - Summary of Benefits and Coverage - Compliance Guidance
EBSA has provided this document to guide employers on compliance with providing a Summary of Benefits and Coverage to all healthcare plan participants as mandated by PPACA.
Uploaded: February 10, 2012
EBSA - Summary of Benefits and Coverage - Final Regulations
EBSA published the final regulations covering the Summary of Benefits and Coverage mandated by PPACA to be made available to all healthcare plan participants.
Uploaded: February 10, 2012
EBSA - Template for PPACA’s Summary of Benefits and Coverage
The DOL’s EBSA has provided a template for the Summary of Benefits and Coverage mandated under the Patient Protection and Affordable Care Act.
EBSA Template for PPACA’s Summary of Benefits Coverage
Uploaded: January 26, 2012
FMLA for Military Families
Hewitt Consulting explains the October 2009 amendment to the Family and Medical Leave Act that expands FMLA provisions for military families.
Uploaded: October 22, 2010
FMLA – DOL’s Online Access to Information About Rights and Responsibilities
This page on the DOL’s Wage and Hour Division website is part of the elaws program. This Family and Medical Leave Act Advisor provides information about the basic rights and responsibilities of employees and employers under FMLA. It includes information about the 2012 expansion of rights for military families and airline flight crews.
FMLA - DOL Online Elaw Resource
Uploaded: March 8, 2012
FMLA – Fact Sheet on Proposed Rulemaking Affecting Military Families and Flight Crews
This DOL Fact Sheet outlines the major provisions of the changes and also includes a link to the Proposed Rule Website which has deadlines and procedures for submitting comments.
FMLA - Military Families and Airline Crews
Uploaded: March 8, 2012
Fact Sheet – Amendment to Regulations on Grandfathered Status
This November 2010 HHS publication is a brief synopsis of the amendment of earlier regulations whereby group health plans will be allowed to switch insurance companies and shop for the same coverage at a lower cost while maintaining their grandfathered status, so long as the structure of the coverage doesn’t violate one of the other rules for maintaining grandfathered plan status.
Fact Sheet - Amended Regs, Grandfathered Status
Uploaded: November 16, 2010
Fact Sheet – Transparency for Annual Dollar Limits of Mini-Med Plans
This Fact Sheet posted on the HealthCare.gov website December 9, 2010, discusses how health insurers offering mini-med plans must notify consumers in plain language that their plan offers extremely limited benefits and direct them to the HealthCare.gov website where they can get more information about other coverage options.
Fact Sheet - Mini-Med Plan Annual Limits
Uploaded: December 13, 2010
GINA - Background on EEOC’s Final Rule on Title II
This link to the EEOC’s website provides background information on Title II of GINA and includes a Q&A format that addresses such questions as “Who must comply with Title II of GINA?”
Uploaded: November 10, 2010
GINA - Final Regulations
On November 9, 2010, the EEOC published a final rule in the Federal Register to implement Title II of the Genetic Information Nondiscrimination Act of 2008 (GINA).
Uploaded: November 10, 2010
GINA Regulations Curtail Health Risk Assessments
This October 2009 Benefits Alert from law firm Nixon Peabody discusses how the GINA regulations impose significant limitations on health risk assessments.
Uploaded: November 9, 2010
GINA Regulations Require Redesign of Wellness and Disease Management Incentives
This Bulletin from The Segal Company’s Sibson Conulting reviews the impact of federal regulations governing the use of genetic information on wellness and disease management plans.
GINA Regs - Impact on Wellness, Disease Management
Uploaded: November 9, 2010
Genetic Information Discrimination – EEOC
This EEOC link discusses the prohibition against using genetic information under the Genetic Information Nondiscrimination Act of 2008 (GINA) to discriminate against employees and applicants.
Uploaded: November 10, 2010
Guidance on Annual Limit Waivers and Minimum Loss Ratio for Mini-Meds
This November 2010 commentary by Aon Hewitt discusses the HHS’s waiver process for mini-med plans whose annual limits for essential services is below those required by the ACA. The article also outlines a new requirement for group health plans and health insurers to issue specific notices to participants of these plans.
Mini-Meds - Annual Limits and Medical Loss Ratio
Uploaded: November 16, 2010
HHS Resources for Creating a Summary of Benefits and Coverage
This page on the HHS website provides access to a whole host of additional information for preparing a Summary of Benefits Coverage. Included are links to instructions and guides for the sample benefit calculations for common scenarios that are a requirement of the regulations.
SBC - Sample Benefits Coverage Calculations
Uploaded: March 1, 2012
IRS - Interim Report on 401(k) Compliance Check Questionnaire
This Interim Report from the IRS summarizes the responses from approximately 1,200 randomly selected sponsors of 401(k) plans. The plan sponsors completed an online questionnaire designed to measure the overall compliance levels among 401(k) plans, evaluate the effectiveness of IRS voluntary compliance programs and determine how the IRS can foster greater compliance.
401(k) Compliance Check Questionnaire
Uploaded: February 14, 2012
Impact of EEOC’s Final Regulations on Health Risk Assessments and Wellness Programs
This report by Aon Hewitt reviews the final regulations issued in November 2010 and discusses the implications for health risk assessments and wellness/disease management programs.
Uploaded: November 16, 2010
Impact of the Affordable Care Act on Dental and Vision Benefits
This December 2010 publication by Sibson Consulting discusses the impact that health care reform has on dental and vision benefits, particularly with respect to whether these benefits are considered “excepted benefits.” The article also includes a suggested list of action steps.
ACA - Dental and Vision Benefits
Uploaded: December 10, 2010
Interim Final Rules—Coverage of Preventive Services Under ACA
This link to the Federal Register provides the text of the interim final rules for group health plans and health insurance issuers regarding the coverage of preventive services under the Patient Protection and Affordable Care Act. The publication also includes a request for comments.
Uploaded: November 26, 2010
Model Language to Notify Plan Participants of Annual Dollar Limits That Apply to Mini-Med Plans
This December 2010 notice from the Department of Health and Human Services provides model language that mini-med health plans must use to disclose the annual dollar limits of the plan to participants.
Model Language - Mini-Med Plans
Uploaded: December 13, 2010
New Rules on Paying for Over-the-Counter Medications
This Sibson Consulting Capital Checkup summarizes the IRS guidelines on the provision in the Affordable Care Act that limits reimbursement for over-the-counter medications to those that are prescribed.
Reimbursement for OTC Medicines
Uploaded: December 13, 2010
Q&A on Title II of GINA for Small Businesses
The EEOC provides this online guide to compliance with Title II of GINA for small businesses in a question and answer format.
GINA Title II - Q&A for Small Businesses
Uploaded: November 10, 2010
Recommended Preventive Services Under the ACA
The ACA requires new plans and issuers to cover certain preventive services without any cost-sharing for the enrollee when delivered by in-network providers. Interim final regulations, issued in July 2010, do not apply to grandfathered plans and issuers. This website provides links to the items and services that must be covered under the interim final regulation.
Uploaded: January 3, 2011
Regulations on Grandfathering Under the Affordable Care Act
This June 2010 bulletin by Sibson Consulting discusses the federal government’s initial regulations on grandfathered plans. It contrasts provisions that apply to all plans versus those that are grandfathered, as well as changes that can cause a plan to lose its grandfathered status.
Uploaded: November 12, 2010
Regulations on Preventive Care Under the Affordable Care Act
This Sibson Consulting Bulletin analyzes the July 2010 interim final regulations covering the specific list of preventive services that ACA requires certain group health plans to cover with no cost sharing. The bulletin also looks at the implications for plan sponsors.
Uploaded: November 10, 2010
Revisions to ACA’s Grandfathering Rules Permit Change in Insurers
This Segal Co. Capital Checkup discusses the revision to the Affordable Care Act’s Grandfathering provision that allows plan sponsors to change health insurance coverage without losing grandfathered status under certain conditions.
Revision of Grandfathering Rules
Uploaded: January 6, 2011
Rules for Coverage on Adult Children Clarified
This June 2010 publication by Sibson Consulting reviews the regulations for the age 26 mandate issued in April and May 2010. Included is an overview of the mandate and who is covered by it as well as discussion of how the mandate interacts with Michelle’s Law and other student health plans.
Uploaded: November 12, 2010
Third Set of Regulations Under the Affordable Care Act
This Sibson Consulting Bulletin examines the third set of regulations published by the federal agencies charged with implementing the new health care reform law. This set, issued in July 2010, covers rules that apply to all group health plans and those that apply only to non-grandfathered plans. The Bulletin also looks at implications for plan sponsors.
Uploaded: November 10, 2010
2011 Retirement Plan Limits
This easy-to-read chart from Sibson Consulting provides a listing of IRS dollar limits for retirement plans as well as the Social Security wage base. Also included is information on the Pension Benefit Guaranty Corporation (PBGC) premiums for 2011.
Uploaded: November 10, 2010
2012 Retirement Plan Limits
This easy-to-read chart from Sibson Consulting provides a side-by-side comparison of IRS dollar limits for retirement plans in 2012 versus 2011. It also provides information on the Social Security wage base and on the Pension Benefit Guaranty Corporation (PBGC) premiums for 2012.
Uploaded: March 2, 2012
Aon Hewitt Summary of Final DC Participant Fee Disclosure
This report summarizes and comments on the DOL’s participant fee disclosure regulations released in October 2010.
Fee Disclosure - DC Participants
Uploaded: November 18, 2010
Cash Balance Plans - Relief on Interest Crediting Rates
Hewitt Consulting offers guidance on the November 2009 announcement by the Treasury Department and IRS providing interest rate relief to cash balance plans.
Cash Balance Plans - Crediting Rates
Uploaded: October 22, 2010
Compliance Alert – Defined Benefit Plans Intranet Posting Requirement
The Segal Company issued this Alert reminding DB plan sponsors that they must post certain information that was filed as part of the Form 5500 on their intranets after the Form 5500 is filed.
Uploaded: November 4, 2010
DOL’s Final Regulations on Disclosure to DC Plan Participants
Sibson Consulting’s February 2011 Bulletin linked below examines plan-related and investment-related information that plan sponsors must provide to participants in self-directed DC plans.
Final Regulations - Participant Fee Disclosure
Uploaded: January 26, 2011
EBSA - Fee Disclosure Failure Notice
This page on the EBSA website outlines action a plan sponsor can take to avoid a prohibited transaction when a plan service provider fails to disclose fee information it is required to under 408(b)(2). The page contains a link to a model notice of covered service provider’s failure to comply as well as links to a 408(b)(2) Fact Sheet and Final Regulations.
Uploaded: February 29, 2012
EBSA - Model 401(k) Plan Fee Disclosure Form for Plan Sponsors
This 11-page model 401(k) fee disclosure form helps plan sponsors identify all of the fees associated with their retirement plans. A glossary is included to help clarify terms.
401(k) Model Fee Disclosure Form
Uploaded: February 29, 2012
EBSA - Detail of Changes to Final 408(b)(2) Fee Disclosure Rule
The DOL’s EBSA has provided information detailing the changes made to the interim 408(b)(2) fee disclosure rule that was published in July, 2010.
Changes to Final 408(b)(2) Fee Disclosure Rule
Uploaded: February 3, 2012
EBSA Fact Sheet – Final Rule on 408(b)(2) Fee Disclosure Rule
The DOL’s EBSA has created a Fact Sheet summarizing the service provider fee disclosure requirements. The deadline for implementation was pushed back from April 1, 2012, to July 1, 2012.
EBSA Fact Sheet – Final Rule on 408(b)(2) Fee Disclosure
Uploaded: February 3, 2012
EBSA – Final 408(b)(2) Plan-Level Fee Disclosure Rules
EBSA published the final rules covering 408(b)(2) plan-level fee disclosure rules in the Federal Register on February 3, 2012. The full text is available below in PDF format.
Uploaded: February 29, 2012
EBSA – Understanding Retirement Plan Fees and Expense
EBSA has provided an easy-to-read article for retirement plan sponsors on its website in conjunction with the February 2012 publication of 408(b)2 plan-level fee disclosures. The article includes explanations of the major categories of plan fees as well as basic information on investment fees. There are also links to several other supporting publications, most notably a link to a model 401(k) plan fee disclosure form.
Understanding Retirement Plan Fees
Uploaded: February 29, 2012
ERISA Litigation - Fiduciaries Breached Duty by Investing in Retail Share Class
Law firm Nixon Peabody looks at a July 2010 court ruling that should make fiduciaries of self-directed retirement plans think twice before offering retail share classes as investment options when less expensive institutional share classes are available.
ERISA Litigation - Retail Funds
Uploaded: November 4, 2010
Fact Sheet: Definition of the Term “Fiduciary”
This Fact Sheet issued in March of 2011, lays out EBSA’s proposal to redefine a fiduciary under ERISA to better reflect the relationships between investment advisers and their employee benefit clients.
Uploaded: August 31, 2011
Fiduciary Checklist for Retirement Plan Sponsors
This is a synopsis of prudent fiduciary practices as articulated by attorney Sherwin Kaplan of Nixon Peabody. The list is not all-inclusive, but is a good place to start.
Uploaded: October 25, 2010
Final Rule to Improve Transparency of Fees and Expenses to 401(k) Participants
This is the published version of the DOL’s final rule regarding fee and expense disclosure at the participant level.
Reporting Fees and Expenses to 401(k) Participants
Uploaded: November 21, 2010
Form 5500 – Fact Sheet on E-Filing, Electronic Signatures, and Civil Penalties
This Fact Sheet provides information on filing help that is available from EBSA. It also covers streamlined options for small business, electronic signatures on the Form 5500 and civil penalties for non-compliance.
Form 5500 - Electronic Filing Fact Sheet
Uploaded: October 18, 2010
Guidance for Governmental Plans
This Segal Company Compliance Alert reviews information from the IRS on safe harbor rollovers and extension of the effective date for governmental plans to comply with normal retirement age rules from plan years beginning on or after January 1, 2011. It also reviews required minimum distribution rules as well as paid time off contributions.
Uploaded: November 9, 2010
IRS Employee Plans News - March 2012
The March 2012 issue has articles on new guidance encouraging plans to offer lifetime income options, an update on the Determination Letter Program, the IRS’ 401(k) plan projects and other employer plan-related topics.
Uploaded: April 17, 2012
IRS Employee Plans Newsletter - December 2011
This issue of the IRS Employee Plans Newsletter outlines significant changes to the Employee Plans Determination Letter Program and also provides a cumulative list of changes in plan qualification requirements for 2011.
IRS December Employee Plans Newsletter
Uploaded: December 20, 2011
IRS Employee Plans Newsletter - October 2011
This issue of the IRS Employee Plans Newsletters contains a number of articles of interest to employers, including a 2011-2012 Priority Guidance Plan.
IRS October 2011 Employee Plans Newsletter
Uploaded: December 20, 2011
IRS Fall 2011 Retirement Plan Newsletter - Employers
The Fall edition of this IRS newsletter has articles on 2012 salary deferral contributions, paying retirement benefits and an update on the IRS’s 401(k) Compliance Check Questionnaire Project.
Uploaded: January 17, 2012
IRS Summer 2011 Retirement Plan Newsletter - Employers
The IRS’ summer 2011 newsletter for employers who sponsor retirement plans contains articles on avoiding and correcting compensation errors in retirement plans and on withholding federal income tax on plan distribution. The newsletter also contains useful links to IRS educational materials for plan sponsors as well as links to the DOL/EBSA website.
IRS Summer 2011 Retirement Plans Newsletter
Uploaded: August 24, 2011
In-Plan Roth Rollovers—New Guidance and 2010 Forms 1099-R and 8606 Reporting Instructions
This article on the IRS website outlines the main features of the agency’s November 2010 guidance concerning in-plan Roth rollovers.
Roth In-Plan Rollovers - IRS Guidance
Uploaded: November 26, 2010
New Safe Harbor Rollover Explanations and Other Helpful Retirement Plan Guidance from the IRS
This Sibson Consulting Compliance Alert reviews information from the IRS on safe harbor rollovers, rollovers to Roth IRAs, sample plan amendments for automatic features in 401(k) plans, and guidance on paid time off contributions to profit sharing or 401(k) plans.
Uploaded: November 9, 2010
Non-Qualified Deferred Compensation – IRS Requires Review of Compensation Agreements
This Benefits Alert from law firm Nixon Peabody concerns a new IRS requirement for employers to review compensation agreements that make payments contingent upon the recipient signing a release.
Non-Qualified Plans - Review of Agreements
Uploaded: November 4, 2010
PBGC - 2010 Maximum Insurance Benefit
This October 2009 press release from the Pension Benefit Guaranty Corporation announced the maximum insurance benefit for participants in underfunded pension plans terminating in 2010 will be $54,000 per year for those who retire at age 65. The announcement includes a chart showing the maximum annual monthly benefits for retirees and survivors beginning from age 45 to 75.
Uploaded: October 25, 2010
PBGC - 2010 Pension Insurance Premiums Fact Sheet
This PBGC Fact Sheet provides information on insurance premiums for 2010.
Uploaded: October 25, 2010
The Fix Is In – Common Plan Mistakes
Articles from the Retirement News for Employers present common mistakes that happen in retirement plans. They describe the problem, how it happened, how to fix it and how to lessen the probability of the problem happening again.
IRS - Common Retirement Plan Mistakes
Uploaded: October 15, 2010
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