Health & Welfare Plans Newsletter

January 23, 2017

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February 7, 2017 in NJ
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Financial Stress in the Defined Benefit System
February 14, 2017 WEBCAST
Society of Actuaries

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[Official Guidance]

Text of IRS Chief Counsel Memo 201703013: Tax Treatment of Benefits Paid by Fixed-Indemnity Health Plans (PDF)
"An employer may not exclude from an employee's gross income payments under an employer-provided fixed indemnity health plan if the value of the coverage was excluded from the employee's gross income and wages. An employer may not exclude from an employee's gross income payments under an employer-provided fixed indemnity health plan if the premiums for the fixed indemnity health plan were originally made by salary reduction through a Section 125 cafeteria plan." [Dec. 12, 2016; released Jan. 20, 2017]
Internal Revenue Service [IRS]

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[Guidance Overview]

End-of-Administration Changes: 21st Century Cures Act, Disability Claims Procedures, and More
"[The 21st Century Cures Act ('Cures')] provides for more enforcement coordination and sharing of information on enforcement efforts.... Cures clarified that if a group health plan subject to the MHPAEA provides coverage for eating disorder benefits, including residential treatment, such benefit coverage must be provided consistent with the MHPAEA.... Cures requires guidance by December 13, 2017 [on relaxed HIPAA] requirements for communications with caregivers of adults with a serious mental illness in order to facilitate treatment. While portions of Cures talk of this solely in reference to health care providers, other provisions refer to this as applying to covered entities in general which would include group health plans."
Winstead PC

Trump Executive Order on ACA: What It Won't Do, What It Might Do, and When
"In sum, nothing happens yet, nor is it likely to happen until the heads of HHS, Treasury, and probably Labor, as well as the CMS Administration and IRS Commissioner are in place; even then it will take a while for changes to be put into motion. In the long run a great deal may change ... But change will only be 'to the maximum extent permitted by law.' There may be, for example, a fairly dramatic shift in the interpretation of section 1332 of the ACA, which permits HHS to grant innovation waivers to states, but waivers will still have to be granted subject to section 1332's requirements. Sale of insurance across state lines is already permitted by the ACA, but subject to state approval and consumer protections that will have to be observed."
Timothy Jost, in Health Affairs

Stolen Pen Drive Results in $2.2 Million HIPAA Settlement
"On January 18, 2017, HHS announced a $2.2 million settlement with the Puerto Rico-based subsidiary of a multinational insurance company for potential HIPAA violations. HHS investigated the subsidiary, which is a HIPAA covered entity and underwriter of life and disability insurance and group health insurance plans, after the subsidiary notified the government of the theft of a pen drive containing electronic protected health information (ePHI)."
Practical Law Company

Court Says Non-Minneapolis Employers Not Likely Required to Comply with City's Paid Sick Time Ordinance
"A Hennepin County Court judge has issued an order temporarily blocking enforcement of Minneapolis's new paid sick time ordinance against employers who are not located within the city limits.... Minneapolis-based employers need to continue preparing for the ordinance's July 1 effective date."
Gray Plant Mooty

CMS Announces 45 ACOs Are Now Participating in Next Generation Model
"For 2017, 28 new participants joined the Next Gen model, bringing the total number of participants to 45. CMS Innovation Center's Next Generation ACO Model was designed to test whether strong financial incentives for ACOs can improve health outcomes and reduce expenditures for Medicare fee-for-service beneficiaries. Provider groups in this model assume higher levels of financial risk and reward than are available under the shared savings program."
Healthcare Finance News

[Opinion]

'Alexa, What Is My Deductible?'
"Benefits technology ... has not had broad adoption by employees. Yes, employers have bought systems or brokers have given them away, but when you look at utilization on the employee side it is abysmal.... [T]he reason for this is because there is not enough value as a stand-alone solution to generate broad adoption."
Joe Markland

[Opinion]

What Does Trump's ACA Executive Order Actually Do?
"The Trump executive order should be seen more as a mission statement, and less as a monarchical edict that can instantly change the law.... [T]he order, crucially, notes that agencies can act only 'to the maximum extent permitted by law.' (How the Trump administration interprets those permissions, of course, is yet untested.) ... The order was not specific and did not direct any particular actions."
The New York Times; subscription may be required

[Opinion]

Is the Trump Administration on Its Way to Its Own 'If You Like Your Health Plan You Can Keep It' Fiasco?
"The short of it is that the Trump administration, by trying to bring relief to some consumers, could just as easily further undermine the already shaky Obamacare risk pool. If the pool were to be made worse than it is now, health plans would be challenged to figure out how they could remain in a market already intended for demolition once the new replacement plan was ready in 2019."
Bob Laszewski's Health Care Policy and Marketplace Review

Executive Compensation and Nonqualified Plans

[Guidance Overview]

That's a FAQ, Jack! New Interpretations from ISS
"On December 19, 2016, ISS issued updates to several of its key FAQs, including those on Equity Compensation Plans, Executive Compensation Policies, and also the explanation of ISS' Pay-for-Performance Mechanics. [This article summarizes] the specific updates under each FAQ and the P4P Mechanics."
EdwardHauder.com

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David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2017 BenefitsLink.com, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.

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