Health & Welfare Plans Newsletter

January 31, 2017

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Defined Contribution Plan / 401k Plan Administrator
N.A. Falcone & Associates, Inc.
in PA

Employee Benefits Associate
Akerman LLP
in FL

Staff Attorney
Groom Law Group
in DC

Senior Pension Administrator
Scholz & Friends Enlightened Retirement Group, Inc.
in TX

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[Guidance Overview]

Medicare Updates Affect Employer Reporting Requirements
"[F]rom April 1, 2018 through December 31, 2019, CMS will begin issuing Medicare Beneficiary Identifiers (MBI) to replace the Social Security Number (SSN) based Health Insurance Claim Number (HICN) currently in use.... For all settlements with Medicare beneficiaries that have the impact of releasing medical care issues, employers and/or insurers should request the MBI to use when reporting the settlement to CMS or determining its potential reimbursement interests based on conditional payments."
Ice Miller LLP

[Advert.]

Successful benefits programs start here

Sponsored by Health & Benefits Leadership Conference

Looking to achieve better bottom-line results through more strategically driven healthcare, wellness and benefits programs? Then join your fellow HR and benefits leaders at HBLC this spring. Register now with Promo Code H17 to save an extra $75.00!


The Return of Health Reimbursement Arrangements
"Small businesses that had been offering health reimbursement arrangements to their employees, under which the business reimburses the employee for individually obtained health insurance coverage, and were forced to stop under threat of penalties imposed under the [ACA], may now return to health reimbursement arrangements if some additional requirements are met. In addition, small businesses that were living under a rock and never altered their health reimbursement arrangements in the face of penalties now have a penalty waiver, but may still have to alter their arrangements somewhat to meet some new requirements."
Accounting Today

In the Seventh Circuit, Another Wellness Litigation Setback for the EEOC
"The EEOC asserted that the disputed wellness program, which required employees to complete a medical questionnaire and undergo biometric testing as conditions to receiving employer-subsidized health insurance, violated a prohibition on involuntary medical examinations under the Americans with Disabilities Act (ADA). Without ruling on the case's merits, the Seventh Circuit affirmed a district court decision to dismiss the case." [EEOC v. Flambeau, No. 16-1402 (7th Cir. Jan. 25, 2017)]
Practical Law Company

Wellness Programs: Key Concerns for Evolving Compliance
"[T]he EEOC continues to take the position that the ADA's safe harbor for insurance does not apply to an employer's decision to offer rewards or impose penalties, and it will be important for employers to watch how this area of the law develops in the courts.... [EEOC rules under GINA] prohibit group health plans (including the wellness programs associated with them) from incentivizing the disclosure of genetic information. This means that your standard program that includes a premium reduction incentive cannot take advantage of the EEOC's new rules."
Poyner Spruill LLP

EEOC v. Flambeau, Judicial Restraint, and the Uncertain Future of Employer-Sponsored Wellness Programs
"The Seventh Circuit's decision on appeal is a model of judicial restraint. (This is the doctrine that holds that cases ought to be decided on the narrowest grounds possible.) Flambeau 'won' on appeal only in the narrow sense that it avoided liability. The Court did not reach the statutory or regulatory issues before it. Rather, it disposed of the case on procedural grounds." [EEOC v. Flambeau, No. 16-1402 (7th Cir. Jan. 25, 2017)]
Mintz Levin

[Advert.]

Online Learning Course: COBRA

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

Even though the ACA has made health care coverage easier for individuals to obtain, group insurance plans must continue to offer COBRA coverage. This course will explain the technicalities of COBRA, including who is entitled and how it must be administered.


Choosing a Wellness Vendor That Gets Results (PDF)
"[An] organization should invest the time to understand its own internal culture, business needs and goals.... It's important to know the level of trust employees have with a company and whether they are open to sharing personal information online with other parties or if they view this as an invasion of privacy.... When evaluating a vendor, know in advance where its online tools and demos -- which can be very persuasive -- fit into overall wellness program needs."
benefits Magazine, published by the International Foundation of Employee Benefit Plans [IFEBP]

DOL Highlights Growth in MHPAEA Enforcement
"Of the 330 health plan investigations closed in the 2016 fiscal year by the [EBSA], 191 included [Mental Health Parity and Addiction Equity Act (MHPAEA)] compliance audits because they involved plans subject to the MHPAEA ... EBSA conducts compliance reviews in all open cases where MHPAEA applies. Many of these stem from individual plan participants' complaints, if the violations seem to be systematic.... In addition to these DOL investigations, MHPAEA lawsuits by plan participants are on the rise, and the [IRS] has the authority to impose excise taxes for violations."
HR Daily Advisor

America's Health Care Coverage at a Glance
Chart shows number and percentage of total covered individuals, according to type of plan: employer-sponsored, Medicare, Medicaid, or ACA Exchange.
Energy and Commerce Committee, U.S. House of Representatives

2017 Health Insurance Exchanges: Evaluating the Online Comparison-Shopping Experience (PDF)
38 pages. "Three exchanges ... offer both integrated provider and prescription drug directories.... Four exchanges ... offer integrated provider directories, but not prescription drug directories. Eight exchanges ... offer an out-of-pocket cost calculator.... The DC Health Link's exchange ranked first overall, scoring 92 out of a possible 100 ... HealthCare.gov, the federally-facilitated exchange that serves 39 states, ranked third ... scoring 81 out of a possible 100.... The average exchange website scored 66 out of a possible 100[.]" [Also online: 2017 Insurance Exchange Website scorecard.]
Clear Choices

[Opinion]

Nine Things to Know About the Cassidy-Collins 'ACA Replacement'
"[1] Millions of people would lose coverage.... [2] The benefits would be much worse.... [3] Costs would spike for older enrollees.... [4] They are not telling the whole truth about pre-existing conditions.... [5] Costs would increase for most enrollees.... [6] Consumers will be unable to use their coverage.... [7] The PFA includes a shocking violation of consumer choice.... [8] Consumer information will be reduced.... [9] Implementation will fail."
National Health Law Program [NHeLP]

Benefits in General

How Much Should a Medicare Beneficiary Save for Health Expenses? Some Couples Need $350,000 (PDF)
"In 2016, a 65-year-old man would need $72,000 in savings and a 65 year-old woman would need $93,000 if each had a goal of having a 50 percent chance of having enough savings to cover health care expenses in retirement.... A couple with median prescription drug expenses would need $165,000 if they had a goal of having a 50 percent chance of having enough savings to cover health care expenses in retirement.... For a couple with drug expenses at the 90th percentile throughout retirement who wanted a 90 percent chance of having enough money saved for health care expenses in retirement by age 65, targeted savings would be $349,000 in 2016."
Employee Benefit Research Institute [EBRI]

Executive Compensation and Nonqualified Plans

[Guidance Overview]

ISO and ESPP Reporting and Disclosure Requirements for Employers
"You must furnish an information statement on Form 3921 (ISO) or Form 3922 (ESPP), as applicable, to each employee (or former employee) by January 31, 2017; you must also file information returns with the [IRS] by February 28, 2017, if filing on paper, or March 31, 2017, if filing electronically."
Hanson Bridgett LLP

Tax Reporting for Stock Compensation: Understanding Form W-2, Form 3922, and Form 3921
"Making sense of Form W-2 when stock compensation is reported ... Form 3922 for ESPPs and Form 3921 for ISOs ... Sell shares in 2016? The fun is just beginning."
myStockOptions.com

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David Rhett Baker, J.D., Editor and Publisher  davebaker@benefitslink.com
Holly Horton, Business Manager  hollyhorton@benefitslink.com

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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