Health & Welfare Plans Newsletter

February 14, 2017

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Employee Benefits Jobs

401(k) Plan Administrator
BlueStar Retirement Services
in FL

Experienced Attorney
Boutique Consulting Firm
in CO

Employee Benefits Associate
Thompson Hine LLP
in OH

Pension Actuary
Aldrich Retirement Solutions [formerly named AKT]
in AK, AZ, CA, ID, NV, OH

Pension Administrator
Aldrich Retirement Solutions (formerly name AKT)
in AK, AZ, CA, ID, NV, OH, OR

Retirement Plan Specialist
Transamerica
in CO

Account Representative
Nolan Financial
in MD, Telecommute

Technical Specialist
Professional Capital Services
in PA

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Webcasts and Conferences

What You Need to Know About the Changing World of Executive Compensation and Reporting
February 22, 2017 in IL
Worldwide Employee Benefits Network [WEB] - Chicago West Chapter

Getting It Right- Know Your Fiduciary Responsibilities
March 23, 2017 in NV
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

HRAs, HSAs, and Health FSAs: New Rules, Existing Rules, and Possible Changes to Come May Require New Action by Employers
April 18, 2017 WEBCAST
HRWebAdvisor

EBIA Advanced Cafeteria Plans and Benefits Conference
July 12, 2017 in CA
Thomson Reuters / EBIA

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[Official Guidance]

Text of IRS Publication 969: Health Savings Accounts and Other Tax-Favored Health Plans, for Use in Preparing 2016 Returns (PDF)
22 pages; Feb. 10, 2017. "An HSA may receive contributions from an eligible individual or any other person, including an employer or a family member, on behalf of an eligible individual.... An Archer MSA may receive contributions from an eligible individual and his or her employer, but not both in the same year... A Medicare Advantage MSA is an Archer MSA designated by Medicare to be used solely to pay the qualified medical expenses of the account holder who is enrolled in Medicare.... A health FSA may receive contributions from an eligible individual. Employers may also contribute.... An HRA must receive contributions from the employer only. Employees may not contribute."
Internal Revenue Service [IRS]

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[Guidance Overview]

DOL Gives a Peek at Non-quantitative Treatment Limitations
"[A recent DOL Fact Sheet] provides some examples of violations of the [mental health parity] rule: [1] A categorical exclusion for 'chronic' behavior disorders ... when there was no similar exclusion for medical/surgical 'chronic' conditions. [2] No coverage resulting from failure to obtain prior authorization for mental health benefits ... [3] A categorical exclusion for all residential treatment services for mental health benefits. [4] Requiring prior authorization for all mental health benefits when that requirement does not apply to medical/surgical benefits. [5] Requiring a written treatment plan and follow-up for mental health benefits when no similar requirements were imposed on medical/surgical benefits."
Benefits Bryan Cave

[Guidance Overview]

Congress Allows Small Employers to Pay for Individual Policies of Insurance (PDF)
"The Act allows small employers to pay or reimburse employees for the cost of coverage under an individual policy of health insurance, but only if certain conditions are met ... Because the Act was enacted so late in the year, it may be difficult for small employers to take advantage of it during 2017, particularly if they are already offering coverage under a group policy issued in the small group market."
Hinkle Law Firm LLC

[Guidance Overview]

HIPAA for HR: Some Good News for Employers
"[E]mployers providing health coverage to their employees through a health insurance policy will generally not be responsible for HIPAA compliance ... The story is different, however, for those employers who sponsor health plans on a 'self-insured' basis ... Most of the information contained in an employer's personnel files and records is not PHI.... Employers may be subject to various state privacy laws, which afford different and additional protections to employees than does HIPAA."
Foley & Lardner LLP

[Guidance Overview]

Local and State Developments Impact San Francisco Paid Parental Leave Obligations
"The [San Francisco Paid Parental Leave Ordinance (SF PPLO)] took effect on January 1, 2017 (for employers with 50 or more employees), and the San Francisco Office of Labor Standards Enforcement has also adopted final rules implementing the SF PPLO, published a required form and poster, and issued supplemental compensation calculation instructions. Additionally, the California Employment Development Department has increased the maximum weekly benefit under the California Paid Family Leave insurance program, which impacts the SF PPLO supplemental compensation amount that must be paid to employees."
Littler

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Employer Must Inquire Further When Employee Seeks FMLA Leave to Care for Ailing Grandparent
"The lower court ruled that the employee's failure to inform the employer that he had an in loco parentis relationship with his grandfather was dispositive. However, after the employee expressly requested leave to care for his grandfather, the employer was obligated to specify any additional information that it needed to determine whether the employee was entitled to such leave, the appeals court held." [Coutard v. Municipal Credit Union, No. 15-1113 (2d Cir. Feb. 9, 2017)]
Wolters Kluwer

Employer's Honest Belief Sufficient to Defeat FMLA Retaliation Claim
"As an employee claiming retaliation for using protected FMLA leave must prove that the very exercise of that right was a determinative factor in the employer's decision to take adverse action against her, ... [employers] can now successfully defend against claims simply by showing they believed in good faith that the employee misused what was otherwise protected leave. While the Seventh, Eighth, and Tenth Circuits have reached similar decisions, this was previously an open issue in the Third Circuit." [Capps v. Mondelez Global, LLC, No. 15-3839 (3d Cir. Jan. 30, 2017)]
Greenberg Traurig

Do Employees Truly Understand the Advantages of an HDHP/HSA?
"While high deductibles can initially scare your employees away, once they compare the overall savings of a lower HDHP premium and the tax advantages of an HSA, they might become a more tempting choice. Make a few subtle changes when you communicate the HDHP/HSA plan and your participation might just go up[.]"
Frenkel Benefits

Anthem-Cigna Merger Denial Should Give Future Mega-Merger Proponents Pause
"Judge Amy Berman Jackson ... said the merger would disrupt competition in the market for 'national accounts' and wouldn't create any merger-specific efficiencies that could excuse that disruption. Jackson's decision comes only two weeks after her colleague on the court, Judge John D. Bates, stopped the proposed $37 billion merger of Aetna Inc. and Humana Inc.... [T]he combined force of both decisions [may] frustrate other proposed mega-mergers in the health insurance industry."
Bloomberg BNA

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Aetna, Humana Walk Away from $34 Billion Deal After Court Ruling
"Health insurers Aetna Inc and Humana Inc walked away from their $34 billion merger deal on Tuesday, after a U.S. judge ruled in January the combination would stifle competition in the private Medicare Advantage program for retirees.... Aetna will pay Humana a $1 billion breakup fee, or $630 million after taxes, and terminated its plan to sell some Medicare Advantage assets to Molina Healthcare Inc[.]"
Reuters

Potential Effects of Expansion of Association Health Plans (PDF)
"[Association health plans (AHPs)] could create adverse selection concerns if they operate under different rules.... AHPs face increased insolvency risk without clearly defined regulatory authority.... AHPs would need to be subject to state-level consumer protection laws.... AHPs would be unlikely to obtain lower provider payment rates than larger insurance companies."
American Academy of Actuaries

Potential Impact of Selling Health Insurance Across State Lines (PDF)
"Allowing insurers to sell coverage across state lines has limited potential for premium savings, as premiums would continue to reflect local health care costs. Out-of-state insurers could have difficulty developing provider networks and negotiating provider payment discounts. Unintended consequences could result if states are given more flexibility regarding benefit requirements or issue and rating rules. Adverse selection would occur, threatening the viability of insurers licensed in states with more restrictive requirements."
American Academy of Actuaries

Republicans Keep Changing When Obamacare Will Be Repealed, Yet Health Insurers Have a Deadline Coming Up
"The political clarity [health insurers] are seeking will affect how they design and price 2018 individual market plans, and even whether they participate in the ACA's exchanges at all. As much clarity as possible by March 'would be helpful,' said Kristine Grow, [spokesperson for] America's Health Insurance Plans. But key Republican figures have offered varying deadlines: March or April, or sometime this year, or maybe even next year."
MarketWatch

[Opinion]

American Benefits Council Warns Against Legislation That Would Tax Employees' Health Insurance
"In a series of letters to the White House today on behalf of the employer community and the employer -- sponsored system generally, the Council offered clear and compelling arguments that a so-called 'cap' on the tax exclusion for employee health insurance would be a big mistake."
American Benefits Council

Benefits in General

[Official Guidance]

Text of IRS Disaster Relief Announcement LA-2017-01 for Victims of Severe Storms in Louisiana
"Victims of the severe storms, tornadoes, and straight-line winds that took place beginning on February 7, 2017 in parts of Louisiana, may qualify for tax relief from the [IRS].... Individuals who reside or have a business in Livingston or Orleans parishes may qualify for tax relief."
Internal Revenue Service [IRS]

[Guidance Overview]

Which Plans are Subject to the DOL's Final Rules for Disability Claims Procedures?
"The DOL noted that nearly two-thirds of all ERISA litigation involves claims under long-term disability plans, and the final rules are intended to improve the 'full and fair review' of disability claims ... by expanding the procedural requirements.... In order for the new rules to apply, both of the following must be true: [1] the plan must make disability determinations affecting plan benefits; and [2] the plan must be subject to ERISA's claims procedures."
Haynes and Boone, LLP

Executive Compensation and Nonqualified Plans

[Guidance Overview]

IRS Chief Counsel Memo: No More Closing Agreements Under FICA 'Special Timing Rule'
"[Chief Counsel Memorandum AM2017-01] raises the stakes for employers that fail to apply the proper FICA taxation rules to nonqualified deferred compensation. An option previously available to those employers has been taken off the table. Under this option -- which required a formal 'Closing Agreement' with the IRS -- both employer and employee FICA taxes could be minimized by voluntarily paying those taxes for years as to which IRS assessments were otherwise barred under the Tax Code's three-year statute of limitations. Without this correction option, employers have an even greater incentive to apply the proper FICA taxation rules to their deferred compensation arrangements."
Spencer Fane

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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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