Health & Welfare Plans Newsletter

February 17, 2017

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Client Account Manager
Burnham Gibson Wealth Advisors
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American National
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Webcasts and Conferences

Everything You Need to Know about Small Business HRAs
February 28, 2017 WEBCAST
WEX Health

14th National Forum on ERISA Litigation
March 1, 2017 in IL
American Conference Institute

2017 Mid-Sized Retirement & Healthcare Plan Management Conference
September 17, 2017 in TX
University Conference Services

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[Guidance Overview]

Unpacking the Trump Administration's Market Stabilization Proposed Rule
"The proposal states that HHS intends to issue guidance delaying 2018 filing deadlines, which likely will give insurers additional time to adjust to the new rules, but deadlines cannot be delayed long.... The first issue addressed by the NPRM is guaranteed availability.... The NPRM proposes reducing the open enrollment period for 2018.... The NPRM preface asks for comments on establishing continuous coverage requirements to discourage adverse selection and encourage continuous coverage.... The NPRM states that it is the intention of HHS to, beginning with the 2018 plan year, rely on state regulators to ensure network adequacy[.]"
Timothy Jost, in Health Affairs

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[Guidance Overview]

Trump Administration Proposes Insurer-Friendly Rule Modifying ACA Exchanges
"The short 20-day comment period indicates that the administration has a desire to implement changes quickly. According to an HHS press release, the Proposed Rule aims to 'stabiliz[e] the individual and small group health insurance markets' by shortening the 2018 enrollment period, lowering insurers' minimum standards for care to qualify for the exchanges and forcing beneficiaries to pay back owed premiums prior to obtaining coverage for the next year."
Carlton Fields

[Guidance Overview]

D.C. Passes Nation's Most Expansive Paid Family and Medical Leave Law
"[All] private D.C. employers will be required to pay what effectively is a payroll tax by contributing an amount equal to 0.62 percent of the wage of each of their covered employees to a Universal Paid Leave Implementation Fund ('Fund'). Collections for the Fund will begin by July 1, 2019, and employees may begin to receive payment under Universal Paid Leave beginning on July 1, 2020."
Epstein Becker Green

Anthem Wins Restraining Order Blocking Cigna's Withdrawal from Merger
"On [Feb. 15], Anthem won a temporary restraining order that blocks Cigna Corp. from immediately terminating the $54 billion merger. Anthem had filed the lawsuit in a Delaware court to compel Cigna to comply with the merger agreement that has been extended until April 30.... In its own lawsuit filed in Delaware, Cigna is asking for the $1.8 billion breakup fee plus $13 billion in damages."
Healthcare Finance News

Health Savings Accounts: A Growing Tool for Consumers (PDF)
"As of January 2016, 59 plans offering HSA/HDHPs reported approximately 20.2 million HSA/HDHP enrollees, up from 19.7 million in 2015, or an annual increase of 2.5 percent.... The [largest group] of HSA/HDHP enrollees (35 percent) were ages 45-64, with 30 percent ages 25-44 ... Large group plans (firms with more than 50 employees) accounted for over 75 percent of all HSA/HDHP enrollment."
America's Health Insurance Plans [AHIP]

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$5.5M Settlement Reminds Health Plans to Implement and Audit HIPAA Compliance
"MHS' failure to follow through to implement the controls required by its policies and audit and enforce compliance with HIPAA and its HIPAA policies was a costly mistake.... [H]ealth plans, their sponsors, fiduciaries and business associates should take documented action to audit and correct ... their operational compliance with HIPAA to mitigate their exposure to similar enforcement action for HIPAA violations."
Solutions Law Press

IRS Issues 2016 Version of Publication 463 on Travel, Entertainment, Gift, and Car Expenses
"Publication 463 ... is especially detailed and useful in its handling of the deductions for business use of an employee's vehicle. Those deductions will not apply if the employee's expenses are reimbursed under an accountable plan, in which case the employer reimbursements are excluded from income and the vehicle expenses are not deductible by the employee."
Thomson Reuters / EBIA

Got an Employee Who Doesn't Follow Your FMLA Call-in Policy? Apparently, You Now Have to Ask Him Why He Couldn't
"Even though Johnny failed to comply with the employer's call-in policy, the DOL took the position that his absences were nevertheless FMLA protected simply because he invoked the FMLA when he finally did make contact with the Company. Why is this so? The DOL investigator explained that the DOL reads into the cited regulation above a requirement that the employer must affirmatively ask the employee why he could not follow the employer's call-in procedures. Yet, this so-called obligation can be found nowhere in the FMLA regulations."
FMLA Insights

Mastering Tough FMLA Issues: Substitution of Paid Leave
"In order to require employees to substitute paid leave for FMLA leave, you would need to provide notice of that requirement in the Rights and Responsibilities Notice. If you don't provide such notice, then the employee will be allowed to choose whether to use the two types of leave concurrently or consecutively. That could mean: [1] Using up all of their paid leave first, then using their 12 weeks of unpaid FMLA leave (or 26 weeks of military caregiver leave); [2] Saving their paid leave for other purposes; or [3] Choosing to have their paid leave run concurrently with FMLA leave. These options also need to be explained in the Rights and Responsibilities Notice."
HR Daily Advisor

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Interactive Tool Compares Proposals to Replace the ACA
Plans available for comparison: [1] The ACA, 2010; [2] Rep. Tom Price's Empowering Patients First Act, 2015; [3] House Speaker Paul Ryan's A Better Way: Our Vision for a More Confident America, 2016; [4] Sen. Bill Cassidy's Patient Freedom Act, 2017; and [5] Sen. Rand Paul's Obamacare Replacement Act, 2017.
Henry J. Kaiser Family Foundation

Small Business Health Fairness Act Fact Sheet
"Introduced by Rep. Sam Johnson (R-TX), chairman of the Subcommittee on Social Security, and Rep. Tim Walberg (R-MI), chairman of the Subcommittee on Health, Employment, Labor, and Pensions, the Small Business Health Fairness Act (H.R. 1101) would empower small businesses to band together and offer coverage through AHPs to purchase quality health care coverage at a lower cost for their employees."
Committee on Education and the Workforce, U.S. House of Representatives

IRS: ACA's Coverage Requirement Still in Effect
"[F]or tax year 2016 [the IRS had] planned to reject silent returns at the time of filing and instruct the taxpayer to correct the omission ... But the President's January 20 order prompted the agency to stop those plans, and the IRS recently informed tax preparation software vendors that it would continue to accept silent returns."
Center on Budget and Policy Priorities

Has the ACA Been a Job Killer? 2016 Update
"[T]hrough 2016, the ACA had little to no adverse effect on employment and usual hours worked per week. Levels of part-time work (29 or fewer hours per week) have fallen since 2014, but remain at somewhat higher levels than would be expected at this stage of the economic recovery.... Involuntary part-time employment was lower than expected. These findings suggest that the ACA did not lead to widespread cutbacks in workers' hours by employers attempting to avoid employer mandate penalties[.]"
Urban Institute

[Opinion]

Insurers, Not Government, Will Lead the Way to Lower Healthcare Costs
"In seeking solutions to the healthcare crisis, politicians have a different focus than insurers. Access is the politician's biggest concern -- how to address the needs of the greatest number of their constituency with the least friction possible.... Health insurance carriers, in contrast, concern themselves most with cost considerations in order to remain competitive in the marketplace.... [A] government-led solution will not work."
Frenkel Benefits

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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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