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[Guidance Overview]
ACA Reporting Is Coming: Is Your Company Prepared? (PDF)
"This [article] presents a high-level, non-exhaustive checklist of action items for employers preparing to report, and briefly discusses notable changes in the final instructions for issuer reporting."
(Seyfarth Shaw LLP)
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[Guidance Overview]
Changes to Paid Sick Time in New Jersey
"On October 29, 2015, the City Council in Jersey City, New Jersey voted to broaden the scope of its paid sick leave ordinance, which was enacted in 2013. Just five days later, on November 3, 2015, voters in Elizabeth, New Jersey approved a paid sick leave law, becoming the 10th municipality in New Jersey to require private employers to provide paid sick time to their employees."
(Littler)
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What's Left to Prepare For, Now That ACA Auto-Enrollment Is Gone?
"With the repeal of the auto-enrollment provisions, there are only two major ACA items yet to take effect for employer-sponsored group health plans. [1] Nondiscrimination rules for fully insured plans ... The Departments continue to informally suggest that these insured plan nondiscrimination rules are not a high priority at the moment, and therefore it does not appear that any guidance is imminent.... [2] The granddaddy of them all: the Cadillac Tax -- effective 2018."
(ABD Insurance & Financial Services)
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Cumulative and Updated List of Introduced or Enacted Bills to Repeal, Defund, Delay or Amend the ACA (PDF)
20 pages. "This report summarizes legislative actions taken to repeal, defund, delay, or otherwise amend the ACA since it was enacted. The information is presented in three tables: Table 1 summarizes the ACA changes that have been signed into law. Table 2 lists all the House-passed ACA bills. Table 3 details the ACA repeal provisions in the reconciliation bill." [Report No. R43289, dated Nov. 4, 2015.]
(Congressional Research Service [CRS])
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High Deductible Health Plans Are on the Rise
"For small firms, 69% of workers have a deductible of $1,000 or more compared to only 39% of workers employed at large firms.... Most workers (99%) have a plan that covers prescription drugs and most workers (94%) are in plans that cover specialty drugs, but 81% have plans that use three or more drug tiers to determine patient copayment amounts."
(Healthcare Economist)
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Health Systems Dipping Into the Business of Selling Insurance
"It's not surprising that health systems might get into the insurance business. Doing so funnels more patients to a health system's hospitals and doctors. And it makes sense that combining clinical and claims data under one roof could lead to better coordinated, more cost-efficient patient care.... Yet even though health care systems can gain insurance know-how by partnering with or acquiring an insurer or third party administrator to handle claims, compliance and customer service, putting it all together can be challenging."
(Kaiser Health News)
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Universal Health Care Amendment Qualifies for 2016 Colorado Ballot
"Coloradans officially will vote next year on whether to establish the first statewide universal health-care system in the country.... Amendment 69, as the measure will be known, would eliminate all of the existing health-insurance plans being sold in the state and replace them with one government-administered plan that will be funded with a 9 percent payroll deduction per employee. Backers say it would save roughly $5 billion on health care spending by eliminating administrative expenses associated with the insurance industry, which would be wiped out in this state, and by allowing the state to negotiate bulk rates for pharmaceuticals."
(The Business Journals)
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People with ACA Plans Are the Least Satisfied with Health System Among Insured Individuals
"Americans with veterans or military health, Medicare, and Medicaid have a higher satisfaction with the way the healthcare system works for them. Satisfaction is lower among those with employer-sponsored and self-paid insurance ... Overall, 67% of Americans are satisfied with the US health system in 2015, which is up slightly from 66% in November 2014.... Those people with health insurance purchased through the Affordable Care Act's exchanges are the least satisfied among people with insurance. According to Gallup, this may be a result of higher deductibles and co-pays for the silver-level ACA plans compared with employer-sponsored plans."
(American Journal of Managed Care)
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[Opinion]
ERIC Comment Letter to HHS on Proposed Regs for Nondiscrimination in Health Programs (PDF)
16 pages. "As interpreted in the Department's proposed regulation, this provision would extend far beyond its statutory boundaries, and would inappropriately encumber the design and day-to-day operation of employer group health plans that do not receive any form of Federal financial assistance.... Employers and the plans they sponsor are already subject to a complex web of Federal statutes and regulation s that prohibit all of these forms of discrimination, and more.... [T]he Department's proposed rule does not adequately reflect the way in which self-funded group health plans are designed and administered. The proposed rule would disrupt the administration of these plans and increase health care costs for employers and employees alike, without adding any additional protection against discrimination."
(The ERISA Industry Committee [ERIC])
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[Opinion]
Chamber of Commerce Comment Letter to HHS on Proposed Regs for Nondiscrimination in Health Programs (PDF)
"The Department estimates that the NPRM will impose aggregate costs of $939.4 million over the first five years, much of which will be concentrated in the first year of implementation. Consideration of the notable omissions, errors, and questionable assumptions found in the Department's analysis suggests that the actual cost may be several times higher. Costs of this magnitude are a burden that may sensibly affect the cost and availability of health insurance and of health care services, adversely impacting achievement of the Affordable Care Act's goals of expanding access to health insurance and of improving the health of citizens. The Department has not adequately considered these indirect, derivative impacts of the NPRM."
(U.S. Chamber of Commerce)
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Benefits in General; Executive Compensation
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Transcript of Oral Argument Before the Supreme Court on Tracing Requirement for Equitable Recovery of Overpayments by ERISA Plans (PDF)
"[Chief Justice Roberts, to counsel for Petitioner Montanile:] I'm just wondering if the solution you're advocating is going to make life a lot more complicated and expensive for the funds, which is, of course, contrary to the idea of preserving the assets.... [Chief Justice Roberts, to counsel for Respondent Health Plan:] It has to be pretty easy for you to protect yourself, doesn't it, at soon as at some suitable time after the injury you do write a letter to the person and say, look, you need to know that if you sue somebody, the money is ours, and because we have these rights of subrogation, or let us know if you're going to, and we'll show up in court with you and ... help you? ... I think your friend has ... a significant point that it's actually not as hard as it might appear." [Bd. of Trustees of the National Elevator Industry Health Benefit Plan v. Montanile, No. 14-11678 (11th Cir. Nov. 25, 2014; oral arg. Nov. 9, 2015)]
(Supreme Court of the United States)
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Is Your Benefits Communication Reaching Your Millennial Employees?
"When it comes to benefits information, the challenge ... has become how to provide the same tech-centric and customer-friendly user experience that millennials have come to expect as everyday consumers.... Effective communication ... involves creativity and revitalizing older strategies: Make information available anytime, anywhere ... Speak to each individual, not the group ... Offer benefits they value ... Don't just talk...listen ... Encourage interaction."
(Frenkel Benefits)
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Press Releases
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David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager
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