Health & Welfare Plans Newsletter

November 11, 2015

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Internal Sales Consultant
Pentegra Retirement Services
in ANY STATE, NC, NY, OH

Implementation Specialist - Retirement Plans
HowardSimon
in IL

Pension Administrator
Comprehensive Pension Administration Firm
in CA

Plan Specialist 140003R2
Transamerica
in NY

DC Plan Administrator
The Benefit Advantage
in ANY STATE

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Webcasts and Conferences

Employer Penalties Under Code § 4980H: What We’ve Learned and What We Expect for 2016
December 10, 2015 WEBCAST
(Thomson Reuters / EBIA)

Sixth Annual Accountable Care Summit
December 10, 2015 WEBCAST
(Healthcare Web Summit)

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Discussions


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[Official Guidance]

Text of 2016 Instructions for IRS Forms 1099-SA and 5498-SA (PDF)
"File Form 1099-SA, Distributions From an HSA, Archer MSA, or Medicare Advantage MSA, to report distributions made from a health savings account (HSA), Archer medical savings account (Archer MSA), or Medicare Advantage MSA (MA MSA). The distribution may have been paid directly to a medical service provider or to the account holder. A separate return must be filed for each plan type. Transfers. Do not report a trustee-to-trustee transfer from one Archer MSA or MA MSA to another Archer MSA or MA MSA, from an Archer MSA to an HSA, or from one HSA to another HSA. For reporting purposes, contributions and rollovers do not include transfers." (Internal Revenue Service [IRS])  


[Advert.]

Institute for Apprenticeship, Training and Education Programs

Sponsored by International Foundation of Employee Benefit Plans [IFEBP]

A looming skills shortage offers opportunities for apprenticeship programs. Learn from experts how to effectively manage training trust funds and best practices for recruitment, retention, adult learning and fiduciary responsibility. Register Today!



[Guidance Overview]

Text of CMS Announcement: 2016 Medicare Parts A & B Premiums and Deductible Amounts
"[T]he annual deductible for all Part B beneficiaries will be $166.00 in 2016.... The Medicare Part A annual deductible that beneficiaries pay when admitted to the hospital will be $1,288.00 in 2016, a small increase from $1,260.00 in 2015. The Part A deductible covers beneficiaries' share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period ... The daily coinsurance amounts will be $322 for the 61st through 90th day of hospitalization in a benefit period and $644 for lifetime reserve days. For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 in a benefit period will be $161.00 in 2016 ($157.50 in 2015)." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Official Guidance]

Text of CMS FAQs and Submission Forms for FFM User Fee Adjustment Submission Requirements (PDF)
"The information submission will: [1] determine the discount that CMS will apply to the user fee that the issuer pays CMS in order to participate on the FFM; [2] ensure that these user fee adjustments reflect payments for contraceptive services paid for under this accommodation, and [3] ensure that the adjustment is applied to the appropriate participating issuer in an FFM." Q&As in this document address: [1] Federally-facilitated Marketplace (FFM) user fee adjustments for contraceptive payments; [2] Submission process and deadlines; [3] Eligible submitters; [4] Claims reporting and user fee calculation; and [5] Transfer of user fee adjustment amount to FFM issuers. Also available are forms and spreadsheets: TPA Notice of Intent Disclosure Form; Issuer Contraceptive User Fee Adjustment Form; and TPA/PBM Contraceptive User Fee Adjustment Form. (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Guidance Overview]

CMS Webinar: Federally-Facilitated Marketplace (FFM) User Fee Adjustments for Contraceptive Payments (PDF)
43 presentation slides. "This stakeholder training session will: [1] Explain the FFM user fee adjustment policy. [2] Discuss the requirements issuers and TPAs/PBMs must follow to receive a user fee adjustment. [3] Explain how to complete and submit the issuer and TPA/PBM User Fee Adjustment Forms. [4] Provide an example of a user fee adjustment calculation." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

Is This Health Cost-Cutter Worth the Morale Hit?
"Backlash appears to be the major factor that's keeping employers from taking advantage of the benefits of a spousal carve-out.... [F]irms should stress how the savings will directly benefit employees by telling them the carve-out may prevent premium increases or allow the company to avoid switching to a higher deductible plan for more narrow (i.e., 'restrictive) networks." (HR Benefits Alert)  

CMS Enters Pricey Hepatitis C Drug Debate
"The letters [sent by CMS to Medicaid directors of all 50 states and four drug manufacturers] were all related to the cost of those drugs, which can run upwards of $90,000 for the course of treatment.... CMS said it was interested in learning about what, if any, 'value-based' purchasing (VBP) arrangements are being offered to private plans and Medicaid plans. The agency said it thinks VBP arrangements may help get the best price for the drugs. CMS also warned against states limiting access to the drugs on the basis of cost." (Bloomberg BNA)  

Benefits in General; Executive Compensation

Death and Employee Benefits: How to Prepare for the Worst
"Ensure your life insurance is adequate and your beneficiary designations are up to date. Understand what benefits coverage you and your spouse have through your employers, and read your employee benefit booklets. Record policy numbers and important contact information (such as your employers' HR departments) and store them in a logical place that your partner knows about -- not on your password-protected cell phone. If you have a safety deposit box that isn't jointly held with your spouse, don't forget about that, either." (Buck Consultants)  

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