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Hot Topics in Employee Benefits: What We're Seeing - December 2015
December 16, 2015 WEBCAST
(Morgan Lewis & Bockius LLP)

14th Annual Future Care Summit
January 21, 2016 WEBCAST
(Healthcare Web Summit)

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Today's Discussions on the BenefitsLink Message Boards

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[Guidance Overview]

The EEOC and Wellness Programs: The Other Shoe Drops (But It's Not That Bad)
"The GINA statute and the 2010 regulations have a broad definition of 'genetic information' that includes, not only 'true' genetic information like genotypes and DNA tests, but also medical history or examinations of the employee's family members.... It appears that the EEOC is now distinguishing 'true' genetic information (for example, genotypes and DNA tests) from medical history and medical examinations. Very strict rules apply to the former, but the rules relating to the latter are not as strict." (Constangy, Brooks, Smith & Prophete, LLP)  

[Advert.]

Executive Forum on Rewarding Healthy Behaviors – Feb 2-3 - Las Vegas

Learn how innovative workplace wellness strategies, preventive health management initiatives, and evidence-based success impact workforce productivity and increase ROI. HR/Benefits Staff: Use code BLINK2 to attend for $195.

[Guidance Overview]

ACA Proposal Addresses Balance Billing and Narrow Networks
"Employers that purchase small group coverage that is federally regulated under the Affordable Care Act will have additional assurances that their plan members will not be balance billed in certain situations, under proposed rules issued in pre-publication form on Nov. 22. The rule also plans for the adoption of network adequacy provisions to compensate for narrower networks that are proliferating to control cost growth some observers say is being exacerbated by the health care reform law." (Thompson SmartHR Manager)  

Drug Makers and Insurance Plans Eye Alliance on Drug Prices
"After years of relentlessly attacking one another, leaders of the pharmaceutical industry and the health insurance lobby are considering -- warily -- cooperating to shape any federal legislation that emerges from the public outrage at the high cost of medications. The two powerful lobbies remain fundamentally at odds in their agendas: In the most basic terms, drug makers want to make as much money as they can for their medicines, and insurance companies want to pay as little as possible." (STAT)  

Health Insurance and Mobile Engagement: What's Working, What's New and What's Next
"Companies seeking to improve consumer engagement have one major ally: The rise of mobile technology. Phone and tablet-based applications allow insurers to reach consumers on the devices they use every day, providing services for their members with the simplicity of a tap or click.... [This report] examines the myriad ways insurers and other organizations engage consumers through mobile technology, assessing the benefits and challenges -- as well as what lies ahead." (FierceHealthPayer)  

Company at Center of Drug Pricing Storm Cuts Cost of Medicine
"Privately-held Turing and its Chief Executive Martin Shkreli sparked outrage in September after it acquired the rights to a 62-year-old drug, Daraprim, and raised the price more than 5,000 percent to $750 a pill from $13.50. The company said it will offer reductions of up to 50 percent off its previously announced price for hospitals, which handle about 80 percent of cases of toxoplasmosis encephalitis, the dangerous infection that Daraprim is used to treat." (Reuters)  

National Association of Insurance Commissioners to Review Pharmacy Benefit Management in 2016
"[T]he National Association of Insurance Commissioners (NAIC) ... 2016 work plan for its Health Insurance and Managed Care (B) Committee ... [includes] among other things, 'review and, if necessary, consider revisions to the Health Carrier Prescription Drug Benefit Management Model Act (#22) -- adopted in 2003 -- to address issues related to: [1] transparency, accuracy and disclosure regarding prescription drug formularies and formulary changes during a policy year; [2] accessibility of prescription drug benefits using a variety of pharmacy options; and [3] tiered prescription drug formularies and discriminatory benefit design.' ... [C]ommittee members indicated support for soliciting initial public comments from interested stakeholders in January, and to begin periodic conference calls in February to consider changes to the model." (National Community Pharmacists Association [NCPA])  

As HMOs Dominate, Alternatives Become More Expensive
"[An] analysis of costs in the three-dozen states selling policies through the federal healthcare.gov website found a sharp difference in premium prices between plans that offer out-of-network care and those that do not. The analysis compared the monthly premiums for the least expensive silver-level plans -- the category that are the most popular purchases -- for a 40-year-old in each county. While the average premium for the least expensive closed network silver plan -- principally HMOs -- rose from $274 to $299, a 9 percent increase, the average premium for the least expensive PPO or other silver-level open access plan grew from $291 to $339, an 17 percent jump ... The cost variations hold true for any age." (Kaiser Health News)  

House Committee Leaders Press Administration on Status of Remaining $1 Billion in Obamacare CO-OPs
"House Energy and Commerce Committee leaders are seeking answers from the Centers for Medicare and Medicaid Services (CMS) on the agency's plans for continued oversight of Obamacare's CO-OPs. To date, 12 of the original 23 CO-OPs have closed, bringing the total cost to taxpayers at more than $1.23 billion. The letter sent Tuesday follows up on a November 5th Oversight and Investigations Subcommittee hearing during which CMS Chief of Staff Mandy Cohen was unable to identify specific actions the agency would be taking to address problems the remaining 11 CO-OPs, which collectively received over $1 billion in federal loans, are facing." (Energy & Commerce Committee, U.S. House of Representatives)  

Clarity Sought as HHS Prepares for Innovation Waivers
"States can apply for the five-year renewable waivers that will begin Jan. 1, 2017. The waivers are an opportunity for states to waive major coverage provisions of the ACA in order to come up with their own innovative ways to expand coverage. The states can request waivers from provisions, including those related to benefits and subsidies, the exchanges and the individual and employer mandates. But states say they need specifics." (Bloomberg BNA)  

Happy Thanksgiving!
We at BenefitsLink would like to express to you our gratitude, and warmest wishes for the Thanksgiving holiday. The opportunity to be a part of your employee benefits career is truly an honor and a privilege. Thank you. (BenefitsLink)  

Will the SEC Finally Provide Some Relief from the Nearly Incomprehensible Proxy Statement Requirement for a New Plan Benefits Table?
"Keith Higgins, Director of Corp Fin, hinted that he might be giving us a welcome gift in the future: a revision of Item 10 of Schedule 14A, the proxy statement ... [which is] a component of the disclosure rules that has too long been ignored and requires serious rethinking and rationalizing.... Corp Fin is currently working on the Disclosure Effectiveness Project, which focuses initially on Regs S-K and S-X, but after that, Higgins advises, the staff will then turn to the executive compensation and corporate governance information in the proxy statement.... Among the areas in the proxy statement that the staff will consider are these: [1] Item 10 of Schedule 14A ... [2] Regulation S-K Disclosure Requirements ... [3] CD&A ... [4] Compensation Tables ... [5] Compensation Committee Report ... [6] Form S-8." (Cooley LLP via Lexology)