Health & Welfare Plans Newsletter

February 18, 2016

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February 24, 2016 WEBCAST
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March 10, 2016 WEBCAST
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[Guidance Overview]

IRS Health Care Tax Tip 2016-20: Understanding the Small Business Health Care Tax Credit
"The small business health care tax credit benefits employers who: [1] have fewer than 25 full-time equivalent employees; [2] pay an average wage of less than $51,600 a year; [3] pay at least half of employee health insurance premiums." (Internal Revenue Service [IRS])  


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Master Health Reform Guide, 2016 Edition

Sponsored by Wolters Kluwer

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Claim of Section 510 Interference with ERISA Rights Survives Motion to Dismiss
"[Should the plaintiffs ultimately prevail], they will potentially become entitled to a restoration of their health benefits and other lost benefits and wages resulting from their reduction in hours to part-time status.... [T]he Court's ruling raises significant concerns for Dave & Buster's and for other employers that implemented similarly aggressive ACA-avoidance strategies." [Marin v. Dave & Buster's, Inc., No. 15-3608 (S.D.N.Y. Feb. 9, 2016)] (McDonald Hopkins)  

Court Allows Employer to Sue Former HR Director for Fiduciary Breach in Failing to Disclose DOL Investigation
"An HR director who contended that she was discriminated and retaliated against when she was fired from her job will be unable to proceed with her claims after summary judgment, a federal district court in Texas ruled, although her employer's counterclaim for breach of fiduciary duty will proceed. The HR director was fired while she was on medical leave, for allegedly failing to send out COBRA notices, which led to a [DOL] investigation." [Clarke-Smith v. Business Partners In Healthcare, LLC, No. 3:14-CV-2732-M (N.D. Tex. Jan. 22, 2016)] (Wolters Kluwer Law & Business)  

Employers Tap Outside Firms to Predict Which Workers Might Get Sick
"Trying to stem rising health-care costs, some companies ... are paying firms ... to collect and crunch employee data.... An employee who spends money at a bike shop is more likely to be in good health than someone who spends on videogames ... Credit scores can also suggest whether an individual will be readmitted to the hospital following an illness ... Based on data such as an individual's history, the firms can identify a person who might be considering costly procedures like spinal surgery, and can send that person recommendations for a second opinion or physical therapy." (The Wall Street Journal; subscription may be required)  

Meeting Employers' High Expectations for Health Care Consumerism
"Self-funded employers have high expectations for health care consumerism. As part of those expectations, they want their employees to have an easy-to-use tool to become active consumers who find out what health care costs before getting treatment. They want to effectively promote the tool so employees know they have options. And they want to know how and when consumers are using cost information as part of their decisions about where and when to seek care." (The Institute for HealthCare Consumerism [IHCC])  

HSA: The Best Retirement Plan for Your Employees?
"A recent analysis of benefit enrollments revealed that HDHP participants eligible for an HSA contributed only about 42 percent of the maximum amount allowed for 2016. Accounts were especially underutilized by millennials, who put away less than a quarter of the contribution limit. Employees are leaving thousands of tax-free dollars on the table -- dollars they most likely will require in retirement." (Benefitfocus)  

California Marketplace May Require Insurers to Pay Agent Commissions
"Regulators in other states have warned insurers about altering commissions in a way that discriminates against higher-cost consumers, but ... Covered California may be the first exchange to adopt specific rules. Health insurers typically pay agents a flat fee or a small percentage of the monthly premium. If companies want to restrict enrollment and avoid some sicker patients, they can try to do so by reducing the incentive for agents to sell their policies across the board or at certain times." (Kaiser Health News)  

CMS, AHIP Release New Quality Measures for Physicians
"The Core Quality Measures represent a collaborative effort to design and implement a standard set of metrics across payers, according to AHIP. Providers who have been forced to report different quality metrics on a payer-by-payer basis should see a reduced administrative burden as CMS and private payers move to the common system." (FierceHealthPayer)  

Benefits in General

Montanile, Amgen, Tackett and Moen: Four Important Benefits Cases
"The year 2016 has only just started, and we have already seen several important court decisions related to employee benefit plans and [ERISA]. This [article] provides a brief overview of four of these cases ... These two U.S. Supreme Court cases and two Sixth Circuit cases ... provide important decisions and insight for employers and fiduciaries of ERISA-covered plans." (Pillsbury Winthrop Shaw Pittman LLP)  

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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2016 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 that content. You may not alter or remove any trademark, copyright or other notice from copies of the content.

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