Health & Welfare Plans Newsletter

March 8, 2016

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Senior Administration Relationship Manager
NestEggs Retirement Plan Services, Inc.
in FL

401(k) Plan Administrator
Alliance Pension Consultants, LLC
in IL

Senior Actuarial Analyst
Verisight
in OH

401(k) Plan Processing Team Leader
Third Party Administrators, Inc.
in NH

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Webcasts and Conferences

Pension Wars: Rise of De-risking
March 22, 2016 WEBCAST
(Findley Davies, Inc.)

Employer Diabetes Forum: Reigniting Diabetes Management Strategies to Treat, Engage & Empower
April 6, 2016 in IL
(Midwest Business Group on Health)

Certificate in Global Benefits Management
June 6, 2016 in IL
(International Foundation of Employee Benefit Plans [IFEBP])

New Trustees Institute
June 27, 2016 in NV
(International Foundation of Employee Benefit Plans [IFEBP])

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Discussions


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[Guidance Overview]

DOL's Proposed Paid Sick Leave for Federal Contractors: Read the Fine Print Carefully -- It May Not Apply to You
"This proposed regulation is much more limited in scope than its title ... implies... [T]he sick leave accrual requirements do not apply to employees who perform work duties necessary to the performance of the contract but are not directly engaged in performing the specific work called for by the contract, who spend less than 20 percent of their hours worked in a particular workweek performing in connection with such contracts." (Michael Best & Friedrich LLP)  


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[Guidance Overview]

ACA Resources for Frequently Asked Questions, Updated March 3, 2016 (PDF)
"The report provides basic consumer sources, including a glossary of health coverage terms, followed by sources on ACA's tax provisions. The next sections focus on health coverage: the individual mandate, private health insurance, and exchanges, as well as public health care programs, such as Medicaid and the State Children's Health Insurance Program (CHIP), Medicare, Indian health care, and veterans' and military health care. It then lists sources on employer-sponsored coverage, including sources on employer penalties, small businesses, and federal workers' health plans. It also provides sources on the ACA's provisions on mental health, women's health, public health, workforce, and quality. Finally, the report lists sources on ACA agency audits and investigations, costs and appropriations, insurance coverage statistics, legal issues, the treatment of noncitizens under the ACA, and sources for obtaining the law's full text." [CRS Report No. R43215] (Congressional Research Service [CRS])  

Ninth Study of Employee Benefits: Today and Beyond (PDF)
36 pages. "Sixty-two percent of employers said that they are increasing or have already increased usage of wellness programs to improve the health of employees and manage employee benefits program costs.... Nearly 85% of employers are looking to reduce the cost of non-health care related group benefits, followed by enhancing group benefits and offering new voluntary benefits.... Forty-five percent of employees said they'd borrow from their savings to pay for $10,000 in out-of-pocket medical expenses. However, many employees do not have the requisite savings from which to draw." (Prudential)  

Workers Without Paid Sick Leave Less Likely to Take Time Off for Illness or Injury
"Those without paid sick leave were 3.0 times more likely to forgo medical care for themselves and 1.6 times more likely to forgo medical care for their family compared to working adults with paid sick leave benefits. Moreover, the lowest-income group of workers without paid sick leave were at the highest risk of delaying and forgoing medical care for themselves and their family members." (Health Affairs)  

Employer-Based Health Insurance: Should It Stay or Should It Go?
"[If] the system is so broken, why haven't employers yet gotten out of managing health benefits? ... Over the last several years, employers have moved from a defined benefit to a defined contribution ... [One author believes that] employer-based coverage will continue to exist, but as consumers become more educated and are forced to shoulder more of the cost burden, 'we will see more interest in looking at other options, including being able to navigate independently in a national marketplace.' " (FierceHealthPayer)  


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Retail Clinics Increase Medical Spending
"Retail clinics by design provide easier access to basic healthcare services that cost significantly less than a trip to the doctor's office or the emergency department. While that care may be less expensive, retail clinics still drive up medical spending by creating a new demand for previously unmet medical services ... The overall spending increase linked to retail clinics was $14 per enrollee per year. A further breakdown showed that each use of retail clinics for new medical services increased per-person spending by an average of $35 per year, which was partly offset by $21 in savings from people whose visit to a retail clinic substituted for higher-priced medical care." (HealthLeaders Media)  

In Medicare Advantage Fight, a New Battle Over Retiree Plans
"The fight over Medicare Advantage payment rates has entered a new front this year as employers, unions, and trade groups embark on an intense lobbying campaign to head off proposed rate increases to insurers for certain retiree health care plans. They hope to persuade [CMS] to reject some aspects of proposed rate changes for 2017.... Jockeying over the proposed rates has become an annual tradition of sorts with Medicare Advantage, but the lobbying focus on retiree health plans is new this year. Advocates want lawmakers to stop what they see as potentially damaging cuts to retirees." (Morning Consult)  

Benefits in General

If You're Alive in 30 Years, Chances Are Good You May Also Be Alive in 1000 Years
"Sure, computers are getting better, but how's that relevant for making people younger? ... In recent decades, biology and medicine has to an increasing extent started to become an information technology. With computers we can now, among other things: [1] Read human genes; [2] Edit genes with CRISPR/Cas9, a revolutionary technology that has been adopted by laboratories worldwide. Still better technologies for gene editing are under development.... So medicine is about to become an information technology, and that's the main reason why we can expect medical technology to advance exponentially in the future." (Haakon Skaarud Karlsen, on haakonsk.blogg.no)  

Supreme Court Rules That ERISA Preempts Vermont Claims Reporting Requirement
"The concurring opinions are alternatively unsettling and odd. The suggestion by Justice Breyer to the effect that the [DOL] might get to the same result as the Vermont law by empowering the states seems reckless if by that he means he is willing to have different rules in each state.... It is impossible to offer a critique of the majority opinion (and of the outcome of the case) that is free from bias. One is likely to agree or disagree with the decision based on one's relationship to ERISA-covered entities." [Gobeille v. Liberty Mutual Ins. Co., No. 14-181 (U.S. Mar. 1, 2016)] (Mintz Levin)  

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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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