Health & Welfare Plans Newsletter

March 11, 2016

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Webcasts and Conferences

Cancer Care Management: Employer Best Practices & Programs that Support Patients, Families & ROI
March 16, 2016 in IL
(Midwest Business Group on Health)

13th Annual Employee Benefits Symposium: Emerging Issues under the Affordable Care Act
April 8, 2016 in IL
(John Marshall Law School)

2016 DOL Fiduciary Rule Summit: Managing Challenges and Finding Opportunities
May 3, 2016 in MA
(LIMRA LOMA Secure Retirement Institute)

Are Health Population Programs Worth It?
May 11, 2016 WEBCAST
(Conference of Consulting Actuaries)

Essentials of Multiemployer Trust Fund Administration
July 6, 2017 in WI
(International Foundation of Employee Benefit Plans [IFEBP])

View All Webcasts and Conferences


Discussions


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[Guidance Overview]

Implications for Employer-Sponsored Health Plans of IRS Notice 2015-87
53 presentation slides. "IRS Notice 2015-87: [1] Part II provides further guidance regarding integrated HRAs and employer payment plans; [2] Part III 'clarifies' aspects of the employer shared responsibility provisions, including how the 'hours or service' determination is impacted by disability and leave payments, and the use of opt-out payments; [3] Part IV provides guidance for governmental employers; [4] Part V addresses how COBRA applies to rolled over FSA amounts; [5] Part VI discusses tax reporting relief regarding ACA Section 6056." (Groom Law Group, for American Benefits Council)  


[Advert.]

ECFC: Championing Choice in Employee Benefits Solutions

Sponsored by ECFC

ECFC is an active voice for tax-advantaged benefit programs and a recognized proponent of flexible compensation. The 35th Annual Conference is the chance to ensure your voice is heard.



[Guidance Overview]

Vermont Employees Will Get Three Days Paid Sick Leave in 2017, Five in 2019
"Only an employer with five or fewer employees who are employed for an average of not less than 30 hours a week may implement a waiting period for existing employees of up to one year during which employees accrue but cannot use earned sick time.... The new law applies to all employers, but there is an exemption for new employers, which delays compliance until one year after the employer hires its first employee." (Wolters Kluwer Law & Business)  

Former Employee Challenges Provision of COBRA Notice to Wrong Address
"The employee had submitted a change of address form shortly after his termination and alleged that he had also notified the employer of the new address four years earlier. As evidence, he provided earlier mailings from the health insurance company and a W-4 withholding certificate showing his updated address. Regardless, the employer instructed the TPA to send the COBRA election notice to the employee's previous address.... The court [stated] that an employer does not act in good faith if it sends the notice to an address at which it knows the employee no longer lives." [Newton v. Prator, No. 14-3116 (W.D. La. Feb. 18, 2016)] (Thomson Reuters / EBIA)  

After Gobeille, Can Federal Regulators Save All-Payer Claims Databases?
"For a moment, let's assume, even though it remains an open question, that the [DOL] can legally develop regulations to compel ERISA plans to contribute data 'through' the federal government such that the states can add these data to their other data holdings.... The [DOL] has limited experience collecting or supervising the collection of the kind of information states want ... Reliance on the goodwill of the federal government to get the data to the states in the desired manner may be misplaced.... The states may not be thrilled with the standards adopted.... A regulatory approach to data collections is likely to be somewhat inflexible." (Health Affairs)  

Out of Many, One: ERISA Preemption, State All-Payer Claims Database Laws, and the Goals of Transparency
"Today, one can expect the now more engaged [DOL] and the newly insurance-savvy HHS to work together, and with states, to systematize the collection of claims data (and hopefully clinical and population health data) and to learn from it. Because of the Supreme Court's ERISA ruling, Vermont and other states can't go it alone, with the risks and costs that such variability might create. But they can expect to work collaboratively with the feds on approaches that will serve both regional and national goals." (Health Affairs)  


[Advert.]

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HSAs and HRAs: How They're Doing (PDF)
"The number of plans offering an HSA or an HRA is decreasing significantly. In 2015, 23.9% of all plans offered an HSA or an HRA, a 29% decrease from 2014.... Overall enrollment in HRA plans has remained flat at 8.7% for the last three years. The average employer contribution for an HRA was $1,767 for a single employee and $3,472 for a family, up slightly from 2014.... California offers the best HRA plans for singles and families; large employers and Southeast businesses offer the worst HRA plans." (United Benefit Advisors)  

Some Employers Consider Ending Domestic Partner Benefits
"[L]arge employers overwhelmingly provide domestic partner benefits to same-sex couples (87% of respondents), and 64 percent of respondents offer them to opposite-sex couples. With marriage now legal for same-sex couples, 40 percent of those companies that participated in the poll are considering ending domestic partner benefits, while an equal number do not plan to end these benefits. Almost 15% of respondents have dropped domestic partner health benefits within the last two years." (The ERISA Industry Committee [ERIC])  

The New Front Door to Health Care
"During the period 2010 to 2015, telemedicine spending increased from $540 million to $1.9 billion. Retail clinic usage increased 176% to 19 million visits and urgent care center usage increased by 5.8% annually. In 2013, 15% of respondents used a retail clinic. This grew to 26% in 2015." (Frenkel Benefits)  

How Big a Burden Are State and Local OPEB Benefits? (PDF)
"This brief provides an updated accounting of [Other Post-Employment Benefits (OPEB)] commitments, with data for 2012 or 2013.... The first section describes the evolution of the new reporting framework. The second section discusses the OPEB sample ... The third section compares OPEB and pension liabilities in the aggregate ... The fourth section puts the OPEB liabilities in perspective. The final section concludes that: [1] aggregate unfunded OPEB liabilities are estimated to be $862 billion -- nearly two thirds of which is held at the local level; [2] these liabilities are equivalent to 28 percent of unfunded pension liabilities ... and [3] while OPEB liabilities are large, several factors limit their potential drain on state and local resources." (Alicia H. Munnell, Jean-Pierre Aubry, and Caroline v. Crawford, for Center for State & Local Government Excellence)  

Majority of California Adults Have Pre-Diabetes or Diabetes
"46 percent of California adults -- 13 million people -- have prediabetes or undiagnosed diabetes, while another 9 percent have already been diagnosed with diabetes. Since diabetes is more commonly seen among older adults, the study's finding that 33 percent of adults ages 18 to 39 have prediabetes is of particular concern[.]" (Marin Independent Journal)  

ACA: Controls Over Financial Accounting for the Premium Tax Credit Should Be Improved (PDF)
22 pages. "TIGTA found errors in the IRS financial accounting and reporting of PTC-related fund outlays.... The errors we identified were due to a programming miscalculation. The miscalculation was not caught due to insufficient testing of the financial system programming developed to account for the impact of the reconciliation of PTC fund outlays (disbursements). Due to this programming error, the IRS understated the amount of PTC disbursements and overstated the balance in the IRS PTC account by $447 million. Further, the error TIGTA identified in the financial accounting records, if left uncorrected, would have resulted in a misstatement of the Fiscal Year 2015 IRS financial statements refundable credits in excess of tax liability account." (Treasury Inspector General for Tax Administration [TIGTA], U.S. Department of the Treasury)  

HealthCare.gov: CMS Management of the Federal Marketplace
"Recently, the HHS Office of Inspector General has released a report that details the development and implementation of healthcare.gov by CMS. [This is a transcript of an interview] with one of the report's authors, Ruth Ann Dorrill ... [Ruth Ann Dorrill] From the beginning, HealthCare.gov faced a high risk of failure, given the complexity needed, a fixed deadline, and a high degree of uncertainty about the mission, scope, and the funding available for the project." (Office of Inspector General [OIG], U.S. Department of Health and Human Services [HHS])  

The Failure of the ACA Health Insurance CO-OPs
63 pages. "HHS approved the failed CO-OPs despite receiving specific warnings from a third- party analyst about weaknesses in their business plans.... [E]ven though HHS was aware of serious financial distress suffered by the CO-OPs in 2014, it failed to take any corrective action or enhance oversight for more than a year.... [D]espite serious financial warning signs, HHS did not withhold any loan disbursements from the now-failed CO-OPs -- and in many cases accelerated planned disbursements.... HHS approved additional solvency loans for three of the failed CO-OPs in danger of being shut down by state regulators, despite obvious warning signs that those CO-OPs will not be able to repay the taxpayer.... HHS looked on as the CO -OPs booked, as assets, massive uncertain payments from the ACA's risk corridor program.... [T]he heavy costs of failed CO-OPs will be borne by taxpayers, doctors, patients, and other insurers." (Permanent Subcommittee on Investigations, Committee on Homeland Security and Governmental Affairs, U.S. Senate)  

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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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