Health & Welfare Plans Newsletter

March 15, 2016

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Webcasts and Conferences

2016 Benefits & Beyond: Navigating EBP
April 5, 2016 in TX
(Weaver)

2016 Professional Standards
April 10, 2016 in DC
(Conference of Consulting Actuaries)

Actuarial Funding Policies and Practices for Public Pension Plans: What’s Behind the White Paper?
April 13, 2016 in DC
(Conference of Consulting Actuaries)

IRA Reporting
May 3, 2016 WEBCAST
(Ascensus)

Top QDRO Mistakes in Divorce
May 13, 2016 WEBCAST
(National Business Institute)

Ensuring a Compliant IRA Program
May 17, 2016 WEBCAST
(Ascensus)

Transfer of a Business: ESOP Tax-Advantage Strategies and More
May 20, 2016 WEBCAST
(National Business Institute)

NBCH 21st Annual Conference
September 26, 2016 in FL
(National Business Coalition on Health [NBCH])

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[Guidance Overview]

DOL Issues Proposed Rule on Paid Sick Leave for Government Contractors
"The DOL's proposed rule closely tracks the Executive Order, and largely parallels its language and structure. The DOL currently estimates that, within 5 years, its proposed rule would extend paid sick leave to more than 800,000 employees, including more than 400,000 workers who currently do not receive any paid sick leave." (Proskauer Rose LLP)  


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[Guidance Overview]

HHS Finalizes 2017 OOP Maximums and Marketplace Guidance (PDF)
"Starting in 2017, states can allow employers with more than 100 employees to participate in the ACA marketplaces. The notice does not address this provision. Given that the PACE Act was enacted because most states did not want to increase the definition of small employer to 51 to 100 employees, it seems unlikely that states will opt to open up their marketplace to larger employers.... [A table] summarizes the ACA indexed dollars limits for 2017 and prior years." (Xerox HR Services)  

Four Steps to Jump-Start Your Wellness Program
"[1] Develop a pre-launch communications campaign ... [2] Create a multilevel wellness team.... [3] Test, test, test when using technology.... [4] Create a workable measurement strategy." (Human Resource Executive Online)  

2016 Medical Stop-Loss Coverage (PDF)
"Interest in stop-loss coverage has grown since the [ACA] eliminated annual and lifetime dollar limits on essential health benefits -- and as the number and value of high-amount claims has risen. This infographic presents 2016 data drawn from more than 200 Segal Consulting health plan clients that have stop-loss coverage." (Segal Consulting)  

Consumer Operated and Oriented Plan (CO-OP) Program: Frequently Asked Questions (PDF)
16 pages. "The fact that about half of the CO-OPs have ceased operations has generated a lot of interest in the program.... The report includes information about the structure of the CO-OP program, program requirements, the loan awards, and the current operating status of the CO-OPs." [Report No. R44414, dated Mar. 11, 2016.] (Congressional Research Service [CRS])  


[Advert.]

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Each year, the nation's top benefits brokers make Benefits Selling Expo their preferred destination to cultivate important relationships and obtain the most practical industry education for positioning their business for sustainable growth. Register today & save!



Just How 'Narrow' Are the ACA Networks -- and How Much Do the Insured Care?
"Looking at changes in participation, only 43 percent of these hospitals maintained or increased the number of marketplace networks in which they participated, while 57 percent of hospitals participated in fewer networks in 2016. Nationally, the number of marketplace networks that included a regionally ranked hospital declined by 20 percent, from 597 to 476." (Association of Health Care Journalists)  


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Benefits in General

[Official Guidance]

Text of IRS Announcement LA-2016-01: Tax Relief for Victims of Severe Storms and Flooding in Louisiana
"Individuals who reside or have a business in Bossier, Claiborne, Grant, Morehouse, Ouachita, Richland, and Webster Parishes may qualify for tax relief.... [C]ertain deadlines falling on or after March 8, and on or before July 15, 2016 have been postponed to July 15, 2016. This includes 2015 income tax returns normally due on April 18." (Internal Revenue Service [IRS])  

Text of First Circuit Opinion: Failure to Include Time Limit for Filing of Civil Suit in Claim Denial Letter Renders Limitations Period Inapplicable (PDF)
"Claimants are obviously more likely to read information stated in the final denial letter, as opposed to included (or possibly buried) somewhere in the plan documents, particularly since, as was the case here, plan documents could have been given to a claimant years before his claim for benefits is denied. The [DOL], recognizing this, has required that the denial letters themselves include certain information that the Department has deemed critical to ensuring a fair opportunity for review. We think it clear that the Department has included the plan-imposed time limit for filing suit among this required information.... [We] conclude that MetLife's failure to include the time limit in the final denial letter rendered, as a matter of law, the contractual three-year limitations period altogether inapplicable." [Santana-Diaz v. Metropolitan Life Ins. Co., No. 15-1273 (1st Cir. Mar. 14, 2016)] (U.S. Court of Appeals for the First Circuit)  

Mobility, Millennials and Benefits Administration: Maximizing Productivity
"In addition to mobility, Millennials want to be recognized as the individuals they are. When it comes to benefits, the old model just won't work. This generation has been raised on personalized recommendations and suggestions tailored to their specific tastes and habits. They expect targeted content in context with their personal situation, and they want to be able to access that information 'whenever, wherever, and however they want it.' " (Benefitfocus)  

Maximizing Employee Benefits Through Multinational Pooling (PDF)
16 pages. "Developing effective local employee benefits programs for multinational companies can be challenging and time-consuming. It requires finding alignment between corporate philosophy, local business needs, market practice, and cultural values. To be effective in the global economy, it is crucial for multinational companies to achieve the right mix of employee benefits programs to attract and retain key talent." (Lockton)  

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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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