Health & Welfare Plans Newsletter

March 21, 2016

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Fringe Benefits Design, Inc.
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in CA

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[Guidance Overview]

New York City Prescribes Changes for Sick Time Rules (PDF)
"Substantive changes and notable clarifications include ... [1] Written policy requirement ... [2] Minimum use increments ... [3] Accrual, hours worked and rate of pay ... [4] Cash outs and carryover ... [5] Temporary help firms, staffing agencies and joint employers ... [6] Recordkeeping requirements ... [7] Enforcement and penalties ... [8] Use and abuse of sick leave." (Xerox HR Services)  


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[Guidance Overview]

Newly Adopted Rules Clarify and Enforce New York City's Earned Sick Time Act (PDF)
"[T]emporary help firms that place temporary employees to perform services on behalf of another organization are solely responsible for compliance with [the New York City Earned Sick Time Act (ESTA)] for those temporary employees, regardless of the size of the organization where the employees were placed.... The Adopted Rules include several requirements for employers' written sick time policies.... [The New York City Department of Consumer Affairs] expects employers to maintain, for a period of three years, records demonstrating compliance with ESTA, including records of the required policies." (Epstein Becker Green)  

Employers Investing in Technology to Improve Employee Wellness
"The highest priority was mobile technology, with more than half of survey respondents reporting that they are using apps and associated technologies to provide their employees with a consumer experience that matches the tablet and smartphone lifestyle.... Gamification, social networking, and wearable sensors were all said to have similar usage of about one-third of responding employers." (American Journal of Managed Care)  

Workers Still Need Congress' Protection from Cadillac Tax
"As it stands now, employees' own individual contributions to their HSAs and FSAs are counted toward the Cadillac tax's threshold, and as a result, many employers will have to drop their offerings of HSAs and FSAs in order to avoid triggering the tax threshold. [Sen. John Thune (R-S.D.)]'s bill, the 'Preserving Consumer Health Accounts Act' (S. 2698), would exempt individual employee contributions from the tax calculation." (The Hill)  

The Elusive Nature of Private Exchanges (PDF)
"Private exchanges became the hottest topic in employee benefits, as employers were trying to rein in the unsustainable increases in healthcare spending, and these selling points resonated with employers. Despite this momentum in the marketplace, employers have been cautious and the exponential growth that was once expected has not materialized. The key question is why." (Milliman, via Bloomberg BNA Pension & Benefits Daily)  


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Workplace and Public Accommodations for Nursing Mothers
"This brief provides an overview of the various federal and state laws concerning workplace and public accommodations for nursing mothers in the United States and identifies the gaps that persist between public health goals and reality for breastfeeding women in this country." (Health Affairs)  

[Opinion]

Don't Let the Talking Points Fool You: It's All About the Risk Pool
"The health policies of the two political parties and their presidential candidates differentiate themselves clearly along the lines of pooling philosophies: the Democrats generally advocate broad-based pooling of health care risk and the Republicans generally advocate more individual responsibility and are willing to accept much greater segmentation of health care risk. These positions have dramatically different implications for individuals when they experience significant health problems, and they also have very different implications for low- and middle-income populations as compared to those with high incomes." (Health Affairs)  


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Forum on Employer Health Care Reform Strategies April 10-12

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Benefits in General

Claim Denial Letters Must Include Plan's Deadline for Filing Suit: First Circuit
"The First Circuit held that the participant's lawsuit was not time-barred because the denial letters did not provide notice of the plan's three-year limitation period and therefore did not comply with the DOL's claims regulations.... Although the circuit courts don't all agree regarding how much notice of plan-imposed time limits is required, at least three circuit courts have taken the view that a plan's claim denial letter must include the applicable time limit for a participant's right to sue, if such a time limit is to be enforceable." [Santana-Diaz v. Metropolitan Life Ins. Co., No. 15-1273 (1st Cir. Mar. 14, 2016)] (Practical Law Company)  

Executive Compensation and Nonqualified Plans

Courts Reject ERISA-Based Participation and Vesting Challenges to Top Hat Plans
"Two recent decisions address a frequent strategy by participants denied benefits under such plans: claiming that the plan fails to meet the top hat exemption, thus making it subject to ERISA and all of its protections. Both ... decisions reject such claims, but are notable mainly for the courts' lack of interest in addressing informal guidance from the [DOL]." (Reed Smith LLP via Lexology)  

Can an Employer Terminate a Non-Qualified Plan and Pay Out Benefits in a Lump Sum Despite Participants' Elections of Other Forms (and Timing) of Payment?
"The only significant differences between the two cases are that: the case won by the employer involved an individual account deferred compensation plan, and the case the employer lost involved a defined benefit-like supplemental executive retirement plan, and the case the employer won had more precise language in the plan document as to the employer's ability to terminate the plan.... [E]mployers should review (and, where necessary, improve) the plan termination language in their non-qualified plan documents and that employer-sponsors of SERPs need to be even more cautious than deferred compensation plan sponsors." (Winston & Strawn 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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