Health & Welfare Plans Newsletter

April 8, 2016

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Retirement Plan Consultant
Associated Pension Consultants, Inc.
in NY

Defined Contribution - Client Service Associate
Milliman
in TX

Plan Documents Specialist
Professional Capital Services
in PA

Senior Retirement Plan Administrator
Professional Capital Services
in PA

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Nova 401(k) Associates
in ANY STATE

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Nova 401(k) Associates
in ANY STATE

Director of Insurance Services
Associated Builders and Contractors Insurance Trust
in DC

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Webcasts and Conferences

Are You Drowning in Health and Welfare Compliance Issues? Help is on the Way!
April 14, 2016 in MA
(New England Employee Benefits Council)

Value-Based Pricing for Prescription Drugs: Opportunities and Challenges
April 15, 2016 in DC
(Alliance for Health Reform)

Benefit Communication Strategies – How to get your Employees’ Attention
April 20, 2016 in MO
(Worldwide Employee Benefits Network [WEB] - St. Louis Chapter)

Benefits Strategies for 2016 and Beyond: Case Studies of Top Performing Employer
April 20, 2016 WEBCAST
(University Conference Services)

Voluntary Fiduciary Correction Program Workshop
April 27, 2016 in WA
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

WorldatWork Total Rewards 2016 Conference
June 6, 2016 in CA
(WorldatWork)

Gain/Loss Analysis: Uniting Current and Traditional Methods
June 8, 2016 WEBCAST
(Conference of Consulting Actuaries)

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[Guidance Overview]

New York Enacts Paid Family Leave Law
"[E]mployers may provide family leave benefits for those employees taking intermittent leave or leave that is less than a full workweek in increments of one full day ... The law requires employers to reinstate any employee who takes paid family leave to the position he or she held immediately prior to taking leave, or to a comparable position with comparable benefits. The law also protects against the loss of any employment benefit accrued prior to the employee taking family leave." (Morgan Lewis)  


[Advert.]

ECFC: Advancing Healthcare Consumerism

Sponsored by ECFC [Employers Council on Flexible Compensation]

In its 35th year, ECFC is the leading organization promoting choice in benefit solutions by working together through education and advocacy to put a consumer-driven account into the hands of everyone. To join, visit www.ecfc.org.



[Guidance Overview]

Rundown of the New San Francisco Paid Parental Leave Law
"The ordinance has staggered effective dates depending on employer size ... The employee counts are regardless of the employee's location ... Employees must sign a form prior to receiving the paid parental leave agreeing to reimburse the employer for the full benefit amount if [1] the employee voluntarily separates from employment within 90 days after the end of the leave period, and [2] the employer requests the reimbursement in writing.... [It] will likely be difficult for employers to recover any parental leave payments from terminated employees." (ABD Insurance & Financial Services)  

[Guidance Overview]

San Francisco Will Require Employers to Provide Paid Parental Leave
"Once this new law takes effect, covered San Francisco employers will be forced to pay the 45% remainder not provided by [California's Paid Family Leave] so that workers receive their normal gross weekly pay during absences of six weeks for the purpose of bonding with a new child ... Even if you do not employ 20 workers within the San Francisco city limits, you have an obligation to provide those employees who work within the City with paid parental leave." (Fisher & Phillips LLP)  

Small Businesses See Big Hikes in Health Plan Costs
"Health insurance premium renewal rates increased an average of 6.2 percent for all plans in 2015, up from the previous year's 5.6 percent increase ... Small businesses with fewer than 25 employees, which account for five million U.S. employers, were hit the hardest ... The Northeast continues to be the region with the highest average annual cost per employee in the country, but Alaska tops the chart with an average annual cost of $12,822 per employee." (United Benefit Advisors)  

Eight Macro-Trends Influencing Employer-Sponsored Health Care Strategies
12 pages. "The advent of public (and private) exchanges creates new benefit delivery channels. Most employers will evolve to cohort segmentation. They will likely segment their population and position each cohort with the delivery channel that affords the greatest value to the employer and the individual.... Beyond managing annual cost increases, the excise tax and other tax-related risks create an even greater need to optimize health plan performance.... Health benefit tax treatment must be considered a business risk and scenarios must be developed to mitigate its impact[.]" (Willis Towers Watson)  


[Advert.]

Interaction of Health Care Reform with Other Laws in 2016 and 2017

Sponsored by Lorman and BenefitsLink

April 19 webinar - What parts of the ACA are to be implemented in 2016 through 2020 (when the Cadillac Tax will be due)? Timelines and websites with information on future forms and filings will be provided. BenefitsLink discount.



Young Adult Insurance Coverage and Out-of-Pocket Spending: Long-Term Patterns
"The [ACA] appears to have improved health insurance coverage for young adults (ages 18-30). But data from twenty national surveys conducted between 1977 and 2013 paint a more complex picture, showing coverage rates lower in 2013 than they were thirty-six years earlier. Racial and ethnic disparities in coverage have declined recently, while out-of-pocket expenditures remain low for most young adults." (Health Affairs)  

Blue Cross Blue Shield Association Confirms Obamacare Death Spiral
"These health plans have not done a great job containing costs in employer-based health plans either. Those policies' average monthly health spending increased 8 percent in the first nine months of 2015 versus 2014. However, costs in individual policies increased 12 percent, half again as much. This means the gap in medical spending between the two markets is increasing." (National Center for Policy Analysis Health Policy Blog)  

California Insurance Marketplace Imposes New Quality, Cost Conditions on Health Plans
"The attempt to impose quality and cost standards on health plans and doctors and hospitals appears to be the first by any Obamacare exchange in the nation. Among the biggest changes: Health plans will be required to dock hospitals at least 6 percent of their payments if they do not meet certain quality standards, or give them bonuses of an equal amount if they exceed the standards. The plan, to be implemented over seven years, is based on a similar strategy pursued by the federal agency that oversees the government-run Medicaid and Medicare health insurance programs." (Kaiser Health News)  

[Opinion]

Media Scrutiny of PBM Corporations Ratchets Up: Part One
"In a testament as to how PBM corporations' lack of transparency frustrates even the largest of corporate partners, [one recent article] points out: The process is so convoluted that even the United States' largest insurer, Anthem, discovered what it said were $3 billion in overcharges by Express Scripts and filed suit ... against the PBM for damages. The insufficient regulatory environment allows PBM corporations' profits to swell at the expense of health plan sponsors, patients and pharmacies.... PBM corporations' highly-touted cost savings are likely a mirage." (National Community Pharmacists Association [NCPA])  

[Opinion]

Media Scrutiny of PBM Corporations Ratchets Up: Part Two
"Regardless of whether the dominant company is the PBM or the pharmacy, the problem is the same. A PBM combined with a drugstore ... has an incentive to steer plan members to its affiliated pharmacies, rather than contracting with as many drugstores as possible on the basis of location, convenience, and care for its patients." (National Community Pharmacists Association [NCPA])  

Press Releases

Court Severely Limits ESOP Attorney’s Ability to Represent Employee Benefit Plans and Fiduciaries
Employee Benefits Security Administration [EBSA], U.S. Department of Labor

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David Rhett Baker, J.D., Editor and Publisher <davebaker@benefitslink.com>
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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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