Health & Welfare Plans Newsletter

May 10, 2016

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Employee Benefits Jobs

Benefits Implementation Project Manager
Willis Towers Watson
in Telecommute

Retirement Plan Administrator
Bates & Company
in FL

Senior Actuarial Consultant
Nyhart
in TX

Temporary Benefits Services Specialist
Stanford University
in CA

Actuarial Analyst
Nyhart
in IN

Business Development / Account Executive
Fred S. Shapiro & Associates, Inc.
in MD

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Webcasts and Conferences

Future of the Individual and Small Group Markets Forum
May 18, 2016 in DC
(Health Affairs)

IRA Basics
June 14, 2016 WEBCAST
(Ascensus)

2016 Legislative & Regulatory Updates
June 14, 2016 WEBCAST
(ECFC [Employers Council on Flexible Compensation])

Final Answers: The Supreme Court ERISA and Litigation Decisions
July 12, 2016 WEBCAST
(ABA Joint Committee on Employee Benefits [JCEB])

Getting It Right - Know Your Fiduciary Responsibilities
August 18, 2016 in NJ
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

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[Guidance Overview]

EEOC Issues New Resource Document Addressing Leave as a Reasonable Accommodation under the ADA
"[T]he EEOC issued a resource document ... that addresses 'the prevalence of employer policies that deny or unlawfully restrict the use of leave as a reasonable accommodation,' which the agency contends 'serve as systemic barriers to the employment of workers with disabilities.' ... [I]t is not voted on by the entire Commission and technically does not carry the weight of official guidance issued by the agency. Still, this resource still should guide employer decision-making when considering leave as an ADA reasonable accommodation." (FMLA Insights)  


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[Guidance Overview]

FSAs and Mid Year HDHP/HSA Implementation (PDF)
"Employees who have coverage under a traditional or 'full-service' FSA (one that reimburses more than just dental, vision and preventive care expenses) are ineligible to make, or even accrue the right to make, HSA contributions for any month they begin while enrolled under the traditional FSA.... The best answer: Avoid these midyear HDHP/HSA implementations, if at all possible. This means getting way out in front of the issue, maybe 6-12 months early." (Lockton)  

[Guidance Overview]

Vermont Will Require Paid Sick Leave for Employees
"The law goes into effect as of January 2017 for employers with more than five employees. Employers with five or fewer employees will have until January 2018 to comply. Initially, the law will require that employers guarantee certain full time employees at least three paid sick days each year. As of January 2019, however, all employers affected by the law must guarantee at least five sick days for certain full time employees." (Bryan Cave LLP)  

[Guidance Overview]

San Francisco Adopts Fully Paid Parental Leave (PDF)
"[C]overed employers will have to pay eligible employees 'supplemental compensation' -- the difference between the employee's gross weekly wage and state PFL benefits, up to a certain cap -- to augment their income while on baby bonding leave. Based on the PFL's current wage replacement rate of up to 55 percent, employers would have to pick up the tab for the remaining 45 percent.... When the PFL wage replacement rate increases to 60 percent or 70 percent (depending on the employee's earnings) in 2018, San Francisco employers would see a corresponding reduction in their supplemental compensation obligation." (Xerox HR Services)  

New York's Own FMLA Poses Challenges for Employers
"Leave time and wage percentages will increase every year until the law is fully implemented in 2021, when employees will be eligible for 12 weeks of leave at 67 percent of their weekly wage. Some of the funding for this program will come from a new payroll tax that will also grow each year, starting at $0.70 and ending with $1.40 per week. In theory, this means that employers will not have to pay anything to give the worker this benefit, but some simple math shows that a program that gathers about $52 per year from each employee is unlikely to pay for itself." (LegalNewsLine.com)  

Examining Multi-Tiered Networks to Minimize Premiums and Foster Consumerism
"The first tier is made up of a small group of providers with compensation based upon outcomes. The second gives access to the much broader network of traditional fee-for-service providers. To incentivize patients to visit tier one providers, insurance policies require lower copays and deductibles than those required for tier two. Multi-tiered networks are an opportunity for employers to promote consumerism in employees and create more efficiency in the healthcare system." (Frenkel Benefits)  

Expanding Generic Drug Use Could Save Billions
"Health insurers and patients could safely save many billions of dollars annually by swapping out a more expensive drug for a less expensive generic in the same class of drugs, according to [a new study]. The suggestion goes beyond the common practice of substituting a generic drug for a brand-name drug with the identical active ingredient. The researchers say that in many instances, a generic with a different chemical makeup, prescribed for the same disease, could work just as well[.]" (InsuranceNewsNet.com)  

Cigna Warns Anthem Deal May Not Close in 2016
"Eight months after contentious negotiations that resulted in a $54 billion merger deal, Cigna warned investors for the approval process could now drag on into next year.... If the deal is not approved by the end of April next year, Anthem would be required to pay Cigna a $1.85 billion break-up fee. An Anthem spokeswoman reaffirmed the company's confidence the deal will close." (CNBC)  

CMS to Hold Forum on Improving the Marketplace Through Innovation
"[S]uccess in the Marketplace requires a different approach to providing care than was required for success in the old individual market. [CMS is] inviting health plans and issuers that have found particular success in serving the new population to present their insights and innovations at a forum on June 9th." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

[Opinion]

How the U.S. Can Lower Out-of-Control Health Insurance Premiums
"In an age where technological disruption is changing business models of everything from taxis to wealth management, it's not surprising that health care has to change, too. That change will only come when health systems make specific commitments to reduce insurance premiums in return for patients promising behaviors that support their health. It's a generational change where premiums will fall because individuals become active participants in managing their own long-term wellness." (MarketWatch)  

[Opinion]

The Sanders Single-Payer Health Care Plan: The Effect on National Health Expenditures and Federal and Private Spending
"Presidential candidate Bernie Sanders proposed a single-payer system to replace all current health coverage. His system would cover all medically necessary care, including long-term care, without cost-sharing. We estimate that the approach would decrease the uninsured by 28.3 million people in 2017. National health expenditures would increase by $6.6 trillion between 2017 and 2026, while federal expenditures would increase by $32.0 trillion over that period. Sanders's revenue proposals, intended to finance all health and nonhealth spending he proposed, would raise $15.3 trillion from 2017 to 2026 -- thus, the proposed taxes are much too low to fully finance his health plan." (Urban Institute)  

[Opinion]

The Urban Institute's Attack on Single Payer: Ridiculous Assumptions Yield Ridiculous Estimates
"To put it bluntly, the estimates are ridiculous. They project outlandish increases in the utilization of medical care, ignore vast savings under single-payer reform, and ignore the extensive and well-documented experience with single-payer systems in other nations -- which all spend far less per person on health care than we do." (Physicians for a National Health Program [PNHP])  

Press Releases

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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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