Health & Welfare Plans Newsletter

May 31, 2016

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[Official Guidance]

Text of IRS Chief Counsel Advice 2016-22031: Tax Treatment of Wellness Program Benefits and Employer Reimbursement of Premiums Provided Pre-Tax Under a Section 125 Cafeteria Plan (PDF)
"An employer may not exclude from an employee's gross income payments of cash rewards for participating in a wellness program. [Further, an] employer may not exclude from an employee's gross income reimbursements of premiums for participating in a wellness program if the premiums for the wellness program were originally made by salary reduction through a section 125 cafeteria plan." (Internal Revenue Service [IRS])  


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[Guidance Overview]

ACA Resources for Frequently Asked Questions (PDF)
30 pages. "The report provides basic consumer sources, including a glossary of health coverage terms. The next sections focus on the individual mandate, private health insurance, exchanges, and employer-sponsored coverage.... The report also provides sources on the ACA's provisions on specific populations: women's health care, Indian health care, veterans' and military health care, and the treatment of noncitizens under the ACA. These are followed by sources on behavioral health (mental health and substance use disorders), public health, workforce, and quality. Finally, the report lists sources on taxes, ACA agency audits and investigations, cost estimates and spending, insurance coverage statistics, legal issues, and sources for obtaining the law's full text." [Report No. R43215, dated May 25, 2016.] (Congressional Research Service)  

[Guidance Overview]

ADA, GINA and Employer Sponsored Wellness Programs
"Prior to the publication of the new final rule, the EEOC took the view that an employer could not offer any inducement to an employee for providing family medical history.... The final rule ... states that an employer may, in certain circumstances, offer an employee limited inducements for the employee's spouse to provide information about the spouse's manifestation of disease or disorder ... However, this exception does not extend to genetic information about a spouse or to information about manifestation of diseases or disorders in, or genetic information about, an employee's children." (Compliance Dashboard)  

[Guidance Overview]

The Push for Paid Sick, Family and Medical Leave in Minnesota: Minneapolis Passes Ordinance
"Although none of the bills addressing statewide paid sick and safe time, paid family and medical leave or state pre-emption of local laws [have] passed through the Minnesota Legislature, Minneapolis passed its Sick and Safe Time Ordinance on May 27, 2016, and St. Paul continues to consider the possibility of extending paid sick and safe time to all employees in Saint Paul." (Faegre Baker Daniels LLP)  

[Guidance Overview]

Minneapolis Becomes First City in Minnesota to Require Paid Sick Leave
"On May 27, 2016, the Minneapolis City Council unanimously passed a citywide sick leave ordinance, the Minneapolis Sick and Safe Time Ordinance, requiring employers with at least six employees, regardless of their location, to provide paid sick and safe time leave to employees who work in the City of Minneapolis. The Ordinance goes into effect on July 1, 2017." (Jackson Lewis P.C.)  


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Businesses Try to Meet Another Big Obamacare and IRS Deadline
"Delays in implementing the employer mandate created the impression in some executives' minds that the mandate -- and the form-filing requirements -- would end up being delayed yet again, killed by a Republican-controlled Congress, or somehow stopped by a Supreme Court challenge. None of those things happened." (CNBC)  

Millennials and Healthcare: What Message Are They Sending?
"They want to be treated as individuals not as patients. They use technologies that provide insight about their diagnoses and treatment options and compare notes with their social networks.... They're not passive users; they're active decision-makers.... They find health insurance unaffordable, confusing and optional. And they imagine a system of health wherein they connected to a reputable team of providers they choose who follow them through their continuing cascade of job, life, and scenery changes." (Paul Keckley)  

Companies Add Parent-Friendly Perks
"A handful of companies are offering parental benefits that go way beyond just paid leave, to include things like surrogacy reimbursement, egg freezing or breast milk shipping for traveling mothers.... Taking care of employees in this way costs far less than, say, health insurance, in part because the benefits are used by a minority of workers, and generally on a one-time or short-term basis." (National Public Radio)  

Empower Your Employees with Health Advocacy
"[R]esearch shows that fewer than 20 percent of employees actually understand their health and wellness benefits.... [I]mplementing a health advocacy program offers an efficient way for you and your employees to deal with health and wellness benefit issues. Representatives known as health advocates provide education and support to help benefits program participants navigate the health care system and better understand their health and wellness benefit options." (HealthFitness)  

A Bundle of Joy? Bundled Payments for Maternity Care
"As a time-limited condition, maternity care may be uniquely well-suited for bundled payment models... [A] range of different stakeholders -- from health plans ... to self-insured employers ... to freestanding birth centers ... are all piloting bundled payment models for maternity care.... The innovators in maternity care bundled payments vary widely in their approaches[.]" (American Journal of Managed Care)  

IRS Ruling Is Obstacle to Accountable Care Organizations
"In its recent ruling, the IRS denied a tax exemption sought by an accountable care organization that coordinates care for people with commercial insurance. The tax agency said the organization did not meet the test for tax-exempt status because it was not operated exclusively for charitable purposes and it provided private benefits to some doctors in its network. The name and location of the organization, formed by a nonprofit health care system, were not disclosed. The ruling does not affect accountable care organizations formed solely to participate in Medicare, but it could affect similar entities serving privately insured patients. Many accountable care organizations coordinate care for both Medicare beneficiaries and privately insured patients." (The New York Times; subscription may be required)  

[Opinion]

Obamacare Exchange Average Premium Hike 16 Percent Next Year
"The lowest premium Silver plan is going up seven percent, and the second lowest 8 percent, which means most Silver plans are going up more than 16 percent. This widening of premium dispersion is not what we would expect in a functioning market." (National Center for Policy Analysis Health Policy Blog)  

Press Releases

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Centre for Fiduciary Excellence [CEFEX]

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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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