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[Guidance Overview]
It's PCORI Return Filing Time Again
"The amount of the fee is determined by the last day of the plan year. If the last day of the plan year was between October 2, 2014 and October 1, 2015, then the fee is $2.08 per covered individual. If the last day of the plan year was between October 2, 2015 and October 1, 2016, then the fee is $2.17 per covered individual.... [Y]ou would count every employee, spouse, and child who is eligible for benefits under the plan."
(Kushner & Company)
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Over 100 CIGNA-Administered Self-insured ERISA Health Plans Sued for Embezzlement
"Just eight days after a federal court slammed CIGNA with a $13M judgment, 113 of CIGNA's self-insured clients, along with their Plan Administrators have been named as defendants in a massive fraud lawsuit, alleging the plans 'participated in a conspiracy and pattern of unlawful, reckless, and deceptive conduct to conceal an embezzlement and/or skimming scheme'."
(AVYM Healthcare Revenue Consultants)
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Weyerhaeuser Faces ERISA Lawsuit Over Retiree Benefits Cuts
"Weyerhaeuser in January 2015 unilaterally terminated its contributions to the retirees' health plan in violation of [ERISA], according to a complaint filed June 8 ... The retirees seek reinstatement of their benefits and $7.8 million in damages allegedly suffered after the company stopped making contributions to the plan.... The proposed class includes retirees and their eligible spouses whose rights to health-care benefits ... had been affected by terminations, reductions or changes since December 2010. The class could include between 4,000 and 5,000 individuals, the complaint says."
(Bloomberg BNA)
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There's No Crying in ACA Reporting
"So you swung at the ACA reporting ball and missed? Or just watched it sail by? Adjust your stance and try again. The IRS recorded a corrections video for your review. [An] IRS webcast, originally broadcast in May 2016, provides practical examples of mistakes and how to correct them. A PowerPoint outline is also available."
(International Foundation of Employee Benefit Plans [IFEBP])
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Avoiding ACA Penalties for Individuals Hired Through Staffing Firms
"If the staffing firm makes an offer of coverage to the worker, on behalf of the ALE member, the offer is also treated as being made by the ALE member for purposes of the pay or play provisions. However, this is only true when the ALE member pays a fee for individuals enrolled in the staffing firm's health plan that is higher than the fee that would be charged had the same individual not enrolled in the staffing firm's health plan."
(Graydon Head & Ritchey LLP)
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Wellness `Carrots' May Cause Indigestion if Taxable
"[W]ellness plan cash awards can't be excluded from income because they don't qualify as de minimis fringe benefits, the IRS said. De minimis fringe benefits are defined under Section 132(e) as any property or service that is 'so small' that accounting for it wouldn't be reasonable ... [IRS Chief Counsel Memo 201622031] notes that a tee-shirt would be considered a non-taxable de minimis fringe benefit, but employer-paid gym membership fees would not be considered a non-taxable de minimis fringe benefit."
(Bloomberg BNA)
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Big Players Dropping HSA Business Despite Growth Potential
"Total HSA assets reached $30.2 billion in 2015, about triple the amount in 2009 ... The potential for growth in HSA assets has prompted giants such as Fidelity Investments, Boston, and Bank of America Merrill Lynch, New York, to continue pursuing their HSA management strategies.... [F]or the dropouts ... HSAs no longer fit their long-term strategies.... Wells Fargo is selling its HSA business to Optum Bank Inc., part of [UnitedHealth Group]."
(Pensions & Investments)
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How Patient Groups Have Begun to Influence the Value and Coverage Debate
"One important health care stakeholder that has not yet 'gotten the memo' is the payer community, which is the critical gatekeeper of access to treatments for patients and is increasingly questioning the value of existing and new treatments. They may not yet have seen a compelling value proposition for how engaging with patients and patient groups could help them achieve their mission of providing access to valuable health care products and services while controlling costs for their clients[.]"
(Health Affairs)
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Insurers Are Selling More Individual Health Plans in ACA Marketplaces
"[In] 2016, 17% of individual health insurance plans are being sold exclusively outside the marketplaces, a 28% drop from 2014.... [B]ronze level plans, the least expensive plans that provide the lowest amount of coverage, are equally popular on and off the marketplaces. The gold and platinum plans, which are the most expensive and provide the most coverage, are much more prevalent off the marketplaces."
(American Journal of Managed Care)
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ACA Coverage Expansions and Low-Income Workers
"This brief ... examines the change in health coverage among low-income workers following implementation of the ACA ... Less than one third (31%) of low-income workers had employer-sponsored insurance through their own job in 2014 compared to half (58%) of higher income workers. Low-income workers were also half as likely to have employer-sponsored insurance coverage as a dependent compared to higher income workers (11% versus 21%)."
(Henry J. Kaiser Family Foundation)
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BenefitsLink.com, Inc.
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Lois Baker, J.D., President
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager
BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2016 BenefitsLink.com, Inc. All materials
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