Health & Welfare Plans Newsletter

July 5, 2016

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Webcasts and Conferences

Operational Impact of Fiduciary Rule Changes
RECORDED
(Roland|Criss Fiduciary Services)

Reverse Churning and How the DOL Addresses the Problem Under the New Fiduciary Rule
RECORDED
(fi360)

CSR Reconciliation Discrepancies Technical Assistance
July 6, 2016 WEBCAST
(Centers for Medicare & Medicaid Services [CMS])

New DOL Fiduciary Rule: Overview and Next Steps
July 13, 2016 WEBCAST
(Practical Law Company)

Eligibility & Forfeitures: Brush-up on the Rules!
July 14, 2016 WEBCAST
(ASC)

Taking the Mystery Out of Retirement Planning A Focus on Women
July 27, 2016 WEBCAST
(Employee Benefits Security Administration [EBSA], U.S. Department of Labor)

Annual Alston & Bird Health & Welfare Compliance Update: Innovative Health Plan Structures in a Post-ACA World
August 10, 2016 in GA
(ISCEBS - Georgia Chapter)

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Text of Sixth Circuit Opinion: ERISA Does Not Preempt Michigan Claims-Paid Tax as Applied to Self-Insured Health Plans (PDF)
"Broadly worded as it is, ERISA's express-preemption provision extends only to the administration of employee benefit plans.... Though Gobeille recognized that 'reporting, disclosure, and recordkeeping are central to, and an essential part of, the uniform system of plan administration contemplated by ERISA,' it held that only state laws that directly regulate these aspects of ERISA -- whether by imposing additional administrative burdens or by interfering with uniform administration -- are preempted.... It is this limitation that ultimately forecloses SIIA's arguments." [Self-Insurance Inst. of America v. Snyder, No. 12-2264 (6th Cir. July 1, 2016)] (U.S. Court of Appeals for the Sixth Circuit)  


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Learn the latest compliance and regulatory issues around the private exchange market at the IHC's Private Exchange FORUM Baltimore. PEX Baltimore will be held at the Renaissance Harborplace hotel in Baltimore, MD Sept. 8-9. Register here for free.



D.C. Court of Appeals Panels Affirm Injunction Against Fixed Indemnity Regulation
"[A] three-judge panel of the D.C. Circuit Court of Appeals affirmed a lower court injunction against a 2014 HHS regulatory prohibition on the sale of fixed indemnity insurance unless the purchaser attests that he or she already has minimum essential coverage.... The D.C. Circuit held that Congress had given HHS no discretion to act in this case.... Insurers may not offer fixed indemnity coverage in coordination with other forms of coverage, but consumers cannot be required to have minimum essential coverage to purchase fixed indemnity coverage. The court affirmed the district court injunction." [Central United Life v. Burwell, No. 15-5310 (D.C. Cir. July 1, 2016)] (Health Affairs)  

Electronic 1094-C Filers Receive an Independence Day Reprieve (PDF)
"Consistent with prior verbal remarks, the IRS writes that if these employers correct and resubmit the erroneous forms within 60 days that it will treat the filings as timely made ... [M]any employers are receiving an 'Accepted with Errors' message as the result of inaccurate Social Security numbers (SSNs). This most recent guidance from the IRS provides no additional insight on how employers should proceed when their efforts to obtain the correct SSN prove fruitless." (Lockton)  

Summary Report on Transitional Reinsurance Payments and Permanent Risk Adjustment Transfers for the 2015 Benefit Year (PDF)
59 pages; dated June 30, 2016. "A total of 839 issuers participated in the Reinsurance and Risk Adjustment programs for the 2015 benefit year ... [T]he initial, estimated reinsurance coinsurance rate for the 2015 benefit year is 55.1 percent. For the 2015 benefit year, as of the date of this report, an estimated $7.8 billion in reinsurance payments will be made to 497 issuers nationwide." (Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS])  

ACA Premium Stabilization Programs, Effectuated Enrollment, and More
"CMS reports that a strong correlation exists between paid claims and risk scores. Ninety-five percent of insurers in the lowest quartile of claims costs were also in the lowest quartile of plan liability risk scores, while 93 percent of insurers in the highest quartile of claims costs were also in the highest quartile of risk scores. Insurers in the lowest quartile of claims costs were assessed on average 12 percent of their premiums for risk adjustment, while those in the highest quartile received on average 11 percent of premium in payments." (Health Affairs)  

2017 Health Care and Medical Cost Trends
"Although next year's growth rate is the same as last year's, it still outpaces general economic inflation. This suggests a possible recalibration on cost-saving strategies -- as the ones deployed over the last few years have run their course and may not be able to bend the cost curve with new inflators on the horizon.... Roughly half of all medical costs come from hospital spending: 30% from hospital inpatient and 19% from hospital outpatient. Physicians account for about 30% and prescription drugs 17%." (PricewaterhouseCoopers)  

Health Care Experts Question Future of Obamacare Marketplace in South Carolina
"More than 220,000 South Carolinians rely on the federal health care law for insurance and, if nothing else changes, most of them will face only two choices for coverage in 2017: BlueCross BlueShield or its subsidiary BlueChoice. The S.C. Department of Insurance will ensure that prices for these remaining plans, including those sold by Aetna in 14 counties, won't skyrocket -- and agency officials insist nothing is set in stone. Still, some health care experts are raising serious questions about the future of the Obamacare marketplace in this state and others." (The Post and Courier)  

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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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